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Understanding Female Offenders: An invaluable resource to those who assess, manage, or treat, enigmatic and dangerous women

By: , Posted on: April 22, 2021

Because of their uniqueness, female offenders are understudied. Understanding their dynamics and behaviors is essential as they have proven themselves capable of committing every type of offense including violent and murderous ones. The 1800’s New Orleans Socialite Marie Delphine Macarty notoriously tortured and killed slaves in her Royal Street Mansion. The Angel Makers of Nagyre´v poisoned around 300 victims in Hungary in the early 1900s. American nurse Kristen Gilbert, the Angle of Death, was convicted of four murders and two attempted murders of patients. Lisa Montgomery fatally strangled a pregnant woman, cut open her body, and kidnapped her baby. Mother, Krystle Villanueva received a life sentence for stabbing and beheading her 5-year-old daughter.  Women are quite capable of committing the most horrendous acts, and like men, they are placed on death row and executed.

Our work with female offenders and female psychopaths evolved over five decades with Carl B. Gacono’s work in the 1980s, Ted B. Cunliffe’s in the 1990s, and Jason M. Smith’s in the 2000s. Our clinical observations and theories, put to the test of scientific rigor, has culminated in Understanding Female Offenders: Psychopathy, Criminal Behavior, Assessment, and Treatment (9780128233726). It marks a ten-plus year endeavor finishing the work began with Carl B. Gacono and J. Reid Meloy’s (1994) The Rorschach Assessment of Aggressive and Psychopathic Personalities.

As scientist-practitioners our opinions are guided by theory, supported by observation, and tested by statistical methods. This makes this text one that can be used to guide one’s practice.

Each chapter can also be considered its own resource. Chapter 1 presents the template for understanding our research while highlighting important issues facing the practicing clinician. For a limited time, you can access this chapter for free on ScienceDirect. Chapter 2 provides an understanding of bias present in clinical psychology which have moved the profession closer to pseudo-science. In what other field does one study the gorillas by visiting them in the zoo rather than living with them in their natural habitat? This is akin to the academic research that fails to include direct observation of behavior which negates its inclusion within the scientific method. Psychopathy and the Rorschach are used as examples to provide clinicians and researchers strategies for evaluating research. Chapter 3 provides an in-depth look at the psychodynamics, motivations, and behaviors of female offenders. Theory, clinical observations and PCL-R, Rorschach, and PAI data converge to provide an empirically sound model for the female’s criminal mind (PCL-R, PAI, and Rorschach data for 337 women are presented). Chapter 4 discusses essential issues in the assessment of these women, providing clues in the subtle differences between male and female psychopaths, along with case examples. Chapter 5 explores the female sex offender, a rarely studied population, providing insights into the motivations for their behaviors (two case studies provided). Finally, Chapter 6, presents guidelines for the use of assessment in determining needs and providing competent treatment. The Epilogue presents challenges to our work with these difficult patients and offers encouragement to those who brave the task. Appendices A & B provide a modified PCL-R clinical interview with these women (Gacono, 2000, 2005) and eight descriptions of traits of these psychopathic women respectively.

As scientist-practitioners we rely on three sources for shaping our theoretical contributions and informing our clinical work. First, we are conversant in theoretical and conceptual writings related to psychopathy and personality development. Second, our clinical experience (assessment, providing treatment, etc.) provides an experiential component to theory through interacting with offenders, antisocial women, and psychopathic ones (see Chapters 3-6). This second component can be contrasted with approaches that rely on a purely academic understanding of concepts (Chapter 2). The direct experience of “theory in action” enhances the understanding of theory and concepts and eliminates the “armchair” quality found in much of the academically based research.

Understanding Female Offenders: Psychopathy, Criminal Behavior, Assessment, and Treatment represents a landmark book that, due to its breadth and usefulness will truly stand the test of time. An invaluable resource to those who assess, manage, or treat, these enigmatic, sometimes dangerous women, it can clarify essential issues and guide their applied work. For the attorney it will aid with case preparation understanding the issues that need to be addressed when female psychopathy is raised as an issue in court. The administrator should find the information contained within this volume a valued supplement when considering institutional policy. The researcher will find important suggestions for capturing the uniqueness of these women throughout the text (see Appendices A & B).

Ready to read this book?

Understanding Female Offenders: Psychopathy, Criminal Behavior, Assessment, and Treatment is available to read on ScienceDirect. Or purchase your own copy on the Elsevier bookstore and save 30% + get free shipping with promo code STC30.

About the authors

Ted B. Cunliffe, PhD, is a Clinical and Forensic Psychologist licensed to practice in the State of Florida, and over the past 6 years, he has been in fulltime private practice and provided expert witness services in various jurisdictions and courts within Florida and beyond ( He has provided assessment services and worked with forensic populations in a wide variety of settings including juvenile detention centers, adult prisons, juvenile probation, and outreach programs in the community for over 30 years. Specifically, he has served as a Staff Psychologist and Mental Health Director at a wide number of correctional facilities in Florida, California, and Canada. Further, he has provided expert witness services to the Florida, California, and Virginia courts in the areas of Competency to Stand Trial, Not Guilty by Reason of Insanity, Dangerousness, Death Penalty, Wrongful Death, Dependency, Mitigation, and Civil Litigation. His clinical and research interests include the forensic use of the Psychopathy Checklist-Revised, the Rorschach inkblot test, trauma-related disorders in a forensic context, domestic violence, stalking, criminal decision-making, dangerousness/violence risk assessment, and criminal recidivism.

Carl B. Gacono, PhD, ABAP, was the Assessment Center Director at Atascadero State Hospital (CA) and the Chief Psychologist at the Federal Correctional Institution (Bastrop, TX), having worked over 20 years in correctional and forensic psychiatric facilities. He is the coauthor of The Rorschach Assessment of Aggressive and Psychopathic Personalities, senior editor of the Handbook of Forensic Rorschach Assessment, author of The Clinical and Forensic Interview Schedule for The Hare Psychopathy Checklist: Revised and Screening Version, editor of the Clinical and Forensic Assessment of Psychopathy: A Practitioner’s Guide (first and second editions), and author or coauthor of more than 100 scientific articles and book chapters ( He received the Samuel J. and Anne G. Beck Award (1984) for excellence in early career research and the Walter G. Klopfer Award (2000). He is a member of the American Board of Assessment Psychology (ABAP) and a Fellow of the Society for Personality Assessment. As a noted artist, Dr. Gacono exhibits his paintings ( and and he has had several displayed on book covers including this one. Currently, Dr. Gacono maintains a consulting practice in Asheville, NC, where he lives with his son, Jackson. Visit for our webinar trainings starting Summer 2021.

Jason M. Smith, PsyD, ABPP, has worked in county jails, forensic private practices, and forensic hospitals. He completed an internship in the Kentucky Department of Corrections focusing on assessing, treating, and researching incarcerated offenders (mainly women). Since 2014, he has worked as a licensed Clinical Psychologist (currently Chief Psychologist) for US female correctional facility where he has continued treating, assessing, and managing incarcerated women. With his coauthors, he has published on female offenders/psychopathy as well as theoretical Rorschach articles ( He is on the Board of Assessors for Rorschachiana, and he has received board certification from the American Board of Professional Psychology (ABPP) in Clinical Psychology. Dr. Smith has presented his research and workshops on assessing and treating female offenders both nationally and internationally. Dr. Smith was awarded the APA Division 18 Criminal Justice Section Outstanding Dissertation Award (2014) and the SPA John E. Exner Scholar Award (2019). Visit for our webinar trainings starting Summer 2021.

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