To what extent do two therapy theories, specifically between Cognitive Behavioral therapy (CBT) and the Group psychotherapy theory effect on the treatment of antisocial personality

disorder?

Jay Desai Candidate #

Supervisor: Mr. Ramsdell Word Count:

November 9th, 2012

“On my honor, I certify that I have neither given nor received inappropriate assistance on this assignment and the work is authentically my own.”

X____________________

Desai1

Table of Contents Cover Sheet ..................................................................................................................................... .

Table of Contents .......................................................................................................................... 1

Abstract .......................................................................................................................................... 2

Introduction/Background .......................................................................................................... 3-5

Investigation ....................................................................................................................................

Cognitive Behavioral therapy (CBT) ........................................................................... 5-9

Effect on the treatment of Antisocial Personality Disorder/Analysis ........... 7-9

Advantages and Disadvantages ........................................................................ 8-9

Group psychotherapy theory ...................................................................................... 9-14

Effect on the treatment of Antisocial Personality Disorder ....................... 10-14

Advantages and Disadvantages .................................................................... 10-14

Comparison between cognitive behavioral therapy and group psychotherapy/Analysis ..... 14-15

Conclusion ................................................................................................................................... 15

Works Cited ............................................................................................................................ 17-21

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Abstract The focus of this paper is a evaluative comparison of two therapy theories, specifically

between Cognitive Behavioral therapy (CBT) and the Group psychotherapy theory in evaluating

treatment of Antisocial personality disorder. Cognitive behavioral therapy is a, “type of therapy

that helps to uncover unhealthy, negative beliefs and behaviors and replace them with healthy,

positive ones” ("Definition"). Antisocial personality disorder is defined by the American

Psychiatric Association’s Diagnostic and Statistical Manual on Mental Disorders, as “...a

pervasive pattern of disregard for, and violation of the rights of others that begins in childhood or

early adolescence and continues into adulthood” ("Antisocial Personality Disorder"). Mayo

Clinic claims that, “Psychotherapy is the main way to treat antisocial personality disorder”

("Definition of Antisocial"). The specific Psychotherapy that will be discussed is Cognitive

Behavioral therapy (CBT). In addition another theory that can be used to treat antisocial

personality disorder is Group psychotherapy theory. The definition of Group psychotherapy

theory is that, “group therapy is a form of psychosocial treatment where a small group of patients

meet regularly to talk, interact, and discuss problems with each other and the group leader

[therapist]” ("Group Therapy"). Both of theories’ strengths and weakness will be explored and

evaluated. In addition the paper will focus on comparing each theory and evaluating it

effectiveness on the treatment on antisocial personality disorder. Note there either theory might

not show 100% absolute certainly effectiveness on the treatment on antisocial personality

disorder, but both theories shows some effectiveness on the treatment on antisocial personality

disorder. For example cognitive-behavioral therapy is evidence-based to some degree (Pucci).

Aldo R. Pucci explains this as, “Each approach to psychotherapy is based on the assumption that

it is correct in terms of its explanation of human behavior” (Pucci).

Word Count: 288

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Introduction:

“Antisocial personality disorder is characterized by a long-standing pattern of a

disregard for other people's rights, often crossing the line and violating those rights” ("Antisocial

Personality Disorder Definition"). The causes antisocial personality disorder are unknown,

several factors have been shown to contribute ("Antisocial Personality Disorder Definition").

According to A.D.A.M, formally known as American Accreditation HealthCare Commission,

their Medical Encyclopedia states that, “Genetic factors and child abuse are believed to

contribute to the development of this condition” ("Antisocial Personality Disorder Sociopathic

Personality"). Studies show that in regards to gender, “Far more men than women are affected

("Antisocial Personality Disorder Sociopathic Personality"). Studies like the Epidemiologic

Catchment Area Study support this statement. “In the Epidemiologic Catchment Area (ECA)

study, a large-scale survey of psychiatric disorders among 15,000 people in five U.S sites, about

2.5 percent of people interviewed-2 to 4 percent of men and .5 to 1 percent of women – were

diagnosed as antisocial” (Black 4). In addition there are much higher percentages among the

prison population ("Antisocial Personality Disorder Causes").

Origins of this disorder start in children or during their teenage years and continue in

their adulthood ("Antisocial Personality Disorder Definition"). “Antisocial personality disorder is

often referred to as psychopathy or sociopathy in popular culture” ("Antisocial Personality

Disorder Definition"). Donald W. Black writes, “The diagnosis of ASP relies on a mental health

professional’s ability to uncover this pattern and trace it through a patient’s life” (Black xii). The

pattern that Black is referring to is “pattern of recurrent antisocial, delinquent, or criminal

behavior that begins in early childhood or early adolescence and is manifested by disturbances in

many areas of life: family relations, schooling, work, military service, and marriage” (Black xii).

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Antisocial personality disorder is very challenging because as described by Mayo Clinic, “people

with this disorder may not even want treatment or think they need treatment” ("Definition of

Antisocial"). The reality is that treatment for antisocial personality disorder is needed but may

require long term treatment plan ("Definition of Antisocial"). “While it can be quite resistant to

change, research shows there are a number of effective treatments for this disorder” ("How Is

Antisocial Personality Disorder Diagnosed"). The treatment varies from psychotherapy, stress

and anger management skills, medications, to hospitalization ("Definition of Antisocial").

There are many disorder symptoms associated with antisocial personality disorder.

According to Mayo Clinic these may include, “Disregard for right and wrong, persistent lying or

deceit, using charm or wit to manipulate others, recurring difficulties with the law, repeatedly

violating the rights of others, child abuse or neglect, intimidation of others, aggressive or violent

behavior, lack of remorse about harming others, impulsive behavior, agitation, poor or abusive

relationships, and irresponsible work behavior” ("Symptoms"). “The severity of symptoms of

antisocial personality disorder can vary in severity” ("Antisocial Personality Disorder Info"). The

causes for the antisocial personality disorder can result from two main factors, genes or

environment, which fall under the nature verses nurture category ("Causes"). “Some people may

have a genetic vulnerability to developing antisocial personality disorder — and life situations

may trigger its actual development” ("Causes"). Many problems can emerge from antisocial

personality disorder. As include but not limited to, “depression, anxiety, aggression or violence,

suicidal behavior, reckless behavior, risky sexual behavior, child abuse, alcohol or substance

abuse, gambling problems, incarceration, relationship difficulties, and social isolation”

("Problems"). When diagnosing antisocial personality disorder, several tests are done.

“Antisocial personality is confirmed by a psychological evaluation” ("Antisocial Personality

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Disorder Causes"). Because antisocial personality disorder is a serious diagnosis, it is essential to

cross out all the other disorders ("Antisocial Personality Disorder Causes"). These range from

physical exams, laboratory tests, to psychological evaluations ("Diagnosis"). A key factor in

diagnosing antisocial personality disorder is how the affected person relates to others”

("Diagnosis"). Written by Mayo Clinic, “To be diagnosed with antisocial personality disorder, a

person must meet the symptom criteria for that disorder listed in the "Diagnostic and Statistical

Manual of Mental Disorders" [DSM] ("Diagnosis"). The treatment for antisocial personality

disorder is very hard. This is because whether or not treatment is necessary falls upon the person

with the disorder ("Definition of Antisocial"). Out of the various different personality disorders,

it is one of the most difficult to treat ("Antisocial Personality Disorder Treatments"). Mayo clinic

further describes that, “…but because antisocial personality disorder is essentially a way of

being, rather than a curable condition, affected people are likely to need close, long-term care

and follow-up” ("Definition of Antisocial").

The focus on this dissertation is to undergo a evaluative comparison through which its

emphasis is evaluate to extent does two therapy theories, specifically between Cognitive

Behavioral therapy (CBT) and the Group psychotherapy theory effect on the treatment of

Antisocial personality disorder.

“Cognitive Behavioral Therapy (CBT) is a form of treatment that focuses on examining

the relationships between thoughts, feelings and behaviors” (Duckworth and Freedman). The

methodology that is used is that it explores patterns of thinking that cause damaging

complications and throughout process behind them; the patient’s patterns are modified to

improve behavior (Duckworth and Freedman). “The definitional variations in emphasis on the

cognitive versus behavioral aspects of the cognitive-behavioral perspective grew out of two

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major historical antecedents: [1] the development of behavioristic interest in the phenomenon of

self-control and [2] the emergence of cognitive learning theories of psychotherapy” (Kendall and

Braswell 3). “According to cognitive behavioral therapy, schemas are strongly held core beliefs

that a person has about himself or herself, others, and the world, and these schemas cause the

person to focus on certain types of experiences and emotions while ignoring others” (Beck, qtd

in “Personality Disorders”). According to the National Alliance on Mental Illness, “CBT is a

type of psychotherapy that is different from traditional psychodynamic psychotherapy in that the

therapist and the patient will actively work together to help the patient recover from their mental

illness” (Duckworth and Freedman). For example because Cognitive Behavioral Therapy is a

long term active treatment, patients might have to homework/practice outside of sessions

(Duckworth and Freedman). Another example that illustrates this is, “…teenagers who receive

therapy that helps them change the thinking that leads to their maladaptive behavior [cognitive

behavioral therapy] have been found to experience a significant decrease the incidence of

engaging in repeat antisocial behaviors ("How Is Antisocial Personality Disorder Diagnosed").

“The teaching component also involves therapist modeling of new ways of thinking and

approaching problems” (Zarb 5).The therapist also plays an important role. They tend to be

“problem-focused and goal-directed in addressing the challenging symptoms of mental illnesses”

(Duckworth and Freedman). “A collaborative and empirical working relationship is established

between therapist and client” (Zarb 5).

Analysis:

Cognitive behavioral therapy can be used to treat many different issues ("Definition").

“It's often the preferred type of psychotherapy because it can quickly help you identify and cope

with specific concerns” ("Definition"). According to Mayo Clinic, “Health conditions that may

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improve with cognitive behavioral therapy include sleep disorders, sexual disorders, depression,

bipolar disorders, anxiety disorders, phobias, eating disorders, substance abuse disorders,

personality disorders, and schizophrenia” ("Definition"). “Studies have shown that CBT actually

changes brain activity in people with mental illnesses who receive this treatment, suggesting that

the brain is actually improving its functioning as a result of engaging in this form of therapy”

(Ken Duckworth and Jacob Freedman). One disadvantage is that, “…research shows that many

practitioners lack the knowledge, experience, and sometimes the willingness to factor cultural

context into their assessments” ("How Is Antisocial Personality Disorder Diagnosed").

“Psychotherapy is the main way to treat antisocial personality disorder” (Mayo). In this

case it would be Cognitive behavioral therapy. “This type of therapy helps to uncover unhealthy,

negative beliefs and behaviors and replace them with healthy, positive ones” (Mayo). Conferring

to Pysch Central, “Cognitive therapy — first developed to help patients with depression — has

recently been applied to ASP [antisocial personality disorder]” ("Antisocial Personality Disorder

Definition"). One study that supports this finding is carried out Davidson Km and his team of

researchers. In this case study the researchers, “investigated the feasibility and effectiveness of

carrying out a randomized controlled trial of cognitive behavior therapy (CBT) in men with

ASPD who were aggressive” ("Cognitive Behavior Therapy Case Study"). The method that was

used was “that Fifty-two adult men with a diagnosis of antisocial personality disorder that

showed acts aggression in the 6 months prior to the study were randomized to either treatment as

usual (TAU) plus CBT, or usual treatment alone” ("Cognitive Behavior Therapy Case Study").

Then how the patients changed over a 12 month period was accessed based on act aggression,

mental state, alcohol misuse, belief, and social functioning ("Cognitive Behavior Therapy Case

Study"). The results were that there was 79% and at 12 month both groups showed “decrease in

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the occurrence of any acts of verbal or physical aggression”, but “trends in the data, in favor of

CBT, were noted for problematic drinking, social functioning and beliefs about others”

("Cognitive Behavior Therapy Case Study"). Despite the findings, the case study calls for a

larger study to fully assess the effectiveness of Cognitive behavioral therapy in helping with

through with antisocial personality disorder ("Cognitive Behavior Therapy Case Study.").

Examination of this study in relation to antisocial personality disorder shows a trend of Cognitive

behavioral therapy in positively helping those effected by antisocial personality disorder, but

may require a larger study to fully validate their findings.

In evaluation of Cognitive Behavioral therapies of the effect of the treatment on

Antisocial personality disorder is that it has a positive outcome as research/case studies support,

but need larger studies and research to further effectively use Cognitive Behavioral therapies to

treat Antisocial personality disorder. The advantages include case studies that support the

positive outcome, though disadvantages include the case studies need more data to validate their

findings. In addition, another disadvantage is, “that many practitioners lack the knowledge,

experience, and sometimes the willingness to factor cultural context into their assessments”

("How Is Antisocial Personality Disorder Diagnosed"). As published by Psychiatric Clinics of

North America report stats, “Research generally supports the conclusion that CBT is an effective

treatment modality for patients with personality disorders, however more research is needed to

develop further our understanding of how best to apply CBT principles and to provide more

specific and unambiguous recommendations for how to treat PD symptoms” ("Cognitive

Behavioral Therapy for Personality Disorders"). Analysis shows the strengths include that as

Cognitive Behavioral therapies is part of Psychotherapy, it becomes the main way to treat

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antisocial personality disorder. The limitations are but not limited include that this therapy has in

several case studies not had a large enough case studies to fully validate their findings.

The definition of group psychotherapy is that it is, “a means of changing behavior and

emotional patterns, based on the premise that much of human behavior and feeling involves the

individual's adaptation and response to other people” ("Group Psychotherapy"). The goal of this

treatment is, “…to enable the individual to participate collaboratively with others and to obtain

interpersonal satisfactions in the context of realistic, mutually gratifying relationships”

(Vinogradov and Yalom 8). “The technique of formally organized group therapy is said to have

been devised by J. H. Pratt in 1905” ("Group Psychotherapy"). “Group psychotherapy is a

special form of therapy in which a small number of people meet together under the guidance of a

professionally trained therapist to help themselves and one another” ("Information about Group

Psychotherapy"). According to the American Group Psychotherapy Association, “It addresses

feelings of isolation, depression or anxiety. And it helps people make significant changes so they

feel better about the quality of their lives” ("Information about Group Psychotherapy"). Through

group Psychotherapy, therapists are able to help those participated in the various setting of their

life, such as school, work, and social life ("Information about Group Psychotherapy").

France De Piano writes, “The microcosmic benefit of group therapy is that in this

environment, the individual begins to manifest his or her true personality with its concomitant

strengths and weaknesses (Fehr 36). Problems do emerge in the process of group psychotherapy

such as, “Some people hesitate to admit to themselves, much less to others, that they cannot cope

adequately with their own emotional reactions ("Group Psychotherapy Approach"). “Group, by

its design, creates an environment in which the real personality feels safe to emerge. It is in this

emergence that the that the therapist and the members have the opportunity of helping

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individuals become aware of how they are affecting their environment and how their

environment is affecting them” (Fehr 36). Sophia Vinogradov, research fellow in Psychiatry at

Stanford University, writes, “Group therapy is an unparalleled mode of psychotherapy because it

relies upon very powerful therapeutic tool, the group setting” (Vinogradov and Yalom 7).

“Clinical experience and research have shown that a majority of people in need of professional

assistance can benefit greatly from certain forms of group psychotherapy…” ("Group

Psychotherapy Approach"). “Multiple outcome studies have tested the efficacy of group

treatment for a wide range of psychological problems and behavioral disorders ranging from

neurotic interpersonal behavior to sociopathy, substance abuse, and chronic mental illness”

(Vinogradov and Yalom 5).

There are many advantages and disadvantages associated with the use of group

psychotherapy. One advantage is that group therapy can reach many people simultaneously by a

single therapist (Weiner 3). Another advantage is, “for techniques that rely heavily on active

teaching, groups are an ideal medium for imparting the material to be learned and for its

reinforcement through group discussion and individual or shared homework” (Weiner 3). This is

highly relevant when addressing the treatment of antisocial personality disorder because it allows

for reinforcement of the material learned in class to be processed and even for further application

in the real world. Another advantage of group psychotherapy, relevant to treatment of antisocial

personality disorder, is that groups serve as a great medium for practicing and learning social

skills in a positive, safe way with fellow group members (Weiner 4). The development of real

friendships can takes place in group psychotherapy without any preconceived social pressures

(Weiner 4). Myron Weiner describes, “[those skills]…can be practiced in the protected

environment of the group until they are sufficiently well learned to be used in ordinary social

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relationships. The social risk of making social blunders is minimal, and the group applauds such

efforts, even if inept or miscarried at first” (Weiner 4). In addition, group psychotherapy

supports, “…the development of more adaptive behavior through the period of time when

important others in members’ lives are still puzzled or disturbed by their new behaviors, and

helps sustain positive change even when temporarily opposed by members’ by friends or

families” (Weiner 4). This is highly relevant to addressing the treatment of antisocial personality

disorder because lets the subjects change their negative behavior, while letting those close to

them to slowly adapt to the new changes that were not used to before. In addition, another

pertinent fact is, “as members try out their insight sin the group, they are helped to extinguish

maladaptive behaviors and understand that others’ needs must be considered before one acts”

(Weiner 4). Group psychotherapy allows for people to get to one another, thus increasing self-

esteem (Weiner 4). “As members respond more healthily to others in a group, their positive

behavior is reinforced and the process is kept in motion” (Weiner 4). “Narcissism, clinging,

defensive isolation, and many other character attributes, coping mechanism, and defenses

manifest in the interpersonal network of the group and become available for comment and

therapeutic work (Wong qtd. Weiner 5). This is applicable to addressing the treatment of

antisocial personality disorder because it shows how certain characteristics of antisocial

personality disorder can be discussed within group psychotherapy setting. Weiner describes,

“The opportunity for multiple partial identifications is an important aspect of group

psychotherapy” (Weiner 5). This is because, “As members accept the inevitable human flaws of

others, they become more self-accepting and can see clearly that their expectations of others are

not the same as their self-expectations, highlighting the irrational operations of the superego”

(Weiner 6). This is an important because it addresses characteristic that is prevalently in those

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diagnosed with antisocial personality disorder and the analysis of this advantage of group

psychotherapy shows that it can positively help deal with those issues. Analysis of all the

advantages that group psychotherapy has, show that group psychotherapy can positively benefit

the treatment of antisocial personality (Weiner 7).

In addition the advantages of group psychotherapy, there are a few disadvantages. “The

greatest disadvantage of groups is that the therapist’s attention is divided” (Weiner 7). Myron

Weiner explains, “While groups are a good arena for learning and practicing social skills, the

norms of a particular group may lead to acting out impulses instead of self-understanding, or

intellectualization of constructive” (Weiner 7). This is relevant to addressing the treatment of

antisocial personality disorder because it shows how the people during go this therapy may not

be self-understanding and thus effecting the efficiency of this form of treatment. In addition,

Myron discusses how, “Patients who do not conform to group norms of intelligence, interest, or

interaction frequently drop out…having failed to live up to their groups’ norms, such patients

may find themselves ostracized by other group members and traumatized by the group” (Weiner

7). This is highly relevant to addressing the treatment of antisocial personality disorder because it

discusses the potentially backlash that that could occur if subjects undergoing group

psychotherapy cannot conform to the group itself. Additionally another disadvantage is, “In the

process of pointing out maladaptive behaviors, groups may persecute persons whose manner of

presentation stimulates aggression. The group’s aggression is rationalized as being for the

member’s own good, and the resultant flight from the group I seen as unwillingness to face

issues, and note as the result of a massive attack on self-esteem” (Weiner 8). This is applicable to

addressing the treatment of antisocial personality disorder because it shows how the negative

symptoms of antisocial personality disorder can be more intensified during group psychotherapy,

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thus the therapy would be negatively affecting the subjects. Analysis of the disadvantages of

group psychotherapy shows that to extent there is a possibility of group psychotherapy not being

effective in treating antisocial personality disorder.

Though, case studies that directly connected group psychotherapy on the treatment of

antisocial personality disorder, closely related case studies were analyzed. On September 01,

1999 Christopher Perry, Elisabeth Banon, and Floriana Ianni published their case study of

Effectiveness of Psychotherapy for Personality Disorders (Perry). The objective of the study was

to, “…examine the evidence for the effectiveness of psychotherapy for personality disorders in

psychotherapy outcome studies” (Perry). The method was that, “Fifteen studies were located that

reported data on pretreatment-to-postreatment effects and/or recovery at follow-up, including

three randomized, controlled treatment trials, three randomized comparisons of active treatments,

and nine uncontrolled observational studies. They included psychodynamic/interpersonal,

cognitive behavior, mixed, and supportive therapies” (Perry). The results were, “All studies

reported improvement in personality disorders with psychotherapy” (Perry). Specifically, “A

heuristic model based on these findings estimated that 25.8% of personality disorder patients

recovered per year of therapy…” (Perry). The conclusions that were drawn include that,

“Psychotherapy is an effective treatment for personality disorders…” (Perry). The analysis of

this study shows that psychotherapy is an effective treatment for personality disorders, but only

specifically group psychotherapy though included in the study, is not the main focus of this

study. The limitations of this study include that there is, “paucity of empirical studies examining

the outcome of personality disorders treated with psychotherapy” (Perry).

Comparison between cognitive behavioral therapy (CBT) and the group psychotherapy

theory revealed numerous differences and similarities. A similarity between therapies is that both

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are a form of psychotherapy, but difference is that that each therapy is more specific/specialized

form of psychotherapy. The main differences between cognitive behavioral therapy (CBT) and

the group psychotherapy include their focus, methods, and effect on the treatment of antisocial

personality disorder. Cognitive behavioral therapy’s main focus is, “examining the relationships

between thoughts, feelings and behaviors” (Duckworth and Freedman). The method, which is

based off the focus, is that, “the cognitive therapist works with the client to confront, or

challenge the erroneous thoughts by pointing out other ways of viewing situations” (Nordqvist).

This directly contrasts with the methodology and focus of group psychotherapy. The focus of

group psychotherapy is to change behavior and emotional patterns through use of group format

("Group Psychotherapy"). The methodology involved is using, “which a small number of people

meet together under the guidance of a professionally trained therapist to help themselves and one

another” ("Information about Group Psychotherapy"). In addition, the extent of the effect that

each therapy has on the treatment of antisocial personality disorder is different. In general, as

analyzed by Mayo Clinic sources, “Psychotherapy is the main way to treat antisocial personality

disorder” (Mayo). Specifically case studies such as the Davidson Km and his team support that

Cognitive behavioral therapy is most directly associated with having an positive effect on the

subjects that are undergoing treatment for antisocial personality disorder. For example the results

were that there was 79% and at 12 month both groups showed “decrease in the occurrence of any

acts of verbal or physical aggression”, but “trends in the data, in favor of CBT, were noted for

problematic drinking, social functioning and beliefs about others” ("Cognitive Behavior Therapy

Case Study"). The extent of the effect that group psychotherapy therapy has on the treatment of

antisocial personality disorder is different from Cognitive Behavior Therapy. Case studies have

shown group psychotherapy was to some degree effectiveness on the treatment as supported by

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the case study of the effectiveness of psychotherapy for personality disorders. It must be noted

that the case did not focus on group psychotherapy, thus not fully validating the group

psychotherapy’s effectiveness of treatment on antisocial personality disorder. Though there is a

lack of empirical studies investigating group psychotherapy effectiveness of treatment on

antisocial personality disorder, the advantages help support the claim that it is effective to a

degree (Perry). Advantages such as reinforcement of the material learned in class, development

of real friendships, minimal social risks, development of more adaptive behavior, and positive

thinking help support the claim that to a degree group psychotherapy’s is an effective form of

treatment on antisocial personality disorder (Weiner 4).

Conclusion

Both cognitive behavioral therapy (CBT) and the group psychotherapy have shown that

they both are effective to a degree as a form of treatment on antisocial personality disorder.

Analysis of both theories show that was not a 100% absolute certainly effectiveness, but both

theories shows some effectiveness on the treatment on antisocial personality disorder.

Specifically case studies such as the Davidson Km and his team support that Cognitive

behavioral therapy is most directly associated with having an positive effect on the subjects that

are undergoing treatment for antisocial personality disorder. Aldo R. Pucci explains this as,

“Each approach to psychotherapy is based on the assumption that it is correct in terms of its

explanation of human behavior” (Pucci). In addition Christopher Perry his team of researchers’

case study of Effectiveness of Psychotherapy for Personality Disorders helped support the fact

that to a degree group psychotherapy’s is an effective form of treatment on antisocial personality

disorder. Though there were limitations on both case studies. The case study pertaining to

cognitive behavioral therapy needed more data in order to fully validate its results. Additionally

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the case study pertaining to group psychotherapy group was not a board case study and not a

directly evaluating the effect of group psychotherapy on the treatment of antisocial personality

disorder. In addition, it was shown that there was lack of empirical studies investigating group

psychotherapy effectiveness of treatment on antisocial personality disorder (Perry).

Both therapies had many differences and similarities. They ranged from their focus,

advantages, disadvantages, and methods that ultimately determined their effect on the treatment

of antisocial personality disorder. Though both therapies were a form of psychotherapy, the

specific method and focus were vastly different. From the empirical evidence that was available,

it can be concluded that both therapies have a positive effect on treatment on antisocial

personality disorder.

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