Eva Fischer*, Trimbos-institute, Utrecht, Netherlands Track: Practice Presentation Topic: Web 2.0 approaches for clinical practice, clinical research, quality monitoring Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: C-Rotunda Room Date: 2012-09-16 02:00 PM – 02:45 PM Last modified: 2012-09-10

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Eva Fischer

Realizing treatment readiness in high-psychopathy forensic patients through a computerized serious game

Background
Forensic patients are convicted for serious violent offences. The court assesses them as not fully accountable for the offence they committed due to their psychiatric disorder. These patients reside in forensic psychiatric hospitals at locked wards. Most of them suffer from psychopathy or antisocial personality disorder. In these forensic psychiatric hospitals they receive treatment to reduce reoffending rates.
Treatment of these kind of patients is hindered by a few factors:
• This group of patients experience little distress of their own actions, are mostly self-satisfied, and lack insight in their own attitudes and behavior.
• These patients are barely motivated
• These patients exhibit more disruptive behavior during treatment and are less tended to remain in treatment
• The interaction between these patients and the professional is complex because of the lying and manipulative behavior of these patients and their strong need for independence
Traditional treatment doesn't seem to have much effect on these group of patients. Therefore, a computerized preparatory intervention preceding treatment to enhance the patient's motivation, or so called 'treatment readiness' is developed.

Aim
Our aims are:
• enhancing treatment readiness in patients with psychopathy or antisocial personality disorders
• enhancing compliance in patients with psychopathy or antisocial personality disorders

Computerized strength based approach
The computerized strength based intervention is called mijnbehandelplan.nl (mytreatmentplan.nl). Mijnbehandelplan.nl is a very innovative approach on treating forensic patients. It is developed as a serious game intervention and it persuades and challenges patients to get to know themselves.
Mijnbehandelplan.nl learns patients:
• who they are
• about their pitfalls
• their qualities and competences
• what they want out of life and what they need in order to achieve it
The strength based approach is an important addition to the traditional offender rehabilitation interventions. It is premised on the idea that we need to build capabilities and strengths in people, in order to reduce their risk of reoffending. By computerizing this intervention the interaction between the patient and the professional is minimized. This excludes the relational complexities which tends to arise during face-to-face treatment. The patients acquire self-knowledge on their own instead of someone else telling them what they are about.
The intervention is a joint production of The Trimbos-institute (Centre of Expertise on Mental Health and Addiction), The Expertise Centre for Forensic Psychiatry (EFP) and The Pompestichting (Forensic Mental Health Services). The intervention is scientifically underpinned and we have used focus groups to explore the wishes and beliefs of the forensic patients in regard to this approach.

Follow-up
The intervention as described above will be ready March 2012. Next we will conduct a process evaluation to examine the effectiveness of this intervention, the patient satisfaction, and in which we will evaluate the impeding and facilitating factors for implementation. If it is effective in realizing enhanced treatment readiness and compliance then the intervention will be stepped up, expanded and further implemented.