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date: 03 August 2020

Abstract and Keywords

Violence perpetrated by persons with serious mental illness (SMI), although certainly not the norm among this group, is of clinical and legal import in numerous legal settings. Among these are civil commitment, forensic psychiatry (insanity acquittees), and the criminal justice system. In this chapter, we provide a critical review of interventions and their empirical support that are used to reduce violence among persons with SMI. Promising findings support the use of cognitive behavioral, social learning, and cognitive skills approaches that are consistent with the Risk-Need-Responsivity (RNR) approach to crime and violence prevention. Anger management remains a promising, focused intervention with reasonable support in the literature. Dialectical behavioral therapy (DBT) has substantial general support. Community-based mandatory service programs such as outpatient commitment and mental health courts appear effective. Finally, the evidence base for the violence-reducing effect of certain psychotropic medication, particularly clozapine, is promising yet inconsistent.

Keywords: SMI, RNR, DBT, Dialectical Behavioral Therapy, serious mental illness, Risk-Need-Responsivity, violence, service, anger management

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