Stephen M. Hudson

Motivational interviewing in health settings: a review

There is evidence that patient-centred approaches to health care consultations may have better outcomes than traditional advice giving, especially when lifestyle change is involved. Motivational interviewing (MI) is a patient-centred approach that is gathering increased interest in health settings. It provides a way of working with patients who may not seem ready to make the behaviour changes that are considered necessary by the health practitioner. The current paper provides an overview of MI, with particular reference to its application to health problems.

Cognitive distortions in sex offenders: an integrative review.

Clinicians and researchers have noted that maladaptive beliefs and distorted thinking play an important role in facilitating or justifying sexual offenses. There have been a number of attempts to describe the nature of these beliefs and to develop ways of measuring them, but in the absence of any integrating theory. We suggest that an understanding of the cognitive processes underlying the initiation, maintenance, and justification of sexual offending is a vital prerequisite to the development of successful treatment programs. In this paper, we use a social cognition framework to review the literature on the role of cognition in sexual offending. Pertinent research in the sexual offending domain, specifically cognitive products, information processing, cognitive change, and the impact of affective and motivational factors on cognitive processes, is described and related to the social cognitive approach. Implications for future research and clinical practice are discussed in light of the major issues and problems highlighted in our review.

Empathy in sex offenders

Abstract Sex offenders are thought to suffer from deficits in their capacity to experience empathy, and this is considered to be important in the development, and particularly the maintenance, of their deviant behaviour. The concept of empathy, however, is confused. A multicomponent staged model of empathy is outlined, and it is suggested that empathy deficits may be more person-specific than has previously been thought. The evidence concerning empathy deficits in sex offenders is considered, and it is concluded that our multicomponent model offers a better way to understand and treat the empathy deficits in these men.

Attachment style in sex offenders: A preliminary study

In the past few decades, a number of theories have been developed to further our understanding of the various aspects of sex offending. Recent work has been focused on the relationship between early interpersonal experiences and the presence of intimacy deficits in sex offenders. Marshall (1989, 1993, in press) developed an etiological model stressing the importance of insecure attachment and intimacy deficits in both the onset and maintenance of sex offending. In this article we used a reformulation of this model, using Bartholomews attachment theory, to carry out a preliminary investigation of the nature of attachment relationships in sex offenders. The participants in this study included child molesters (55), rapists (30), violent non‐sex offenders (32), and non‐violent, non‐sex offenders (30). Their general romantic attachment style was assessed using Bartholomews self‐report scales. Results indicated that the majority of sex offenders were insecurely attached. However, this was true for all four gr...

A Descriptive Model of the Offense Chain for Child Molesters

A grounded theory approach was taken to the qualitative analysis of the descriptions of thoughts and feelings provided by 26 incarcerated child molesters while describing their most recent or typical offense. The resulting descriptive model comprised nine stages, with three contributing factors that describe the sequence of cognitive and behavioral events that form an offense chain. The model incorporates offender type, offense type, and offers a description of the possible interactions between the various stages and factors. The model was then applied to the offense descriptions of an independent sample of 12 incarcerated child molesters in order to ascertain its cross-sample validity and the reliability of classification. The results suggest that the model has provisional validity and adequate interrater reliability. The theoretical, research, and clinical implications of the descriptive model are then discussed.

A Model of the Relapse Process in Sexual Offenders

Models of the relapse process set out to provide a rich description of the cognitive, behavioral, motivational, and contextual factors associated with a sexual offense. Theory at this level typically includes an explicit temporal factor and focuses on proximal causes or the how of sexual offending. Pitherss adaptation of the relapse prevention treatment model to sexual offenders is based on a particular view of the relapse process. In this approach, relapse is essentially caused by an inability to cope effectively with high-risk situations. Although this influential perspective has contributed greatly to the treatment of sexual offenders, it suffers from a number of conceptual and empirical problems. In this article, we present a self-regulation model of the relapse process that addresses these problems and accounts for the diversity of relapse pathways.

An Examination of Intimacy and Loneliness in Sex Offenders

Two studies are reported examining intimacy and loneliness in sex offenders and various control subjects. Sex offenders were both more lonely and deficient in intimacy than other offenders and community controls. Intimacy seemed to be the most important deficit among the sex offenders with the rapists and child molesters being the most deficient. The results are discussed in terms of their relevance for theory and clinical practice.

Attachment Style and Intimacy Deficits in Sexual Offenders: A Theoretical Framework

In the past few decades a number of theories have been developed to further our understanding of various aspects of sexual offending. Recent work has focused on the relationship between early interpersonal experiences and the presence of intimacy deficits in sexual offenders. The present paper develops a comprehensive attachment model of intimacy deficits in sexual offenders by drawing extensively upon the burgeoning interface between the attachment literature and social cognition research. In particular, the concept of an internal working model, as developed by Bowlby, is introduced as a bridge between early attachment experience and adult intimacy problems. It is suggested that a comprehensive model of intimacy deficits in relation to the sexual offender must pay attention to attachment style, the internal working model, and current behavioral strategies for gaining or avoiding intimacy. The clinical and research implications of this model are presented and discussed.

Sourcebook of treatment programs for sexual offenders

Adult Male Offenders: Prison Settings: The Twin Rivers Sex Offender Treatment Program A. Gordon, G. Hover. Kia Marama: A Treatment Program for Child Molesters in New Zealand S.M. Hudson. Community Settings: The Faithful Foundation Residential Program for Sexual Offenders H. Eldridge, R. Wyre. Community-Based Treatment with Sexual Offenders A. Eccles, W. Walker. Psychiatric Settings: Working with Sexual Offenders in Psychiatric Settings in England and Wales D. Fisher. The Treatment of Sexually Aggressive Offenders in the Dr. Henri van der Hoeven Kliniek: A Forensic Psychiatric Institute in The Netherlands D. van Beek, J. Mulder. Diverse Populations: An 11-Year Perspective of Working with Female Offenders J.K. Matthews. Adult Intellectually Disabled Sexual Offenders: Program Considerations E. Coleman, J. Haaven. Ethnic Populations: Te Piriti: A Bicultural Model for Treating Child Molesters in Aotearoa/New Zealand J. Larsen, et al. Blending the Traditional with the Contemporary in the Treatment of Aboriginal Sexual Offenders: A Canadian Experience L. Ellerby, J. Stonechild. Conclusions and Future Directions W.l. Marshall, et al. 21 Additional Chapters. Index.

Cognitive Distortions and Affective Deficits in Sex Offenders: A Cognitive Deconstructionist Interpretation1

Sexually aggressive behavior is often facilitated and justified by distorted thinking and affective deficits. However, there is no clear conceptual model that accounts for the mechanisms which generate these phenomena and informs treatment goals. Sex offenders frequently demonstrate a number of underexplained features such as denial or minimization of offending, victim blaming, passivity, covert planning, dependence on immediate consequences, empathy and other emotional regulation deficits, intimacy and other social competency deficits, and, finally, alcohol and other drug problems. These features are usually seen as offense precursors. We argue that Baumeisters construct of cognitive deconstruction, the process by which people attempt to reduce the negative implications of self-awareness, provides both a middle-level theoretical explanatory framework that integrates these puzzles in a parsimonious way and a mechanism that suggests that these features may be consequences of, as well as precursors to, an offense. Suggestions for research and clinical practice are offered.