Topic 11: Treatment of Offenders Flashcards
What is treatment?
term is used very broadly –> can mean just about anything
Sechrest et al. (1979): “the result of any planned intervention that reduces an offender’s further criminal activity, whether the reduction is mediated by personality, behavior, abilities, attitudes, values, or other factors”
note that this makes no mention of mental health outcomes per se
What are levels of intervention?
based on the public health model
primary, secondary, and tertiary
What is primary prevention?
“stop it before it ever happens”
requires good knowledge of development and risk factors
effectiveness depends on large scale screening
examples: “Head Start” program (Zigler, 1994), mentoring strategy (Sherman et al., 1998), Big Brother/Sister programs
What is secondary prevention?
“let’s nip it in the bud”
aimed at individuals showing early signs of criminal involvement, but not yet formally charged
candidates identified by family court, school guidance offices, social services
examples are: custody diversion, alternative measures (extrajudicial sanctions; EJS)
usually only available for minor infractions
difficult to evaluate because their nature limits supervision, and kids may already be more involved in crime than the infraction suggests
What is the secondary prevention of Gang monitoring?
Spergal Model
gang leaders held “responsible” for actions of subordinate members
provides recreational, economic, and educational opportunities
What is tertiary prevention?
formal treatment
attempts to prevent/reduce future crimes by targeting individuals already criminally involved
most restrictive, most costly, least effective
may be only available option due to client’s legal circumstances
as in all other areas of health care, early intervention is preferable and tends to produce better outcomes than later intervention
What is the continuum of treatment goals?
two goals: rehabilitation and punishment
What is the goal, method, and agent of rehabilitation?
goal: produce productive citizen
method: treatment
agent: enable training/therapy
What is the goal, method, and agent of punishment?
goal: stop crime
method: incarceration
agent: restrict isolation/deprivation
What is the sentencing theory stated in CCC s. 718?
the fundamental purpose of sentencing is to contribute, along with crime prevention initiatives, to respect for the law and the maintenance of a just, peaceful and safe society by imposing just sanctions that have one or more of the following objectives:
a. to denounce unlawful conduct
b. to deter the offender and other persons from committing offences
c. to separate offenders from society, where necessary
d. to assist in rehabilitating offenders
e. to provide reparations for harm done to victims or to the community
f. to promote a sense of responsibility in offenders, and acknowledgement of the harm done to victims and to the community
What are the goals of treatment (i.e. rehabilitation)?
the goals of treatment (i.e., rehabilitation) are encapsulated in the goals of sentencing, but sentencing goals are much broader
there is no denouncement (general deterrence), public protection (isolation), or restitution (reparation) component inherent to treatment
they are hoped-for outcomes
What is the comparison of rehabilitation and punishment?
while rehabilitation and punishment are not mutually exclusive, the environments in which they take place tend to strongly favor one or the other
What are community-based interventions?
much cheaper, and generally more effective than institutional or inpatient approaches
range from short-term to longer-term, outpatient to residential
easier generalization of treatment effects
delivered in, or closer to, actual operational environment
can utilize naturally occurring reinforcers
often utilize a tridactic model
What are the special considerations of community-based interventions?
community security
interagency coordination
contingencies may be difficult to manage
if done residentially, community may strongly oppose
if done in natural home, family may undermine therapist’s efforts
safety of therapists
What are juvenile awareness programs?
e.g., Scared Straight
flimsy track record
problem: based on intensity, not probability of punishment
What are wilderness experience programs?
e.g., Outward Bound
foster self-esteem
What are restitution/community service orders (EJS)?
behavioral principle: Overcorrection (prove that shortcuts take longer and aren’t desirable)
frequently used in Alberta
often satisfies community
effective for less serious offenders who will comply
What is the “Street Corner” program by (Schwitzgebel, 1967)?
approached kids on street and simple Tx: differential reinforcement of prosocial statements
What is the “Shape” program by Ostapiuk (1982)?
delivered in community housing or hostel settings
taught “survival” skills: job hunting, etc.
What is the “Achievement Place” program by Braukman & Wolf (1987)?
started in US Midwest in late 60s
based on a “houseparent” model: usually a married couple
simulates a functional home
spread quickly until the mid 1980s
outcomes weren’t as good as was expected: identified need for transition programs, in fairness many youth were returned to homes in which prosocial skills weren’t necessarily adaptive
What are direct and incidental teaching of prosocial skills in the “Achievement Place” program by Braukman & Wolf (1987)?
room/property care
table manners
non-aggressive speech
group/democratic decision making
appropriate conversation
negotiation
What are the phases that proceed the token economy in the “Achievement Place” program by Braukman & Wolf (1987)?
Merit: means of reinforcement are more direct
Homeward bound (discharge planning)
What is Parent Management Training?
a form of transition programming
teach parents the rudiments of behavior theory, and contingency contracting
other systems focus on spotting antecedents of delinquent behavior and using DRO techniques
also teach: social skills, use of time-outs, how to employ role plays
may be most effective with younger, less delinquent kids: parents still have control over their contingencies
What is Functional Family Therapy?
based on family systems theory: deviant behavior is considered the consequence of pathological communication styles
works with family to improve style and quality of interactions, and learn effective problem solving
early studies were promising, e.g., Gordon et al. (1988) 11% (treated) versus 67% (control) recidivism at 1 year follow up
subsequent studies were equivocal
results: Exp. group members committed fewer major but more minor offenses
possible explanations: regression to the mean effect, exposure to more serious offenders
What is Multisystemic Therapy (MST)?
most promising of all OP models thus far
not really a new idea, but only recently formalized and manualized
MST teams available 24/7 to clients and their families
make scheduled and non-scheduled visits
assist with RT crisis intervention
do practical training of skills
includes elements of supervision, instruction, crisis intervention, mentoring, instruction
highly effective and cost efficient: even high risk offenders can be managed with relative safety, lots of supports required for MST team members, e.g. linkages with probation
generalization is maximized since training occurs in the real environment
What is the role of therapy in prisons?
lower recidivism
assess and relieve distress
What were the approaches of therapy in prisons documented by Kazdin (1986)?
most were unique to the practitioners, and not empirically grounded or formally evaluated
Parloff (1984) referred to California rehab strip as “Silly Con Valley”
Why is treatment a mess in inpatient and institutional treatment?
large number of non-forensic, clinical psychologists failing to see they’re no longer dealing with the “worried well”
sparse evidence for the efficacy of psychodynamic/humanistic approaches with this population
e.g., Kassebaum et al. (1971): no significant difference in outcome between three groups; mandatory counseling, voluntary counseling, controls
What are the “eclectic” approaches used within institutions in the study by Persons (1967)?
subjects were 38 boys in reformatories
matched on age and other demographic variables
randomly assigned to treatment or control group: treatment got 80 hours of therapy over 20 weeks including a variety of interventions
at 1 year follow up, 13 Tx vs 25 controls had been re-incarcerated; also had fewer probation violations
What are the problems with the “eclectic” approaches used within institutions?
eclectic approaches are unstandardized
very difficult to isolate those aspects that produce the effect
therapist qualities can have a dramatic influence
What are the applied behavioral analysis approaches used within institutions?
idea is to change environmental cues and contingencies
punish deviant behavior, reinforce prosocial behavior
token economy programs are on off-shoot
big in the 60s and 70s
fairly easy to bring behavior under control in the institutional setting
What are the problems with the applied behavioral analysis approaches used within institutions?
lack of generalization is huge problem
sometimes unclear relationship between target behaviors and crime
ethical constraints on what privileges can be withheld (e.g., snacks, recreation)
fails to promote intrinsic motivation
What are the cognitive-behavioral approaches used within institutions?
now predominate in Canadian prisons
often resemble remedical education programs because of emphasis on skills training
habits, cognitions, deficits, lifestyle factors that perpetuate criminal lifestyle
What is the treatment of dangerous offenders?
violent, sexual, and psychopathic/APD offenders are included under this heading
risk level prohibits community treatment
What are biologically-based treatments of sex offenders?
neurosurgery (hypothalamic nuclei), orchidectomy, antiandrogenics: all attempts to lower sex drive
fairly effective, but some males retain some sexual functioning: ethically contentious
What are psychotherapy treatments of sex offenders?
based in belief that identification of underlying issues such as abuse and anger will lower risk
questionable assumption
Groth (1983), however, published data suggesting significant effectiveness
What were the results of the Groth (1983) study on the effectiveness of psychotherapy treatments of sex offenders?
non-sexual offenses: treated 19%, controls 36%
sexual offenses: treated 8%, controls 16%
in both cases, untreated were twice likely to reoffend
What are cognitive-behavioral treatments of sex offenders?
focused on reducing deviant arousal
early efforts used aversive shock
Pavlovian: paired deviant stimulus with shock non-contingently
Operant: only if arousal is registered on PPG (penile plethysmograph)
extinction effects are the main problem
What is the covert sensitization treatment of sex offenders?
imagined pairing with something incompatible with arousal
also imagine rewards of withholding deviant behavior
requires a cooperative client with good imagination
Hayes, Brownell, Barlow (1978) monitored arousal with PPG; no monitoring over fantasy content however
What is the “shame” method of treatment of sex offenders?
expose to a clinical audience and video camera; verbalize fantasies
not effective at all
What is the satiation/boredom therapy treatment of sex offenders?
client masterbates to appropriate fantasy
continues after orgasm, while verbalizing and tape recording deviant fantasy
What is the orgasmic reconditioning (ORC) treatment of sex offenders?
masturbates to deviant fantasy; switches to appropriate one just prior to orgasm
orgasm is a reflex
switches earlier in subsequent sessions
What is relapse prevention treatment of sex offenders?
originated in substance abuse literature
What are “other” methods of treatment of sex offenders?
dating skills, anger management, cognitive distortions, human sexuality, education, marital therapy
What is the treatment of aggressive offenders?
less likely to be deemed in need; more likely to just be locked up
as a group, seldom seek therapy in the absence of secondary gains
as with sex offenders, denial, blaming of others, and refusal of responsibility are uniquitous
What is the pharmacotherapy treatment of aggressive offenders?
usually tranquilizers are given only on a PRN basis to manage outbursts
not an enduring solution, unless the aggression is rooted in a psychosis, EPD, ADHD, or bipolar disorder
lots of potentially harmful side effects
side effects may also encourage non-compliance, e.g., dry mouth, tremors, frequent urination, nausea
What is the cognitive-behavioral treatment of sex offenders?
anger management (e.g., Novaco, 1978)
three steps:
1. prep (education)
2. skills training
3. practice
packages often sold commercially
special versions for nasty kids and marital conflict are avilable
excellent transition support
What is the dialectical behavior therapy treatment of sex offenders?
actually designed and validated for Tx of BPD
stresses balance between change and acceptance
teaches tolerance of negative affective states that contribute to potentially criminal behavior: mindfulness, meditation, relaxation
combines several elements of conventional CBT; particularly challenges to all-or-nothing thinking, or catastrophic thinking
What is the treatment of personality disordered/psychopathic offenders?
APD is over diagnosed in jail settings; e.g., Harris, Rice, Cormier (1989), 2/3 got the Dx, but 1/4 actually qualified
some (e.g. Carney) have argued that the question becomes moot upon conviction
flawed assumption since “personality” implies enduring characteristics and therefore inflexibility
What is the study by Levine & Bornstein (1972) on the treatment of personality disordered/psychopathic offenders?
only 8 of 295 meta-analyzed reports on ASPD treatment contained encouraging results
most of the 295 were methodologically unsound and could not be used however
picture may not be as bleak as once thought
What is the problem with the study by Levine & Bornstein (1972) on the treatment of personality disordered/psychopathic offenders?
ASPDs and psychopaths are not usually distressed
can’t rely on negative Rf of treatment effects
What studies show that purely punitive settings do not work well?
Gendreau (1996) studied reactions in recidivism
jail only: 6% less crime
treatment: 25% less crime
Why has treatment effectiveness been difficult to measure?
Martinson (1974): “Nothing works!”
reflection of interpretative errors
mainstream criminology had an “anti-psychological” reputation
lends support to a “Just desserts” model, which fuels outcry for stiffer penalties
What were the results of the Palmer (1975) study on treatment effectiveness?
treatment can be effective, but it must be tailored to the criminogenic needs of the client
What were the results of the Gendreau & Ross (1980) study on treatment effectiveness?
“meta-analysis”
reviewed outcomes of 95 treatment studies
86% showed positive outcomes
What were the features of effective programs proposed by Lipsey (1989)?
- longer duration, more meaningful contact
- services provided outside correctional facility
- programs are reviewed and adjusted regularly
- cognitive-behavioral, multifaceted, skill-oriented approach
- targets higher risk offenders
- includes careful discharge planning
What features of effective programs were added to the ones proposed by Lipsey (1989) by Andrews, Bonta & Hoge (1990)?
- criminogenic factors are specifically targeted
- treatment is matched to the learning style of the offender
What features of effective programs were added to the ones proposed by Lipsey (1989) by Lipsey & Widom (1998)?
- services should be delivered by mental health professionals
What is Risk-Needs-Responsivity?
research has shown a direct relationship between number of R-N-R principles utilized and Tx outcome
closely tied to SPJ instruments, and shows their potential utility in Tx planning
most treatment outcomes if have all three things, actually make people worse if none are present
