How the Good Lives Model Can Complement Mentalization-Based Treatments for Individuals Who Have Offended With Anti-Social Personality Disorder and General Forensic Mental Health Needs: Practice Update

• Date: 01 November 2020
• Author: Gary Byrne
• DOI: 10.1177/0306624X20928017
• Published date: 01 November 2020
• Subject Matter: Articles

Original Manuscript

How the Good Lives

Model Can

Complement

Mentalization-Based

Treatments for

Individuals Who Have

Offended With Anti-

Social Personality

Disorder and General

Forensic Mental Health

Needs: Practice Update

Gary Byrne

1

Abstract

Limited research to date has focused on strengths-based rehabilitative approaches,

such as the Good Lives Model (GLM) and the additive benefits such approaches have

in ameliorating mental health needs of those in contact with forensic services.

Mentalization-based therapies (MBTs) may be an effective treatment in forensic

settings. This article aims to provide an overview of how GLM theory can integrate

MBT within forensic settings. The review provides a conceptual overview of the

many commonalities between GLM and MBT principles and provides information

about how MBT can be embedded within forensic communities adhering to GLM

1

Health Service Executive, Dublin, Ireland

Corresponding Author:

Gary Byrne, Primary Care Psychology Department, Health Service Executive, Churchtown, Dublin 14,

Ireland.

Email: gary.byrne@hse.ie

International Journal of

Offender Therapy and

Comparative Criminology

2020, Vol. 64(15) 1587–1606

!The Author(s) 2020

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DOI: 10.1177/0306624X20928017

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principles. The article closes by offering an overview of the evidence of MBT

approaches for individuals with anti-social personality disorder (ASPD) and those

in contact with forensic services.

Keywords

mentalization, Good Lives Model, anti-social personality disorder, mental health,

rehabilitation

Introduction

The reduction of violence is a priority of many disciplines, bisecting analyses

that traverse the micro and the macro, from individual psychosocial factors to

structural societal dimensions. Exposure and injury from violence has been

associated with signif‌icant physical and mental health diff‌iculties as well as

f‌inancial costs associated with treatment and societal costs (Bellis et al., 2012).

The impact of violent crime is not conf‌ined only to the victims, as perpetra-

tors with a diagnosis of anti-social personality disorder (ASPD) have a high

level of comorbid physical and mental health diff‌iculties (Byrne et al., 2013;

Lenzenweger et al., 2007). Rehabilitation is therefore a multifaceted process

that includes the reentry and integration of the individual into society and

needs to focus on capacity building, skill acquisition, and the enhancement of

emotional well-being along with the reduction of risk (Ward & Maruna, 2007).

A number of strengths-based rehabilitative theories have been put forward to

help clinicians and practitioners negotiate the challenges associated when work-

ing with incarcerated individuals. The aim of this article is threefold. First, it

aims to highlight how mentalization-based therapies (MBTs; Bateman &

Fonagy, 2016) can be readily adopted into broader strengths-based rehabilita-

tive theories, such as the Good Lives Model (GLM; Ward & Brown, 2004) in

aiding treatment goals and informing practice for incarcerated individuals with

mental health diff‌iculties, namely, ASPD. Second, the article highlights how

strengths-based rehabilitative theories can complement and guide MBT

informed treatments. Finally, a brief review of the effectiveness of the current

MBT literature used either in forensic settings or with individuals diagnosed

with ASPD is provided.

Rehabilitative Theories

Rehabilitative theories are comprehensive practice frameworks that have pro-

vided forensic practitioners with a blueprint in the management of individuals

who offend for nearly the past 50 years. Such theories provide guidance on

1588 International Journal of Offender Therapy and Comparative Criminology 64(15)