Metacognitive interpersonal therapy for male domestic offenders ( MIT ‐ MDO ) with personality disorders: A proof‐of‐concept case series

BACKGROUND AND AIMS: Intimate partner violence (IPV) is a serious health worldwide issue, and current treatment options are far from satisfactory. In this case series, we focused on male domestic offenders (MDO) as they are the most frequently responsible for IPV and targeted individuals displaying personality disorders (PDs) features and emotion dysregulation who were willing to accept court-mandated treatment. The underlying idea was that addressing PD factors through a specific treatment would help form and sustain a working alliance, understand the psychological triggers of violent behaviours, and then develop strategies to reduce them. We evaluated an adaptation of metacognitive interpersonal therapy (MIT) for MDO. The primary qualitative outcome was a reduction in violent behaviour. The main quantitative outcome was the reduction in manifestations of PD features. Secondary outcomes were reductions in global symptoms and interpersonal problems. We also analysed changes in emotion dysregulation, impulsivity and metacognition. METHODS: In a case series design, three court-mandated MDO underwent 24 individual sessions of MIT-MDO. They were assessed at baseline, post-treatment and 3-month follow-up. RESULTS: All participants ceased all forms of violence post-treatment, and results were stable at follow-up, reported by both participants and their partners. Two participants achieved significant reductions in PD scores, global symptoms and interpersonal problems. CONCLUSIONS: MIT-MDO is a promising new approach for tailoring treatment for MDO willing to undergo psychological treatment. MIT-MDO is a suitable candidate for further evaluation in larger effectiveness studies.