The effectiveness of psychological interventions for adults who set fires: A systematic review

Firesetting is an international public health concern with significant consequences for individuals and society. However, the adult firesetting literature is limited, especially for treatment provision. PsycINFO, EMBASE, MEDLINE Complete, PsycArticles, Web of Science, Scopus, ProQuest Central, and CINAHL were searched for peer-reviewed quantitative studies considering psychological interventions targeting deliberate firesetting in adults and subject to a narrative synthesis. Of the 4542 identified studies, 14 (n = 343 firesetters) met the broad inclusion criteria. Most studies comprised single-case or small-scale evaluations with highly selected samples, heterogeneous needs, and methodological limitations (e.g., lacking experimental control or reliable evaluation methods). Cognitive behaviour therapy (CBT) in a group format is currently the most evaluated intervention in UK secure living environments. High-quality studies showed that CBT group-based interventions improved firesetting-specific outcomes (i.e., problematic interest and associations with fire) and psychological vulnerabilities associated with firesetting (e.g., anger expression or offence-supporting attitudes) among prisoners and mental health inpatients. The paucity of high-quality evaluation studies and the considerable heterogeneity of the available study designs make it difficult to compare the existing interventions and draw reliable conclusions about what works for whom. Larger prospective longitudinal studies are needed internationally with multi-site designs, follow-up recidivism data in the community, and control groups to determine whether these interventions can effectively reduce firesetting risk.