Devon L. L. Polaschek

Assessing Relationship Quality in Mandated Community Treatment: Blending Care With Control

Traditional measures of the therapeutic alliance do not capture the dual roles inherent in relationships with involuntary clients. Providers not only care for, but also have control over, involuntary clients. In 2 studies of probationers mandated to psychiatric treatment (n=90; n=322), the authors developed and validated the revised Dual-Role Relationships Inventory (DRI-R). The authors found that (a) relationship quality in mandated treatment involves caring and fairness, trust, and an authoritative (not authoritarian) style, (b) the DRI-R assesses these domains of relationship quality, is internally consistent, and relates in a theoretically coherent pattern with ratings of within-session behavior and with measures of the therapeutic alliance, relationship satisfaction, symptoms, and treatment motivation, and (c) the quality of dual-role relationships predicts future compliance with the rules, as assessed by probation violations and revocation. The DRI-R covaries with multiple domains more strongly than a leading measure of the therapeutic alliance, suggesting that it better captures the nature and effect of relationship quality in mandated treatment.

The implicit theories of potential rapists: What our questionnaires tell us

Theories of rape give some prominence to the role of offense-supportive cognitive processes and attitudes. Yet, research on the relationship between cognition and rape has produced a confusing picture. Numerous methodological issues are no doubt contributing to this confusion. However, in this article, we argue that another major contributor is the lack of attention given to the underlying mechanisms responsible for generating rape-supportive beliefs. Firstly, we review the relevant cognitive research on rapists and rape-prone men. Then, we present psychological research on implicit theories, and on the nature of conceptual representation, development, and change. We apply this implicit theory perspective to existing scales that measure rape-related distorted cognitions, and derive some core theories from the scale items. We describe these theories, giving examples of items that support them. Finally, we discuss the clinical and research implications of the implicit theories we have identified.

Imagination and Memory

A growing body of literature shows that imagining contrary-to-truth experiences can change memory. Recent experiments are reviewed to show that when people think about or imagine a false event, entire false memories can be implanted. Imagination inflation can occur even when there is no overt social pressure, and when hypothetical events are imagined only briefly. Overall, studies of imagination inflation show that imagining a counter-factual event can make subjects more confident that it actually occurred. We discuss possible mechanisms for imagination inflation and find that, with evidence supporting the involvement of both source confusion and familiarity in creating inflation, the primary mechanism is still to be determined. We briefly review evidence on individual differences in susceptibility to inflation. Finally, the widespread use of imagination-based techniques in self-help and clinical contexts suggests that there may be practical implications when imagination is used as a therapeutic tool.

Rapists' Offense Processes A Preliminary Descriptive Model

Models of the offense process set out to provide a description of the cognitive, behavioral, motivational, and contextual factors associated with a particular type of offense. They model the temporal relationships between the variables of interest and focus explicitly on the proximal causes or the how of offending. In this study, qualitative analysis was used to develop a descriptive model of the offense process for 24 adult rapists. Sentenced offenders provided detailed retrospective descriptions of their thoughts, emotions, and behavior prior to and during their most recent rape. These descriptions were analyzed using a grounded-theory approach. The resulting preliminary model contained the following six phases: background factors to the offense, goal formation, approach behavior, offense preparation, the offense, and postoffense behavior. These stages are discussed along with the models theoretical, research, and clinical implications. The model is consistent with existing multivariate theories of rape and has clear taxonomic potential.

Rape and rapists: Theory and treatment

The sexual assault of adult women is noteworthy by its huge social and personal cost to the victims, their families, and ultimately society as a whole. The past decade has seen burgeoning research and clinical interest regarding child molesters but a lack of equivalent effort concerning rapists. Rapists are significantly different from child molesters. While considerable heterogeneity exists within this group, there is a lack of distinctiveness when compared to the wider population of serious criminal offenders. These two features of rapists have implications both for research and treatment. We also argue that despite the advances of the last decade this has been in terms of theory proliferation rather than integration, and that major explanatory gaps remain. In particular, there is a need for more middle-level theory that articulates mechanisms and can underpin treatment. Current treatment approaches have typically been developed for child molesters, and while there has been a significant increase in comprehensiveness and sophistication, the evidence for treatment efficacy with rapists remains tentative. Treatment programs need to be tailored to the specific needs of rapists and to the issues of treatment engagement and completion. We conclude with a variety of suggestions for the research agenda over the next decade.

Linking Violent Thinking Implicit Theory-Based Research with Violent Offenders

Violent offenders often articulate offense-supportive cognitions during rehabilitation, yet these statements have received little theoretical attention, and intervention approaches have targeted each type of statement individually, as if they were unrelated. An implicit theory approach to cognitions has proved fruitful for research and intervention. The authors apply it to violent offenders. The first study presents a grounded theory investigation of offense-supportive cognition in prisoners attending an intensive rehabilitation program for violent offenders. Analysis of offense transcripts enabled the identification of several implicit theories. These results were refined with a second sample and trialed in the rehabilitation program. Findings suggest that several implicit theories held by violent offenders are linked to each other through the widespread normalization of violence. Few offenders experienced their violent behavior as abnormal, or completely outside of their control, once initiated. The authors make suggestions for enhancing the empirical status of this research domain, particularly through experimental investigations.

Cognitive-Behavioral Rehabilitation for High-Risk Violent Offenders An Outcome Evaluation of the Violence Prevention Unit

Rehabilitation programs for adult violent offending are still novel, and few published studies examine the recidivism outcomes of those who complete such programs. This study describes a New Zealand prison program for high-risk violent men. The program is intensive and cognitive behavioral. Preliminary outcome data are presented for three indices during2 or more years of follow-up: nonviolentre conviction, violent reconviction, and subsequent imprisonment. In comparison with untreated offenders, treated men were less likely to be reconvicted of a violent offense, and those who were took longer to fail. There was also a 12% difference in favor of the treated men on the two other indices, nonviolent reconviction and reimprisonment. The authors conclude that the program shows early promise and that further evaluation with a larger sample of treated men will be important in clarifying whether the program is having a differential impact on violent versus nonviolent offending.!

Rehabilitating serious violent adult offenders: an empirical and theoretical stocktake

Extensive meta-analyses of the correctional programme evaluation literature have generated developments in the technology of programme design. However, the risk, need and responsivity principles do not constitute a rehabilitation theory and cannot answer specialist offender programme design questions. After more than a decade of involvement in programmes for seriously violent offenders, we decided to reassess the empirical evidence underpinning violence rehabilitation in adult men. We focused on both mixed and violent offender samples, reviewing the outcome data from nine evaluations of cognitive–behavioural interventions. Despite a plethora of methodological difficulties, it appears that most of the programmes had small to large effects on violent and non-violent recidivism. Little could be concluded from these evaluations about the most promising theoretical framework for future programme development. Most programmes contained only scant information on their underlying theory base. None referred to multivariate aggression or crime theories. We conclude that there is a pressing need for additional evaluative research, and theory development. To date, the case for specialist violent offending programmes has not been made.

A brief motivational interviewing intervention with prisoners: when you lead a horse to water, can it drink for itself?

Offenders’ readiness to engage in changes that will reduce their risk of reoffending is now recognized to be as important as the design and delivery of programmes that support such change. Interest is growing in both how to increase engagement in change processes, and how to measure any improvements in engagement. This study evaluated the effects of a brief offending-focused motivational interviewing (MI) intervention on reconviction in male prisoners serving sentences for diverse crimes. Men who undertook MI were significantly less likely to be reconvicted than those who did not. The results also served to validate a stage-based measure of readiness to change derived from Prochaska and DiClementes Transtheoretical Model. Prisoners who were offered MI increased their readiness to change by an average of one stage, while the scores of men who were not remained unchanged. Furthermore – whether men undertook MI or not – change in stage of change predicted reconviction. This was a high-risk sample, making the results intriguing for at least two reasons. First, reductions in recidivism are usually achieved only with much more intensive programmes for high-risk men. Second, according to ‘traditional’ cognitive–behavioural rehabilitation theory, programmes need to target change in dynamic risk factors directly to reduce reconviction risk. That these results were obtained with men whose initial motivation was low, and in the absence of any ‘traditional’ criminogenic rehabilitation, raises questions about whether there is more than one mechanism involved in desistance.

High-Intensity Rehabilitation for Violent Offenders in New Zealand: Reconviction Outcomes for High- and Medium-Risk Prisoners

As the empirical evidence accumulates, so does confidence that carefully designed and delivered rehabilitation approaches can reduce risk. Yet little is known about how to rehabilitate some specialized groups, such as high-risk violent offenders: career criminals with an extensive history of violent behavior. Since 1998, New Zealand’s Rimutaka Violence Prevention Unit (RPVU) has provided intensive cognitive-behavioral rehabilitation to violent men. In this evaluation, 112 medium- and high-risk prisoners who entered the program after 1998 are case matched to 112 untreated men. Reconviction outcome data over an average of 3.5 years postrelease show that 10% to 12% fewer program completers were reconvicted for violence compared to their untreated controls. High-risk completers also are less likely to be reconvicted for any offense. Those men who opted out of the study are a slightly higher-risk group than those who completed it, but noncompletion does not further increase their risk. Given the lack of program theory, and formidable practical challenges involved in working with such a high-risk group, these results are very promising.