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Relapse Prevention: A Critical Analysis

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Abstract

In the last decade the application of the relapse prevention (RP) model to both the conceptualization and the treatment of sexual offenders has emerged as an innovative approach. Underlying the treatment utility of this perspective has been a social learning view of the relapse process in addictive behavior. In this paper we critically examine both Marlatt's original RP model and Pithers' application of this perspective to the sexual offending area. After outlining its basic assumptions, we describe the RP model in some detail. Following a critique of Marlatt's theory, we examine the strengths and weaknesses of Pithers' RP approach. Finally, we conclude with some comments on the implications of our critique.

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... This paper critiques Pithers' theory of the relapse process, and outlines a selfregulation model that can address the problems identified in his model. Because of space limitations, only a brief summary of Marlatt's original model is provided to provide the necessary background for the critique (for a systematic critique of Marlatt's model see Ward & Hudson, 1996). has numerous opportunities to resume control over his or her drug taking. ...
... For example, he over-emphasises the role of skill deficits in relapse and ignores the role of conscious decision making in creating opportunities to reoffend (Rohsenow, Niaura, Childress, Abrams, & Monti, 1991). Because of space limitations, only the most significant problems associated with Pithers' model are outlined (for a systematic critique see Ward & Hudson, 1996). ...
Article
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Models of the relapse process set out to provide a rich description of the cognitive, behavioural, motivational and contextual factors associated with a sexual offence. Theory at this level typically includes an explicit temporal factor and focuses on proximal causes or the “how” of sexual offending. Both Marian's original relapse prevention model and Pithers' adaptation of it for sexual offenders are 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. While this influential perspective has contributed greatly to the treatment of sexual offenders, it suffers from a number of conceptual and empirical problems. This paper critiques Pithers' models of the relapse process and presents a self-regulation model that is able to deal with these problems, and account for the diversity of relapse pathways.
... Definic intimity lze v literatuře nalézt vícero a nejsou vždy jednotné, což je odrazem komplexity daného konstruktu a potřeby jej přesněji kon ceptualizovat. Obvykle se ale výzkumníci shodují na tom, že intimita zahrnuje sebeodhalování (self-disclosure), lásku či citový stav (affection), blízkost (closeness) a vzájemnou závislost mezi partnery (interdependence) (Doweny, 2001;Ward & Hudson, 1996in Wood, 2007. Intimní vztahování se k někomu je založeno na pozitivních behaviorálních komponentách, které se netýkají pouze představ, ale mají svůj vnější projev, styl komuni kace, v němž oba partneři zažívají pocit sdíleného významu (Sullivan, 1953;Erik-son, 1963;Firestone & Firestone, 2004). ...
... Though initially highly influential on the field, the RP model has since been subject to challenges and critique in the literature, particularly from Ward and colleagues (e.g. Ward & Hudson, 1996;1998;Ward et al., 1995;see Stinson, 2017 for a summary). Crucially, it was demonstrated by Marques et al. (2005) that RP did not generate reductions in recidivism. ...
Thesis
Research indicates that autistic individuals are no more likely to offend than anyone else in the general population. However, it has been suggested that when autistic individuals do offend, their offending behaviour can be contextualised by their autism. One of the most common forms of offending reported to be committed by autistic individuals are sexual offences, and research has outlined how autism can contribute to those offences. Additionally, recent research has also indicated that autistic prisoners may experience unique challenges and have specific support needs during their prison sentences, which potentially differ from their non-autistic peers. Despite this, little research has specifically explored how to work with, support and manage autistic individuals with sexual offence convictions (ISOCs) in prison-based interventions to address sexual offending. This thesis details an exploratory sequential mixed method approach used to explore effective work practices with autistic ISOCs in prison-based interventions to address sexual offending. Specifically, this thesis explored the following research questions; 'How appropriate are current prison-based sexual offending interventions for autistic ISOCs?' And 'What is best practice when working with autistic ISOCs in prison-based sexual offending interventions?'. To answer these research questions, the thesis sought to: (i) identify challenges associated with prison-based sexual offending interventions for autistic ISOCs; (ii) identify beneficial features of prison-based sexual interventions for autistic ISOCs; and (iii) to generate evidence-based, practical recommendations on how to work with autistic ISOCs in prison-based sexual offending interventions. This thesis is constructed of six chapters. Chapter 1 provides a broad introduction to the topic background and rationale of the thesis, concluding with the overarching research questions and aims. Chapter 2 provides a discussion of the methodological issues that were relevant to the empirical studies of the thesis, including a rationale for the mixed method design. Chapter 3 reports Study 1, which was a qualitative narrative exploration of the life stories of autistic ISOCs (N= 4). This study incorporated an inclusive, participatory autism research approach, and discusses how diversity and similarities in those life stories may be relevant for interventions. Chapter 4 reports Study 2, a multi-perspective qualitative study that utilised a phenomenologically informed thematic analysis to explore the issues surrounding working with autistic ISOCS in prison-based interventions to address sexual offending, from the perspectives of autistic ISOCs (N= 12) and staff (N= 13). Chapter 5 details Study 3, a quantitative study that sought to confirm qualitative findings reported in Chapter 4; relating to the relationships between autistic traits, the prison social climate, mental wellbeing and readiness to 6 engage with interventions in a sample of ISOCs serving prison sentences (N= 177). Finally, Chapter 6 provides a synthesis and general discussion of the collective findings from the empirical studies. Chapter 6 also details practical recommendations for working with autistic ISOCs in prison-based sexual offending interventions, directions for future research, highlights the original contributions of the thesis, considers broader limitations of the research, and offers a final conclusion.
... Selon cette lecture, le sujet est un acteur qui cherche à s'autoréguler en répondant à ses besoins fondamentaux de manière fonctionnelle (Dieu, 2020). L'infraction est alors un moyen pour le sujet de répondre à ses besoins (Ward et Stewart, 2003), à travers diverses trajectoires qui connaissent des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward et Hudson, 1996 ;. Le GLM est une approche qui prend en compte certains aspects du modèle du risque RBR et les approches de la psychologie positive (Harkins et al., 2012). ...
Article
L’hypothèse de base du Good Lives Model (GLM) est que les humains sont des agents intentionnels qui s’efforcent de répondre à leurs besoins dans un environnement particulier. Cette hypothèse, qui insiste dès lors sur les ressources de la personne, son adaptation, ses besoins, en fait un exemple de psychologie positive appliquée à la criminologie réhabilitative. Le GLM est donc par nature un modèle fondé sur l’agency (dit PAM). Mais il est nécessaire d’intégrer les éléments criminogènes du sujet. Les facteurs de risque dynamiques (FRD) sont les concepts les plus utilisés dans le domaine de la criminologie. Ils guident la pratique de manière prédictive en se basant sur les données probantes, et cela est nécessaire. Nous verrons comment le GLM, avec un modèle basé sur l’agency, permet une intégration des facteurs de risque dynamique dans un raisonnement global du cas, de son analyse structurée et de l’accompagnement individualisé.
... Another point is that intimacy is a multidimensional structure. The intimacy of some researchers; While they state that it is a four-structure variable, including self-disclosure, compassion, closeness, and commitment (Downey, 2001;Ward & Hudson, 1996), closeness by some researchers; self-disclosure, activity, sexuality and love (Clark & Reis, 1998;Heller & Wood, 1998;Patrick, Sells, Giordano & Tollerud, 2007). Hartfield and Rapson (1993) and Hook, Gerstein, Detterich, and Gridley (2003) defined romantic intimacy as a four-dimensional structure; self-disclosure, personal affirmation, trust with love and affection. ...
Article
Purpose: The aim of this study is to test, an investigation of the relations between parental bonding with intimacy andauthentic self in mediated by attachment style.Design/Methodology/Approach: Research data have been collected from 1022 university students: 711 females and 311males who were attended in 2013-2014 academic year at Mersin University, Education Faculty. The data related with thepredicted variables romantic intimacy and authentic self have been collected by using “Romantic Intimacy Scale” and “TheAuthenticity Relationship Scale” which have been adopted by researcher; whereas data of predictor variables have beencollected by “Parental Bonding Instrument” and “Experiences in Close Relationships Inventory”. SPSS 20.0 and AMOS 22.0software has been used for statistical analyses of research data. In pursuant to aim of the study, path analysis was used todetermine variables that effect romantic intimacy and authentic self. Signifiance level vas .05 for all analyses.Findings: In this study, first of all a model which relation to effects of styles of humor on attachment styles wassuggested, after that, the most suitable model was favored among alternative models. According to the resultsof analyses, while mother bonding has been presented as a predictor. In line with the findings obtained withinthe scope of the research, suggestions were made to the employees and researchers in the field of application.
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
Book
Chapitre 1 : Introduction aux réflexions de Tony Ward et aux orientations « Good Lives » Chapitre 2 : Les modèles de la désistance et la question temporelle TIM-E en lien avec le GLM Chapitre 3 : L’opérationnalisation du GLM et des réflexions actuelles de Tony Ward Chapitre 4 : Quand la Justice restaurative rencontre le Good Lives Model : contribution à une criminologie de la confiance Chapitre 5 : Violence Sexuelle, le Good Lives Model et la Justice restaurative Chapitre 6 : Le Good Lives Model appliqué à la problématique de la radicalisation : brèves réflexions et illustrations de cas cliniques en Quartier d’Evaluation de la Radicalisation. Chapitre 7 : Programme de Parrainage de Désistance (PPD), un programme de Criminologie positive entre le GLM, la désistance et la Justice Restaurative Chapitre 8 : L’approche des Plans de Vie en Réalité Virtuelle, une alliance entre le GLM et les perspectives temporelles TIM-E Chapitre 9 : L’apport de l’orientation « Good Lives » du programme CéSURE auprès des femmes en détention Chapitre 10 : Penser l’articulation des pratiques pénitentiaire et sanitaire pour un accompagnement global de la personne placée sous main de justice. Chapitre 11 : GLM et EMDR sous l’angle temporel TIM-E en Centre Hospitalier spécialisé sur le Psycho-traumatisme. Chapitre 12 : La dimension éthique dans le choix d’une prise en charge des délinquants sexuels : l’intérêt du Good lives model (GLM)
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... Il n'y aurait pas un seul chemin conduisant à la rechute. Il y aurait plutôt kyrielles trajectoires avec des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward & Hudson, 1996 ;Ward & Hudson, 1998 ;Ward, et al., 1998). Le sujet n'aurait pas nécessairement de déficits émotionnels, il faudrait plutôt considérer qu'il puisse s'orienter volontairement vers l'infraction dans un but de plaisir immédiat (ex. ...
... RP became instantly popular, although again in the absence of relevant evidence, and soon spread across North America as the basis for the treatment of sex offenders [101]. Later criticisms of RP as applied to sex offender treatment [102], and the disappointing results of a carefully designed evaluation [103], led to a call to markedly curtail the deployment of RP [104]. ...
Article
Full-text available
Purpose of review: The goal of this paper is to provide a history of psychological theories, research, and treatment of male sex offenders from the onset of modern approaches that emerged in the 1960s up to the present time. The questions addressed in this paper primarily concern the reasons and justifications for the observed changes. Recent findings: Current conceptualizations of the motivations of sex offenders are quite comprehensive with a central focus on deficits in attachment and coping skills. Research now provides an empirical foundation for the issues to be addressed in treatment and for the manner in which treatment is delivered. Advances in theory and research have brought the field of sex offender treatment to the point where the empirical bases point to a structure that, if followed, seem likely to achieve the goal of reduced recidivism.
... Selon cette lecture, le sujet est un acteur qui cherche à s'autoréguler en répondant à ses besoins fondamentaux de manière fonctionnelle (Dieu, 2020). L'infraction est alors un moyen pour le sujet de répondre à ses besoins (Ward et Stewart, 2003), à travers diverses trajectoires qui connaissent des vécus émotionnels propres, selon que l'individu s'oriente vers la rechute ou au contraire tente d'y faire face (Ward, et al., 1995 ;Ward et Hudson, 1996 ;. Le GLM est une approche qui prend en compte certains aspects du modèle du risque RBR et les approches de la psychologie positive (Harkins et al., 2012). ...
Conference Paper
La prise en charge des personnes placées sous main de justice (PPSMJ) vise à modifier des comportements jugés inadaptés. La notion de changement est fortement liée à la perception de notre capacité à le réaliser. Or, un déficit dans le sentiment d'efficacité personnelle est lié à des rechutes constantes. Prévenir la récidive passe par le développement de sa propre compétence à anticiper les situations de vulnérabilité (Ward, Day, Howells & Birgden, 2004). La création d'un outil spécifique à la prise en charge pénale permettant de mesurer le sentiment d'efficacité personnelle est apparue comme nécessaire afin de cibler les vulnérabilités de la personne et de déterminer les objectifs de prise en charge. La clinique psycho-criminologique, au croisement des modèles Risque-Besoin-Réceptivité et Good Lives Model et des interventions cognitives et comportementales nous ont permis de déterminer deux dimensions constitutives des compétences à acquérir pour la PPSMJ : l'anticipation cognitive et émotionnelle des situations à risque et l'autorégulation comportementale. Les apports de l'outil que nous avons créé seront discutés : mesure de l'efficacité de la thérapie, réalisation d'une analyse fonctionnelle, support de scénario catastrophe ou de réussite pendant la séance (restructuration cognitive ou flèche descendante par exemple). Pouvant être interprété sous un abord criminologique (facteurs de risque/de protection) ou psycho-thérapeutique (anticipation/régulation) son utilisation est aussi envisageable sur une population non judiciarisée.
... RP has been criticized as having a weak theoretical base (Keeling & Rose, 2005; see also Laws, 1999;Ward & Hudson, 1996). RP has not been completely dismissed by the field of sex abuser treatment as it has function as a part of a comprehensive treatment program. ...
Thesis
Full-text available
This dissertation will discuss the research question, “What is the experience of providing therapy to sex abusers?” based on the results of a qualitative case study. A literature review will establish the preceding research related to sex abuse treatment. By filling a gap in previous research, this researcher seeks to encourage sex abuse treatment providers by authenticating their experiences, to provide valuable information to educators, as well as to inform legislators, the judiciary, and the general public about sex abuse treatment. Based on nine transcribed and analyzed interviews with providers of sex abuse treatment to adult male sex abusers who abuse children, this researcher discovered five themes and fourteen patterns within the providers’ experiences. This study augments awareness of the field of sex abuse treatment as articulated by practicing providers.
... Vermeidung von Risikosituationen, alternative Reaktionsweisen). Diese Vorgehensweise wurde in der Folge auch auf die Behandlung von Sexualstraftätern übertragen, wo es ebenfalls darum geht, die einer Tat vorhergehenden Verhaltensweisen und scheinbar irrelevanten Entscheidungen zu identifizieren und Gegenstrategien zu entwickeln (Ward & Hudson, 1996;vgl. unten die Ausführungen zum BPS). ...
Article
Current offender treatment approaches focus on the reconstruction and discussion of the offender’s criminal act, with the goal that the offender should take responsibility for the crime and develop victim empathy. While the analysis of the offense seems necessary for diagnostic and prognostic purposes, its function in terms of risk reduction seems questionable: Neither denial nor failure to take responsibility nor victim empathy are risk factors for recidivism. Further, focusing on the offender’s past and primarily on his negative features can have demotivating or even stigmatizing effects. In addition, discussing offenses in treatment groups could foster detrimental effects in some cases. This paper calls for a better theoretical and empirical foundation of offense-focused treatment approaches, a routine and explicit rationale for an offense-focused approach and its goals in every treatment plan and the development or adaptation of treatment programs for offenders who deny their crimes.
... Ward and his colleagues (Ward & Hudson, 1996;1998; offered a series of critical evaluations of the RP approach. They pointed to its many theoretical faults and problematic treatment implications. ...
Article
This chapter first addresses the problems with punishment-based strategies with sexual offenders in order to demonstrate the inadequacy of this approach and turn to a consideration of more positively based, and demonstrably effective, ways of dealing with the problems these offenders present. Next, it considers the relevance of theories for effective treatment, beginning with a brief survey of target-specific theories followed by a similar examination of theories that encompass all aspects of sexual offending. The attention is then directed at treatment evaluation where it considers the value of the random controlled trial (RCT), the so-called incidental design involving a comparison with an incidentally available group of untreated offenders, and finally the use of risk estimates of expected recidivism as the basis upon which to evaluate treatment-induced reductions in reoffending. This is followed by a brief appraisal of the available outcome literature.
... It is interesting that the first serious challenge to the dominance of cognitive SOS therapy arose indirectly through more recent attacks on its marriage partner, relapse prevention (RP). Both the Self-Regulation Model (Ward & Hudson, 1998) and the Good Lives Model (Ward & Stewart, 2003) have attacked Relapse Prevention for its narrow emphasis on offense abstinence, avoidance goals and faulty presumption of a motivation to change (Yates & Ward, 2009). The Self-Regulation Model exploded the traditional RP notion of a singular offense cycle by showing multiple offense pathways with corresponding self-regulation styles, while the Good Lives Model expanded the focus of treatment to encompass areas of life beyond offending behavior, such as friendship, relatedness, spirituality, self-efficacy, intimacy, purpose and personal meaning. ...
Article
Full-text available
Although cognitive-behavioral therapy (CBT) is touted as the predominant approach in sex offender-specific group treatment, a review of the field shows that the "behavioral" part of CBT has become minimal in relation to that which is cognitive. The authors show how a revitalized "behavioral sensibility" may help to enhance group treatment by focusing greater attention on directly observable behaviors. This clinical practice article presents an array of behaviorally-oriented techniques for conducting groups, beginning with the establishment of an operant group environment that supports behavior change; expanding empirical awareness of events occurring in group; streamlining interventions with non-verbal signals; targeted reinforcement of social interaction and bonding; and more. The article also describes several behavioral techniques designed specifically for sex offender-specific groups, which can enhance self-disclosure, social awareness, self-esteem, empathy, and management of deviant thoughts.
... The Relapse Prevention (RP) model has been the dominant approach to understanding the sexual recidivism and offence processes of sex offenders over the last twenty years and in many instances was used as the organizing therapeutic framework for sexual offender programmes (Laws, 2003, Laws, Hudson, & Ward, 2000Ward & Hudson, 1996). Offence process theories describe the temporal sequence of psychological and situational factors that occur in offending (behavior chain analysis). ...
Article
Full-text available
The field of victimology has become an area of serious scientific enquiry only recently and now attracts a wide range of theories from within multiple disciplines. In this paper the contribution that the science of behavior analysis can make to the conceptualization of the field is explored by investigating what makes people vulnerable to becoming victims or indeed perpetrators of violence and by examining why some people who have experienced violent incidents become victims while others grow to be survivors. A behavior analytic perspective sheds new light on these issues.
... The Relapse Prevention (RP) model has been the dominant approach to understanding the sexual recidivism and offence processes of sex offenders over the last twenty years and in many instances was used as the organizing therapeutic framework for sexual offender programmes (Laws, 2003, Laws, Hudson, & Ward, 2000Ward & Hudson, 1996). Offence process theories describe the temporal sequence of psychological and situational factors that occur in offending (behavior chain analysis). ...
Article
Full-text available
Much has been said about the specific psychological, physical, social, and cultural consequences of years of violent conflict and war, however little is known about the effects of post-ceasefire violence. In this paper, we take the individual case as unit of analysis and consider how two women cope with post-ceasefire violence in Northern Ireland. Quantitative as well as qualitative data show that while, on the surface, these women seem to ‘put on a brave face’, their psychological health is deeply affected by personal circumstances and fluctuating levels of post-ceasefire violence. This micro-level analysis is discussed in relation to the assertion in previous psychological literature that coping with the conflict in Northern Ireland was predominantly based on resilience, avoidance, and denial (Cairns & Wilson, 1984). Findings are discussed from a behaviour analytic view.
... The Relapse Prevention (RP) model has been the dominant approach to understanding the sexual recidivism and offence processes of sex offenders over the last twenty years and in many instances was used as the organizing therapeutic framework for sexual offender programmes (Laws, 2003, Laws, Hudson, & Ward, 2000Ward & Hudson, 1996). Offence process theories describe the temporal sequence of psychological and situational factors that occur in offending (behavior chain analysis). ...
Article
Full-text available
The assessment of sexual offenders consists of the systematic collection of clinically relevant information in order to detect clinical phenomena or problems and to provide clear treatment targets. The result of this process is a conceptual model, or case formulation, representing the client’s various problems, the hypothesized underlying mechanisms, and their interrelationships. The focus of this article is on the importance of psychological assessment and case formulation in the rehabilitation and management of individuals convicted of sexual offences. First, we make a number of general points about the importance of evidence based assessment and clinical reasoning in case formulation. Second, we review key elements of contemporary sexual offender theory that highlights the heterogeneity evident among sex offenders and the implications for case formulation and treatment planning. Third, we discuss the role of case formulation for risk assessment and management. Finally, we illustrate our major points with a brief case study and conclude with a brief consideration of the value of case formulations.<br /
... The Relapse Prevention (RP) model has been the dominant approach to understanding the sexual recidivism and offence processes of sex offenders over the last twenty years and in many instances was used as the organizing therapeutic framework for sexual offender programmes (Laws, 2003, Laws, Hudson, & Ward, 2000Ward & Hudson, 1996). Offence process theories describe the temporal sequence of psychological and situational factors that occur in offending (behavior chain analysis). ...
Article
The assessment of adolescents and children who commit sexually abusive behavior is a complex and challenging task. Incorporating empirically based assessment methods into psychosexual evaluations promises appropriate coverage of relevant domains, sound interpretation of the meaning of data, reduced clinician biases and error, and greater certainty in decision-making. In this paper we review empirically-based assessment methods currently available for use in psychosexual assessment of adolescents and children who sexually abuse others. Our review describes the robustness of these measures and provides guidance for their appropriate use in assessment. The review highlighted that several empirically-based measures are suitable for clinical use with adolescents, but very little is available to guide assessment of children's abusive behavior per se.
Chapter
The chapter seeks to demonstrate and describe, from a critical perspective, the most widespread treatment models and programs for sex offenders in prison, opting for integrated approach based on risk assessment and the evaluation of their psychological and social characteristics. Furthermore, specifying factors that can affect the success of the treatment leads to the conclusion that sex offenders require the implementation of differentiated programs focused on their personal characteristics and needs. The reduction of recidivism is indicated as a criterion with which to assess the effectiveness of the programs, although the results achieved in research on the matter do not always agree and do not always confirm a reduction in repeat offenses in the subjects undergoing treatment. The chapter concludes by calling for greater program development and more precise methodological accuracy in verifying the results.
Article
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Mean-making is a very complex process, involving social, moral and psychological aspects. When it comes to trauma or crimes, the ability to "make sense" of the events and to find meaning in the midst of chaos is associated with greater psychological resilience (Chan et al., 2006). However, when it comes to sexual offenders, the existence of a usual stuck-point in mean-making. Specifically, given the many levels of the crime the offender is usually not able to access all these levels, as some are deeper than their awareness. At that moment, the talk therapy and cognitive behavioral therapy for developing adaptive skills are crucial, as they have to create a safe context, in which the person can think freely and explore their inner world.
Chapter
Im Kapitel werden die Grundlagen zweier übergreifender deliktpräventiver Straftäterbehandlungsmodelle dargestellt. Anhand eines Fallbeispiels wird das Behandlungsvorgehen aus der Perspektive des Risk-Need-Responsivity und des Good Lives Modells überblicksartig beschrieben und kurz auf die Evidenzbasierung beider Ansätze sowie deren Vereinbarkeit eingegangen.
Article
The aim of the current study was to investigate specific pathways in the offending process of extrafamilial sexual child molesters. Forty-four men who had committed at least one sexual offense against a nonfamilial prepubescent child were included in this study and were classified using cluster analysis. Subjects using the coercive pathway (n = 30) had generally used psychoactive substances before their offenses. Furthermore, they had molested a female victim without perceived vulnerability and whom they had already well known. These molesters had not planned their offense, which was of short duration (less than 15 min), and involved coital activities and coercion (verbal and/or physical). Subjects using the noncoercive pathway (n = 14) had generally used pornography and deviant sexual fantasies before their offenses. Moreover, they had molested a male victim, in whom they perceived a psychosocial vulnerability and who was not familiar to them. These molesters had planned their offense, which was of longer duration (more than 15 min) and involved noncoital activities without coercion. These two pathways were compared to the two pathways in the offending process identified by Ward and his colleagues.
Chapter
This chapter describes a cognitive-behavioral model for treating sexual offense behavior, called recidivism risk reduction therapy (3RT). In 3RT, dynamic risk factors are targeted using existing CBT techniques, such as the skills modules described in dialectical behavior therapy (DBT). DBT skills were designed to address deficits in self-regulation, such as emotional dysregulation, behavioral dyscontrol, and relationship chaos – many of the same problems associated with sexual offense behavior. By drawing upon DBT skills, as well as other existing cognitive-behavioral techniques, 3RT offers a flexible, individualized, empirically derived, face-valid CBT approach to treat the highly complex behavior of sexual offending.
Chapter
The Kia Marama special treatment unit was established in late 1989, in response to a confluence of a number of factors. By 1986, the high rates of reoffending among child molesters released from New Zealand prisons (approximately 25%) had been identified by local research. Second, the Psychological Service of the New Zealand Department of Justice (now Department of Corrections) had developed an explicit mission statement involving a commitment to reducing future offending. There was also a developing sense of optimism with respect to the ability of cognitive—behavioral-oriented interventions to reduce the reoffending rate of sexual offenders. The early proposal for the unit was modeled on the Atascadero Sex Offender Treatment and Evaluation Program; however, Marshall devised the original program and trained the first group of staff.
Chapter
A small but growing niche of clinical practice involves services provided to sexual offenders, typically within the criminal justice system. This is an emotionally, and ethically, challenging area of practice that has, for all practical purposes, been unregulated, with the sole exception of the efforts of one professional organization (Association for Treatment of Sexual Abusers). Given the unusual demands placed on the clinicians working with sex offenders, and the high stakes nature of their work (providing effective treatment for clients disposed to committing sexual offenses, and offering evaluative judgments about the risk posed by these clients), it would seem reasonable to expect that this area of practice would be well regulated. As noted, this appears not to be the case. In this chapter we provide a framework for establishing guidelines for professional competence at two levels of practice – basic and expert. Our mission is not to provide an end product, but rather a blueprint to initiate dialogue and, in so doing, a process that will eventuate in a uniformly adopted standard for professional competence in this area.
Article
Evidence shows that sexual offenders have higher levels of adverse childhood experiences (ACE) than either the general population or other criminal populations. Historically, it was considered standard practice for sex offender therapists to dissuade their clients from addressing childhood trauma or adversity for fear of excuse making for his offending. The pathways model, which highlights etiology, made room for trauma treatment for offender's ACE as a legitimate treatment intervention. The adaptive information processing model inherent in eye movement desensitization and reprocessing (EMDR) trauma therapy is theorized to reorganize the maladaptively stored clustering of cognitions and emotions related to overwhelming or traumatic experiences such as childhood sexual abuse. We suggest EMDR therapy as a means of restructuring distorted implicit cognitions and personal vulnerability factors which are theorized to drive offending behavior. Through a comprehensive literature review, the authors considered 5 extant models in the sex offender literature and developed the offense drivers model. This model is designed to guide and inform EMDR therapy with sex offenders. A case example illustrates the implementation of this treatment process. A checklist of offense drivers is provided to assist in case conceptualization and treatment.
Article
Sexual offences against women and children constitute a serious and distressingly prevalent social problem. The psychological and emotional costs to victims and their families, the high reoffending rates of some types of offenders, and the financial costs of incarceration all highlight the urgent need for effective research and treatment of this problem behaviour. In the past two decades, a number of innovations have led to improved treatment of these difficult men. In addition, theories and models have been developed with the aim of furthering our understanding of sex offenders. In this paper we identify a number of issues within the broad areas of assessment and treatment that we believe to be problematic, and make some suggestions about ways of resolving these problems in the future.
Article
The assessment of sexual aggression presents many difficulties for clinicians. The tendency of offenders to minimise or deny their offending, and their frequent distrust of mental health professionals, require high levels of skill to circumvent. In addition, the multifactorial nature of rape means that assessment needs to cover a broad range of content areas and utilise a number of different methods. In this paper we suggest that a comprehensive assessment should inquire into the developmental history of rapists, social competency, attitudes and beliefs about women and sexual crimes, sexual knowledge, sexual preferences and disorders, empathy, offence variables, psychiatric history, and substance abuse. The clinical interview remains the primary method of information acquisition, and needs to be tailored to match the particular interpersonal style of rapists. The use of psychometric and physiological measures are also valuable sources of clinical data.
Article
Driving while disqualified represents a serious and recurrent social problem, with approximately 40% of convicted individuals reoffending. The high relapse (or recidivism) rates in this group are thought to be associated with compulsivity or addictive processes. In this paper we describe a cognitive-behavioural treatment program (relapse prevention) for offenders convicted of driving while disqualified. This program represents a significant innovation in the rehabilitation of persistent driving offenders, as in the past most intervention programs have focused on driver education and/or alcohol treatment. A major assumption of the relapse-prevention approach is that for many men their driving offences represent a maladaptive response to stressful events such as interpersonal conflict. Therefore, the primary treatment approach revolves around teaching individuals more effective ways to solve their interpersonal problems and to regulate negative affective states.
Article
Where do we come from? What are we? Where are we going?Process and motivational issuesStrength-based approachCognitions, behaviors, and emotionsIntegrating pharmacological strategiesAssessment of treatment-induced changesTreatment outcome evaluationConclusions References
Article
There are several significant problems with both Marlatt's and Pither's relapse prevention (RP) models. It is argued in this paper that there are good empirical, theoretical, and practical reasons for viewing the offense and relapse process as functionally equivalent. The core construct in both these traditionally different models is the problem behavior process. The application of a framework based on the problem behavior process has significant theoretical and clinical advantages and can overcome the major difficulties associated with Marlatt's and Pithers' RP models.
Article
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This article promotes the use of an integrated (holistic) approach to treating juvenile sexual offenders. An integrated model takes into account the fact that: (a) youth are resilient, (b) youth progress through various stages of development, (c) these stages are often arrested as a result of trauma, child abuse and neglect, and attachment disorders, (d) humanistic approaches and the therapeutic relationship are essential to the healing and recovery process, (e) youth learn and work with a variety of learning styles and multiple intelligences, (f) many traditional assessment and treatment approaches can be modified and blended with an integrated approach, and (g) the use of experiential treatments can have a positive and profound impact in treating youth with sexual behavior problems.
Article
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In all, 87 male child abusers, who had sexually offended exclusively against children, were included in this study. The participants' ages ranged from 21 to 75 (M = 39.5,SD = 12.6). The majority of the participants (62%) had offended outside the family, 15% had offended inside the family, and 23% had offended both inside and outside the family. Of the participants, 36% had offended against boys, 33% against girls, and 31% had offended against both sexes. And 53% of the sample had a previous conviction for a sexual offense.
Article
In recent years, the development of models of the offense process, relapse prevention in particular, have provided frameworks for the implementation of treatment. However, relapse prevention suffers from some conceptual problems, and therefore we have developed a descriptive model that attempts to provide a more satisfactory account of the offense process. This model contains a number of distinct points of individual differences, which create the possibility of different pathways. The current study examines these pathways, evident in offense transcripts from 86 sexual offenders. The majority of offense profiles were classifiable as belonging to three major pathways. Approximately one third reflected an appetitive, positive affect pathway. One quarter of the sample reflected the traditional covert planning, negative affect, restraint pathway. The third major pathway reflected a negative restraining process but with explicit planning. The clinical significance of these pathways is described and some suggestions for future research are made.
Article
The idea that sexual offenses occur as the culmination of a chain of actions on the part of offenders is central to contemporary cognitive behavioral models of relapse prevention. However, quantitative tests of this idea have remained rare. This article presents a mathematical model of the offense chain that allows a quantitative hypothesis test and tests the model using archival records of the daily behaviors of 7 developmentally disabled sex offenders. The results lend statistical support to models of the offense chain and allow consideration of the implications of the dynamics of offender behaviors for treatment
Article
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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. Pithers's 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.
Article
Classical psychoanalysis has been unable to adequately address the underlying narcissistic character pathology in sex offenders and sufficiently reduce relapse. Recent theoretical constructs about the nature of attachments to others and the formation of self-esteem are discussed and applied to sexually exploitative behavior A new dimension of relapse prevention-the interpersonal dimension-is described, along with an enhanced explanation of the cycle of offending behavior and the nature of high-risk situations. Principles of change and recovery to follow in the treatment of the offender character pathology are also described This deeper theoretical understanding of the motivation of sex offenders has formed the basis for treatment developed by the Counseling and Psychotherapy Center (C.P.C.). Two cases serve to illustrate this theoretical approach.
Article
Driving-while-disqualified (DWD) offenders represent a significant proportion of the driving offender population, and contribute to a significant drain on governmental and societal resources. The reoffence or relapse process of recidivist DWD offending has been somewhat neglected in the past, and this paper represents a first attempt at developing an empirically generated model of this phenomenon. In this study, we undertook a grounded theory analysis of offence chain information obtained from 28 male recidivist DWD offenders. The grounded theory analysis resulted in the development of a 15-stage model of the relapse process of recidivist DWD offenders. The model identifies and describes the sequence of psychological, behavioural, and environmental factors, including mediating variables that contribute to DWD reoffending. The model was then applied to 14 new offence chains to examine its level of saturation, content validity, and inter-rater reliability. The results suggest that the model has provisional validity and adequate inter-rater reliability, and achieved a high level of saturation. The strengths and value of the model are discussed, as are its clinical and research implications.
Article
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Models of the offense chain or relapse process provide a description of the cognitive, behavioral, motivational, and contextual factors associated with a sexual offense. In a sense these micromodels represent the touchstone of more general theories of sexual offending and serve to identify possible clinical phenomena that subsequent theory sets out to explain. In this paper we present a self-regulatory model of the offense process that we suggest can integrate existing theoretical work in the area. We first briefly comment on and critique a number of influential models of the sexual offense chain, then review the literature on the self-regulation of behavior. Following this we formulate a self-regulatory model of the offense process based on the idea that there are three core offense pathways: underregulation, misregulation, and intact regulation. We then briefly discuss the model's theoretical and clinical implications.
Article
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Correctional systems worldwide are currently undergoing a shift towards rehabilitation. Underpinning rehabilitation are the principles of risk, need, and responsivity. Responsivity includes internal responsivity (offender characteristics) and external responsivity (staff and setting characteristics). The responsivity principle has been neglected in the literature. While contemporary psychological theories of offender rehabilitation address internal responsivity, they do not address external responsivity, particularly in relation to the impact of the law. Therapeutic jurisprudence as a legal theory provides the opportunity to complement psychological theory and to address responsivity in offender rehabilitation. Therapeutic jurisprudence utilizes psychological knowledge to determine ways in which the law can enhance individual well-being. The purpose of this article is to demonstrate a psycholegal approach to offender rehabilitation. Psychological approaches can be applied to motivate offenders and provide them with the opportunity to make informed decisions about participation in rehabilitation programmes. However, this approach will not succeed without harnessing correctional staff as legal actors and potential therapeutic agents. A cognitive--behavioural model of an organizational culture change towards rehabilitation is proposed. In this endeavour “the will and the way” in both offenders and staff can be harnessed to maximize the therapeutic effects of the law.
Article
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Rapists' rehabilitation attracts little attention compared to the rehabilitation of child sexual offenders. One consequence of being overlooked, is that there is surprisingly little research to guide whether and how rapists can be rehabilitated effectively. Examination of traditional cognitive-behavioural treatment programs for sex offenders suggests a common core of offence-specific treatment targets, but little agreement on other components of treatment that are not sexually oriented. Furthermore, some dynamic recidivism risk factors (i.e., criminogenic needs) that are commonly addressed in general offender programs, are seldom the focus of intervention for sex offenders. Yet, research on the offence process in rapists, and on the dynamic predictors of recidivism in sexual and other offenders suggests considerable overlap in these rehabilitative needs. There are a variety of common responsivity barriers for rapists that compromise rehabilitation, and these barriers may also be desirable treatment targets. We argue that the inclusion of a broader range of criminogenic needs, the design of specialist rehabilitation programs for rapists, or referral to existing specialist sexual or violent offender programs on the basis of individually assessed needs, are useful future directions. An urgent research priority is the publication of more treatment outcome studies for rapists, that include an analysis of both sexual and violent recidivism.
Article
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Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach. Key words: smoking cessation, relapse prevention (RP), theoretical approaches
Article
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The generality of Marlatt and Gordon’s (1980, 1985) model of relapse to dietary treatment of diabetes was tested. Forty-six adults with insulin-dependent diabetes mellitus (IDDM) and 43 obese adults with non-insulin-dependent diabetes mellitus were interviewed regarding their most recent dietary violations, and the results were coded using the schema developed by Marlatt and Gordon. As the model would predict, most nonadherence episodes occurred in a limited range of high-risk situations. Although the two diagnostic groups lapsed in remarkably similar situations, there was atendency for the IDDM adults to report a larger proportion of lapses insituations characterized by negative emotions. Approximately 21% of the dietary lapses occurred when the person was busy with a competing activity or had no choice, and these lapses did not fit into Marlatt and Gordon’s coding schema. These violations consistently differed from those studied by Marlatt and Gordon in that they were errors of omission rather than errors of commission. Evidence for the abstinence violation effect was not found in this sample. Overall, the results suggest that most non adherence to dietary treatment of diabetes may be best understood as intermittent lapses that typically do not develop into full-blown relapses. Key words: diabetes mellitus, relapse, adherence, dietary management, hemoglobin Alc
Article
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In this chapter a theory of motivation and emotion developed from an attributional perspective is presented. Before undertaking this central task, it might be beneficial to review the progression of the book. In Chapter 1 it was suggested that causal attributions have been prevalent throughout history and in disparate cultures. Studies reviewed in Chapter 2 revealed a large number of causal ascriptions within motivational domains, and different ascriptions in disparate domains. Yet some attributions, particularly ability and effort in the achievement area, dominate causal thinking. To compare and contrast causes such as ability and effort, their common denominators or shared properties were identified. Three causal dimensions, examined in Chapter 3, are locus, stability, and controllability, with intentionality and globality as other possible causal properties. As documented in Chapter 4, the perceived stability of a cause influences the subjective probability of success following a previous success or failure; causes perceived as enduring increase the certainty that the prior outcome will be repeated in the future. And all the causal dimensions, as well as the outcome of an activity and specific causes, influence the emotions experienced after attainment or nonattainment of a goal. The affects linked to causal dimensions include pride (with locus), hopelessness and resignation (with stability), and anger, gratitude, guilt, pity, and shame (with controllability).
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This chapter represents an attempt to integrate a widely disparate literature concerning factors which play a role in the etiology of sex offending and lead to its persistence. In particular we are concerned that most researchers seem to take a rather narrow perspective of this behavior, stressing their own preferred processes (i.e., psychological, biological, or sociological) to the virtual exclusion of others. We have previously emphasized the role of learning experiences (Marshall and Barbaree, 1984a), sociocultural factors (Marshall, 1984a), and biological processes (Marshall 1984b) in the etiology of rape, but this represents our first attempt at integration and the first time we have extended our theorizing to account for other sex offenses. We believe that a proper understanding of sex offending can only be attained when these diverse processes are seen as functionally interdependent.
Article
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Two studies are reported that examined attribution-emotion-action linkages across the lifespan. Specifically, two sets of relations were examined: (1) that between causal controllability, the social emotions of anger and pity, and intended helping behavior; and (2) that between causal locus, the achievement-related emotion of pride, and intended self reward. In Experiment 1, participants ranging in age from 5 to 95 years were given a set of vignettes concerning a person in need of help with the cause of that need manipulated to be either controllable or uncontrollable. Perceptions of controllability, emotional reactions of anger and pity, and likelihood of help were ascertained. In Experiment 2, subjects comprising the same age groups were given a set of scenarios describing an achievement success with the cause of that success manipulated to be either internal or external. Perceptions of causal locus, emotional reactions of pride, and intended reward allocation were similarly measured. The linkages involving anger and pity were understood by all age groups from 5 to 95 and were in accord with attributional predictions. In contrast, the data for pride were more complex, showing clear change across the lifespan. Among very young children and the elderly, causal locus, pride, and reward allocation were not systematically interrelated. The implications of these findings for testing the generality of social psychological principles were discussed.
Book
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For a long time I have had the gnawing desire to convey the broad motivational sig nificance of the attributional conception that I have espoused and to present fully the argument that this framework has earned a rightful place alongside other leading theories of motivation. Furthermore, recent investigations have yielded insights into the attributional determinants of affect, thus providing the impetus to embark upon a detailed discussion of emotion and to elucidate the relation between emotion and motivation from an attributional perspective. The presentation of a unified theory of motivation and emotion is the goal of this book. My more specific aims in the chapters to follow are to: 1) Outline the basic princi ples that I believe characterize an adequate theory of motivation; 2) Convey what I perceive to be the conceptual contributions of the perspective advocated by my col leagues and me; 3) Summarize the empirical relations, reach some definitive con clusions, and point out the more equivocal empirical associations based on hypotheses derived from our particular attribution theory; and 4) Clarify questions that have been raised about this conception and provide new material for still further scrutiny. In so doing, the building blocks (if any) laid down by the attributional con ception will be readily identified and unknown juries of present and future peers can then better determine the value of this scientific product."
Article
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The application of Marlatt's relapse prevention model to the treatment of sexual offenders has greatly facilitated the assessment and therapy of these difficult men. In particular, Pithers' reformulation of the model has been found useful. However, in applying this model of addiction to the sexual aggressr, certain conceptual and empirical problems have been overlooked. Specifically, redefining a lapse and incorporating the problem of immediate gratification into the abstinence violation effect has created theoretical confusion and is not supported by recent empirical research. The clinical implications of these problems are discussed.
Article
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Several learning-based theories have been forwarded to account for the problem of drug relapse, including conditioned withdrawal, conditioned compensatory responding, appetitive motivational models, and social learning models. The various models are compared and evaluated against available evidence from studies with humans pertaining to alcohol and tobacco addiction. Studies that are reviewed focus primarily on the antecedents and consequences of alcohol and smoking relapse, as well as on reactions to cues that have been associated with prior drug ingestion, in an attempt to understand their motivational relevance. Problems in evaluating the various relapse models in humans are discussed. It is concluded that the appetitive model is better supported than the withdrawal model, and the compensatory model is least supported. Reactions to substance use stimuli may play an important role in alcohol and smoking relapse. Concepts drawn from the various theoretical models are linked tentatively in a schematic diagram of a hypothesized sequence of cognitive/affective, physiological, and behavioral events that lead to initial drug use after a period of abstinence (slip) and then to continued use (a relapse). The treatment implications of some of the cue reactivity models are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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Examines relapse by integrating knowledge from the addictive disorders of alcoholism, smoking, and obesity. Commonalities across these areas suggest at least 3 basic stages of behavior change: motivation and commitment, initial change, and maintenance. A distinction is made between lapse and relapse, with lapse referring to the process (slips or mistakes) that may or may not lead to an outcome (relapse). The natural history of relapse is discussed, as are the consequences of relapse for patients and the professionals who treat them. Information on determinants and predictors of relapse is evaluated, with the emphasis on the interaction of individual, environmental, and physiological factors. Methods of preventing relapse are proposed and are targeted to the 3 stages of change. (156 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The abstinence violation effect (AVE) proposed in Marlatt and Gordon's (1980, 1985) model of smoking relapse was operationalized as a combination of internal, stable, and global causal attributions for smoking a cigarette following the attainment of abstinence from smoking. Causal attributions both for maintaining abstinence and for smoking in hypothetical high-risk situations were obtained prior to quitting from participants in a smoking cessation program. After treatment, subjects who relapsed also provided retrospective causal attributions for initial smoking episodes. Results showed that participants who relapsed following a slip reported significantly higher AVEs (more internal, stable, and global causal attributions) than those who regained abstinence following a slip. Furthermore, the AVE emerged as the strongest predictor of subsequent smoking when included in a discriminant analysis along with other factors associated with the initial smoking episode. Prospective pretreatment attributions for smoking and not smoking in hypothetical high-risk situations were not significantly related to attributions for actual smoking episodes.
Book
A useful tool for practitioners, researchers, theorists, and advanced students, Handbook of Sexual Assault analyzes the nature and extent of the problem of sexual offending and classifies the types of offenders according to an empirically developed system. In addition, contributors present the theories of the etiology and maintenance of sexual offending; offer various perspectives and factors relevant to accurate assessment; and detail contemporary treatment procedures.
Chapter
Throughout history, whenever a socially frightening disorder existed, and its etiology was not widely known, tentative explanations were invoked that sometimes proved erroneous and regrettable. Ancient Romans feared inhaling nighttime air, believing that it bore vapors, emitted from nearby swamps, which were regarded as the cause of a potentially fatal respiratory disease. Today, “swamp vapors” are called bacteria, and the disorder is known as pneumonia. Epileptics in colonial Salem, Massachusetts, were hanged in the mistaken belief that their seizures signified that they were demon-possessed witches. In current society, both disorders are readily treated and create little concern.
Article
A comprehensive cognitive-behavioural treatment program for incarcerated child molesters is described. This program operates within Kia Marama, a medium-security unit for sex offenders in the New Zealand prison system. It lasts 32 weeks and includes a four-week assessment process both before and after the 24 weeks of intensive treatment. Treatment covers a variety of issues including distorted cognitions, sexual issues, victim empathy, social skills, problem solving, life skills, stress management, and relapse-prevention training. In addition, when offenders are relaesed they are supervised by professionals trained in relapse-prevention procedures. As this program began in late 1989, it is too early to properly estimate its success, but similar programs in North America have produced promising outcome data, and what tentative evidence we have to date suggests that the program is valuable.
Article
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.
Article
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 Baumeister's 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.
Article
An examination of the bases of two influential sets of publications suggests that their conclusions regarding the effectiveness of treatment with sex offenders were unnecessarily gloomy. The present article presents a more optimistic view of the literature, asserting that recent, relatively well-controlled evaluations have shown that treatment can be effective. To be maximally effective, according to this appraisal of the literature, treatment must be comprehensive, cognitive-behaviorally based, and include a relapse prevention component. Earlier outcome research that produced either treatment failure, or at best equivocal results, did not meet these criteria.
Article
the Sex Offender Treatment and Evaluation Project is a clinical research program specifically mandated by the California State Legislature the project, which began in 1985, consists of a treatment component (an intensive, 2-year relapse prevention program for sex offenders) and an evaluation component (a comparison of the outcomes of treated subjects with those of two matched control groups) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
society does not yet widely accept an explanation for the existence of sexual aggressors / struggling to ascertain the determinants of sexually abusive acts so that effective treatments may be devised, early theorists proposed a number of speculative accounts past theories regarding etiology of sexual aggression / sexual aggression as an impulsive act / reinterpretation of the impulsivity hypothesis / sex offenders as "sexual psychopaths" / flaws of sexual psychopath legislation / relapse prevention / internal self-management dimension / assessment of high-risk situations / assessment of coping skills / treatment procedures for avoiding lapses (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
the roots of [relapse prevention] RP as both theory and clinical intervention are anchored in the mainstream development of cognitive-behavioral treatment / what has made RP different . . . is its emphasis on the lapse-relapse sequence as a learning experience rather than a treatment failure / argued that RP could be successfully applied not only to the classical addictive disorders from which it originated but also to virtually any disorder of impulse control / outlined a theory of RP in terms of basic principles, derived propositions, and empirically testable hypotheses (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Covering, as it does, the important features involved in the assessment and treatment of sexual aggressors, as well as theories concerning the development and maintenance of such offending, this book summarizes, in the words of experts in each area, current understanding of this pervasive and socially destructive problem. It is our hope that this book will prove to be valuable to researchers who are concerned with expanding our present understanding of sexual aggressors by encouraging present researchers not only to continue their valuable work, but also to recognize the broader context of their contributions. Students who are training in the various disciplines (e.g., psychiatry, psychology, social work, sociology, law, criminology) relevant to the scientific, clincal, and social response to sexual aggression will have available in this book a comprehensive summary of present research findings. Finally, governmental agencies responsible for dealing with sexual offenders and their victims might consider this book as a resource. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Marshall (1971) was the first behavior therapist to add social-skills training to a treatment package which also attempted to decrease deviant interests and increase appropriate sexual desires / since that time there has been a progressive expansion of the components in behavioral programs, in particular, the inclusion of procedures aimed at modifying distorted cognitions now more commonly described as "cognitive-behavioral" and are understood to be quite comprehensive in terms of the range of problems addressed in treatment / despite the ever-growing popularity of these comprehensive cognitive-behavioral programs, until very recently there was little in the way of outcome evaluations / before we turn to the issues of the effectiveness of these programs, however, we need to describe their nature content of programs / sexual behaviors / social incompetence / cognitive distortions / format of programs (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The influence of self-perceived dieting ability on restrained eaters was tested in a study directly manipulating such self-perceptions. The hypothesis that a dieter's perception of her own dieting ability would affect how she handled an acute challenge to her diet was tested by manipulating the restrained eater's view of themselves as good or bad dieters. Restrained and unrestrained subjects were given ad lib access to ice cream after either a high-calorie preload or no preload. As predicted, dieters induced to see themselves as “good” ate less after the preload than did dieters whose self-perception was not manipulated, but dieters who saw themselves as “bad” also reduced their intake. Over the next week, restrained subjects in general lost more weight, with those who had been led to focus on their dieting ability in the face of a challenge, being mainly responsible for this effect.
Article
In this cross-sectional test of the occurrence of the abstinence violation effect (AVE), a community sample of 323 social drinkers completed measures of drinking restraint (perceived efficacy for controlling alcohol consumption and behavioral attempts to limit drinking) and causal attributions for drinking-related events. These measures were included as predictors in a multivariate multiple-regression equation in which three aspects of self-reported drinking served as dependent variables: minimum number of drinks per occasion, maximum number of drinks per occasion, and drinking-related problems. The results indicated differential sets of predictors for each of the dependent variables. Both aspects of restraint predicted minimum consumption, and both aspects of restraint and attributions for positive drinking situations predicted maximum consumption. Perceived efficacy for controlling alcohol consumption and attributions for negative drinking situations predicted alcohol-related problems. The consistency between this pattern of results and Marlatt's (1985a) reformulation of the AVE is discussed.
Article
Previous reviews have taken either a severe methodological stance and concluded that treatments have not been demonstrated to be effective with sex offenders, or they have ignored methodological considerations and expounded about the value, of particular treatment approaches. We have attempted to adopt a position somewhere between these, two and have concluded that some treatment programs have been effective with child molesters and exhibitionists but not, apparently, with rapists. In examining the value of the different approaches, we concluded that comprehensive cognitive/behavioral programs (at least for child molesters, incest offenders, and exhibitionists) are most likely to be effective, although there is a clear value for the adjunctive use of antiandrogens with those offenders who engage in excessively high rates of sexual activities.
Article
It is argued that the central issue in the treatment of sexually aggressive behavior is the tendency to relapse shown by offenders. A model of the relapse process is presented along with what is described as its central feature, the abstinence violation effect (AVE). This construct is critically examined and its shortcomings identified. A brief description of Weiner's attributional theory is provided and this is used to reformulate the AVE. The advantages of the reformulated AVE are described, as are the clinical implications. Suggestions are then made for future research.
Article
Several learning theory based models propose that substance users may have conditioned reactions to stimuli (cues) associated with substance use and that these reactions may increase the probability of relapse. The conditioned withdrawal, conditioned compensatory response, and appetitive motivational models were evaluated in light of empirical evidence from cue reactivity studies with alcoholics, smokers, opiate users, and cocaine users. The nature of the stimuli that elicit reactivity and the nature of the responses elicited are most consistent with an appetitive motivational model and do not appear to support the other two models. A few studies have been conducted or are underway that investigate the use of cue exposure with response prevention as a treatment to decrease cue reactivity. Preliminary work with alcoholics, opiate users and cocaine users is promising but insufficient evidence exists to evaluate this approach. The implications for theory and treatment are discussed.
Article
Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.
Article
The generality of Marlatt and Gordon's (1980, 1985) model of relapse to dietary treatment of diabetes was tested. Forty-six adults with insulin-dependent diabetes mellitus (IDDM) and 43 obese adults with non-insulin-dependent diabetes mellitus were interviewed regarding their most recent dietary violations, and the results were coded using the schema developed by Marlatt and Gordon. As the model would predict, most nonadherence episodes occurred in a limited range of high-risk situations. Although the two diagnostic groups lapsed in remarkably similar situations, there was a tendency for the IDDM adults to report a larger proportion of lapses in situations characterized by negative emotions. Approximately 27% of the dietary lapses occurred when the person was busy with a competing activity or had no choice, and these lapses did not fit into Marlatt and Gordon's coding schema. These violations consistently differed from those studied by Marlatt and Gordon in that they were errors of omission rather than errors of commission. Evidence for the abstinence violation effect was not found in this sample. Overall, the results suggest that most nonadherence to dietary treatment of diabetes may be best understood as intermittent lapses that typically do not develop into full-blown relapses.
Article
The reformulation of the abstinence violation effect (AVE) is briefly described together with the empirical support for the construct. Twenty-six incarcerated male child molesters were assessed, using the Differential Emotions Scale and the Attributional Dimension Scale, at three points (high-risk, lapse, and relapse) while they listened to an audiotaped recording of a description of their most typical offense chain. Eighteen Ss experienced an AVE at the point of relapse and 7 as a result of lapse. There were significant increases in most negative emotions and decreases in interest over the relapse chain. There were significantly higher disgust, contempt, hostility, fear, shame, shyness and anger scores reported by those showing an AVE. Conversely, the AVE group showed significantly lower scores for joy and surprise. There were no significant differences on any of the 4 attributional dimensions across the relapse process but those showing an AVE reported significantly more uncontrollability and higher stability scores. The significance of these results for clinical practice are discussed.
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