The Counterterrorism International Conference (CIC) was held recently in Riyadh, concluding that the war on terror had now become a global struggle against violent extremism and that it required not only a robust military confrontation but also an ideological campaign to change the minds and behaviour of those susceptible to recruitment for terrorism. One of the key recommendations of the conference was that an international centre be established under the auspices of the United Nations to develop mechanisms for the exchange of information, technology, training, methods and expertise so that, depending on the circumstances, exchange of information can be achieved either on a multilevel or bilateral basis. A basic recommendation of the conference was that confronting the terrorists was equally as important as trying to find the root causes of terrorism. Serious clinical work to stop terrorists from spreading their misguided ideology and finding a fertile ground for recruitment was applauded. Terrorism is a malignant cancer. No country is immune from its ugly visage. Pakistan needs a comprehensive policy on deradicalisation and counterterrorism strategies. Negotiations are on the table but the negotiators and men on the other side of the table are still in flux. Tactically, dialogue was used by the militants in the past as a tool to regain time to regroup. Amid the fury of all this, Pakistan has announced its counterterrorism policy. The prime minister will oversee the National Counter Terrorism Force (NCTF) with the proposed four-pronged ‘4Ts strategy’, which includes tracing the terrorists, trailing coordination among intelligence agencies, tackling terrorists and transforming the roles of imams, clerics, mosques and religious madrassas (seminaries) in accordance with the true meanings of Islam. At the end of the day, both the problem and the solution emerge from communities and that is where solutions to counter radicalisation may be found. The Swat deradicalisation programme, similar to other worldwide deradicalisation programmes, is similar to the rehabilitation recovery models used regularly in secure forensic hospitals and prison settings, the only difference being that “faith is the main engine of change” as compared to the behavioural modification theme applied to change the attitudes and criminal behaviours of the offenders in forensic hospitals and prisons. A recent visit by Premier Nawaz Sharif and similar visits by former prime minister Yousaf Raza Gillani during his term of office reflect that Pakistan’s government is showing interest or is required to show results from the rehabilitation and reintegration of the militants through the deradicalisation programme, which is in both ways crucial. After reporting encouraging early results that over 2,200 youth have reintegrated, evaluation of “wrap around services” is required to gain system accreditation showing motivation, change in the response of rehabilitated militants and a reduced recidivist rate. The deradicalisation rehabilitation programme operates on a psycho-socio-education model, imparting changes in the altered cognition and beliefs of the radicals through basic education followed by psychological counselling and vocational therapy. Critics would argue that it lacks definition if any well-known and tested specific psychotherapy and risk assessment tools are used during the deradicalisation rehabilitation programme. The ‘risk-needs model’, ‘desistance’, ‘good lives model’ and ‘hybrid interventions’, e.g. Cognitive Behavioural Treatment (CBT) programme delivered within a dedicated deradicalisation programme will help to improve the indicators of effectiveness. Focus on sustaining motivation and belief that change is possible through a cognitive motivational and belief programme has shown good results. Paramount is the ‘wrap around services’, which include organising the continuity of care, resettlement and job opportunities. Families have been involved in the Swat deradicalisation project, which has huge significance, though once again adding family therapy along with militants being only tracked and interviewed would help to make a clinical difference in the outcome and recovery results. As a forensic psychiatrist, I write without any hesitation that this is a commendable effort by the Pakistan army and that the programme has a holistic approach — efforts have also expanded to include the role of a detainee’s family. In addition to the family visiting during the programme and providing post-release support, family members are encouraged to provide input on how to design an individualised programme for each detainee and inform how his progress is evaluated. Clinically, the gradual trial leaves the family to observe how the detainee responds to the community environment, helps assess the individual undergoing rehabilitation and determine whether family members will be capable of supervising him after release. This last step is critical to ensure that the family can help prevent a formerly violent extremist from becoming a threat again; the Swat deradicalisation programme covers this aspect carefully. Though forensic assessment of risk is lacking and it is difficult to implement with scant rehabilitation resources, experts in this field can be invited to support security officials. This would improve the scientific value and potential long-term benefits in this approach, particularly regarding broader efforts to combat radicalisation in our society. Change is not a one off event and is often a ‘zig-zag’ process. Analysis of the impact of a combination of interventions shows it is not just a single programme. Clinically approved methods and logically robust studies like the Randomised Controlled Studies (RCS) of psychometric change in militants attending psychological counselling is scientifically needed to ascertain an international accreditation of the outcome and successful results. The Swat deradicalisation programme is observed by security officials and professionally experienced staff and it is expected that improvements should (but will they?) be translated into success to reduce recidivism. Hardcore radicals have rightly been missed out from the deradicalisation programme but deniers and low risk IQ individuals will also have to be identified to improve the impact of the intervention. Researchers will be pleased to help if the Pakistan government, among others, gave outsiders greater access to its programme’s methods and statistics. (Concluded) The writer is a member of the Diplomate American Board of Medical Psychotherapists Dip.Soc Studies, member Int’l Association of Forensic Criminologists, associate professor Psychiatry and consultant Forensic Psychiatrist at the Huntercombe Group United Kingdom. He can be reached at fawad_shifa@yahoo.com