Building the evidence base for assessments and treatment planning with adults who have set fires

Adult-perpetrated deliberate firesetting is a prevalent problem with devastating consequences for wider society. Therefore, the accurate assessment and effective treatment of adults who have set fires is of paramount importance. The overall aim of this thesis was to address gaps in the existing literature to enable clinicians to engage in evidence-based assessments and treatment planning when working with adults who have set fires. Study 1 established, meta-analytically, untreated base rates of reoffending to facilitate clinicians' engagement in more defensible decision making when undertaking risk assessments. These base rates highlighted that repeat firesetting is a significant issue, with 1 in 5 individuals with a history of deliberate firesetting setting further fires. This study also found that individuals with a history of firesetting had five times greater odds of setting further fires than individuals with no known history. Together, these findings highlight the need for specialised firesetting assessments and treatments, particularly for adults who have set fires. In order to ensure such treatments are appropriately tailored, Study 2 undertook a theoretically informed approach to the examination of psychological vulnerabilities associated with multiple firesetting. This study highlighted identification with fire, anger-related cognition and arousal, antisocial attitudes, and impulsivity as potential dynamic risk factors, while also highlighting wider offending and a history of setting cell fires as possible risk markers. Studies 3 and 4 explored the potential to use Virtual Reality (VR) in the assessment and treatment of adult-perpetrated deliberate firesetting. Specifically, Study 3 examined clinicians' perceptions of VR use in this context and identified ways in which VR can improve current assessment and treatment protocols, as well as highlighting barriers that would inhibit wider implementation of the technology. Study 4 constituted a pilot study of the viability of using VR for the assessment of inappropriate fire interest with hospitalised adults. Overall, the findings of this thesis aim to enable clinicians to make better informed decisions when working with adults who have set fires and provide direction for further research in this area.