Anger dysfunction and its treatment among offenders

This thesis sought to explore the effectiveness of CBT based anger management interventions with offenders. This was achieved in part through a random control trial on a sample of 24 community based male offenders, screened for dysfunctional anger. Statistical analysis revealed significant post-intervention reductions for both Groups in the reported anger symptoms and a substantial overall treatment effect noted (r = .89). The intervention used in the RCT was adapted to provide treatment for a female offender (N=1). An in-depth formulation of the case study facilitated the adaptation of the programme for the female offender. The case study was assessed at baseline, after the intervention and after a period of follow-up. The results obtained indicated clinically significant changes which seemed to justify the formal adaption of the programme. A psychometric critique also delved in the suitability of using the Anger Disorder Scales (Di Giuseppe & Tafrate, 2004) as the main measure of anger in the research and case study. Its reliability and validity and its strengths in terms of developing in-depth formulation of offenders’ anger dysfunction were discussed. The research and case study used psychometric measures to assess the efficacy of interventions. Thus, to compensate for the reliance on self-reported measures, the systematic review and meta-analysis explored the effectiveness of CBT based interventions by analysing long-term behavioural changes of interventions as measured through general and violent recidivism. All the included studies (n=14) were submitted to a quality assessment prior to extracting the required information. An overall risk reduction of 23% was estimated for general recidivism (k = 7; n = 1836; RR = .77; 95% CI .61 to .96) and 28% for violent recidivism (k = 7; n = 1888; RR = .72; 95% CI .55 to .93) following treatment. Furthermore the risk reduction for general recidivism increased to 42% (k = 6; n = 703; RR = .58; 95% CI .39 to .87) and increased to 56% for violent recidivism (k = 6; n = 1029; RR = .44; 95% CI .27 to .71) for those offenders completing treatment compared to treatment drop-outs. The magnitude of effect in the included studies also compared lower intensity programmes such as anger management with more intensive violence prevention programmes. Conclusions of this meta-analysis were discussed in terms of the economic viability of interventions and magnitude of treatment effects