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首页> 外文期刊>The journal of forensic psychiatry & psychology >Rehabilitating antisocial personalities: treatment through self-governance strategies
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Rehabilitating antisocial personalities: treatment through self-governance strategies

机译：恢复反社会人格：通过自治策略进行治疗

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Offenders with antisocial personality disorder (ASPD) are widely assumed to reject psychotherapeutic intervention. Some commentators, therefore, argue that those with the disorder are better managed in the criminal justice system, where, following the introduction of indeterminate sentences, engagement with psychological treatment is coercively linked to the achievement of parole. By comparison, National Institute of Clinical Excellence guidelines on the management and treatment of ASPD recommend that those who are treatment seeking should be considered for admission to specialist psychiatric hospitals. The rationale is that prison-based interventions are underresourced, and the treatment of ASPD is underprioritised. The justification is that offenders with ASPD can be rehabilitated, if they are motivated. One problem, however, is that little is known about why offenders with ASPD seek treatment or what effect subsequent treatment has on their self-understanding. The aim of this paper is to address these unresolved issues. It draws on the findings of Economic and Social Research Council (ESRC) funded qualitative study examining the experiences of sentenced male offenders admitted to a specialist personality disorder ward within the medium secure estate and the medical practitioners who treat them. The data are analysed with reference to Michel Foucault's work on governmentality and strategy in power relations. Two arguments are advanced: first, offenders with ASPD are motivated by legal coercive pressures to implement a variety of Foucauldian-type strategies to give the false impression of treatment progress. Second, and related, treatment does not result in changes in self-understanding in the resistive client with ASPD. This presupposes that, in respect of this group at least, Foucault was mistaken in his claim that resistive behaviours merely mask the effectiveness of treatment norms over time. Nevertheless, the paper concludes that specialist treatment in the hospital setting can effect changes in the resistive offender's self-understanding, but not if the completion of treatment results, as is commonplace, in his prison readmission.
机译：人们普遍认为患有反社会人格障碍（ASPD）的罪犯会拒绝心理治疗干预。因此，一些评论员认为，在刑事司法系统中可以更好地管理患有精神障碍的人，在这种情况下，采用不确定的刑罚之后，进行心理治疗与假释的实施具有强制性的联系。相比之下，美国国家临床卓越研究所有关ASPD管理和治疗的指南建议，应将寻求治疗的患者考虑入专科精神病医院。理由是基于监狱的干预措施资源不足，而ASPD的治疗优先考虑。理由是，只要有动机，患有ASPD的罪犯就可以康复。然而，一个问题是，鲜为人知的是，患有ASPD的罪犯为何寻求治疗，或者后续治疗对其自我理解有何影响，人们所知甚少。本文的目的是解决这些未解决的问题。它借鉴了经济及社会研究理事会（ESRC）资助的定性研究的结果，该研究考察了在中等安全等级内被送入专业人格障碍病房的被判刑男性罪犯的经历以及对其进行治疗的医生。数据参考了米歇尔·福柯关于权力关系中政府性和战略的工作进行了分析。提出了两个论点：首先，患有ASPD的罪犯是受到法律强制压力的驱使而实施各种福柯式的策略以给人治疗进展的错误印象。其次，相关的是，治疗不会导致ASPD抵抗性客户的自我理解发生变化。以此为前提，至少对于这一类人来说，福柯误以为抵制性行为只是掩盖了随着时间推移治疗规范的有效性。尽管如此，该论文得出的结论是，在医院环境中进行专科治疗可以改变抵抗性犯罪者的自我理解，但如果完成治疗（如通常的情况）导致他再次入狱，则不会。

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