This chapter considers treatment of those with ASPD from the perspective of (1) higher levels of integration of the personality than in previous chapter and (2) managing clients at the more severe end of the ASPD spectrum (i.e., those with violent behaviour detained within secure settings). In respect of item (1) we make specific reference to and describe the phases of exploration and integration in Livesley’s Integrated Modular Treatment. As this requires an emotional maturation in the client (as compared with the establishment of emotional stability in Chapter 6), extra demands are placed on both client and therapist. In the latter case, the ‘fit’ between therapist and therapy is explored. As regards managing those with violent behaviour (including those with psychopathic traits), the principles of the two major criminological interventions (i.e., risk-needs-responsivity [RNR] and the Good Lives Model [GLM]) are compared and contrasted. There is a discussion on those who may be beyond treatment and where interventions can actually lead to harm. Finally, the differences between a forensic case formulation and a case formulation are discussed, with the former focusing on the risk that the individual may pose.