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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
Iedere leerkracht of pedagogisch medewerker die met jonge kinderen werkt, ervaart dat sommige kinderen het moeilijk vinden om een goede relatie met andere kinderen op te bouwen en hun gedrag af te stemmen op regels en structuur van de groep. Dit heeft te maken met de ontwikkeling van zelfregulatie. In dit artikel wordt beschreven wat zelfregulatie is en hoe het zich ontwikkelt in wisselwerking met de omgeving. Vervolgens wordt beschreven hoe de leerkracht of pedagogisch medewerker de ontwikkeling van zelfregulatie van jonge kinderen kan ondersteunen en stimuleren en de rol van (spel)activiteiten hierbij.
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