Category: News


Aggression and violence have significant adverse health, social and economic impacts.

Current situation and Needs:

  • Absence of definitive high quality studies exploring violent offender treatment effectiveness;
  • Lack of knowledge on impact of intensive multi-module violence offender treatments in a forensic mental health setting.

The current study, recently published in The Journal of Forensic Psychiatry & Psychology, took place in a mental health hospital in England with an inpatient population approximately 200 and average length of stay of approximately six years.

The treatment approach

The study evaluated the impact of the Life Minus Violence-Enhanced (LMV-E) treatment, a cognitive-behavioural treatment programme comprising a minimum of 125 treatment sessions (approximately 300 h of therapy) of group work as well as individual cognitive rehearsal sessions.

As a whole, there are 7 treatment modules that extend over a 10–12 month period:

  1.  Barriers to change, optimism and resilience (approx. 6 sessions)
  2.  Emotional acceptance, reactivity and regulation (approx. 26 sessions)
  3.  How I got here (approx. 14 sessions)
  4.  Information processing and aggression (approx. 43 sessions)
  5.  Consequences for self and others (approx. 27 sessions)
  6.  Interpersonal skills (approx. 13 sessions)
  7.  Working towards the future: Relapse prevention and the ‘Good Life Wheel’ (approx. 24 sessions)

The study investigated the change in Intermediary outcomes (dynamic risk factors) including impulsivity, coping, cognitive and emotional empathy, anger expression and control, readiness to change, beliefs about aggression, social problem solving, and hostile and dominant interpersonal styles, in a group of male violent offenders with mental disorder who completed the LMV-E treatment compared with violent offenders with mental disorder who did not receive psychological treatment addressing their violent behaviour. The study assessed also aggregate risk for violence and aggressive behaviour during treatment.


Treatment attendance was high: on average, participants in the LMV-E group completed 93% of available sessions.

Both groups showed

  • reduced problems with impulsivity an anger regulation and improvements in social problem solving
  • lessened aggregate risk for future violence
  • reduced aggressive behaviour

However, the completion of the LMV-E conferred additional improvements in some facets of social problem solving and anger regulation.

In addition, neither group showed improvements in empathic responses, coping skills or problematic interpersonal style.


Take-home message

Anger regulation, impulsivity and social problem solving appear most amenable to change, and reductions in certain facets of these dynamic risk factors transpires with nonspecific psychiatric inpatient treatment.

The authors stated that the findings of this study provide preliminary support for the effectiveness of LMV-E treatment for violence offenders with mental disorder in terms of additional benefits with regard to anger regulation, sensitivity to provocation and social problem solving.

The article full text is available at:


Daffern M, Simpson K, Ainslie H, Chu S (2018) The impact of an intensive inpatient violent offender treatment programme on intermediary treatment targets, violence risk and aggressive behaviour in a sample of mentally disordered offenders, The Journal of Forensic Psychiatry & Psychology, 29:2, 163-188,  doi: 10.1080/14789949.2017.1352014

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