CBT in justice system

Question 1

CBT skills that still apply

Answer 1

Same general principles + processes in assessment and therapy

• Principles, Therapeutic relationship, Assessment, Formulation

Question 2

Schemas, AT, intermediate beliefs

Answer 2

Schemas
- lenses colour perception of the world
- Hard to modify learnt early in life, modelled by significant others, reinforced, acquired from credible source
- Not helpless, unlovable, worthless VS Predator, paranoid, over controller

Intermediate beliefs
- accessible, level of awareness, modifiable
- Core belief “I’m in control” intermediate belief “things have to be done my way”

Automatic thoughts
- spontaneous unrehearsed from intermediate level
- Directly impact how someone feels and behaves
- ask the client to complete the sentence “if I don’t stick up for myself it means…” rather than wording it as qs to them

Question 3

How are cognitions different for JS

Answer 3

“offence supportive cognitions”=
1. victim blame
2. group loyalty
3. hostility/cynicism to System
4. minimisation

Question 4

Cognitive targets

Answer 4

Different cognitive targets
Anxiety doesn’t = overestimation of threat.
Depression doesn’t = guilt and blame for self

Help them:
- Understanding of the consequences of their crime, perspective taking and empathy

• Note: Less focus on taking full responsibility rather than how patterns of thinking is linked to behaviour
  o acknowledging responsibility doesn’t lower the chance of offending sometimes even increases it
  o a label of offender leaves more mood problems and self-fulfilling prophecy

Question 5

Psychometrics for beliefs

Answer 5

Measure of Offender Thinking Styles (MOTS)

Question 6

Techniques for Just corrections

Answer 6

Decision Grid
- Benefits and costs/long-term and short term

Cognitive affective associations
– ask the client to complete the sentence “if I don’t stick up for myself it means…” rather than wording it as qs to them

Experiential techniques:
- role plays, two chairs, guided imagery – sit in different chairs while experiencing different views to help realise and notice thoughts, write a letter to self from the perspective of the victim,

Safety planning:
- Chain of offence
- Safety plan individualised to your chain of offence

Question 7

Challenges likely to face

Answer 7

• The motivation of client – didn’t ask to see us
• Therapy behaviours of the client – countertransference – sympathy or anger,
• Treatment setting and competing priorities – physical location, recourses, set up
• Compassion fatigue – burnout need boundaries
• Consequences of treatment failure – greater consequences if they don’t get better “what if they hurt someone”

Burnout
- supervision
- Discuss with colleagues
- Self-care
- Realistic expectations

Question 8

therapeutic relationship

Answer 8

• Expect difficulty - need to be alert to it
• how they interact with us gives a clue of how they are like
• address this early and often
• anti-social client = critical of a therapist, qs competence, challenge tx, blame therapist
• the therapist must respond confidently, maintain respect and positive regard, persist

Question 9

Therapist features that facilitate change and impede change

Answer 9

(same as normal CBT)
- 1. Directiveness and confidence
- 2. Empathy, warmth, genuine, respectful, support, emotional expression, supportive, interest, honesty, sincerity, use of humour, reward/encouraging, flexible
Impede change
- Confrontation, cold, support without direction, inflexible

Question 10

CBT tx

Answer 10

Group Based is gold standard

RNR and GLM = frameworks for offender rehabilitation, CBT is the treatment model (under general responsivity RNR)

· Offence chain – relapse prevention approach tool – to increase insight and help identify cognitions, beh aspects (eg skills lacking) and emotion management/coping skills that could be tx targets
· Psychoeducation re cognitive model (T – F & B)
● Challenge offence supportive beliefs (eg CUNDE (Ward and Keenan; 1999), minimisation, victim blaming, cynicism of system)
● Identify ATS and Intermediate beliefs and evaluate (for & ag, diff perspectives)
● Mitchell & Tafrate (2010) 13 thinking patterns in 3 areas: 1) Perception of self or others (CDHOPE), 2) Interactions with the environment (JHEE), 3) Problem-solving and decision making (PIC)
● Work on 7/ central 8 (crim needs/dynamic risk factors - minus Antisocial hx)
● Emotion regulation and relaxation
● Safety plan individualised to your offence chain
Additional from GLM perspective:
- Treatment focus on ‘primary human goods’ they most value/common life goals (risk factors will then be targeted incidentally) eg improve connections – work on rela and intimacy skills, inner peace – sexual/emo regulation