An Area of Uncertainty: Practitioners’ Experiences Working with Psychopathy

Psychopathy is an area of research that has been impacted by a great deal of prejudice and stigma. Studies pertaining to therapeutic interventions for psychopathy often argue that the condition might be untreatable. However, more recent research suggests that certain approaches are helpful as they work with strengths, weaknesses, limitations and self-interests. Moreover, qualitative research into both client and practitioner experience in treatment seems to be substantially lacking. The above conflicting opinions, combined with a lack of qualitative research in the area, motivated this research, which comprises an examination of the experience of practitioners who work with psychopathy. Six semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis (IPA), which revealed four superordinate themes: “There’s Something Powerful about that Label”, The “Continuum”, An “Area of Uncertainty, Pessimism and Nihilism” and Beyond “Hanging in There”. Each theme revealed three subordinate themes related to opinions concerning the associations and characteristics of psychopathy, while lending insight to treatment approaches. The findings showed the influence that the label could have on practitioners and clients alike, with positive and negative reactions being observed. There also seemed to be the view that psychopathy, much like other mental health diagnoses, comprised a spectrum. Treatment approaches and outcomes appeared to be met with uncertainty and pessimism, with many participants sharing the difficulty of working with psychopathy. Nonetheless, effective approaches from experience were openly shared and discussed.