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Anthony February 22nd, 2005 12:19 PM

CBT and Aggression
Does anyone have any recent references, or knowledge of work-in-hand, in relation to CBT with very aggressive forensic patients with schizophrenia?
Any help or contacts gratefully received!

James Pretzer March 8th, 2005 10:53 AM

Re: CBT and Aggression (in schizophrenics in a forensic setting)
I've been waiting in the hopes that someone who works with this population would reply. However, since they haven't I'll contribute a few ideas.

Plenty of work has been done on CBT with anger/aggression, CBT with schizophrenia, and CBT in forensic settings but I haven't seen much that combines the three. (You can find info on each of these topics in the archives)

I'd expect it to be quite difficult to develop a collaborative relationship with aggressive schizophrenics in a forensic setting. Unfortunately, it is difficult to do CBT effectively without a collaborative relationship. A Motivational Interviewing approach probably would be a useful way to identify collaborative goals and generate motivation for change.

My experience with paranoid/aggressive schizophrenics has been that treating them with respect makes a big difference. It is important to communicate respect both verbally and non-verbally. They can be very sensitive to even subtle signs of disrespect and this has a major impact on interactions within the session and compliance between sessions.

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