Treatment of adults and youths with psychopathy

NOTE: This is a chapter in a book titled "Handbook of Psychopathy, 2nd Edition" by Christopher J. Patrick

Psychopathy is a form of personality pathology associated with varying degrees of social harm, which makes treatment an important goal. Lack of agreement about what psychopathy is, what causes it, and whether it is modifiable challenges the development of effective treatments. But the biggest barrier to knowledge about prevention and treatment to date has been the notable lack of research on whether change can be achieved—either in the harmful behavior associated with psychopathy, or in the condition itself.

In this chapter, we review available published studies that have directly addressed the treatability of high-psychopathic individuals. The pool of such studies is limited, but findings from these investigations paint a relatively optimistic picture. Before reviewing these findings, we contextualize work to be reviewed by noting that conclusions of “nothing works with psychopaths” echo broader conclusions reached prior to the late 1980s regarding the treatment of criminal offenders in general. Since that time, research by an influential group of Canadian psychologists has convincingly demonstrated that some treatments do indeed “work” to reduce risk for recidivism.