Dr Lars Madsen1, Mrs Shay Addison1
1Forensic & Clinical Psychology Centre, Brisbane, Australia
Biography:
Dr Lars Madsen is a Clinical and Forensic Psychologist with experience working with high-risk offenders in correctional, forensic mental health, and private practice settings. He is an Advanced Accredited Schema Therapist, Supervisor, and Trainer (ISST-recognised) and Clinical Director of the Forensic and Clinical Psychology Centre. Lars specialises in the application of schema therapy to forensic populations, particularly personality disorder, institutional violence, and risk assessment. He provides expert evidence to the courts, delivers training and supervision across Australia, New Zealand, Singapore, and Hong Kong, and co-hosts the podcast Beyond the Crime: A Psychological Analysis.
Abstract:
This paper presents findings from an aggregate-level qualitative analysis of de-identified forensic psychological reports examining violence in secure correctional settings. Using Bernstein's schema mode model with forensic adaptations, three distinct pathways to institutional violence were identified through hybrid directed content analysis.
The Reactive / Vulnerability-Driven pathway was characterised by rapid activation of the Vulnerable Child mode, typically triggered by perceived disrespectful treatment or loss of autonomy, followed by Angry Child or Angry Protector modes resulting in explosive or retaliatory violence. The Instrumental / Status-Control pathway was dominated by Bully and Attack and Detached Overcontroller modes, with violence serving functions of status maintenance, dominance, or retribution. A third Mentally Ill / Psychosis-Driven pathway emerged in which severe mental illness, particularly schizophrenia-spectrum disorders, was the primary driver of violence, with schema mode dynamics complicated or secondary to psychotic symptoms, thought disorder, or command hallucinations.
The three pathways demonstrated clear differentiation in offender characteristics, including age, psychopathy, personality disorder profiles, trauma histories, and substance use. Schema mode analysis provided explanatory value by illuminating the psychological sequences linking pre-existing schemas to specific institutional triggers and violent behaviour.
Findings support the integration of forensic schema therapy frameworks into formulation, violence prevention, and training in secure environments. This study involved secondary analysis of de-identified, aggregate-level data from existing psychological reports. No individual offenders are identifiable. The research was conducted in accordance with the National Statement on Ethical Conduct in Human Research.