3/1/2018 CURATIVE FACTORS IN THE TREATMENT OF MEN AND WOMEN WHO SEXUALLY OFFEND: WORKING WITHIN THE RNR MODEL OVERVIEW OUTLINE OF THE RNR MODEL

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1 CURATIVE FACTORS IN THE TREATMENT OF MEN AND WOMEN WHO SEXUALLY OFFEND: WORKING WITHIN THE RNR MODEL OVERVIEW Outline of the RNR Model Risk Principle Intensity of interventions matched with risk level Assessing risk in males and females Research on supervision and treatment intensity Need Principle Supervision and treatment to target criminogenic needs Examples of common criminogenic factors Different risk levels, different needs Different gender, different needs Responsivity Principle Being responsive to client Therapeutic and working alliance research Resistance, culture, risk level, cognitive ability Empirically supported models for treatment OUTLINE OF THE RNR MODEL RISK THE WHO NEED THE WHAT RESPONSIVITY THE HOW 1

2 EVIDENCE FOR RNR MODEL RISK PRINCIPLE 120 AND 300 RISK PRINCIPLE FEW STUDIES HAVE EXAMINED SUPERVISION CONTACT AND SEXUAL RECIDIVISM 2

3 RISK PRINCIPLE ASSESSING AND ASSIGNING RISK LEVELS WITH MALES RISK PRINCIPLE ASSESSING AND ASSIGNING RISK LEVELS WITH FEMALES RISK PRINCIPLE ASSESSING AND ASSIGNING RISK LEVELS WITH FEMALES PRELIMINARY 3

4 RISK PRINCIPLE ASSESSING AND ASSIGNING RISK LEVELS WITH FEMALES THINGS TO CONSIDER: MOST ARE VERY LOW RISK TO SEXUALLY RECIDIVATE (1-4% SEXUALLY RECIDIVATE OVERALL) WE HAVE NO VALIDATED TOOLS OR SPECIFIC VARIABLES THAT HAVE CONSISTENTLY PREDICTED SEXUAL RECIDIVISM FOR FSOS MORE GENDER-SPECIFIC FACTORS TO CONSIDER (FSOS ARE VERY DIFFERENT FROM MSOS) SUBGROUPS ARE DIFFERENT (E.G., FSOS WHO ALLOW ABUSE OF THEIR CHILDREN; CO- OFFENDERS) INTIMACY ISSUES, MENTAL HEALTH ISSUES, THEIR OWN VICTIMIZATION HISTORIES, SUBSTANCE ABUSE NEED PRINCIPLE NEED PRINCIPLE 4

5 NEED PRINCIPLE ALWAYS NEVER RESPONSIVITY PRINCIPLE GENERAL THERAPY: TREATMENT EFFECTIVENESS IS INFLUENCED BY THE THERAPEUTIC ALLIANCE (TO INCLUDE THERAPIST STYLE AND CLIENT S PERCEPTION OF THERAPIST) (MARSHALL ET AL., 2003) EMPATHY, WARMTH, AND GENUINENESS HAVE BEEN SHOWN TO INFLUENCE OUTCOME IN CBT (KEIJSERS ET AL., 2000) GROUP COHESIVENESS VIEWED AS CENTRAL CURATIVE FACTOR (YALOM, 1980) THERAPIST SINCERITY AND RESPECT HAVE BEEN LINKED TO POSITIVE TREATMENT OUTCOME (RABAVILAS, BOULOUGOURIS, & PERISSAKI, 1979) 5

6 GENERAL THERAPY: (CONT.) POSITIVE TREATMENT OUTCOME RELATED TO DEGREE CLIENTS HAVE OPPORTUNITY TO BE EMOTIONALLY EXPRESSIVE (COOLEY & LAJOY, 1980; ORLINSKY & HOWARD, 1986) BEING DIRECTIVE ENCOURAGES CLIENTS TO PRACTICE SKILLS OUTSIDE OF THE SESSION (SCHAAP ET AL., 1993) THERAPEUTIC FLEXIBILITY SHOWN MORE EFFECTIVE THAN RIGIDLY FOLLOWING STRICT PROCEDURES OR UNWAVERING ADHERENCE TO A MANUAL (RINGLER, 1977) GENERAL THERAPY: (CONT.) 6

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8 Demonstrates empathy, respect, warmth, friendliness, sincerity, genuineness, directness, confidence Exhibits interest in the client Is a pro-social model Communicates clearly Listens actively Firm but fair Reinforces and encourages Creates opportunities for success Deals appropriately with frustration and other client difficulties Challenges without being aggressively confrontational Creates a secure treatment atmosphere 8

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10 CURATIVE FACTORS IN SEX OFFENDER TREATMENT THE THERAPIST-ACCORDING TO THE OFFENDER CURATIVE FACTORS IN SEX OFFENDER TREATMENT THE GROUP ACCORDING TO THE OFFENDER CURATIVE FACTORS IN SEX OFFENDER TREATMENT THE GROUP ACCORDING TO THE OFFENDER (CONT.) 10

11 CURATIVE FACTORS IN SEX OFFENDER TREATMENT THE GROUP ACCORDING TO THE OFFENDER (CONT.) 11

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