Psychological interventions in forensic services

Background: Dialectical Behaviour Therapy (DBT) has been increasingly utilised in forensic services to target emotional dysregulation that may be linked with self-harm, suicide, offending behaviour, and institutional rule-breaking, yet no systematic review of empirical research in this area has been carried out. Aim: To explore the nature and quality of research into the uses and effectiveness of comprehensive DBT and DBT skills training in forensic services. Method: An electronic search for studies utilising DBT with a forensic sample was carried out using PsycInfo, Scopus, and Web of Knowledge databases. Reference lists of relevant retrieved papers were also examined. Results: After application of exclusion criteria, a total of thirteen papers were reviewed. The interventions targeted a range of psychosocial variables related to emotions, personality, self-evaluation, psychopathology, coping strategies, self-harm/suicide, risk, and offending behaviour including institutional rule-breaking. They were broadly categorised into studies that specifically targeted individuals with Borderline Personality Disorder (BPD) in the criminal justice system, and studies that targeted the general offender population. Conclusions: When similar outcomes were assessed across studies, there were no consistent improvements in any emotional, psychological, cognitive, interpersonal, or behavioural variables. Implications of methodology and study quality are highlighted and recommendations for future research are made