Psychotherapeutic approaches to aggressive and violent patients

A broad range of psychotherapeutic approaches have been marshalled alone and together with pharmacotherapies in the treatment of aggression and violence, although the research and clinical literature is characterized by marked heterogeneity of patient populations, treatment settings, and outcome measures. This article presents general principles that underlie most forms of psychotherapy with aggressive and violent individuals. Representative approaches are described including behavioral and cognitive behavioral therapies, group, couples, and family therapies, and therapeutic communities. The ongoing needs for standardized, controlled research designs for the study of efficacy and effectiveness, greater focus on specific mediating and moderating variables relevant to treatment success, development of algorithms for combined modality treatment, and application of psychotherapeutic strategies for primary prevention are highlighted.