NCJ Number
57517
Date Published
1978
Length
25 pages
Annotation
THE LONG-TERM INPATIENT TREATMENT OF PERSONS WITH PERSONALITY DISORDERS IS DISCUSSED, WITH REFERENCE TO THE TREATMENT PROGRAM AT THE PATUXENT INSTITUTION IN MARYLAND.
Abstract
THERE ARE ENOUGH COMMONALITIES AMONG THE DYNAMICS OF PERSONALITY DISORDERS (SOCIOPATHY, PASSIVE-AGGRESSIVE PERSONALITY, ETC.) TO MAKE THEM ALL AMENABLE TO THE SAME BASIC THERAPEUTIC APPROACH. THESE COMMONALITIES INCLUDE THE INABILITY TO TRUST, TO FEEL, TO FANTASIZE, OR TO LEARN. SPECIALIZED FACILITIES, THERAPEUTIC COMMUNITIES, CONTINUITY OF TREATMENT, AND DIRECTION BY MENTAL HEALTH PROFESSIONALS ARE AMONG THE APPROACHES THAT HAVE BEEN SUGGESTED FOR DEALING WITH PERSONS WHOSE PERSONALITY DISORDERS MAKE THEM DANGEROUS. IN THE UNITED STATES, THE PATUXENT INSTITUTION HAS SERVED AS AN EXAMPLE OF WHAT CAN BE DONE FOR SUCH PERSONS. AT PATUXENT, PSYCHIATRISTS, PSYCHOLOGISTS, AND SOCIAL WORKERS DETERMINE WHETHER AN OFFENDER MEETS THE INSTITUTION'S CRITERIA FOR ADMISSION AND DETERMINE WHETHER AN OFFENDER IS READY TO BE PAROLED. A 1977 LAW ABOLISHED THE INVOLUNTARY COMMITMENT AND INDETERMINATE SENTENCING ASPECTS OF THE PATUXENT PROGRAM. TREATMENT AT PATUXENT HAS MANY OF THE FEATURES OF A THERAPEUTIC MILIEU. WHETHER THE PATUXENT CONCEPT IS VALID MAY BE MORE A QUESTION OF LAW THAN OF PSYCHIATRY, BUT THE INSTITUTION'S EXPERIENCE HAS LED TO SOME OBSERVATIONS ON THE PROCESS OF PRACTICING PSYCHOTHERAPY IN A PRISON SETTING WITH AN ESSENTIALLY SOCIOPATHIC POPULATION. FOUR ELEMENTS--ACCEPTANCE, CONTROL SUPPORT, AND LEARNING--HAVE EMERGED AS ESSENTIAL IN THE TOTAL TREATMENT OF SEVERE PERSONALITY DISORDERS. PATUXENT REPORTS A 7-PERCENT RECIDIVISM RATE FOR FULLY TREATED PATIENTS--THOSE WHO SPENT AN AVERAGE OF 4 YEARS IN THE INSTITUTION AND ANOTHER 3 ON PAROLE/OUTPATIENT STATUS. THE PATUXENT EXPERIENCE INDICATES THAT, ALTHOUGH THE HISTORY OF TREATING PSYCHOPATHS IS FILLED WITH FRUSTRATION, SOCIOPATHS ARE NOT UNTREATABLE. A LIST OF REFERENCES IS INCLUDED. (LKM)