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Psychotherapy for forensic psychiatric patients diagnosed with schizophrenia or schizoaffective disorders : a mixed methods systematic review

Dichmann, Kirstine ; Bryde, Anne ; Pereira Ribeiro, Johanne LU ; Nielsen, Kåre Donskov ; Stjernegaard, Karina ; Brandt-Christensen, Mette ; Møllerhøj, Jette ; Os Stølan, Liv ; Gryesten, Jasmin and Rønne, Sabrina Trappaud , et al. (2026) In Journal of Forensic Psychiatry and Psychology 37(2). p.219-254
Abstract

Most forensic psychiatric patients are diagnosed with schizophrenia or schizoaffective disorder. Psychotherapy is recognized as an important part of treatment for this patient population, yet no clinical guidelines exist. This mixed-method systematic review aimed to evaluate the scope, quality, and findings of psychotherapy research involving this population. Following the Joanna Briggs Institute methodology, thirteen studies were included after critical appraisal. A convergent-segregated synthesis approach was used due to heterogeneity in study designs and outcomes. Only two studies provided sufficient qualitative data for formal synthesis, while the remaining studies were narratively summarized. Meta-analysis was not feasible due to... (More)

Most forensic psychiatric patients are diagnosed with schizophrenia or schizoaffective disorder. Psychotherapy is recognized as an important part of treatment for this patient population, yet no clinical guidelines exist. This mixed-method systematic review aimed to evaluate the scope, quality, and findings of psychotherapy research involving this population. Following the Joanna Briggs Institute methodology, thirteen studies were included after critical appraisal. A convergent-segregated synthesis approach was used due to heterogeneity in study designs and outcomes. Only two studies provided sufficient qualitative data for formal synthesis, while the remaining studies were narratively summarized. Meta-analysis was not feasible due to methodological heterogeneity and small sample sizes. Most studies examined cognitive-behavioral or skills-based interventions, suggesting potential improvements in social functioning, psychiatric symptoms, and reductions in violence. However, these findings were largely derived from small, non-controlled studies. A smaller number of studies have explored music and art therapies, suggesting potential benefits for negative symptoms and self-narrative, though the evidence remains limited. High-quality research, including patient perspectives, women, and the phenomena of the working alliance, is critical to develop the evidence base for forensic psychiatric patients who are diagnosed with schizophrenia or schizoaffective disorder.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Forensic Psychiatry, Mentally disordered offenders, mixed methods systematic review, psychotherapy, schizophrenia, working alliance
in
Journal of Forensic Psychiatry and Psychology
volume
37
issue
2
pages
36 pages
publisher
Routledge
external identifiers
  • scopus:105035794376
ISSN
1478-9949
DOI
10.1080/14789949.2026.2647910
language
English
LU publication?
yes
id
03fc27d6-4909-4279-b34b-517bb9581def
date added to LUP
2026-06-23 15:34:36
date last changed
2026-06-23 15:35:03
@article{03fc27d6-4909-4279-b34b-517bb9581def,
  abstract     = {{<p>Most forensic psychiatric patients are diagnosed with schizophrenia or schizoaffective disorder. Psychotherapy is recognized as an important part of treatment for this patient population, yet no clinical guidelines exist. This mixed-method systematic review aimed to evaluate the scope, quality, and findings of psychotherapy research involving this population. Following the Joanna Briggs Institute methodology, thirteen studies were included after critical appraisal. A convergent-segregated synthesis approach was used due to heterogeneity in study designs and outcomes. Only two studies provided sufficient qualitative data for formal synthesis, while the remaining studies were narratively summarized. Meta-analysis was not feasible due to methodological heterogeneity and small sample sizes. Most studies examined cognitive-behavioral or skills-based interventions, suggesting potential improvements in social functioning, psychiatric symptoms, and reductions in violence. However, these findings were largely derived from small, non-controlled studies. A smaller number of studies have explored music and art therapies, suggesting potential benefits for negative symptoms and self-narrative, though the evidence remains limited. High-quality research, including patient perspectives, women, and the phenomena of the working alliance, is critical to develop the evidence base for forensic psychiatric patients who are diagnosed with schizophrenia or schizoaffective disorder.</p>}},
  author       = {{Dichmann, Kirstine and Bryde, Anne and Pereira Ribeiro, Johanne and Nielsen, Kåre Donskov and Stjernegaard, Karina and Brandt-Christensen, Mette and Møllerhøj, Jette and Os Stølan, Liv and Gryesten, Jasmin and Rønne, Sabrina Trappaud and Arnfred, Sidse}},
  issn         = {{1478-9949}},
  keywords     = {{Forensic Psychiatry; Mentally disordered offenders; mixed methods systematic review; psychotherapy; schizophrenia; working alliance}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{219--254}},
  publisher    = {{Routledge}},
  series       = {{Journal of Forensic Psychiatry and Psychology}},
  title        = {{Psychotherapy for forensic psychiatric patients diagnosed with schizophrenia or schizoaffective disorders : a mixed methods systematic review}},
  url          = {{http://dx.doi.org/10.1080/14789949.2026.2647910}},
  doi          = {{10.1080/14789949.2026.2647910}},
  volume       = {{37}},
  year         = {{2026}},
}