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Risk assessment instruments have become a preferred means for predicting
future aggression, claiming to predict long-term aggression risk.
To investigate the predictive value over 12 months and 4 years of two
commonly applied instruments (Historical, Clinical and Risk Management -
20 (HCR-20) and Violence Risk Appraisal Guide (VRAG)).
Participants were adult male psychiatric patients detained in a high
secure hospital. All had a diagnosis of personality disorder. The focus
was on aggression in hospital.
The actuarial risk assessment (VRAG) was generally performing better than
the structured risk assessment (HCR-20), although neither approach
performed particularly well overall. Any value in their predictive
potential appeared focused on the longer time period under study (4
years) and was specific to certain types of aggression.
The value of these instruments for assessing aggression in hospital among
patients with personality disorder in a high secure psychiatric setting
Crisis negotiation was initially introduced as hostage negotiation in the early 1970s. It is different from the common forms of negotiation, which assume that all participants wish to bargain, are happy to do so, and happy to exchange proposals as part of the problem-solving process. Part of the role of crisis negotiation is to make efforts to change the situation from that of crisis to a more normative problem-solving process. Crisis negotiation attempts to do this in a number of ways, such as creating a climate where compromise and problem solving can be considered by the individual in crisis, as well as using a range of crisis negotiation strategies. When exploring mental illness and personality disorder, one of the few authors who have considered the application of crisis negotiation strategies to such individuals is Strentz. One of the main challenges in the crisis negotiation literature is that of effective evaluation.
Thirty-seven (37) couples experiencing child behavior problems and concurrent marital conflict were randomly
assigned to one of two variants of a group parent training program, either Standard Group Triple P (SGTP;
n=19) or Enhanced Group Triple P (EGTP; n=18). SGTP incorporated 8 sessions (4 group sessions
and 4 telephone consultations) and taught parents to identify the causes of child behaviour problems, promote
children's development, manage misbehavior and plan ahead to prevent child behavior problems in “high
risk” parenting situations. Families in the EGTP condition received SGTP plus 2 additional group sessions
of parent support training that taught partners to support one another to parent as a team. These additional
sessions included information and active skills training in communication skills; giving and receiving
constructive feedback; holding casual conversations; supporting each other when problems occur; holding
problem solving discussions; and improving relationship happiness. There were significant improvements
from pre- to post-intervention for both conditions, on measures of disruptive child behavior, dysfunctional
parenting style, conflict over parenting, relationship satisfaction and communication. No differences,
however, were found between the two conditions, with both the EGTP and the SGTP programs resulting in similar
outcomes. In the main, initial treatment effects for both mothers and fathers were maintained at 3-month
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