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Instilling Hope Into Forensic Treatment: The Antidote to Despair and Desperation

Dr. Hillbrand is Director of Psychology and Dr. Young is Attending Psychiatrist, Connecticut Valley Hospital, Middletown, CT. Both are on the clinical faculty of the Department of Psychiatry, Yale University School of Medicine, New Haven, CT. An earlier version of this paper was presented at the 16th Annual Meeting of the International Association for Forensic Psychotherapy, Oxford, UK, March 30, 2007. Address correspondence to: Marc Hillbrand, PhD, Connecticut Valley Hospital, Box 351, Middletown, CT 06457. E-mail: marc.hillbrand{at}po.state.ct.us

The importance of hope in the treatment of physical ills is well documented. Less is known about its role in the treatment of mental illness. Hope, the expectation of achieving a goal, figures prominently among the curative influences that help forensic patients recover. The cognitive processes that fuel violence and bring patients into our care often result in the loss of hope. Successful treatment requires the restoration and fueling of hope as patients progress through the phases of recovery. We review the extant literature on hope as it relates to clinical concerns, including the genesis of violence, mood, adjustment to physical illness, spirituality, forensic assessment and treatment, staff morale, and patient-centered care.