Dražen Kovačević

Marina Kovač

Sanja Radeljak

Tija Žarković Palijan

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Acta Clin Croat,  Vol. 49,  (Suppl) No. 2,  2010 65T. Žarković et al. Treatment of Forensic Psychiatric PatientsSATELLITE SYMPOSIUM: FORENSIC PSYCHIATRYTREATMENT OF FORENSIC PSYCHIATRIC PATIENTSTija Žarković Palijan, Marina Kovač, Dražen Kovačević, Sanja RadeljakNeuropsychiatric Hospital Dr. Ivan Barbot, Popovača, Department of Forensic PsychiatryA speciﬁ c psychological and social pathology is present in forensic psychiatric population. Working with such patients requires a systematic and specialized edu-cation, continuous attention, a high level of empathy, but also psychological strength. Th e main purpose of treat-ment is to develop awareness among patients of their mental state and functioning. Th e treatment involves biological, sociological and psychological methods of treatment, and may be individual, group, or speciﬁ cally designed, for example in therapeutic communities (Mc-Gauley and Humphrey, 2003). It can also take place in the therapeutic programs in the community or on an out-patient basis, which provide various models of treat-ment (Bateman, 1996; Norton, 1996). In closed forensic departments, next to the implementation of treatment, the task of the professional team is psychological as-sessment of progress and possibility of moving the pa-tient to the lower-security department. Safety issues and risks are much stronger here so the specialists often have a conﬂ ict in their role of therapists and assessors (McGauley and Humphrey, 2003), i.e. in their account-ability to the client and responsibility towards society (Taylor, 1998). General meaning of the term forensic psychotherapy involves the application of psychological therapy in the management and treatment of criminal oﬀ enders who suﬀ er from mental disorders (McGau-ley and Humphrey, 2003). Th e environment in which the treatment takes place determines the objectives and course of treatment. Th e main domain is the application of forensic psychotherapy in psychiatric hospitals and penitentiaries (Hoﬀ mann and Kluttig, 2006). Forensic psychotherapy is the work of the entire team which, in addition to the medical staﬀ  includes clinical psycholo-gists, psychotherapists, social workers, social educators, special educators, occupational therapists and experts in other related ﬁ elds who are trained to work with speciﬁ c populations (McGauley, and Humphrey, 2003; Norton and McGauley, 2000; Cordess and Cox, 1996). Th e pre-dominantly used approaches are psychodynamic, cogni-tive and systemic. Forensic psychotherapy involves four basic types of activities: direct clinical practice (assess-ment and treatment), supervision, clinical meetings, con-sultations or institutional supervision (McGauley, and Humphrey, 2003). A forensic psychotherapist must take into account the context in which the treatment takes place. Sometimes a supportive therapy will be necessary rather than therapy directed at self-inspection (self-in-sight?). Th e period of supportive therapy may pave the way for more active treatment, such as individual psy-chodynamic therapy (Bateman and Fongay, 1999), dia-lectal behavioral therapy (Linehan et al.,1993), cognitive analytic therapy (Ryle, 1997) or group psychotherapy (Horowitz, 1987 ). Contemporary psychodynamic psy-chotherapy has developed over the years, expanding the theory and practice and now includes (in either the experimental or applied clinical sense) populations that were once considered socially unsuitable, such as people with psychosis, psychopathy, the elderly, etc. (Xenitidis et al., 2005). Forensic psychotherapy is a separate and demanding discipline, whose need in Croatia has yet to be recognized. It is a relatively young discipline that is still being formed and interest in this branch has in-creased only in recent decades (Norton and McGauley, 2000; Welldon, 1994).

Treatment of Forensic Psychiatric Patients

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