Property of NOTA 2017

Transcription

1 Incorporating innovation and evidence informed practice into a new generation of programmes for men who have been convicted of sexual offences HM Prisons and Probation Service Dr Mark Farmer National Specialist Lead Interventions Services

2 But brothers, this biting of their toe nails over what is the cause of badness is what turns me into a fine laughing malchick. They don t go into the cause of goodness, so why the other shop? badness is of the self, the one, the you or me on their oddy knockies I am serious with you, brothers, over this. But what I do I do because I like to do. Anthony Burgess, A Clockwork Orange

3 Overview of presentation Timeline of changes Theory behind the changes Risk, need and responsivity What should we do less of? What should we do more of? The bio-psycho-social model of change How have we used desistance research? The New Delivery Model Conclusions

4 Redesign of sexual offending programmes 2010 Re-write project begins 2012 Hi Intensity and Medium Intensity programmes provisionally accredited Pilots in prison and probation 2014 Development of Horizon begins 2015 Horizon accredited 2016 Horizon roll out begins 2016 Kaizen accredited 2017 Kaizen roll out begins

5 40 Mark s learning curve

6 Developments in the literature: The importance of the Risk, Need and Responsivity (RNR) model The influence of biological, psychological, and social factors on criminogenic need and intervention methodology. The importance of strengths based, brain friendly approaches. Developing understanding of desistance as well as risk

7 What do we know? Risk Need Responsivity Andrews, D. A., & Bonta, J. (2006). The psychology of criminal conduct (4th ed.). Newark, NJ: LexisNexis/Matthew Bender. Hanson, R. K., Bourgon, G., Helmus, L., & Hodgson, S. (2009). The principles of effective correctional treatment also apply to sexual offenders: A meta-analysis. Criminal Justice and Behavior, 36,

8 Psychological Risk Factors for Sexual Recidivism (Mann, R. E., Hanson, R.K. & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse: A Journal of Research and Treatment, 22 (2), ) Empirically supported risk factors Promising risk factors Not risk factors Sexual preoccupation Hostility toward women Depression Any deviant sexual interest Machiavellianism Poor social skills Offence supportive attitudes Callousness Poor victim empathy Emotional congruence with children Dysfunctional coping Lack of motivation for treatment at intake Lack of emotionally intimate relationships with adults Lifestyle instability General self-regulation problems Poor cognitive problem solving Resistance to rules and supervision Grievance/hostility Negative social influences

9 Doing too much of? Offence responsibility Victim empathy

10 Not doing enough of? Sexual self regulation Sexual interests Offence supportive attitudes Impulsivity Problem solving & coping Grievance, hostility and callousness Social support Intimacy support Employment or constructive use of time

11 What should we do less of?

12 Relationship of Victim Empathy to recidivism Hanson and Busierre (1998) VE unrelated to sexual recidivism Hanson and Morton Bourgon (2004) VE not significantly related to recidivism Mann, Hanson and Thornton (2010) VE not a risk factor Hanson,. R.K. and Bussiere, M.T. (1998) Predicting Relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical Psychology. 66, 2. Hanson, R. K., & Morton-Bourgon, K. E. (2005). The characteristics of persistent sexual offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical Psychology, 73, Mann, R. E., Hanson, R.K. & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse: A Journal of Research and Treatment, 22 (2),

13 What might disrupt the empathic process? Failure to pick up on cues that someone might be distressed (due to intense emotions, shame, implicit theories) If cues are identified lack of concern or restricted ability to feel emotion (indifference, grievance thinking, entitlement thinking) If attend to distress and accurately interpret it might have problems in managing distress, victim blaming, minimisation etc. Barnett, G. & Mann, R.E. (2012). Empathy deficits and sexual offending: A model of obstacles to empathy. Aggression and Violent Behavior, 18,

14 Implications for treatment programmes Move away from Victim Empathy as a single concept Look at how people can overcome blocks to empathy in the future Target Grievance Hostility Callousness Offence supportive attitudes Child abuse supportive beliefs Sexual entitlement Women are deceitful Poor self-regulation Sexual preoccupation Inadequacy Barnett, G. & Mann, R.E. (2012). Empathy deficits and sexual offending: A model of obstacles to empathy. Aggression and Violent Behavior, 18,

15 Jim Old Approach Sexually abused a 14 year old child who was the daughter of someone he worked with. Says she chatted him up. Says it did no harm. Says he believes she was mature for her age. Now he is angry with her mother who he says caused all of this when she found out about the abuse and reported him to the police. Victim letter? Victim ripple exercise? Watching videos of other victims?

16 Jim New Approach Sexually abused a 14 year old child who was the daughter of someone he worked with. Says she chatted him up. Says it did no harm. Says he believes she was mature for her age. Now he is angry with her mother who he says caused all of this when she found out about the abuse and reported him to the police. Offence supportive attitudes Child abuse supportive beliefs Sexual entitlement Women are deceitful Poor self-regulation Sexual preoccupation? Grievance Hostility Callousness

17 Responsibility for past offending

18 What do we mean by taking responsibility? A full and accurate account of offending? Acceptance of internal, stable causes Not just I did it Absence of denial and minimisation? Ability to shoulder the blame for it? No victim blaming?

19 Relationship of denial to recidivism Hanson and Busierre (1998) denial unrelated to sexual recidivism Hanson and Morton Bourgon (2004) denial not significantly related to recidivism Mann, Hanson and Thornton (2010) denial not a risk factor (but with some exceptions) Hanson, R.K. and Bussiere, M.T. (1998) Predicting Relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical Psychology. 66, 2. Hanson, R. K., & Morton-Bourgon, K. E. (2005). The characteristics of persistent sexual offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical Psychology, 73, Mann, R. E., Hanson, R.K. & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse: A Journal of Research and Treatment, 22 (2),

20 Denial and minimisation Often occur after the offence (post hoc) Some studies suggest those who deny their offences are at lower risk of reoffending Desisting sexual offenders consistently deny and minimise their offending Likely to be protective for some men who have committed sexual offences, but not where it indicates underlying schema Excuses might be an indicator of dynamic risk factors (e.g. I did it because I was stressed = poor coping skills?) Maruna, S. and Mann, R.E. (2006) A fundamental attribution error? Rethinking cognitive distortions. Legal and criminal psychology, 11: Farmer M, McAlinden A-M, Maruna S (2015) Understanding desistance from sexual offending: A thematic review of research findings. Probation Journal, 62(4): Yates, P.M. (2009) Is sexual offender denial related to sex offence risk and recidivism? A review and treatment implications, Psychology, Crime and Law, 15: 2, Snyder, C. R., Higgins, R. L. (1988) Excuses: Their effective role in the negotiation of reality. Psychological Bulletin, 104, Hood, R., Shute, S., Feilzer, M., Wilcox, A. (2002). Reconviction rates of serious sex offenders and assessment of their risk. Home Office Research Finding 164.

21 This is my truth, tell me yours Aneurin Bevan

22 Harry Old Approach Harry has been convicted of sexually abusing his 9 year old daughter. He committed the offences at a low point in his life [Excuse Challenge], when he had separated from his partner. He says his daughter clung to him because she was scared [Failure to take responsibility; Victim blaming Challenge]. He says he did not encourage this, and his sexual thoughts towards her only arose when she got into the bath with him (creating opportunity to offend? challenge). He says that he was drunk at the time, and had he not been drunk he would not have acted on those sexual thoughts [Excuse Challenge]

23 Harry New Approach Harry has been convicted of sexually abusing his 9 year old daughter. He committed the offences at a low point in his life [possible poor problem solving], when he had separated from his partner [possible lack of intimacy/relationship skills/impulsivity]. He says his daughter clung to him because she was scared. He says he did not encourage this, and his sexual thoughts towards her only arose when she got into the bath with him. He says that he was drunk at the time, and had he not been drunk he would not have acted on those sexual thoughts [possible alcohol/ addiction problems, self-management].

24 Passive responsibility taking responsibility for the past Active responsibility taking responsibility for the future Maruna, S. and Mann, R.E. (2006) A fundamental attribution error? Rethinking cognitive distortions. Legal and criminal psychology, 11:

25 So what should we be doing more of?

26 Psychological Risk Factors for Sexual Recidivism (Mann, R. E., Hanson, R.K. & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse: A Journal of Research and Treatment, 22 (2), ) Empirically supported risk factors Promising risk factors Not risk factors Sexual preoccupation Hostility toward women Depression Any deviant sexual interest Machiavellianism Poor social skills Offence supportive attitudes Callousness Poor victim empathy Emotional congruence with children Dysfunctional coping Lack of motivation for treatment at intake Lack of emotionally intimate relationships with adults Lifestyle instability General self-regulation problems Poor cognitive problem solving Resistance to rules and supervision Grievance/hostility Negative social influences

27 What do we mean by risk factor? What we generally term risk factors for sexual offending should be seen as manifestations of underlying genetic factors and neuropsychological systems interacting with social learning, the social and cultural roles of the offender, and the environment in which he/she lives Ward, T., & Beech, A. R. (2006). An integrated theory of sexual offending. Aggression and Violent Behavior, 11,

28 Towards a bio-psycho-social model Mann, R. E. & Carter, A. J. (2012). Organising principles for the treatment of sexual offending. In B. Wischka, W. Pecher & H. van der Boogaart (Eds)., Behandlung von Straftätern: Sozialtherapie, Maßregelvollzug, Sicherungsverwahrung [Offender treatment: Social Therapy, Special Forensic Hospitals, and Indeterminate Imprisonment]. Centaurus. Psychological personality and developmental experiences Biological genetic and neurodevelopmental influences Dynamic risk factor Social influence of others as well as cultural and situational influences

29 For example Psychological early attachment problems can lead to disordered models of intimacy Biological overactive amygdala as a result of childhood experiences Problems with social and emotional functioning Social conflict in social environment due to relational style

30 For example Psychological conditioning, attachment problems Biological neurological impairment associated with childhood trauma, other biological impairment Problems with sexual interests Social disordered attachment styles intimacy problems Tenbergen, G., Wittfoth, M., Frieling, H., Ponseti, J., Walter, M., Walter, H., Beier, K. M., Schiffer, B., & Krueger, T. H. C. (2015). The neurobiology and psychology of pedophilia: Recent advances and challenges. Frontiers of Human Neuroscience. 9:344

31 For example Psychological Schema/personal rules Biological no biological basis established (possible rigid cognitive style) Offence supportive attitudes Social rape myths, sexualisation of children, objectification of women

32 For example Psychological regulatory difficulties associated with poor attachments, Biological genetic influences on selfregulation, other relationships between neurological problems and self-control Selfmanagement problems Social association with delinquent peers, emotional isolation from peers

33 How do we write biologically informed programmes?

34 My brain? That s my second favourite organ Woody Allen The Sleeper,

35 The need for biologically informed programmes Significant histories of abuse, neglect and other traumatic experiences Attachment difficulties Alcohol abuse, drug addiction, poor health & nutrition Traumatic injury McMakin, Leisen, Cusak, LaFratta & Litwin, 2002, The relationship of trauma exposure to sex offending behavior among male juvenile offenders. Journal of Child Sexual Abuse, 11 (2)25-40 Creeden, K. (2004). Integrating trauma and attachment research in the treatment of sexually abusive youth. In M. C. Calder (Ed.), Children and young people who sexually abuse: New theory, research, and practice developments: Russell House Publishing. Creeden, K. (2006). Neurological impact of trauma and implications. In R. Longo & D. Prescott (Eds.) Current perspective: Working with sexually aggressive youth and youth with sexual behavior problems NEARI Press Williams WH1, Mewse AJ, Tonks J, Mills S, Burgess CN, Cordan G. 2010, Traumatic brain injury in a prison population: prevalence and risk for re-offending. Brain injury 24 (10)

36 Neuroprocessing obstacles Our treatment approaches tend to be primarily presented in a language based modality (which) largely ignores the type of neuro-processing obstacles that might make it difficult for many of our clients to learn, remember, and retrieve useful information and skills necessary to avoid or prevent further abusive behaviour (Creeden, p234)

37 Visual: paying attention to visual messages Auditory: paying attention to auditory messages Kinaesthetic: paying attention to action

38 Use visual aids Pictures / Photographs / Clipart Drawing Flow charts / Diagrams Symbols Time lines Storyboarding Collage making

39 Clear simple language use Concrete not abstract 80/20 discussion Consider tempo & pace Use of rhyme, rhythm, rap, song, music

40 Encourage active participation - Opportunities for successful practice Put them in roles which show their learning eg perspective taking Show me/ you show me what I should do Use gestures to support other messages

41 The Great Eight tactics

42 Methods designed to build biological resources Mindfulness techniques especially affect labelling and slow deep breathing Monitoring and Repetition such as diary keeping and repeated practice of important new skills Problem solving training using structured steps Diet and exercise monitoring Medication (SSRIs and anti-androgens)

43 Social Methods Developing social capital Encouraging social protective factors Employment, accommodation, hobbies Enhancing social support Filling gaps for those who lack support Maintaining family ties Teaching better relationship skills such as negotiation, assertiveness etc.

44 Psychological methods Exercises in which healthy psychological functioning is repeatedly experienced Relationship skills Self-management skills Problem solving Changing thoughts and attitudes Personal rules/schema Managing sexual thoughts/interests Use of Life Map

45 How have we used desistance research? y of NOTA 2017

46 Crime and research two paradigms What Works? Risk Need Responsivity Desistance Social bonds/transitions Cognitive transformations Identity

47 Understanding desistance from sexual offending Some themes Denial and minimization Identity change Future planning Farmer M, McAlinden A-M, Maruna S (2015) Understanding desistance from sexual offending: A thematic review of research findings. Probation Journal, 62(4): McAlinden, A-M., Farmer, M., & Maruna, S. (2017). Desistance from Sexual Offending: Do the Mainstream Theories Apply? Criminology and Criminal Justice, 17(3), Farmer, M., McAlinden, A.M., Maruna, S. (2016) Sex offending and situational motivation: findings from a qualitative analysis of desistance from sexual offending. International journal of offender therapy and comparative criminology. 60 (15),

48 Practice implications Denial/minimisation not a treatment target We should concern ourselves more with getting people to take responsibility for the future than the past We should help them make plans for the future We should assist ex-offenders to develop a positive non-offending identity We should be careful about the language we use

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50 The New Delivery Model Extended SOTP TV-SOTP SCP N-SOG High Intensity HRP C-SOG Chromis Core SOTP TV-SOTP C-SOG N-SOG C-SOG BNM NMS* BNM HSP Kaizen Horizon Becoming New Me+ New Me Strengths Healthy Sex Programme 50

51 I knew what was happening, O my brothers. I was like growing up. Anthony Burgess, 1962 A Clockwork Orange 51