Treatment approaches for violence and aggression : essential content components

The current chapter aims to provide an outline of recommended content for violence/ aggression therapy. It aims to provide a review rather than detailed analysis of the core approaches required for effective treatment. Points will be illustrated where possible using elements of a recently developed and revised violence treatment programme (Life Minus Violence: see Ireland 2007, and Chapter 4, this volume). Focus will be on the concept of habitual aggression (i.e. repeated aggression), since it is habitual aggressors who are most likely to come into contact with professional services for aggression management. Regardless of the exact nature or emphasis of therapy for violence and aggression there are five domains that treatment should have in common if they are to begin to reflect the treatment needs of habitual aggressors. These are the areas of: 1 information processing; 2 emotional acceptance, reactivity and regulation; 3 developmental changes (including learning history); 4 aggression motivation; and 5 relapse prevention. These five areas are integral to the core aggression literature, particularly the first four, with relapse prevention more commonly found in the antisocial literature base. Researchers and clinicians who concern themselves solely with the antisocial literature base, however, are at risk of neglecting the importance and influence of information processing, emotions, developmental changes and aggression motivation in particular. As discussed in Chapter 4, there is overlap between the aggression and antisocial literature (Ireland 2007; Tremblay and Cote 2005), but an over-focus on the latter will lead to the neglect of core aggression theory and literature, as appears to have happened with some 'violence' treatment approaches (e.g. Violence Reduction Programme: Wong et al. 2007) which arguably are more antisocial management programmes than aggression management. The importance of accounting for developmental changes and aggression motivation (areas 3 and 4) are covered in detail in Chapter 4, and readers are thus referred there for a comprehensive discussion of the importance of these two topics. Focus in the current chapter will be on the importance of incorporating the three areas of information processing, emotions and relapse prevention. What will become apparent as the chapter progresses is the complex interplay between information processing and emotion. This highlights how separating these two areas clinically is artificial and that both also feature in relapse prevention which, like information processing and emotions, has to form a core component of therapy.