Treating Psychopathy

HOPE IS: The product of knowledge. The power that connects us. And part and parcel of any treatment option.
This information should not be used to diagnose or treat. It is not meant to take the place of consultation with a healthcare professional. If you have concerns, you should contact your healthcare provider for a screening.

YES, PSYCHOPATHY IS TREATABLE.

Adult woman shows young child blank document
And while there’s a variety of ways to improve symptoms, there’s still much to be done to develop more effective options.
The most successful approaches to treating psychopathy are multimodal. This means they include multiple approaches at once, including psychotherapy, behavioral skills training, and recognition of the important roles of family, school, peers, and the community. They may also incorporate medication.

Below, we provide more information about all of these treatment options.

Treatment Options

Psychopathy Individual Therapy
Individual-focused therapies may be appropriate for people of any age with psychopathy. 
Psychopathy Teens
Family-focused therapies are appropriate for children and adolescents with psychopathy.
Residential Treatment
Residential treatment programs are appropriate for some children and adolescents with psychopathy if home-based treatment methods have not been successful.
Medication
Medications are appropriate for some children, adolescents and adults in combination with other forms of therapy. Medication should not be a first-line treatment.

Finding a Therapist

It can be challenging to find a clinician who is comfortable treating psychopathy or serious conduct problems. Parents may find it hard to find a therapist if Conduct Disorder with Limited Prosocial Emotions (CD-LPE, a diagnosis that indicates high risk for psychopathy) is being considered as a diagnosis. It is important to start by finding a clinician who is experienced using one of the recommended forms of therapy for psychopathy.

To locate a therapist, you can start by asking your physician, school counselor, or social worker for recommendations. Make sure to emphasize that you are seeking a clinician with specific expertise using effective methods to treat psychopathy or serious conduct problems. You can also consult an online therapist search engine, such as the ones offered by Psychology Today or the American Psychological Association
In the Psychology Today search engine enter your ZIP code and then in the Issues menu click Show more issues then select one or more of these options: Anger Management / Antisocial Personality / Behavioral Issues / Narcissistic personality / Teen violence. In the Types of Therapy menu you can also select one or more of these options, all of which are backed by scientific evidence: Cognitive Behavioral (CBT) / Forensic psychology / Parent child interaction (PCIT).

For the American Psychological Association search engine, enter your ZIP code and then in the Issues menu click See More and then select one or more of these options: Anger management / Behavior problems / Firesetting / Forensic / Personality disorders / Violence". In Treatment Methods you can select one or more of these options: Cognitive/Behavioral / Forensic evaluation / Parent Guidance
When scheduling your meeting or during the initial meeting, be sure to ask the therapist if they are informed about current research and best practices for treating psychopathy. Ask the therapist about their experience using the treatment programs described above. Ideally they will have prior experience with one of these programs or can refer you to another therapist who does. If a therapist with prior expertise is not available, an experienced clinician who is willing to seek more information about these therapeutic programs can also be effective.

Those seeking treatment may find it helpful to bring the results of the online psychopathy screening to the initial visit with the therapist, as well as this worksheet.

We recognize how difficult it is for parents to find qualified and experienced clinicians and treatment programs. We are working to solve this problem. We are crowd-sourcing the first ever database of clinicians and treatment programs with expertise in treating psychopathy. You can help! Learn how here.

Barriers to Treatment

Families seeking treatment for children with psychopathy frequently encounter barriers to effective treatment. These include: 
  • Lack of knowledge about psychopathy among many healthcare providers
  • Stigma attached to the diagnosis of psychopathy for both children and families
  • Being blamed for the child’s behavior problems
  • The common myth that psychopathy does not respond to treatment, which contributes to the unwillingness of some insurers to cover treatments for psychopathy
  • A lack of sufficient community support for families raising a child with psychopathy, which can make it difficult for families to keep their child in the community for treatment
  • Limited available services outside of the juvenile justice or child welfare system. This means a child’s behaviors must become very serious before the child can access some treatments.
These and other barriers sometimes require parents to make difficult choices about how to access care for their child.

Treatments to Avoid

When seeking therapeutic options, it is important to keep in mind that not all therapies are effective. Clinicians are not required by any accrediting body to use only therapies that have been demonstrated to be effective. This is why it is important for those seeking treatment to request specific, scientifically validated tested therapies.