Firesetting in secure settings: theory, treatment and management

This chapter briefly reviews the epidemiology of firesetting, its relationship with mental disorder and the prevalence of firesetting among particular patient groups who may be resident in secure care. We then describe established theories of firesetting including motivational typologies, single-factor theories and previous attempts at multifactor theories. We then present a newly developed multi-trajectory theory of adult firesetting (M-TTAF; Gannon et al, 2012a). This theory is important because it proposes different motivational drivers and prominent risk factors for firesetting across various groups, many of whom may be characterised by particular psychopathological features common in secure settings. The implication is that different groups will hold different risk factors and require varying therapeutic approaches. Some psychological treatment interventions delivered in secure settings are then examined. Finally, we discuss aspects of practical risk assessment and management of firesetters in the secure environment.