Comprehensive Outpatient Treatment and Management

This chapter describes outpatient treatment, management, and supervision programs for psychopathy (e.g., forensic outpatient clinics, probation, and parole programs), including special problems and interventions for substance abusers and sexual offenders with psychopathy. It focuses on psychological interventions, especially cognitive-behavioral therapy and community-based programs. The chapter focuses on the assessment, treatment, and monitoring of adult, male criminal offenders with psychopathic symptoms in outpatient and community settings, in contrast to institutionalized inpatient settings, such as prisons and forensic or other psychiatric hospitals. Based on a review of empirical studies, it outlines the assessment, psychotherapeutic and pharmacological treatment, and monitoring of psychopathic offenders in ambulatory settings. The chapter addresses special characteristics and needs of psychopathic individuals with comorbid substance abuse and other mental disorders as well as psychopathic sexual offenders. Recidivism as well as epidemiological studies suggest that impulsive antisocial behavior is more relevant for criminal recidivism and also less stable over time.