Pinpointing change in virtual reality assisted treatment for violent offenders: a pilot study of Virtual Reality Aggression Prevention Training (VRAPT)

Abstract

Preventing relapse into violence and its destructive consequences among persistent re-offenders is a primary concern in forensic settings. The Risk-Need-Responsivity framework models the best current practice for offender treatment, focused on building skills and changing pro-criminal cognitions. However, treatment effects are often modest, and the forensic context can obstruct the delivery of interventions. Developing treatments for offenders should focus on the best method of delivery to make “what works work.” Virtual reality (VR)-assisted treatments such as Virtual Reality Aggression Prevention Training (VRAPT) are a new and innovative approach to offender treatment. This pilot study followed 14 male violent offenders who participated in VRAPT in a Swedish prison context and measured changes from pre-treatment to post-treatment and 3-month follow-up in targeted aggression, emotion regulation, and anger. It also investigated potential impact factors (pro-criminal cognitions, externalizing behaviors, psychosocial background, and childhood adverse experiences). In Bayesian linear mixed effects models, participants showed a high probability of change from pre-treatment to post-treatment and to follow-up on all outcome measures. All outcome measures demonstrated a low probability of change from post-treatment to follow-up. Analysis of reliable change showed that participants’ results ranged from recovery to deterioration. We discuss the implications of the study for VRAPT’s impact on the target group, those who might benefit from the approach, and suggested foci for future studies in the field of VR-assisted offender treatment. The study was preregistered at the International Standard Randomized Controlled Trial Number registry (https://doi.org/10.1186/ISRCTN14916410).

VR-assisted aggression treatment in forensic psychiatry: a qualitative study in patients with severe mental disorders

“…Patients’ experiences of their treatments are important to our understanding of the responsiveness of these treatments (to the patient) which will in turn influence motivation, treatment engagement and efficacy ( 14 , 45 – 48 ), providing directions for further treatment developments. Recently, the VRAPT intervention was revised ( 9 ) and pilot studies carried out in forensic psychiatric and prison settings ( 49 ). In its revised version [see ( 9 )], VRAPT aims to increase the participant’s understanding and management of his/her dysfunctional and reactive aggressive behaviors through a CBT approach theoretically underpinned by the General Aggression Model GAM ( 50 – 52 ).…”