February 28, 2011

Positive approach key to sex offender change

Trailblazing authors have walked the walk for 40 years

John distorts his offense history and refuses to accept his sexual deviance. Although the other members of his treatment group vigorously challenge him, they are not fully transparent in their own disclosures. The therapist feels stymied. What should she do?

First, she should abandon confrontation and negative labeling. Next, she should race lickety-split for her computer and order a radical new book that will help her succeed as a therapist and also feel better about herself.

The visionary book is Rehabilitating Sexual Offenders: A Strength-Based Approach, written by the team at Rockwood Psychological Services in Canada. Under the leadership of Bill Marshall, a pioneer in the field, the program has successfully treated sex offenders for 40 years. Unlike most sex offender treatment programs, Rockwood has a negligible refusal rate and a negligible dropout rate. Offenders enter therapy, they complete therapy, and when they get out they are very unlikely to reoffend.

Therapist is the key

As psychologists know from the general treatment research, the therapeutic alliance is a primary factor in successful therapy, with more impact than any specific theory or technique. With sex offenders, who are often mistrustful and reluctant to enter therapy or disclose information that may be used against them, the therapist is even more critical, accounting for between 30% to 60% of change.

Like anyone else (only more so), John isn’t going to benefit from confrontation or shaming. Instead of being critical or judgmental, an effective sex offender therapist is empathetic, warm, respectful, and even humorous at times.

Toss out those iatrogenic labels

Language is powerful. When we call people names -- pedophile, rapist, offender, sex offender, deviant – we encourage their negative and harmful beliefs about themselves. That certainly doesn’t reduce shame or foster change.

Instead, the Rockwood authors (Bill Marshall, his son Liam Marshall, Geris Serran, and Matt O’Brien) focus on strengths, invoking a vocabulary heavily influenced by the positive psychology movement and motivational interviewing.

Their guiding principle:

Inside every offender is a good person waiting to throw off the burden of his dysfunctional past. It is the therapist’s job to facilitate the emergence of that good person.

(Ironically, they do use the term “psychopath,” if only to say that scores on the Psychopathy Checklist  are NOT predictive of treatment failure or recidivism. Of the 70 offenders in their outcome research who scored high on psychopathy, only one reoffended during the 8-year follow-up period.)

The authors do not mince words in critiquing the dominant treatment approach that emphasizes deficits and avoidance. When treatment fails, they say, it is most likely because it was too confrontational. When confronted, patients learn to say what the therapist wants to hear, rather than to genuinely engage.

Denial: Not necessarily a bad thing

One of the most unusual features of the Rockwood program is its emphasis on helping men who continue to deny their offenses despite having been convicted. The therapists do not challenge these offenders to admit their crimes. In fact, they don’t think admissions are that big a deal. They offer several reasons for this:
  • Given what we know from the false-confession literature, some deniers truly are innocent. And it is impossible to know which ones.
  • Forcing an offender to match his account to his victim’s is silly, because we know from research that victim accounts are highly unreliable. 
  • Men who deny offending or offer excuses actually have lower rates of recidivism. As Shadd Maruna found in his research with criminal offenders in the UK, excuse-making is related to good mental health as well as to guilt, which (unlike shame) suggests prosocial values.

For those engaged in treatment, the manual gives loads of practical advice on how to structure and run a program. For forensic evaluators on the outside looking in, who have watched in mounting horror as iatrogenic practices are systematically mislabeled as “treatment,” this book lays out the research that can help you explain real treatment to judges, jurors, and attorneys.

Rehabilitating Sexual Offenders is an auspicious debut for the American Psychological Association series, Psychology, Crime, and Justice, edited by Shadd Maruna. I can’t wait to see what’s next.

If you found this review helpful, please visit my Amazon review (HERE) and click on "yes" (this review was helpful). 

The art on this page is by Ricky Romain, an internationally acclaimed human rights artist in the UK whose work focuses on themes of justice, alienation and sanctuary. Mr. Romain has kindly given permission to showcase his art here. I encourage you to check out his extensive online gallery (HERE).