Background. Violent criminal offenders with personality disorders (PD’s) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods. We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results. Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*- time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*- time: t(1387) = −2.85, p = 0.005). Conclusions. These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community
Abstract: The Problem-Solution Chain (PSC) models proposed in this exploratory paper are conceived as describing chains of problem-solution links, thereby modelling specific multi-link ‘problem-solving’ paths, typically (but not exclusively) from a high-level business problem to lower-level functional solution components. The main elements are ‘Problems’ and ‘Solutions’. These may be selected from purpose-made, domain-specific collections of elements. Single ‘Problem-Solution links’ are comparable to compact, high-level descriptions of design patterns and can be directly related to design problem templates as used in Design Science. Coherent collections of such links would resemble boiled-down representations of pattern languages. Instantiations of PSCs for specific situations aim to help conceptualise and discuss pre-architectural, high-level overviews, for example, of (options for) functionalities or applications representing ‘solutions’ for ‘solving’ some business need or capability ‘problem’. A useful metaphor is that PSCs help describe and discuss basic ingredients (related problems and solutions) for some specific situation, which can later (out of scope here) be developed into a recipe (e.g. an enterprise or process architecture and roadmap) and eventually into an actual dish (realisation of the architecture/solution). Thus, PSCs can, for example, be conceptualisations and conversation aids in the early stages of business-IT alignment efforts and system design. This explorative, practice-oriented paper presents our initial conceptualisation of PSCs. We also present a syntax and notation for problem-solution chains as specified for the Simplified Modelling Platform (SMP), and we briefly discuss the possibility of supporting PSC modelling with guided conversations for PSC modelling. We demonstrate and evaluate our proposed concepts by applying them in a single real case. Much work lies ahead.
Author Supplied: In the last decades, architecture has emerged as a discipline in the domain of Information Technology (IT). A well-accepted definition of architecture is from ISO/IEC 42010: "The fundamental organization of a system, embodied in its components, their relationships to each other and the environment, and the principles governing its design and evolution." Currently, many levels and types of architecture in the domain of IT have been defined. We have scoped our work to two types of architecture: enterprise architecture and software architecture. IT architecture work is demanding and challenging and includes, inter alia, identifying architectural significant requirements (functional and non-functional), designing and selecting solutions for these requirements, and ensuring that the solutions are implemented according to the architectural design. To reflect on the quality of architecture work, we have taken ISO/IEC 8402 as a starting point. It defines quality as "the totality of characteristics of an entity that bear on its ability to satisfy stated requirements". We consider architecture work to be of high quality, when it is effective; when it answers stated requirements. Although IT Architecture has been introduced in many organizations, the elaboration does not always proceed without problems. In the domain of enterprise architecture, most practices are still in the early stages of maturity with, for example, low scores on the focus areas ‘Development of architecture’ and ‘Monitoring’ (of the implementation activities). In the domain of software architecture, problems of the same kind are observed. For instance, architecture designs are frequently poor and incomplete, while architecture compliance checking is performed in practice on a limited scale only. With our work, we intend to contribute to the advancement of architecture in the domain of IT and the effectiveness of architecture work by means of the development and improvement of supporting instruments and tools. In line with this intention, the main research question of this thesis is: How can the effectiveness of IT architecture work be evaluated and improved?
