Lecture 8- offender treatment

Question 1

who was the first person to critique offender treatment

Answer 1

• Martinson (1974) – ‘therapeutic nihilism’ and ‘despair’ leading to doctrine that ‘Nothing Works’

Question 2

what were the implications of martinsons write up ‘nothing works’

Answer 2

• Martinson (1974) – ‘therapeutic nihilism’ and ‘despair’ leading to doctrine that ‘Nothing Works’
  o Issue = thernilhism= removal of treatment of offenders due to this article
  o What martison intended to say what that something’s (treatment modalities) work for some peole (responsivity due to how much they want and need it etc)

Question 3

when and by who decided that martinsons critical paper was misinterpreted

Answer 3

• 1980’s ‘Nothing Works’ position heralded as a misinterpretation or misrepresentation of the evidence (McGuire 2010)

Question 4

what does RNR stand for

Answer 4

risk need responsivity model

–> a treatment modality model

Question 5

When did the RNR model get regarded as the premier model

Answer 5

• 1990’s Risk-Need-Responsivity (Andrews, Bonta & Wormith, 2011) heralded as the premier model
  o RNR= treatment modality model
   Primary model for over 30 years

Question 6

what model has now overtaken the RNR model

Answer 6

the good lives model

Question 7

who created the GL model and why

Answer 7

– Good Lives Model of Tony Ward & colleagues on the ascendency, supported by research on Desistence from the field of Criminology.

Question 8

what type of people commit offenses

Answer 8

• A diverse group

Question 9

why do we need an individualised treatment programme for offenders

Answer 9

because a diverse group of people commit offences- no 2 people the same
- End of a long causal chain, involving complex interactions between social, biological, behavoiural, affective and cognitive processes
o Biosocial model

Question 10

is offending dynamic or static

Answer 10

offending exists in a dynamic state, fluid within the offender and fluid within the context it occurs within and resulting from the interaction of the two
o Not static

Question 11

what are the implications of offenders being so dynamic

Answer 11

• Therefore requires individual formulation to lead to personally tailored treatment focus and targets
  o Without good assessment wont have a formulation
   Formulation = dynamic non-static (can change , only consistent at the one moment of time )
  o Synthesise information from individuals and collateral info
   Eg precipitating factors (proximal/ disitmal) + maintaining factors

Question 12

what type of factors affect people who commit offenses

Answer 12

precipitating factors (proximal/ disitmal) + maintaining factors

Question 13

what does the formulation of a treatment consist of

Answer 13

 Formulation = dynamic non-static (can change , only consistent at the one moment of time )
o Synthesise information from individuals and collateral info
 Eg precipitating factors (proximal/ disitmal) + maintaining factors

Question 14

who influences the rehab agender

Answer 14

• Social agendas
• Political agendas
• Treatment agencies from the forensic area
• Evidence from other disciplines/philosophical positions

Question 15

give an example of how the socio-political climate affects treatment of offenders

Answer 15

o NHS practtioners also don’t have the background in substance misuse (as its not treated on the NHS) socio-political climate affects how we practise
o Therefore they wont treat an individual with a substance misurse (or dual) diagnosis  but we should be treating co-morbidity together

Question 16

what does the RNR model focus on

Answer 16

• R-N-R – Offence specific targets looking at risk and criminogenic need predominantly
  o Primarily looks @ risk factors

Question 17

what does the RNR model not focus on that it potentially should

Answer 17

• Should treatment targets be wider ranging and encompass the notion of full recovery capital?
• OR
• Are all required for the full and meaningful rehabilitation of offenders
  o May also look at pro-social as just looking at defisits leads to risks that the rehab is not liing up to its potential

Question 18

what did Johan Wolfgang Van Goethe say about offender treatments

Answer 18

• “If you treat an individual as he is, he will stay as he is, but if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be”

Question 19

who created the RNR model

Answer 19

Andrews & Bonta, 1998

Question 20

who created the GL model

Answer 20

(Ward & Stewart, 2003)

Question 21

what model originates from north amrica

Answer 21

RNR

Question 22

what are the therapeutic principles of the RNR model

Answer 22

o Risk Principle - Match level of risk to level of treatment received

o Need Principle – primarily target criminogenic need (dynamic risk factors associated with recidivism that can be changed)
 Look @ specifically offender behaviorus
• But ethics X looking at wider model

o Responsivity Principle – the programmes ability to make sense to those in receipt of it.
 Have adaptations of programmes for pople who have these challenges
• Eg struggle with speaing/ reading  less word based programmes which are focused around pictures as opposed to words

Question 23

what are the strengths of the RNR model

Answer 23

o Empirically supported therapies
o Proven effectiveness and lower recidivism rates (Reduction in reoffending rates in general and sexual offenders of 10-50% ( Andrews & Bonta, 1998; Hanson et al, 2002; Hollin, 1999)

Question 24

when considering the strength that the RNRr model has lowered recidivism- linking this to sexual offending why might this not be the case in the UK

Answer 24

o Proven effectiveness and lower recidivism rates (Reduction in reoffending rates in general and sexual offenders of 10-50% ( Andrews & Bonta, 1998; Hanson et al, 2002; Hollin, 1999)
 This is dependent on which research you look at
• UK research = negative results from the outcome studies of RNR based sex offender treatment programme, and enhanced programme which led to the withdrawal of these treatments
o This is counter to the north American studies which showed up to 50% recidivism (but their treatment given by psychologists)

Question 25

who usually givs out treatment using the RNR model in normal UK prisons

Answer 25

non-psychologists

Question 26

name some issues with the strengths of the RNR model

Answer 26

 Outcome studies disappointing  Problems with implementation • David farrington says that you should actually target people early on so don’t reach high risk  Concerns about both programme quality and programme provision, delivery, fidelity and treatment integrity ( Goggin & Gendreu, 2006; Young, 2010)

Question 27

what are some weaknesses of the RNR model

Answer 27

o Mechanistic  Adhering to manual – no scope to go away from the model as non-psychologists don’t know what to do o Fails to consider contextual factors in both offending and rehabilitation  Only looks at internal risk factors to the individuals o Offender responsivity/Offender motivation lacking attention  Very heavily blaming model  will this erode prisoners motivations to participate  Doesn’t account fo the context that offenders offend in o Sexual Offender Treatment and Evaluation Project (SOTEP) found poor results (Marques et al, 2005). Too structured and limited individualization. o Offenders seen as “disembodied bearers of risk” (Ward et al, 2007) o Fails to provide an integrated and holistic approach o Reductionist approach (does not address the issue of human agency and personal identity) o Ignores importance of human needs and their role in offending behaviour o Does not emphasise the therapeutic relationship and therapist factors and attitudes to offenders o Emphasis on negative or avoidant treatment goals

Question 28

why is the fact that the RNR model is mechanistic problematic

Answer 28

• Programmes are highly manualized , given by non –sychologists (UK) whilst psychologists supervise o Also a concern , when they are given in groups (gb programme) that people bring things to the discussion which aren’t on the programme, which a trained professional could lead to another line of enquiry, but non-psychologists have to stick to the manual, don’t know what to do when goes off script o Programme drift o In N America psychologist run

Question 29

what is the research from the GLM based on

Answer 29

- Empirically and theoretically grounded rehabilitation approach, originating from sex offender treatment field

Question 30

what are the strengths of the GLM

Answer 30

o Widely looks at the broader picture or life goals for the individual - Attention is given more widely to the offenders life than just offence specific behaviours - Promotes the attainment of broader life goals in prosocial ways with the aim of personal fulfillment - Human Rights emphasised with emphasis on respect & dignity o Human rights= key value - Emphasises offender motivation and the role of personal identity, instillation of hope and inculcation of belief in possibility of pro-social, non-criminal identities in the future. o Treats a dynamic for between the individual and the person giving the treatment (this enhances the motivation of both) o Looks at how to achieve their goals in a non-offending what  Work to develop a pro-social identity rather than just no-offending 7  Research shows its hard for offender to have a prosocial identity once out of prison – always identified by their historic risk

Question 31

HOW DOES THE GLM link to achieving human goals

Answer 31

- Good life attained by understanding what is important to client and helping client to obtain these goals - Risk managed by helping client to attain what is important in life - Criminogenic needs = internal or external obstacles that block achieving goods - Risk managed by changing and monitoring known risk factors - Both attained by overcoming obstacles and developing capacity (int. & ext.) o Develop the capacity to attain primary human goals - Offending = pursuit of legitimate goals via inappropriate means o Eg sexual offenders goals = could be not just wanting to pursue a child, but alternatively could be fearful of adults (due to childhood) so easier (safer) to have sex with a child  Attaining intimacy and sex using a child to attain this goal - Offenders, like all human beings, are goal-directed and are predisposed to seek primary human goods - Primary human goods = action, experiences, circumstances, states of being, etc. that all humans seek for their own sake - Secondary goods = concrete ways (means) to secure primary goods

Question 32

what is the aim of treatment in the GLM

Answer 32

o Develop a plan for life (a good life plan) that is meaningful to the individual and that will also manage risk  That is bespoke and meaningful to tat individual o Establish positive approach goals and work toward building skills and external opportunities to attain these

Question 33

what is the aim of supervision in the GLM

Answer 33

o Monitor implementation of good life plan in addition to risk.  Reduces the risk = leads to better quality of life

Question 34

what is a primary human good according to the GLM

Answer 34

things individuals seek to obtain for their own sake

Question 35

how many primary human goods are tehre

Answer 35

11

Question 36

what affects the value we place on each primary human good

Answer 36

- Value or importance placed on various goods determines an individual’s conceptualization of a “good life” and a good life plan - PHG’s weighting reflects core values and identity: parent (relatedness), teacher (community), mechanic (work) etc. o Result of early years/ upbringing - Good life plan = individual roadmap to fulfilling, well-balanced life

Question 37

what are the primary human goods (glm)

Answer 37

- Life – including healthy living and functioning - Knowledge - Excellence in work and play - Excellence in agency (autonomy and self-directedness) - Inner Peace (freedom from emotional turmoil and stress) - Friendship (intimate, romantic and family relationships) - Community - Spirituality - Happiness - Creativity

Question 38

what are the main flaws of the GLM

Answer 38

- GLM proposes that offending, life problems, result from flaws, implementing good life plans - Goal of treatment is to identify and resolve flaws, develop capacity to attain goods ``` 4 main problems = lack of scope means conflict among goals lack of capacity ```

Question 39

expand on the weakness of the GLM called 'means'

Answer 39

 Inappropriate strategies to obtain goods, dynamic risk factors  e.g. Seeking to obtain goods of relationships or pleasure via social/sexual contact with children  e.g. Obtaining personal choice/independence through dominating others  e.g. Meeting needs re: community or relationships via antisocial or pro-criminal peers

Question 40

expand on the weakness of the GLM called 'lack of scope'

Answer 40

 Important goods are not included in the individuals good life plan  E.g., too great focus on sexual pleasure (happiness) with insufficient focus on intimacy, relationships, community  narrow future plans as haven’t had the opportunity to experience a wider life

Question 41

expand on the weakness of the GLM called ' Conflict among goals/goods sought

Answer 41

 Among goals/goods sought • Eg highly valuing intimacy + independence = conflicting as cant have both in a relationship  Between means to obtain goods  Can result in psychological stress and one or neither good being met  E.g., highly values both intimacy and personal choice/independence  E.g., healthy life activities versus socialising with friends • Conflicting as friends are often other criminals, drug users etc

Question 42

expand on the weakness of the GLM called ' Lack of capacity (internal and external).

Answer 42

 Internal and external  Lack of capabilities to implement GL plan  E.g., knowledge, skills to achieve goals  E.g., lack of ability to adapt  E.g., self-regulation deficits, dynamic risk factors  E.g. lack of opportunity (external environment)  Male prisons have a rate of 60-80% with a personality disorder

Question 43

what is the key emotion elicited from treatment of offenders

Answer 43

shame

Question 44

name some reasons why we need to develop a better model about shame

Answer 44

- Same is a common emotion for all of us - It brings people into therapy (Tangney & Dearing, 2014) - It keeps people away from therapy - It can be a barrier when in therapy

Question 45

how is the therapist affected by shame

Answer 45

- The power imbalance between patient and therapist, offering intimacies without reciprocity is to a degree inherently shaming o Reports affect trajectory through prison + offenders are vry aware of this - Shame in the therapist is evident (particularly trainee forensic psychologists) o Feel de-skilled / lost in therapeutic context, fl like they cant help - Shame is ubiquitous in the clinical context

Question 46

what are the 2 main mechanisms created by shame

Answer 46

withdrawal and anger - mainly anger

Question 47

explain the link between rage and shame

Answer 47

- Anger and rage have been found to serve as a cover/mask for shame (Gilligan, 2000) - Anger is seen as a face saving and coping response (Greenberg & Iwakabe, 2014) - Grandiosity and a sense of ‘unique specialness’ also apparent to defend against shame - Offenders rage and potential for rage can lead to therapists avoiding scratching at shame laden experiences (e.g. offending behavior) - Offenders learn that rage is adaptive and functional - Therapists learn that pejorative labelling of potential experiences of shame as denial, minimization, justification, rationalization is more acceptable in a system that seeks to position offenders solely as perpetrators

Question 48

what can result from offenders finding rage after they are shamed

Answer 48

- Rage can often lead to therapist avoiding talking aboutr shame o Wont help reduce the risk of these offenders to the community o Therefore need to find an indirect dialogue which is safe for everyone

Question 49

what happens to the therapist in the GLM

Answer 49

- Weight and impact of hearing many, often abhorrent, narratives, both in the immediacy of hearing and over time - Difficulties in adhering to a treatment model (e.g. remaining respectful and embodying the GLM when listening to victim empathy role-plays) - Highly complex level of understanding and skill required to respond flexibly to this complex client group is challenging to all

Question 50

what is the role of the forensic psychologist in treatment

Answer 50

- Depends very much on treatment model used - Depends on treatment context - Role has evolved and developed over the years - Trainee FP’s may co-facilitate RNR style programmes - Qualified hold Programme Manager and Treatment Manager roles - Other non-psychology staff become group facilitators and supervision falls to FP’s to maintain programme integrity and treatment protocols.