Risk Management in Transitions Between Forensic Institutions and the Community: A Literature Review and an Introduction to a Milieu Treatment Approach

Abstract

The main goals of this article are to: (1) present findings from a literature search on structured approaches to rehabilitation of violent forensic patients; (2) outline the rationale and theoretical base of progression ladders (ProLad), a milieu treatment approach to risk management; and, (3) give a brief case illustration in order to exemplify clinical application of the ProLad strategy in rehabilitation and risk management. No single publication was found in this search of the literature that dealt with individually adopted and stepwise criterion-based progression, either as case material or as introduction to this kind of methodology. Methodological limitations pertaining to this finding are discussed. Clinical application of the ProLad approach in violence risk management is illustrated by considering a patient's stepwise coping of violencetriggering psychotic symptoms and stress-vulnerability interactions. Finally, flaws and limitations pertaining to clinical application of the ProLad strategy are presented.