Monitor your own emotional reactions:
It is easy to become too punitive or submissive when working with highly antisocial individuals.
Limit excessive expectations of improvement (particularly in the short term):
The evidence regarding treatability is mixed and motivation is a problem. Most antisocial offenders desist by their late 20s as being antisocial is exhausting, and maturation sets in. Be positive, transparent, respectful, but not overly invested in the outcome.
Be firm and persistent;
Take a behavioural approach to problematic behaviours; give clear feedback, provide consistent responses, never make a threat you are not prepared to carry out.
Use ‘enlightened self-interest’:
Identify shared goals – perhaps money for lifestyle, or keeping out of prison – and encourage the offender to explore the costs and benefits associated with offending or a problem behaviour.
Be mindful of attempts to deceive or manipulate:
Do not be too trusting as it will make ASPD individuals suspicious. If anxious, they will manipulate or deceive you to restore the ‘status quo’. Try not to feel personally humiliated or defensive if you are caught out.
Appendices | 75 Tips for general offender management:
Address criminogenic need in the usual way:
For most individuals, general offender management targeting criminogenic variables with standard interventions is appropriate. Specialist assessment or intervention is likely to be needed with certain high risk, high harm, or high psychological dysfunction cases only.
Consider co-morbidity:
There are also sufferers of ASPD with more complex presentations. These individuals may present with mood disorders, may be highly psychopathic, or also meet the criteria for other personality disorders (e.g. borderline, narcissistic, paranoid). Signs which might suggest the need for further specialist assessment or support would include very early onset conduct problems, a history of serious childhood trauma, a diverse offending history, sadism, high levels of instrumental violence, very difficult or volatile interpersonal behaviour during supervision, attacks on staff, suicide/self harm, or a history of engagement with mental health services.
Target substance misuse;
This is a priority, due to the strong association with antisocial traits, substance misuse and risk of violence.
Prioritise external controls but NOT rules
ASPD offenders are rule breakers, so do not create long lists of conditions which they will inevitably break! Prioritise.
Sanctions
Think about these in advance, as you will need them! Anti-authoritarian rule-breakers with chaotic lives, miss sessions, drop out of programmes, and re-offend before completing orders. Make sure the offender knows and understands the consequences in specific, not general, terms.
4. Paranoid Personality Disorder
View of Self View of Others Main Beliefs Main Strategy
Right/noble Inviolable Malicious Demeaning World is hostile World is complex Suspicious Provocative Quick Reference
Overview: High levels of mistrust and suspiciousness. Easily provoked into feeling unfairly treated or attacked, developing grievances and harbouring resentments.
Link to Offending: May facilitate angry aggression due to perceiving others as threatening, undermining, disloyal or dangerous. Linked to domestic abuse and stalking.
Tips: A more distant management approach in which trustworthiness may be proved over time is advised. Limit direct challenges to paranoid thoughts and behaviours.
Profile of a Paranoid Personality
Mistrusting and suspicious with a tendency to hold grudges against others. They are often guarded interpersonally and distant in relationships, avoiding closeness. They may be hypervigilant to threats in their environment and are prone to over-reacting to seemingly innocuous situations. Their thinking style may be rigid and inflexible, making them harder to rationalise with.
A person experiencing paranoia sees other people through a lens which emphasises hostility, malice and persecution. They more readily interpret the actions, words and intentions of others as potentially damaging to them. The world is viewed as complex and intricate, a place that needs to be unpicked and interpreted with caution. Situations and interactions are less likely to be taken at face value and the individual may search for hidden meanings which confirm their suspicions. The world is seen as a controlling and intrusive place which conspires against the individual. A paranoid person may wish to seek refuge from these dangers that they see all around them. Paranoid people tend to see themselves as righteous and noble. They may feel
incorruptible in a corrupt and manipulating world. Their stance becomes rigid, inflexible and closed off. They may feel the need for assistance, but doubt the sincerity of that help when it is offered and just reject it. They
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) identifies common features:
• Suspicions that others are deceiving, exploiting or harming the individual • Preoccupations with unjustified doubts
as to the loyalty or trustworthiness of associates/friends
• A Reluctance to confide in others, fearing information will be used maliciously • The perception of hidden, demeaning or
threatening content in ordinary events/ comments
• A persistent bearing of grudges
• Perceptions of personal attacks on their own reputation or character, responding quickly with anger or counterattacks. • Unjustified, recurring suspicions about
Appendices | 77 may refuse to engage in rational discussion. To protect themselves against the feeling of being controlled, they may act with stringent autonomy. They may try to counter feelings of persecution by making complaints or threats.
Relationship to offending
Some examples of offending include:
• Domestic violence – possibly escalating from arguments about the partner’s fidelity.
• Reactive aggression – this may occur spontaneously when the individual perceives a (real or imagined) threat.
• Planned pre-emptive strikes – this may occur when a paranoid individual takes preventive action against a threat (the perceived cause of the paranoid belief system).