CORRECTIONAL COUNSELING AND REHABILITATION, FIFTH …
Correctional Counseling and Rehabilitation, Seventh Edition
by
Patricia Van Voorhis, Michael Braswell
& David Lester
Instructor’s Guide
Copyright © 2009
Anderson Publishing Co./A Member of the LexisNexis Group
Phone 877-374-2919
Web Site anderson/criminaljustice
All rights reserved. Other than for use in test creation by instructors who have adopted this textbook, no part of this guide may be reproduced in any form or by any electronic or mechanical means including information storage and retrieval systems without permission in writing from the publisher.
These materials are strictly for the use of instructors who have adopted Correctional Counseling and Rehabilitation, Seventh Edition.
© 2009 by LexisNexis Matthew Bender
ISBN-13: 978-1-4224-6140-2
Two files have been provided, one that has the answers of objective questions indicated in the file, and the other without for use in test creation.
Chapter 1
The Process of Correctional Counseling and Treatment
Michael Braswell and Jennifer L. Mongold
Key Concepts and Terms
community-based counselors
counseling and case management
educational specialists
effective risking
institutional counselors
meta-analysis
professional humility
psychotherapy
recreational programs
storytelling
therapeutic intention
therapeutic relationship
timing
Goals of Offender Counseling and Treatment
Correctional counselors are helping professionals who work in correctional settings. They have studied both the science and art of human behavior and been trained to use therapeutic intervention strategies. Their primary goal is to intervene therapeutically with various clients, the majority of whom happen to be offenders. Their interventions include prison adjustment, prisoner re-entry, risk of future offending, substance abuse, education and employment, and mental health concerns. In sum, these interventions contribute to offenders’ reform as well as their personal and social transformation.
The Counseling Process
Correctional counseling and psychotherapy are comprised of a process that includes four essential qualities: a sense of timing, effective risking, high-quality therapeutic relationships, and professional humility. The judicious use of these elements can assist an offender in making positive choices because the intention itself is a meaningful reward, regardless of the outcome. Storytelling and story listening also provide meaning to these elements. In the final analysis, the offender gaining self-respect is a core therapeutic goal.
Types of Correctional Counseling
Correctional counseling occurs in both community-based and institution-based systems, and most recently includes specialized mental health and drug courts and restorative justice programs. Ideally, institution and community-based counselors coordinate their efforts to make an inmate’s transition easier from institution to community. The types of interventions that occur in these settings include individual counseling, group counseling, educational and vocational counseling, recreation, and psychotherapy.
Effectiveness of Offender Counseling and Treatment
This section analyzes the term effectiveness. The manner in which effectiveness is defined plays a part in determining the outcome of evaluation studies. A number of approaches have been used to measure the effectiveness of correctional counseling. One of the most respected of these methods uses meta-analysis to summarize results across studies. Qualitative methodology also contributes to a better understanding of dynamic human behavior. The consensus is that an effective counseling/treatment program is comprised of elements that include a cooperative treatment community, a willingness to change from the status quo, and a well-trained and educated staff, among several other key elements.
Conclusions
Pre-release, post-release, and family readjustment counseling all fall within the domain of the correctional counselor. The scope and purpose of offender counseling covers a dynamic range of professional expertise and responsibility.
True/False Questions
1. The traditional idea of correctional counseling may not be compatible with the legitimate interests and purposes of helping offenders.
2. We should view counselors as helping professionals who apply their skills and expertise in correctional and related settings.
3. In order to develop a sense of timing, the counselor needs to carefully plan the session ahead of time and play it out exactly as planned.
4. According to the authors, communication is the lifeblood of relationships.
5. Typically, a counselor who works in a correctional setting is concerned first with the rehabilitation and treatment needs of the offender, and second with the security/custody needs of the agency and community.
6. Risking, in a therapeutic sense, is exemplified by an offender committing to a serious effort to substantially change attitude and behavior patterns.
7. The roles of probation and parole officers are conflictual in that they must maintain a balance between enforcing the conditions of probation or parole, yet provide counseling and guidance services.
8. Therapeutic intention may be more important to long-term rehabilitation than immediate outcomes from treatment.
9. One of the guiding principles for gender-responsive policies is that gender does not make a difference in terms of counseling offenders.
10. Parole is perhaps most utilized as an alternative to sentencing juvenile and adult offenders to correctional facilities.
11. Confidentiality is not an issue in the dual role conflict experienced by probation/parole officers.
12. To a large extent, institutional counselors are more involved in offender or correctional maintenance than in offender or correctional treatment.
13. Meaningful communication most often occurs when we effectively filter people and events through the mindset of our dominant culture.
14. Without genuine care and commitment to the helping process, therapeutic outcomes for both the client and counselor will fall short.
Multiple-Choice Questions
1. Which of the following is not a focus of therapeutic intervention that might be utilized by a counselor?
a. education and employment
b. mental health concerns
c. prison adjustment
d. none of the above
2. Which of the following is not one of the four essential abilities of counseling, as suggested by the authors?
a. high-quality therapeutic relationships
b. focus on task at hand
c. professional humility
d. effective risking
3. Correctional counseling includes which of the following?
a. creating opportunities for personal and social transformation
b. assisting with institutional adjustment
c. encouraging personal reform
d. all of the above
4. Parole and probation counseling fall under the _____ category in the correctional setting.
a. institutional
b. community-based
c. prison environment
d. diversion
5. Counselors who demonstrate the key quality of _________ will persevere in their attempts to impart in their clients a desire to do the right thing.
a. expectation
b. sense of timing
c. therapeutic intention
d. contentment
6. The primary focus of the institutional counselor known as the _________ is often to help inmates survive the stresses of prison life.
a. probation officer
b. parole officer
c. case manager
d. prison chaplain
7. One of the more important roles of the institutional counselor is to:
a. prepare reports on inmates for their parole boards.
b. initiate revocation proceedings when necessary.
c. assist in the inmate’s transition to the community.
d. none of the above
8. The United Nations Economic and Social Council endorses correctional education standards, including:
a. involving the outside community as fully as possible.
b. access to education for all prisoners.
c. developing the whole person.
d. all of the above
9. The failure of offenders in mainstream educational settings is often the result of:
a. the “treatment versus security” dilemma.
b. misuse of psychotherapy as treatment.
c. the tendency of these offenders toward recidivism.
d. unaddressed learning disabilities.
10. Which of the following is not one of the four basic categories of treatment programming?
a. reintegration
b. education
c. recreation
d. psychotherapy
11. Which of the following represents a major problem in the area of correction recreation?
a. an increase in physical conflicts among inmates
b. the inability of physically disabled offenders to participate
c. the perception that the recreation specialist is no more than an activity coordinator
d. the current debate about the effectiveness of recreation as treatment
12. Outward Bound and Youth Wilderness Programs offer youthful offenders opportunities to engage in socially acceptable group activities. Which of the following is not an opportunity provided by these programs?
a. money management
b. physical conditioning
c. team training
d. technical training
13. Which of the following are measurements of effective counseling?
a. information on recidivism
b. statistics on long-term, post-release follow-up
c. both a and b
d. neither a nor b
14. In treating an offender who requires medication to control a mental disorder, which of the following professionals would be legally qualified to administer such a medication?
a. psychologist
b. clinical social worker
c. psychiatrist
d. psychometricist
15. The statistical technique of meta-analysis:
a. corrects methodological problems of individual studies.
b. allows the summarizing of results across studies.
c. creates a statistic to gauge effectiveness of program types.
d. all of the above
16. Practitioners and researchers generally agree that the elements comprising an effective counseling program include:
a. a method for matching the offender with a therapist and a program.
b. relapse prevention strategies.
c. a willingness to maintain the status quo in following consistently successful strategies.
d. both a and b
17. Psychotherapy in the context of correctional counseling includes maintaining the perspective of therapeutic intention as more important than:
a. effectively incorporating the skills of timing and risking.
b. having a clear, professional identity.
c. the outcome of decreased recidivism rates.
d. all of the above
Short-Answer and Discussion Questions
1. The primary goal of correctional counselors appears to be one of intervening therapeutically with various clients. Provide two examples of more specific goals that counselors may endeavor to achieve when working with clients in a prison setting.
2. We live in a social system that is often punishment-oriented. How can counselors’ retributive feelings affect treatment efforts?
3. Risking in a therapeutic sense is a commitment that neither an offender nor a nonoffender would take lightly. How can a counselor help offenders become better able to take risks effectively?
4. Discuss the importance of therapeutic intention in rehabilitation and achieving and maintaining long-term stability.
5. Why is it important that institutional and community-based counselors coordinate their efforts in counseling offenders?
6. What are two factors associated with incarceration that can compromise inmates’ mental well-being?
7. Discuss the potential benefits to society that correctional educators can provide in successfully meeting the challenge in the education of inmates.
8. Why are inmates a difficult population to educate?
9. When correctional institutions operate varied and comprehensive recreational programs, problems and benefits may occur. Provide an example of a potential problem and a likely benefit.
10. Discuss the four essential abilities of a counselor as suggested by the authors. Do you agree or disagree with them? Would you add or take away some attribute that you feel is more or less important?
11. How effective is offender counseling? What are some fundamental or key ingredients of offender counseling that make it effective?
12. Discuss the conflict that arises out of the need to maintain order, yet provide some type of treatment. How do you feel about this? Should such a conflict exist and if so, why? If not, which should take precedence?
13. Should correctional counselors be concerned with both institutional and outside world adjustments? Are these mutually exclusive? Explain.
14. Discuss how storytelling and story listening contribute to experiencing ourselves and others in a more personal and dynamic context.
15. What are some issues involved in differentiating between offender and correctional counseling?
16. What is meant by gender-responsivity, and how might it be demonstrated?
17. What are the six basic elements of communication, and how do they relate to the “abilities” in question 10?
18. What are four ways in which correctional counselors become more sensitive to the ethnic and cultural diversity of offenders?
19. Discuss the crucial role that both education and recreation specialists play as part of the correctional counseling and treatment team.
Chapter 2
Understanding the Special Challenges Faced by the Correctional Counselor in the Prison Setting
William N. Elliott and Jeffrey L. Schrink
Key Concepts and Terms
brutality of prisons
burnout prevention
cognitive-behavioral interventions
collaborative relationship
collateral information
contextual demands
counseling principles
counseling techniques
criminal lifestyle
criminal personality
crisis intervention
dual/multiple relationships
ethical dilemmas
ethnocentrism
group counseling
“here and now”
interpersonal boundaries
positive peer culture
power and control tactics
power struggles
redirection
reframing
resistance to treatment
reversal of responsibility
special needs offenders
stereotyping
suicide prevention
thinking errors
treatment versus security dichotomy
Preliminary Considerations
Correctional counseling is an intensive, powerful, interactive process. Most corrections departments require at least an undergraduate degree. Correctional counselors run the gamut from dedicated professionals to those who just do the job for a paycheck.
Principles and Techniques
A collaborative relationship between counselor and client is required for successful interventions. The correctional counselor must also be able to confront the offender with the bad decisions and behavior that led to incarceration. Although personal involvement with the offender is essential to success, maintaining interpersonal boundaries is important. Looking to the past for understanding of an offender’s behavior is often fruitless, as offenders generally think more in the “here and now.” Group counseling is a preferred mode of treatment due to the feedback and peer group pressure provided. Counselors are advised to seek collateral information about their clients. Cognitive-behavioral interventions have some efficacy in reducing criminal risk and recidivism. The authors are advocates of the cognitive-behavioral approaches referred to as “The Criminal Personality” and “The Criminal Lifestyle.” Challenging the “thinking errors” of offenders is an integral part of treatment. Focusing counseling efforts on criminal thinking requires the patience and commitment of the counselor.
Resistance to Treatment
Resistance to treatment can take many forms. Twelve specific power and control tactics employed by offenders, known as the “dirty dozen,” have been identified. Power struggles between counselor and offender are counterproductive to successful counseling. To avoid power struggles, counselors need to employ indirect methods, including such strategies as those known as the “3Rs”: redirection, reframing, and reversal of responsibility. An important element in managing resistance is avoiding extended debates with offenders.
Ethical Dilemmas
Conflicting ethical demands arise when abstract standards collide with the practical realities of counseling. The authors would argue that treatment and security are not necessarily conflicting demands; instead, they would contend that successful treatment can only occur in a secure environment. The question of who is the client is not a multiple-choice item, as interests of offender and institution can overlap, and both the offender and institution can be considered clients of the counselor. Counselors can be faced with the dilemma of dual or multiple relationships when performing tasks unrelated to treatment, such as security-related tasks. Although it is ethically imperative that counselors be sufficiently knowledgeable and competent to treat offenders, counselors need to be careful that they function within the boundaries of their expertise. Because ethical standards require that counselors report to authorities when clients indicate an intention to harm someone, counselors need to clarify with the offender what communications will be kept confidential and what protections the client has in the relationship.
Contextual Demands
A host of issues and demands arise from the correctional environment and make the counselor’s job more difficult. Correctional counselors may have a difficult time coping with the regimentation that is endemic to prison operation. Other contextual demands include handling excessive paperwork and managing large caseloads. Counselors need to avoid the tendency to resort to ethnocentrism and stereotyping that can result from the racial and ethnic skewing found in prison populations. To do this, the counselor can assume a more racially and ethnically sensitive approach, which is often referred to as multicultural counseling. The caseloads of correctional counselors often consist of special needs offenders, such as substance abusers, mentally ill or mentally retarded individuals, and those that have been victims of physical or sexual abuse. Counselors must deal with crisis intervention issues such as adjustment difficulties, internal distress, and suicidal tendencies. Counselors may find it difficult to endure both the inherent brutality of the prison environment and the exposure to accounts of the pain and misery caused by offenders.
Final Considerations
Ten strategies for burnout prevention and career satisfaction have been dubbed the “Ten Commandments for Prison Staff.” The authors recommend that counselors maintain a healthy sense of humor, including “gallows humor.”
True/False Questions
1. Most corrections departments require at least an associate degree in criminology/criminal justice or a social or behavioral science.
2. Counselors who explore the offender’s past for antecedents of current problems are likely to find the cause of the offender’s behavior.
3. One of the reasons group counseling is preferred is that peer group pressure and influence are inherently therapeutic.
4. Investigations of collateral information are not enlightening because many offenders are masters of deceit.
5. Challenging the thinking errors employed by offenders is not an integral part of treatment.
6. Offenders that are outwardly compliant are not usually resistant to treatment.
7. An offender circulating a petition calling for the reassignment of a counselor labeled as “racist” is an example of the power and control tactic known as “disreputation.”
8. An offender complimenting a counselor on her perfume and asking if her husband likes it is an example of the “ingratiation” tactic of power and control.
9. Power struggles between counselor and offender often reveal the counselor’s vulnerabilities or “hot buttons.”
10. It is imperative that counselors become adept at using direct methods of engaging offenders in the counseling process.
11. The “redirection” strategy of the “3Rs” of managing offender resistance includes the technique of focusing on the offender’s resistance and ignoring other group members’ reactions to the resistance.
12. One of the most important elements in managing resistance is avoiding extended debates with offenders.
13. The premise that treatment and security are mutually in conflict is widely accepted.
14. One ethical dilemma faced by correctional counselors is who the client is, i.e., whether the client is the institution or the offender.
15. An example of when the ethical dilemma of dual/multiple relationships might arise is when a counselor is asked to participate in a search for contraband.
16. By supplementing his or her training and experience, in areas pertinent to working with offenders, a counselor can become something akin to all things to all people in terms of serving the full range of offender needs and problems.
17. Because confidentiality in the offender-counselor relationship is essential, the counselor is not required to report to authorities when a client indicates the intent to harm someone.
18. Working in a bureaucracy and handling excessive paperwork are two of the contextual demands that regularly confront the correctional counselor.
19. Because the counselor is not required to accept any and all inmates assigned, he or she is able to develop a specialized caseload.
20. Multicultural counseling is an approach that enables counselors to judge people based on assumed group characteristics.
21. One recommendation for burnout prevention is that a counselor should maintain and exercise a healthy sense of humor.
Multiple-Choice Questions
1. The caliber of individuals who work as correctional counselors includes:
a. highly dedicated professionals.
b. those who take their work seriously.
c. those who just put in the hours for a paycheck.
d. all of the above
2. Establishing a meaningful relationship with the offender:
a. is important to establishing interpersonal boundaries.
b. is essential to successful counseling.
c. prevents the counselor from confronting the offender with the irresponsible decisions that led to his or her incarceration.
d. none of the above
3. Many counselors are reluctant to build personal involvement with offenders because they:
a. have very little time to do so because of their heavy caseloads.
b. are aware that personal involvement with offenders is unethical.
c. fear manipulation and exploitation from the offenders.
d. fear becoming overly emotionally involved with the offenders.
4. Group counseling is a preferred mode of providing offender treatment because:
a. groups provide the offender with a wealth of new information gathered from interactions from other individuals.
b. offenders challenge each other with feedback.
c. peer group pressure and influence are inherently therapeutic.
d. all of the above
5. Collateral information can be enlightening to a counselor because:
a. many offenders are masters of deceit.
b. collateral information can help present a comprehensive impression of the offender.
c. offenders tend to present themselves to their counselors in a favorable light.
d. all of the above
6. Which of the following is not one of the “Dirty Dozen,” i.e., the power and control tactics exhibited by inmates?
a. sphere of influence
b. diversion
c. thinking errors
d. rumor clinic
7. Which of the following is a reason power struggles between counselors and offenders are counterproductive?
a. offenders will always emerge victorious from power struggles
b. power struggles can impact the physical safety of the counselor
c. power struggles tend to cause feelings of inferiority in offenders
d. none of the above
8. The “3Rs” of managing offender resistance to counseling are redirection, _________, and reversal of responsibility.
a. reinforcing
b. reframing
c. recrimination
d. raising consciousness
9. What can the counselor do to avoid extended debates with offenders?
a. point out the thinking errors that led to the offenders’ consequences
b. terminate the counseling session for the time being
c. point out the self-defeating nature of the offenders’ behavior
d. all of the above
10. Some argue that ethical dilemmas naturally arise because:
a. of the dichotomy of practicality and safety.
b. counselors are often required to assume the role of a helper.
c. of the unavoidable conflict between rehabilitation and retribution.
d. of the unavoidable conflict between treatment and security.
11. A major ethical issue is seen in the counselor’s divided loyalties between:
a. practical concerns and ideals.
b. institution and offender.
c. theoretical concepts and practice.
d. all of the above
12. The performance of security-related tasks does not pose significant ethical problems unless:
a. the counselor’s tasks related to security distract him or her from counseling duties.
b. the security-related tasks negatively affect treatment of offenders.
c. both a and b
d. it can be demonstrated that offenders would be jeopardized or exploited.
13. Ethnocentrism involves:
a. judging others based upon their beliefs.
b. judging others based upon our beliefs.
c. an attempt to be open to cultural diversity.
d. assisting others in feeling good about their racial and social backgrounds.
14. Stereotyping others is:
a. judging them based on objective research results.
b. judging them on assumed group characteristics.
c. an appropriate method of grouping offenders.
d. none of the above
15. Which of the following is a good way for the correctional counselor to avoid problems related to ethnocentrism?
a. assume a more ethnically sensitive approach
b. adopt the approach of unicultural counseling
c. learn to appreciate individuals as belonging to a larger group
d. none of the above
16. What special needs do female offenders often present to counselors?
a. problems with their relationships with other offenders
b. problems with their relationships with their children
c. problems caused by physical abuse in their past
d. both b and c
17. Which of the following is one of the fastest-growing subpopulations of offenders since the 1960s?
a. minority offenders
b. recidivistic offenders
c. poorly educated offenders
d. mentally ill offenders
Short-Answer and Discussion Questions
1. Describe the importance of education and experience as factors in effective counseling of offenders.
2. How can conventional counseling be used to effectively treat offenders?
3. Why has group counseling become a preferred means of providing treatment to offenders?
4. It has been said that there is no “magic bullet” for the effective treatment of offenders. What techniques have been effectively used to address criminal thinking?
5. What are the various forms of resistance to treatment that counselors commonly encounter?
6. Describe the ethical considerations that arise from the axiom that confidentiality is essential to the counseling relationship.
7. Describe the effect that racial and ethnic skewing has on the efforts of correctional counselors.
8. What crisis intervention services are correctional counselors often required to provide to inmates?
9. Discuss effective strategies employed by correctional counselors to avoid burnout prevention.
10. Discuss the importance of identifying and challenging criminal thinking when counseling offenders.
11. Describe the strategies recommended by the authors for managing offender resistance to counseling.
12. What are some of the ethical dilemmas facing the correctional counselor? How can they be successfully resolved?
13. Discuss some of the contextual demands encountered by the correctional counselor that make his or her job more stressful.
Chapter 3
Psychoanalytic Therapy
David Lester and Patricia Van Voorhis
Key Concepts and Terms
anxiety
become conscious of unconscious desires
countertransference
defense mechanisms
delinquent superego
ego
ego control
ego deficits
ego failures
ego ideal
ego psychology
ego strengths
free association
id
interprets
object relations
principle of psychic determinism
projection
projective identifications
psychodynamic therapy
reaction formation
superego
therapeutic alliance
transference
windows to the unconscious
Psychoanalytic/Psychodynamic Theory
Sigmund Freud, in developing his comprehensive theory of human behavior, asserted a basic assumption: all behavior is motivated by primitive instincts. Freud called this assertion the principle of psychic determinism. Freud’s motivation theory was expressed in wishes that are unconscious. In explaining the interaction of the individual and his or her environment, Freud posited three mental structures: the id, the ego, and the superego. They are developmental in nature.
The crucial motivator in psychic interaction is anxiety. Anxiety occurs when the individual experiences conflict between wish fulfillment and external demands. Thus, all behavior is a compromise between the individual and the environment: (1) ways to satisfy unconscious desires without becoming conscious of them, and (2) ways out of dilemmas.
Freud’s use of defense mechanisms further describes the adaptive response to conflict. Figure 3.1 provides an excellent summary of the defense mechanisms. Freud held that the use of defense mechanisms represents a “less than honest” response to anxiety. Defense mechanisms, while useful, represent “short-term solutions to long-term problems.”
Psychoanalysis has undergone many transformations since Freud. In fact, psychoanalytic therapy has evolved into psychodynamic therapy, including the recent branch of ego psychology.
Psychoanalytic Therapy
The goal of psychoanalysis is to “make conscious what is unconscious.” Because one is dealing with unknown quantities of anxiety, the process must be accomplished over long periods. The techniques used by psychoanalytic therapists include free association, dream analysis, and transference. In this model, the therapist serves as an interpreter of a client’s behavior. Each of these models seeks to understand the influence of early childhood development on adult behavior.
Psychoanalytic Approaches to Crime
The therapist asks, “What typical desires that we find in most people are missing in this person?” Each individual provides a unique answer to this question. This section provides a case study to assist in exploring this issue.
Aggressive Delinquents
The following sections focus on the work of Redl and Wineman (1951), highlighting the variety of criminogenic factors that should be included in any evaluation of an aggressive delinquent. First, ego deficits, ego failures, and ego strengths, as well as characteristics of the delinquent superego are discussed. Second, the sources of these peculiarities are reviewed and illustrated. Third, implications for treatment are revealed in this final section with a review of Redl and Wineman’s recommendations for maintaining an appropriate and effective therapeutic environment and process. Such components as providing a hygienic environment, focusing on ego support, and exploiting live events provides the student with an overview of avenues to assist in “making the unconscious conscious.”
Psychoanalysis for Criminals
Psychoanalysis is not a practical alternative for most criminals or delinquents. Some valuable vestiges of psychoanalytic theory can be made part of a good therapy program for offenders, including recognizing defense mechanisms and transference exhibited by clients, and being aware of the countertransference tendencies of the counselor. Therapists can potentially address the problem of ego control in their clients. They need to show responsibility and concern for others, and they should be unpredictable and seek the new and novel in counseling their delinquent clients.
Psychodynamic therapy of offenders continues to be practiced in some settings. The tenacity of psychodynamic therapy has an important perspective on the effects of trauma. Transference with a trusted therapist is a useful vehicle for addressing unresolved traumas.
True/False Questions
1. Psychoanalytic theory, as discussed in Chapter 3, is primarily based on the work of Sigmund Freud.
2. Psychoanalytic counseling focuses on unconscious as well as conscious thoughts and desires.
3. Freud himself admitted to the complexity of his theory and refused to change or modify his opinions on the subject throughout his lifetime.
4. Psychoanalysis provides a historical foundation for many major techniques of counseling.
5. One of the basic assumptions of psychoanalytic theory is that all behavior is motivated.
6. Ego wishes are wishes that we take over and adopt from other people; they comprise the “conscious and the ego-ideal.”
7. Psychoanalysis typically involves three to five meetings per week for three to seven years or more.
8. Redl and Wineman state that the delinquent ego cannot tolerate the emotions that accompany frustration.
9. Peculiarities of the superego in delinquents develop because of inadequate role models.
10. Ego deficits in an inmate indicate that he or she is unable to make moral decisions.
11. The delinquent ego insists upon a total gratification of its wishes.
12. The delinquent superego is totally devoid of moral/social standards.
13. Psychoanalysis, because of the comprehensiveness of its theory, is the treatment of choice for most insurance companies.
14. In applying psychoanalytic principles to the counseling of delinquents, the therapist must be predictable.
15. Basic drives also emerge from the id, such as the desire for food and warmth, or fight or flight.
Multiple-Choice Questions
1. The function of the _________ is to balance the wishes of the _________, the social demands of _________, and the requirements of one’s external environment.
a. superego, id, ego
b. ego, id, superego
c. id, ego, superego
d. id, superego, ego
2. When a desire is changed or transformed into the opposite feeling or desire, it is known as:
a. denial.
b. projection.
c. reaction formation.
d. regression.
3. The defense mechanism of finding an acceptable reason for doing something unacceptable is known as:
a. rationalization.
b. regression.
c. denial.
d. repression.
4. A change in the primary focus of a feeling or desire to a secondary one that is less intimidating is known as:
a. sublimation.
b. displacement.
c. denial.
d. projection.
5. The _________ perceives and judges the external environment, seeks alternatives and selects the reasonable course of action, and attempts to balance our internal demands.
a. id
b. ego
c. libido
d. none of the above
6. Which of the following is not an ego failure?
a. The ego cannot tolerate the emotions that accompany frustration.
b. The ego has difficulty taking care of objects that are valued and that the ego might want to keep.
c. The ego resists change.
d. The ego is not realistic about rules or routines.
7. Which of the following statements best describes projection?
a. You are angry at your boss but yell at your wife instead.
b. You no longer love someone but instead accuse him or her of no longer loving you.
c. You punish your child, but say, “I’m only doing this for your own good.”
d. You are under stress and get angry at your cellmate, so you throw a temper tantrum.
8. Which of the following statements best describes sublimation?
a. You forget that you had a dog that was killed by a truck when you were young.
b. You want to hurt your father, but you choose to become a professional hockey player instead.
c. Your child dies but you behave as if the child is still alive, by maintaining his or her bedroom.
d. You hate or deeply resent your mother, but you tell everyone how much you love her.
9. Which of the following does not constitute a functional treatment component for delinquents?
a. fully-trained staff
b. appropriate recreational activities
c. strengthening their conscious by helping them to ignore their guilt feelings
d. exploitation of life events
10. Psychoanalytic therapists place greater emphasis on _________ than do other types of therapists.
a. our cognitive styles
b. the conscious mind
c. the unconscious mind
d. our cognitive schemas
11. The id operates in terms of the _________ principle.
a. pleasure
b. reality
c. idealistic
d. collective
12. The superego:
a. is the internalized representation of societal norms and values.
b. is the more rational form of the ego.
c. regulates defense mechanisms to protect people from anxiety.
d. is based on memories and survival mechanisms inherited from our evolutionary past.
13. While waiting for the results of his AIDS test, the inmate said, “I’m sure it’s negative. I’ve probably got a bad case of the flu.” The inmate’s comment most likely illustrates which of the following defense mechanisms?
a. repression
b. projection
c. sublimation
d. denial
14. Joe, an inmate, actively attempts to push wishes and thoughts out of his consciousness. This is known as:
a. reaction formation.
b. denial.
c. repression.
d. regression.
15. Transference:
a. interferes with the progress of therapy.
b. occurs only if the counselor allows his or her own unresolved issues to interfere with the client’s
therapy.
c. occurs only if the counselor resembles an early authority figure.
d. offers insight into early interpersonal relationships and serves to facilitate therapy.
16. According to recent research, what type of offender has a higher rate of recidivism than other types of offenders?
a. neurotic offenders
b. juvenile offenders
c. sexual offenders
d. deviant offenders
Short-Answer and Discussion Questions
1. What is meant by the “principle of psychic determinism”?
2. How could the ego ideal of a person who is raised in a criminal environment facilitate his or her inclination to engage in criminal behavior?
3. According to Freud, in what two ways is anxiety created?
4. What is the goal of psychoanalysis?
5. Identify and describe one technique used in psychoanalysis.
6. What is meant by the statement “psychoanalysis is a historical approach to counseling”?
7. How is it that people develop delinquent egos and superegos?
8. Psychoanalysis is most appropriate for people with what characteristics? Are typical delinquents considered ideal clients for psychoanalytic treatment?
9. What is “countertransference” and why is it important that correctional workers be familiar with the phenomenon?
10. According to Redl and Wineman, rewards should be given to juvenile delinquents in their program based on what criteria? What is their rationale?
11. Explain how psychoanalysis developed. What are the basic assumptions underlying psychoanalytic theory?
12. What is a defense mechanism and what function does it serve? Give three examples of how defense mechanisms are used in our everyday lives.
13. Briefly describe the treatment program devised by Redl and Wineman. Do you think this program would work on delinquents today? Why or why not?
14. Can you think of any evidence that the unconscious exists? Have you ever been convinced that you have an unconscious? What evidence can you list?
15. Is psychoanalysis a reasonable procedure to use with criminals? Why or why not? Can you argue both points of view?
16. Describe the essential characteristics of the delinquent children studied by Redl and Wineman.
17. Have you ever had criminal desires, thoughts, or fantasies? What stopped you from satisfying those desires? Can you relate the desires and the inhibiting factors to Freudian concepts?
18. Describe the basic techniques used in psychoanalytic therapy.
19. What sorts of lessons can be borrowed from psychoanalytic/psychodynamic theories and used in our daily work with offenders? Which aspects of these theories should not be used by those untrained in psychoanalysis?
Chapter 4
Radical Behavioral Interventions
David Lester, Michael Braswell, and Patricia Van Voorhis
Key Concepts and Terms
abstinence reinforcement
aversion therapy
aversive consequences
classical (respondent) conditioning
conditioned response
conditioned stimulus
contingency contract
contingent
covert sensitization
exposure therapy
fade
flooding
functional behavioral assessment
generalizable
here and now
in vivo therapy
mini-phobia
negative reinforcer
operant conditioning
positive behavioral support
positive reinforcer
Premack Principle
prompts
punishment
radical behavioral approaches
relapse prevention
response costs
shaping
stimulus control
systematic desensitization
token economy
time-out
unconditioned response
unconditioned stimulus
Classical Conditioning
Classical conditioning is primarily concerned with the use of an external stimulus and its impact on the response made by an organism. The stimulus occurs prior to the response.
This section discusses two stimuli. They are: unconditioned stimuli and conditioned stimuli. Unconditioned stimuli elicit unconditioned responses (e.g., a loud noise will cause a fear or startle response in an animal or human).
The conditioned stimulus, when paired with an unconditioned stimulus, creates a conditioned response; when the loud noise is associated with another object (a rat), the person learns to fear not only the loud noise but also learns to fear the rat. Conditioned stimuli serve as critical antecedents to behavior. The primary example of the use of classical conditioning as a radical behavioral intervention is aversion therapy (see pp. 66-67, text). The second example is systematic desensitization (p. 68, text).
Operant Conditioning
Operant conditioning involves modifying behavior by the judicious use of rewards. As noted in this section, the rewards (idiosyncratic reinforcers) can be either positive or negative. In operant conditioning we can shape a response and thereby create behaviors that are new to the client. Operant conditioning is employed therapeutically in both individual and group settings.
Examples of the use of operant conditioning in therapy are: shaping, contingency contract, structuring prompts, ceasing to reinforce the target behavior, employing negative consequences, including aversive consequences. In implementing these interventions, the positive interventions should outnumber the negative interventions by a factor of four to one.
Radical Behavioral Approaches to Early Intervention and Offender Therapy
In this section, examples of behavioral family programs are discussed. Abstinence reinforcement programs are discussed as examples of operant conditioning used to treat drug abuse problems. The authors then detail the use of token economies and their effectiveness with juvenile offenders. Token economies are especially valuable because they can be used with groups of clients. The token economy is governed by a structured system of roles designed to ensure that reinforcers will be effectively administered. A particularly successful example of a model use of the token economy came to be known as The Teaching Family Model.
In addition to token economies, the most recent applications of radical behaviorism have been the performance of functional behavioral assessments and positive behavioral supports. The authors describe these concepts and their relative effectiveness in application.
The Stability of Newly Acquired or Decelerated Behaviors
A major goal of behavioral therapy is to develop strategies for making the therapy generalize to other settings. The more meaningful the behavior to the client, the more likely he or she is to be motivated to maintain it after therapy.
The employment of social learning strategies and operant conditioning assists the client to overcome early deficits in social, academic, and vocational skills, and learn to obtain rewards through legitimate means.
True/False Questions
1. Behavior modification is the outgrowth of work carried out by psychologists trying to understand how animals acquire behavior.
2. Classical conditioning was first described by a Russian physiologist, Ivan Pavlov.
3. By creating mini-phobias, people can be conditioned to be afraid or upset by objects that once attracted them.
4. The most common behavioral technique used today is aversive conditioning.
5. Systematic desensitization is a process whereby the client is trained to relax by a series of mild doses of a relaxant drug.
6. Classical conditioning is not likely to have long-term effects if the client is not motivated to change his or her behavior.
7. Operant conditioning involves modifying behavior on the basis of punishment only.
8. When employing abstinence reinforcement programs to treat drug abuse, the magnitude of the reinforcement is an important factor in the success of the program.
9. A negative reinforcer is the onset of an unpleasant stimulus.
10. To effectively treat offenders through behavioral approaches, it is necessary that the client and therapist develop a personal relationship.
11. A weakness of behavioral approaches is that they tend to be particularly inappropriate for addicts and sexual offenders.
12. Behavioral approaches are often used in conjunction with other treatment efforts.
13. Behavior therapy tends to be less expensive than traditional counseling.
14. A positive behavioral support results from a school developing a plan to address problems identified in functional behavioral assessments.
Multiple-Choice Questions
1. The process by which individuals are conditioned to be afraid of an object that once attracted them is known as:
a. systematic desensitization.
b. mini-phobia.
c. negative reinforcement.
d. none of the above
2. When a behavioral therapist creates a situation for a client in which aversive elements are woven into a story involving a desired object, it is known as:
a. mini-phobias.
b. negative reinforcement.
c. covert sensitization.
d. systematic desensitization.
3. In Maletzky’s 1980 study using covert sensitization in the treatment of exhibitionists, _________ percent of the clients learned to eliminate all overt exhibitionist behaviors.
a. 47
b. 68
c. 87
d. 98
4. Which of the following is not a common myth about classical conditioning?
a. Classical conditioning will not work if the client is not motivated to change his or her behavior.
b. Creating a mini-phobia is sufficient to eliminate a behavior.
c. Aversive conditioning is not the same thing as punishment.
d. none of the above
5. Operant conditioning was developed by which well-known scholar?
a. Ivan Pavlov
b. Gerald Patterson
c. B.F. Skinner
d. Joseph Wolpe
6. A program that focuses on rewarding young people for academic achievement by giving them points that they can then exchange for tangible rewards is typically referred to as a:
a. rewards economy.
b. point system.
c. token economy.
d. achievement program.
7. The process of conditioning in which the focus is on the stimulus—the event that occurred “before” the response—is known as:
a. operant conditioning.
b. classical conditioning.
c. aversive conditioning.
d. social learning.
8. Choose the type of therapy most likely to make the following statement: “Freedom is an illusion; our actions are very much controlled by our environment.”
a. Humanistic
b. Cognitive
c. Existential
d. Behavioral
9. Classical conditioning is best characterized by which of the following statements?
a. Behavioral changes are the result of internal forces.
b. Behavioral changes are the result of environmental forces.
c. Behavioral changes are the result of psychomotor neural forces.
d. Behavioral changes are the result of cognitive restructuring.
10. Using operant conditioning, practitioners have found that it is effective in:
a. reducing the effects of fear.
b. understanding maladaptive behavior.
c. strengthening appropriate behavior and weakening inappropriate behavior.
d. reducing the consequences of stressful experiences.
11. A behavioral technique that assumes that we are conditioned by environmental forces is:
a. classical conditioning.
b. operant conditioning.
c. Maslow’s Hierarchy of Needs.
d. congruence of ideal-self and real-self.
12. A therapeutic technique that is based on the principle of eliciting a competing or antagonistic response to a fearful stimulus is:
a. systematic desensitization.
b. implosive therapy.
c. existential therapy.
d. behavior modification.
13. The primary element in the treatment of anxiety is:
a. positive reinforcement.
b. assertiveness.
c. relaxation.
d. exposure.
14. Aversion therapy is based primarily on the principle of:
a. extinction.
b. covert desensitization.
c. classical conditioning.
d. punishment.
15. The goal of behavior therapy is to:
a. regain control over one’s thoughts.
b. gain greater insight into what caused his or her inappropriate behavior.
c. bring desired responses under the control of the individual.
d. change inappropriate feelings.
16. Bob has tried to stop smoking many times without success. What type of treatment is likely to be most helpful for Bob?
a. Psychoanalytic
b. Medical
c. Behavioral
d. Family therapy
17. _________ refers to a treatment approach that decreases anxious responses to a stimulus by having the client engage in relaxation while gradually being exposed to increasingly more anxiety-provoking stimuli or situations.
a. Covert desensitization
b. Systematic desensitization
c. Aversion therapy
d. Behavior therapy
18. In order to help her stop drinking, Sue is given a medication that will make her nauseous when she drinks alcohol, and then she is asked to drink. The intent is to condition a negative experience to a previously attractive one. What kind of treatment is Sue receiving?
a. Aversion therapy
b. Desensitization therapy
c. Behavior therapy
d. Psychoanalysis
19. _________ is a behavioral strategy in which the client and the counselor agree on what behaviors will be expected from the client and what, in turn, the counselor will provide for the client as well as what other outcomes might occur.
a. Negative reinforcement
b. Positive reinforcement
c. Behavioral contracting
d. Token economy
20. All of the following are advantages of using behavioral therapy compared with psychoanalysis except:
a. The treatment approach is more specific.
b. The principles used in behavior therapy are more scientifically valid.
c. Behavior therapy is effective for problems regarding identity and insight difficulties.
d. Behavior therapy is more cost-effective.
21. Contingency contracting:
a. must cover all the inappropriate behaviors of a given client in order for the contract to be successful.
b. typically uses tokens as incentives in institutional settings such as prisons.
c. often is used to identify specific behaviors that need to be changed and attempts to maximize the chances that these changes will occur.
d. is consistently successful in drug treatment groups for offenders.
22. One of the problems with aversion therapy is that:
a. new behaviors resulting from aversion therapy often do not easily generalize to other life situations.
b. an alternative form of gratification must be substituted for the maladaptive behavior.
c. the aversion treatment must be so severe to be effective that many professionals feel that such treatment is “cruel and unusual.”
d. a and b
Short-Answer and Discussion Questions
1. The radical behavioral perspective assumes what to be the source of dysfunctional behavior? How does this assumption translate into intervention techniques?
2. Explain two differences in the roles played by psychoanalysts and radical behavioral counselors.
3. Explain the purpose of aversion therapy and describe one technique that falls under this type of classical conditioning.
4. What may happen if a conditioned stimulus is presented without the unconditioned stimulus for numerous trials? How might this phenomenon help alleviate fears, but also minimize the effects of treatment?
5. Differentiate between classical and operant conditioning in terms of what aspect of the environment is manipulated.
6. Explain one of the seven principles of effective reinforcement set forth by Spiegler and Guevremont.
7. Describe the content of a contingency contract. Who is involved in developing the contract?
8. How do criminal justice sanctions such as prison sentences and fines conflict with the guidelines for decelerating undesirable behavior?
9. Give an example of an abstinence reinforcement program. What considerations should be addressed to make these programs more likely to be effective?
10. What are token economies? How can they elicit desired behaviors and decelerate unwanted behaviors?
11. How can the generalizability of behavioral therapy be maximized?
12. Choose two behavioral therapies and compare and contrast them. Give examples of situations in which they could be applied to correctional treatment.
13. What are some of the ethical considerations involved with behavioral therapies? What are the advantages and disadvantages of using these techniques?
14. What is the difference between overt and covert reinforcers and how might behavior modification programs become abusive and/or coercive? Give examples as they apply to the correctional setting.
15. Describe classical conditioning.
16. How is operant conditioning different from classical conditioning?
17. Can you think of behaviors that your parents modeled that shaped your behavior? For what behaviors did they reward you, and what kinds of general rewards did they use?
18. What are the criticisms of behavior therapy versus traditional counseling as a way of changing people’s behavior?
19. How can behavior therapy be abused, and what steps can be taken to guard against such abuse?
20. What steps might be taken to improve the prospects of generalizing the results of behavioral therapy to day-to-day life?
21. What role does monitoring play in the construction of an operant conditioning program?
22. How might a parent-training program not be culturally sensitive?
Chapter 5
Early Approaches to Group and Milieu Therapy
David Lester and Patricia Van Voorhis
Key Concepts and Terms
Adult ego state
catharsis
Child ego state
conditional positive regard
confrontation
congruence
ego state
empathic understanding
game
genuine
Guided Group Interaction
milieu therapy
paraphrasing
Parent ego state
Person-Centered Therapy
Positive Peer Cultures
psychodrama
Reality Therapy
therapeutic community
transactions
Transactional Analysis
treatment effect
unconditional positive regard
Introduction
In recent years, the use of group counseling has grown in popularity. Yalom (1995) lists the following curative properties of group counseling: imparting information, instilling hope, universality, altruism, corrective recapitulation of the primary family group, development of social skills, imitative behavior, interpersonal learning, catharsis, and group cohesiveness. Group size and membership structure are important factors in the effectiveness of group counseling. Two advantages of group counseling are that it is more economical and that it subjects the offender to input from his or her group.
Person-Centered Therapy
Person-Centered Therapy was developed by Carl Rogers, who assumed that each client had within him or herself the potential for positive change and self-actualization if appropriate conditions were present in the therapeutic situation. The critical components include: unconditional positive regard, empathic understanding, conditional positive regard, congruence, and genuineness.
Transactional Analysis (TA)
TA was developed by Eric Berne (1961). Initially it was based on Freud’s psychoanalytic theory. This section discusses two major components of this theory. The first is structural analysis of ego states. Berne called his ego states the Parent, Adult, and Child. The second major component of TA is concerned with transactions, or ways of communicating.
The section details several applications of TA principles. In one of the earliest, Ernst and Keating (1964) switched to TA after a psychoanalytic approach failed. In another (Jesness, 1975), one school for delinquent youths was set up with a TA program and another with behavior modification. In a third, Krauft (1974) placed sixth-grade boys with behavioral problems into one of three groups: a TA program, a normal school program, or an independent study program.
Psychodrama
In psychodrama, the client is given the opportunity to act out and thereby experience various aspects of his or her life situation in front of an audience. The psychodrama session consists of three phases: warm-up, primary action, and the final phase which deals with a group discussion of the events in the action phase.
Various techniques are used in the primary action phase. They include: role reversal, soliloquy, the double, the mirror technique, the behind-the-back technique, the high chair, the empty chair, and the ideal other.
Treating offenders with psychodrama was first used by Moreno in 1934. It has been used with pedophiles, a group of sexual offenders, general offenders, a psychopath, and psychiatrically disturbed offenders. Psychodrama has also been used to prepare offenders for specific anticipated events. Other applications include: training in giving offenders new roles, training with parents of juvenile offenders, and assisting in the learning of basic educational skills.
Milieu Therapy
One of the goals of traditional institutions is to keep inmates away from the rest of society. Milieu therapy attempts to train inmates to reenter society and become responsible members of their respective communities.
The introduction of a therapeutic community into an institution changes the whole social structure of the institution. The staff, in particular, must switch from authoritarian to more democratic procedures. Thus, the therapeutic community is clearly more like a normal community. Stress is placed on inmate involvement in every phase of the community’s decision-making processes.
Guided Group Interaction (GGI)
Guided Group Interaction was designed to harness the power of peer pressure and support. GGI programs are typically set up for delinquents, but it now appears that GGI may be a label given to some applications of group therapy in therapeutic communities. One such program is called Positive Peer Cultures.
Reality Therapy
Reality Therapy (Glasser, 1965) argues that everyone who seeks therapy suffers from some basic inadequacy—an inability to fulfill his or her essential needs. Glasser suggested that we have two basic needs: the need to love and be loved, and the need to feel that we are worthwhile to ourselves and others. In order to feel loved and worthwhile we must maintain a satisfactory standard of behavior. We must correct ourselves when we break the rules of society and praise ourselves when we follow them. When we fulfill our needs, we must take care not to deprive others of their ability to fulfill their needs. If we do all this, we are responsible. If we do not follow these guidelines, we are irresponsible.
The Techniques of Reality Therapy
Reality Therapy has three components: involvement, rejection of irresponsible behavior, and teaching. The counselor focus is on what the client is doing, not on why he or she is acting that way. The reality of what the client is doing and its consequences are crucial.
The Techniques in Action
This section gives case examples of each of the three components of Reality Therapy. Other topics in the chapter include discussions of the use of Reality Therapy in an institution and of the use of the element of confrontation.
True/False Questions
1. Instilling hope is one of Yalom’s curative properties of group counseling.
2. “Interpersonal learning” occurs when interactions in the group bring up emotions and the group members can express these emotions in the group setting; the more emotional the transaction, the more potent can be the impact.
3. “Imparting information” occurs when group counseling provides opportunities for social learning.
4. Offenders frequently are not motivated to change.
5. Psychodrama is a form of group counseling in which the client is given an opportunity to act out and thereby experience various aspects of his life situation in front of an audience.
6. Soliloquy is one of the special techniques used in psychodrama.
7. In psychodrama, if the protagonist is having difficulty holding his or her own against the other actors, and the director chooses another group member to play the protagonist with him, so that there are two individuals having the same role, this technique is known as the “mirror technique.”
8. Eliasoph has used psychodrama to help addicts prepare to face peer pressure to use drugs when they are once again out on the street.
9. The concept of the therapeutic community, or milieu therapy, was developed by Maxwell Jones and others after World War II as a result of their attempts to rehabilitate repatriated prisoners of war.
10. Essential to the functioning of therapeutic communities is the hands-off philosophy of the professional staff.
11. Transactional Analysis proposed a structural description of human attitudes and values and an interpersonal description of human interactions.
12. There has been very little change in transactional theory since its conception.
13. Initially, Transactional Analysis had a strong resemblance to cognitive therapies but in recent years has leaned more toward psychoanalytic theory.
14. Berne defined an ego state as a coherent system of feeling about an object.
15. Berne’s three ego states—Child, Adult, and Parent—are very similar to the psychoanalytic concepts of id, ego, and superego.
16. Empathic understanding refers to the client’s understanding of the concerns of the counselor.
17. Person-Centered Therapy promotes self-actualization.
18. In Transactional Analysis, “transactions” are overt, but not covert.
19. Jesness is most closely associated with the use of Transactional Analysis at the Youth Center Research Project in California.
20. Psychodrama has not been as successful as hoped in the treatment of child abusers.
21. The effectiveness of medications in treating disturbed inmates has limited the importance of milieu therapy in correctional facilities.
22. The introduction of Guided Group Interaction to general military offenders at Ft. Knox, Kentucky, resulted in a major revamping of the program.
23. According to Reality Therapy developer William Glasser, there are three basic human needs.
24. According to the text, research on the effectiveness of group counseling reflects an overall success story.
25. Reality Therapy focuses on why the client makes decisions rather than on what the client is doing.
26. Glasser suggests that two basic human needs are the need to love and be loved and the need to feel that we are worthwhile to ourselves and others.
Multiple-Choice Questions
1. Which of the following is not one of the three procedures associated with Reality Therapy?
a. Involvement
b. Teaching
c. Cognitive interfacing
d. Rejection of irresponsible behavior
2. When social learning is facilitated by the tendency of clients to model themselves on the other group members and on the counselor, _________ occurs.
a. corrective recapitulation
b. development of socializing techniques
c. imitative behavior
d. interpersonal learning
3. Being able to hear other inmates report similar thoughts and feelings and to see them suffer from similar problems, thereby lessening their social isolation, is know as:
a. altruism.
b. universality.
c. corrective recapitulation.
d. catharsis.
4. In psychodrama, a technique used when the protagonist is permitted to interact with a group member playing a significant other as the protagonist would like him or her to act, is known as:
a. high chair.
b. the double.
c. ideal other.
d. role reversal.
5. Which of the following does not contribute to the success of a therapeutic community?
a. Voluntary participation
b. Custodial setting
c. Reinforcement of normal social orientation
d. Interpersonal dynamics
6. The child ego state is most comparable to which of Freud’s concepts?
a. Id
b. Ego
c. Superego
d. Transference
7. When a person takes on a nurturing role with a friend, he or she is in the _________ ego state.
a. Adult
b. Parent
c. Child
d. Sibling
8. Eric Berne relied heavily on which of the following persons to develop his structural model of Parent-Adult-Child?
a. Jung
b. Maslow
c. Harris
d. Freud
9. In counseling, the goal of Transactional Analysis is to emancipate the:
a. Parent ego state to give the client more self- and social control.
b. Adult ego state to give the client more self- and social control.
c. Child ego state to give the client more self- and social control.
d. Client from his or her fear of crossed transactions.
10. _________, developed by Maxwell Jones, was initially designed to assist returning prisoners of war after World War II.
a. Human potential seminars
b. Gestalt group therapy
c. Psychodrama
d. Milieu therapy
11. When counseling offenders in a group setting, it is important to know that they:
a. are all criminals.
b. are all motivated to change.
c. are often not motivated to change.
d. love the warden.
12. Which of the following is not one of Yalom’s “curative properties” of group counseling?
a. Free association and dream analysis
b. Imparting information
c. Development of socializing techniques
d. Universality
13. Which of the following are clear advantages of the use of group counseling?
a. Groups may be open or closed.
b. Groups are more economical and provide input to inmates.
c. Groups provide inmates with structured and unstructured experiences.
d. all of the above
14. Which of the following is not a phase in a psychodramatic session?
a. Warm-up session
b. Primary action phase
c. Phase-out session
d. Post-discussion phase
15. In psychodrama, the airing of his or her thoughts and feelings by the protagonist is called:
a. high chair.
b. soliloquy.
c. role reversal.
d. empty chair.
16. When one group member plays the role of a significant other in the protagonist’s life, and the director interrupts the action and has the actors switch roles, it is called:
a. the mirror technique.
b. ideal other.
c. the double.
d. role reversal.
17. According to Yalom, the technique that allows the protagonists to see themselves as others see them is called:
a. role reversal.
b. the mirror technique.
c. behind the back.
d. the double.
18. Guided Group Interaction programs are typically designed for which of the following groups?
a. Delinquents
b. Adult offenders
c. Addict-run drug addiction groups
d. all of the above
19. Transactional Analysis is a theory that was first developed by:
a. Carl Rogers.
b. Raymond Cattell.
c. Alfred Adler.
d. Eric Berne.
20. _________ is a technique of counseling introduced by William Glasser, which argues that those who seek psychotherapy suffer from the same basic inadequacy—an inability to fulfill their essential needs.
a. Rational Behavior Therapy
b. Direct Decision Therapy
c. Reality Therapy
d. Rational Emotive Therapy
Short-Answer and Discussion Questions
1. Compare and contrast psychodrama and milieu therapy. Give examples of each.
2. What are some of the key reasons behind the rising popularity of group and milieu therapy? What are the advantages of this type of therapy as compared with more traditional types?
3. What is Guided Group Interaction? What are some of the ways in which it can be effectively used in the correctional setting? How could such a program be abused?
4. How can Transactional Analysis be especially helpful for offenders? Explain.
5. Define the following terms from the curative properties of group counseling (Yalom):
a. universality
b. imitative behavior
c. interpersonal learning
6. Discuss the three ego states of Transactional Analysis.
7. Present and discuss the three primary characteristics required of a person-centered therapist.
8. How is the role-playing technique of psychodrama similar to (or different from) the role-playing technique of social learning?
9. Contrast characteristics of the therapeutic community with the characteristics of traditional correctional institutions.
10. Contrast the role or requirements of clients participating in milieu therapy with either psychoanalysis or classical conditioning.
11. Why is group counseling successful, and how does it differ from individual counseling?
12. What are the disadvantages of group counseling? That is, what can you get from individual counseling that you cannot get from group counseling?
13. What is meant by a curative property of group counseling? What are some examples of curative properties?
14. Define psychodrama. How would this technique be applied and on whom do you think it would be most successful?
15. Describe the treatment process used by Guided Group Interaction.
16. Explain the purpose of therapeutic communities/milieu therapy.
17. Why does Reality Therapy focus on responsibility and behavior as a means for helping clients meet core needs in their lives?
18. Why is it important for Reality Therapy to encourage clients to acknowledge core needs?
19. Should correctional clients ever be confronted? If so, when, and under what conditions?
20. How does one decide whether a given counseling program will work with offenders? Do we need to follow hunches?
Chapter 6
Diagnosis and Assessment of Criminal Offenders
Joyce L. Carbonell and Joye C. Anestis
Key Concepts and Terms
antisocial personality disorder
avoidant personality disorder
bipolar disorder
borderline intellectual functioning
borderline personality disorder
competency to stand trial
dependent personality disorder
DSM-IV-TR
dynamic assessments
dysthymic disorder
guilty but mentally ill
histrionic personality disorder
insanity defense
major depressive disorder
manic disorder
mental retardation
Millon Multiaxial Clinical Inventory III
Minnesota Multiphasic Personality Inventory 2
mood disorders
narcissistic personality disorder
not guilty by reason of insanity (NGRI)
obsessive-compulsive personality disorder
paranoid personality disorder
personality disorders
projective tests
psychotic disorders
schizoid personality disorder
schizophrenia
schizotypal personality disorder
static assessments
substance abuse
substance-dependent
Thematic Apperception Test
Wechsler Adult Intelligence Scales - IV
The Role of the Correctional Staff
Correctional staff can play an important role in the assessment of inmates and probationers by serving as sources of information for the mental health professional. They are in a unique position to observe inmate behavior because they have the opportunity to interact with and see the inmate in a variety of situations and contexts. The correctional counselor must judiciously filter this information to avoid observer bias.
The DSM-IV-TR
While the correctional counselor is not in the business of diagnosis, DSM-IV-TR provides great insights regarding mental health categories. Criteria in DSM-IV-TR are properly noted to be guidelines. DSM-IV-TR describes symptoms that generally characterize a mental disorder. The prudent counselor will note the overlap between categories and act with caution in applying labels to inmates.
DSM-IV-TR is a multiaxial system with five axes ranging from criteria for mood disorders to an assessment of global functioning. Axis I describes clinical disorders and Axis II describes personality disorders and mental retardation. The other axes relate to general medical conditions and social and environmental stressors. This section of the chapter provides an overview of the categories of mental disorders that are the most important in the correctional setting. They are: mood disorders, psychotic disorders, mental retardation, personality disorders, and substance abuse/dependence.
Suicide
While not a DSM-IV-TR category, knowledge about suicide is critical to the correctional counselor, because completed suicides and attempted suicides are becoming more common in our correctional settings. Synopses of studies of jail suicides indicate that it is the leading cause of death in jails and that the suicide rate in jails is greater than in the general population.
Techniques of Assessment and Diagnosis
The correctional counselor has at his or her disposal a number of diagnostic tools and techniques to assist in the overall evaluation of an inmate. The three primary instruments of assessment discussed in this section are: interviews, intelligence tests, and personality tests.
Legal Issues and Mental Health Assessment
While assessment is a critical tool for the correctional counselor, it is important to note that there are psycho-legal issues involved that can affect the nature of psychological evaluation. This section notes that determinations of competency to stand trial, the use of legal insanity as a defense, and the issue of diminished responsibility are major examples of this issue. The authors note that there is an “imperfect” fit between psychological issues and legal issues.
True/False Questions
1. Typically, probation officers and case managers are qualified to conduct psychological evaluations.
2. Regarding the role of correctional staff in assessment: “it is the observation and intervention of correctional personnel that frequently lead to assessment and treatment for the offender.”
3. While observer bias can be a problem, the text notes that experienced custody staff are able to separate their assumptions from the facts.
4. Unlike mood disorders, psychotic disorders are almost always pre-existing.
5. A mentally retarded inmate will in all likelihood choose to be passive in order to survive in prison, because he or she cannot cope in other ways.
6. The largest group of incarcerated people with retardation is likely to be in the serious mental retardation range.
7. Current studies indicate that a person cannot abuse substances without becoming dependent.
8. Individual tests of intelligence are much less expensive to administer, but give less information about the individual.
9. With the publication of DSM-IV-TR, we now have a clear link between diagnostic issues and legal issues.
10. Suicide is the number-one cause of death in jails, and the rate is considerably higher than in the general population.
11. Substance abuse is rarely a problem for prisoners who have mental illnesses.
12. Prisons can aggravate mental health conditions if the mentally ill are not properly cared for.
Multiple-Choice Questions
1. A psychiatrist or psychologist is often consulted when the question concerns the presence of:
a. mental retardation.
b. personality disorder.
c. suicidal intentions.
d. all of the above
2. A test that attempts to sample the problem-solving ability of the test-taker in a standardized and structured manner is known as a test of:
a. academic achievement.
b. intellectual ability.
c. organic dysfunction.
d. psychological disturbance.
3. An example of a type of test used to assess psychological disturbance is the:
a. Wide Range Achievement Test.
b. Wechsler Intelligence Scale for Children.
c. MMPI.
d. Benton Visual Retention Test.
4. Defining the clinical picture of any abnormal behavior is critical to:
a. developing a classification system.
b. investigating the causes of the abnormal behavior.
c. developing and evaluating the effectiveness of treatment programs.
d. all of the above
5. The DSM-IV-TR diagnostic criteria assign diagnoses on the basis of:
a. psychological testing.
b. response to treatment.
c. causal factors.
d. symptoms and signs.
6. Axis I of the DSM-IV-TR is used to describe:
a. any long-standing personality disorder.
b. chronic criminal behavior.
c. psychosocial and environmental dysfunctions.
d. major depressive disorders.
7. Major depressive disorder differs from dysthymia in that:
a. intermittent normal moods may last a few days or weeks in major depression, but not in dysthymia.
b. major depressive disorder must include sexual dysfunction.
c. major depressive disorder requires more symptoms and they are present for a longer duration than in dysthymia.
d. dysthymia is of a longer duration than major depressive disorder.
8. Which of the following is true of major depressive disorder?
a. Those with this disorder experience a depressed mood almost every day.
b. It is equally common in men and women.
c. It is not a common inmate experience.
d. It tends to be of low intensity.
9. A dysthymic disorder is usually characterized as being/having:
a. chronic in nature.
b. not normally diagnosed as depression.
c. a loss of concentration and decision-making ability.
d. all of the above.
10. Which of the following exhibits an interpersonal causation in the origin of depression?
a. Poor social skills
b. Restricted social support network
c. Marital stress
d. all of the above
11. Suicide is often associated with a variety of different kinds of negative events. These different kinds of negative events have a common theme underlying them, which is:
a. incarceration.
b. loss of social status.
c. hopelessness about the future or loss of a sense of the meaning of life.
d. a traumatic event causing serious personal loss.
12. Most people who commit suicide:
a. never give any warning of what they plan to do.
b. communicate their intent to a correctional counselor, but not to other inmates or family members.
c. communicate their intent to other inmates or family members, either directly or indirectly.
d. do so impulsively, with no time to give any warning.
13. A severe loss of contact with reality is called:
a. neurosis.
b. psychosis.
c. paranoia.
d. dementia praecox.
14. Which of the following is an example of a negative schizophrenic symptom?
a. Hallucinations, both visual and auditory
b. Emotional turmoil resulting from internal confusion
c. Emotional unresponsiveness
d. Delusions or thought disorders
15. Mental retardation is generally defined in part by an IQ score below:
a. 100.
b. 85.
c. 70.
d. 50.
16. Personality disorders in general are characterized by:
a. antisocial behavior.
b. egocentric traits.
c. inflexibility and maladaptive traits.
d. eccentricity.
17. With respect to the DSM-IV-TR, individuals with personality disorders who are most likely to come to the attention of legal authorities for their impulsive behavior are probably from:
a. Cluster A (odd-eccentric).
b. Cluster B (dramatic-emotional).
c. Cluster C (anxious-fearful).
d. No clear patterns exist.
18. According to the text, the Bureau of Justice Statistics (2006b) indicates that _________ of state prison inmates who have a mental health problem abuse drugs or are dependent on alcohol.
a. 52%
b. 74%
c. 21%
d. 89%
19. Which of the following statements is true about alcohol use?
a. Alcoholism is extremely serious but rarely fatal.
b. Alcoholism is more common in women than in men.
c. Intoxication increases an inmate’s risk of committing suicide.
d. Alcoholism is more readily associated with accidental death, but not with acts of violence.
20. The most common procedure to gain information about a client is to administer/conduct:
a. psychological tests.
b. intelligence tests.
c. personal interviews.
d. family interviews.
21. The “Revised Beta Examination” is an example of:
a. an individual test.
b. a group test.
c. a fraternity test.
d. a failed attempt at inmate screening.
22. The term “objective” in “objective personality tests” refers to the:
a. decision to test.
b. scoring of the test.
c. interpretation of the test score.
d. choice of theories on which to base the test.
23. Projective tests are primarily:
a. objective in nature.
b. academic in nature.
c. subjective in nature.
d. vocational in nature.
24. The Rorschach Ink Blot Test and Thematic Apperception Tests are not objective tests of personality because they:
a. actually measure intelligence.
b. elicit answers to the tests that are subject to the interpretation of the person scoring the tests.
c. seek to reveal patterns of unconscious behavior.
d. must be administered to one person at a time.
25. The term psycho-legal refers to:
a. incarcerated psychotics.
b. the wedding of psychology and law.
c. the areas where psychology and law overlap.
d. a judicial interpretation of forensic law.
Short-Answer and Discussion Questions
1. How can correctional staff assist mental health professionals in assessing offenders? Stated differently, what information do correctional staff have access to that is not readily available to mental health professionals?
2. What is the difference between a static assessment and a dynamic assessment?
3. Describe one of the general caveats provided regarding the use and/or interpretation of major mental health categories by individuals without specialized clinical training.
4. Choose one of the mood disorders discussed in the text and describe the characteristics of the specific disorder.
5. What suggestions are provided in the text for dealing/interacting with a schizophrenic?
6. According to the current conception of mental retardation, what criteria are used to determine whether a person is mentally retarded?
7. Identify one of the three personality disorder clusters presented in the text and discuss the common characteristics of the personality disorders that fall within that cluster.
8. What are two signs that should alert correctional workers to the possibility that an offender may be suicidal?
9. Are projective or objective personality tests more common in institutional correctional settings? Why?
10. Distinguish between “competency to stand trial” and the insanity defense (how is incompetence different from NGRI?).
11. What is dysthymia?
12. Identify five of the symptoms of major depressive disorder.
13. Discuss the positive and negative symptoms of schizophrenia.
14. What do we mean by the term personality disorder?
15. Why is it important for correctional staff to have some knowledge of mental illness?
16. What types of problems warrant the referral of a correctional client to a psychologist/psychiatrist or mental health unit?
17. What types of mistakes should we seek to avoid in observing and reporting a correctional client’s behavior to mental health officials?
18. What procedures are typically followed in diagnosing mental illness?
19. Why is a diagnosis of mental illness not enough to secure a verdict of NGRI?
Chapter 7
An Overview of Offender Classification Systems
Patricia Van Voorhis
Key Concepts and Terms
Adult Internal Management System (AIMS)
correctional classification
criminogenic needs
differential treatment
dynamic risk factors
gender-responsive
internal classification
Interpersonal Maturity Level (I-level)
matching
Megargee MMPI-based typology
myth of efficiency
needs assessment systems
needs principle
psychological classification systems
reliability
responsivity assessment
responsivity characteristics
responsivity principle
risk assessment
risk factors
risk/needs assessment
risk principle
seamless classification systems
static risk factors
treatment amenability
type
typology
validity
Purposes and Principles of Effective Classification
Correctional facilities have a responsibility to evaluate the risks associated with a particular inmate, as well as the needs of the inmate in question. Structured tests and procedures for classifying offenders provide a means of effectively and efficiently determining how best to allocate correctional resources, streamline decisionmaking, and place offenders in appropriate treatment programs. This section discusses three principles of effective classification programs. They are: the risk principle, the needs principle, and the responsivity principle. Other purposes of classification are discussed as well.
The Risk Principle
This principle speaks to the fundamental purpose of corrections: to protect society and to keep correctional populations safe. Treatment implications include identifying high-, medium-, and low-risk offenders, directing intensive treatment efforts to high- and medium-risk offenders, and avoiding assignment of low-risk offenders to institutional placements or intensive treatment interventions.
The Needs Principle
Basic offender needs are frequently attended to by correctional staff, yet this principle maintains that needs related to future offending should receive high priority as we match offenders to programs; these needs related to criminal behavior are also risk factors and are labeled criminogenic needs.
The Responsivity Principle
This principle maintains that programs should accommodate offender characteristics and situations that are likely to become barriers to success in a given correctional program; this translates into amenability, and is based on differential (individualized) treatment or matching.
Types of Commonly Used Classification Systems
The classification system chosen by a particular institution is regulated by the overall purposes of the facility. Generally, classifications can be grouped into three areas:
1. Risk Assessment Systems, which assign offenders to institution- or community-based correctional options on the basis of security criteria (designed to predict new offenses or prison misconduct); most state custody classification systems have not been validated for women.
2. Needs Assessment Systems, which identify offenders according to important treatment needs (designed to inform identification of needs, links to appropriate services, individualized case planning, and agency resource allocation).
3. Risk/Needs Assessments, which assign individuals to treatment options or living units on the basis of personality or behavioral criteria; includes only those needs that are also risk factors; newer instruments contain dynamic items; questionable relevance of older gender-neutral tools to the needs of women offenders, but new gender-responsive assessments are beginning to be validated.
Assessing Responsivity
Assessing personality characteristics, learning styles, and intellectual and emotional capabilities helps to identify potential treatment barriers. Examples of psychological classification systems suitable for this purpose include the Jesness Inventory–Revised (formerly the Interpersonal Maturity or I-Level), Adult Internal Management System (AIMS), and the Megargee MMPI-based Typology.
Future Directions in Correctional Classification
An overview of the most recent work in classification and assessment shows this is an area that continues to evolve. Three new directions concern the classification of female offenders (i.e., gender-responsive), the development of risk models for specific types of offenders (e.g., sex offenders and psychopaths), and the development of seamless classification systems. Differences between validity and reliability, and the myth of efficiency, are also discussed.
True/False Questions
1. Correctional classification represents one of the most popular innovations in the treatment technology of the 1960s and 1970s.
2. Structured tests and procedures are a more subjective way of classifying offenders as opposed to the older, open-ended model.
3. Correctional classification systems are usually administered to all offenders in a correctional institution or program at the point of intake.
4. A needs assessment assigns offenders to institution- or community-based correctional options on the basis of security criteria.
5. Psychological systems identify offenders according to important treatment needs (e.g., educational, employment, family, mental health, economic, etc.).
6. In a growing number of community control agencies, risks and needs assessments are being combined into a single instrument.
7. The Interpersonal Maturity Classification System is based on the ways in which people view themselves and others, as well as the ways in which they interact with others.
8. Upon completion of the classification process, offenders are classified into subgroups that are relatively heterogeneous.
9. Only recently have classification systems addressed correctional goals of security and custody.
10. Only recently has the risk principle been used to assist in rehabilitative efforts.
11. Research indicates that intensive correctional treatments are less successful with high-risk offenders.
12. The risk principle, when applied to low-risk offender groups, notes that they do not do well in intensive therapy.
13. Reitsma, Street, and Leschied (1988) and Warren (1971, 1983) noted that responsivity is now commonly incorporated into correctional treatment or evaluation of correctional programs.
14. Despite claims by Don Andrews (the inventory’s designer), the Level of Supervision Inventory has not been found to be a high predictor of recidivism among a variety of inmates.
15. Although new to adult corrections, internal classification has been commonly used with juveniles.
16. The asocial passive responds to unmet needs through increased interpersonal interaction.
17. Responsivity is a vehicle for making differential treatment assignments.
18. Regarding the future of criminal classification systems, one new direction is the development of seamless classification systems.
19. Most states have examined their classification instruments and have found them to be valid for women offenders.
20. Gender-neutral classification instruments tend to overclassify women by assigning them to higher- than-necessary security levels.
Multiple-Choice Questions
1. The classification system and treatment model that is based on the ways in which people view themselves and others, as well as the ways in which they interact with others, is known as:
a. Kohlberg’s Stages of Moral Development.
b. Megargee’s MMPI-based Typology.
c. Behavioral Classification System for Adult Offenders.
d. Interpersonal Maturity (Jesness Inventory–Revised).
2. In Harris’s (1988) abbreviated description of the Interpersonal Maturity System, when youths have learned that they have power, their behaviors affect the responses they receive from others, and much of their activity centers around learning how power is structured, they are in stage:
a. I2.
b. I3.
c. I4.
d. I5.
3. Conforming to whoever has the power at the moment and seeing self as less powerful than others best describes which subtype of the I-level classification system?
a. Asocial Passive
b. Immature Conformist
c. Cultural Conformist
d. Cultural Identifier
4. Which of the following definitions best characterizes the Cultural Identifier?
a. Conforms exclusively to a specific group of peers
b. Conforms to whoever has the power at the moment
c. Internalizes certain values as part of his or her own socialization
d. Counteractive to any source of power, adult or peer
5. Which of the following is not one of the five personality types that can be diagnosed in the Adult Internal Management System?
a. Inadequate-Dependent
b. Neurotic-Anxious
c. Manipulative
d. Neurotic Acting-Out
6. Which of the following is not true regarding criminal classification systems?
a. They are usually administered to offenders at the point of intake.
b. They assist correctional decisionmakers in allocating resources efficiently.
c. They have become more subjective over the past 20 years.
d. They can enhance treatment effectiveness.
7. Classification subgrouping assists the correctional program in all but which of the following?
a. Predictions about future behavior
b. Identifying offender needs
c. Allocation of staff and other program resources
d. Classification subgrouping assists the correctional program in all of the above activities.
8. Andrews and Bonta noted a number of common criminogenic needs. Which of the following is not a criminogenic need?
a. Antisocial associates
b. Antisocial values and attitudes
c. Antisocial personality characteristics
d. Family history of antisocial behavior
9. Factors such as intelligence, anxiety, cognitive maturity, attention deficit disorder, and learning style are particularly relevant to which of the following classification principles?
a. responsivity principle
b. personality principle
c. needs principle
d. risk principle
10. Which of the following has traditionally not been a commonly used classification system?
a. Risk assessment
b. Criminogenic needs assessment
c. Needs assessment
d. Psychological assessment
11. An example of a risk assessment instrument is the:
a. Minnesota Mulitphasic Personality Inventory.
b. the National Institution of Corrections Prison Model.
c. Jesness Inventory–Revised (I-level).
d. Symptom Checklist 90.
12. Which of the following is not an example of psychological classification?
a. Interpersonal Maturity Level (I-level)
b. Salient Factor Score
c. Stanford Psychological Functioning System
d. Megargee MMPI-based typology
13. The psychological characteristics measured by the Jesness Inventory–Revised (I-level) are:
a. mood and cognitive.
b. affective and psychopathy.
c. cognitive and personality.
d. intelligence and social.
14. The developmental component of the Jesness Inventory–Revised (I-level) assumes that cognitive development:
a. involves changes in qualitative thought processes.
b. has a strong affective component.
c. occurs through the stages of human development.
d. both a and c are correct
15. The personality-based subtype that is characterized by a negative self-image, a high level of activity, social distancing, and verbal attacks is:
a. neurotic anxious.
b. immature conformist.
c. asocial aggressive.
d. neurotic acting-out.
16. The Megargee MMPI-based Typology was designed for use with:
a. youthful offenders.
b. psychotic offenders.
c. adult and youth offenders.
d. psychotics and obsessive-compulsive offenders.
17. The Megargee MMPI-based typology that exhibits inadequacy, anxiety, dogmatism, and a tendency to abuse alcohol is:
a. Easy.
b. Able.
c. Charlie.
d. Baker.
18. The text proposes that psychological assessments can be distilled down to four types among adult males. Which of the following is not a type listed in the text?
a. Situational
b. Psychotic
c. Asocial
d. Neurotic
19. Gender-neutral classification systems
a. are valid for equally predicting male and female risk and needs.
b. are preferred for use across all correctional populations.
c. tend to overclassify women offenders.
d. none of the above
20. The American Correctional Association recommends supplementing needs assessments with
a. presentence investigations.
b. medical reports.
c. psychological evaluations.
d. all of the above
Short-Answer and Discussion Questions
1. Present two criticisms of classification schemes based on professional judgment of an offender’s dangerousness rather than on the use of structured tests and procedures.
2. Discuss the treatment implications of the “risk principle.”
3. What are criminogenic needs? List the three most important criminogenic needs.
4. In the discussion about the responsivity principle, it is mentioned that failure to incorporate responsivity into correctional treatment or evaluations of correctional programs often results in “masking” the treatment effect. How does this happen? In other words, how can failure to attend to responsivity affect the overall effectiveness of a treatment program?
5. Aside from the treatment applications of classification assessments, what are two purposes of offender classification?
6. How is it that needs and psychological assessment systems may have implications for the determination of an offender’s level of risk for recidivating?
7. Differentiate between static and dynamic risk factors. Which type of risk factors are the most relevant for treatment? Why?
8. Among the principles of classification (i.e., the risk, needs, and responsivity principles), which is most obviously served by psychological classification typologies? Explain the relevance of the psychological typologies to that classification principle.
9. Discuss the personality styles by which adult male parolees can be classified when employing the Jesness Inventory.
10. Several mistakes that have been made in using classification systems were noted in this chapter. Describe one of the mistakes and what can be done to prevent the likelihood of the mistake occurring.
11. What is the purpose of having classification systems? What are some of the advantages and disadvantages of classifying offenders?
12. Define and distinguish the different types of classification systems. Which do you feel would be the most effective, and why?
13. Choose one of the psychological classification systems and discuss its basic points. What are the advantages and disadvantages of the system you have chosen?
14. What are the common points of the classification systems discussed by Van Voorhis?
15. Which of the systems is the most popular for classifying offenders? Why?
16. What does Van Voorhis mean when referring to the myth of efficiency?
17. Distinguish among the risk principle, the needs principle, and the responsivity principle. How is each important to correctional treatment efforts?
18. How might an accurate correctional classification system make a correctional treatment program more effective?
19. What is meant by the statement that a classification system should be valid and reliable?
20. Why is it unethical to use a classification system that is not known to be valid?
21. Discuss the importance of gender-responsive classification instruments. How do they benefit women offenders and overall correctional treatment program effectiveness?
Chapter 8
Social Learning Models
Patricia Van Voorhis and Emily Salisbury
Key Concepts and Terms
accurate feedback
affective valence
arousal levels
cognitive organization
complex goal behaviors
component responses
covert modeling
distinctive
external reinforcement
functional value
general imitation versus specific imitation
generalize
goal behaviors
imitate
live model
modeling
motor rehearsal
observational learning
participant modeling
perceptual set
prevalence of role models
role model
role-playing
self-efficacy
self-observation
self-reinforcement
sensory capacities
Structured Learning Training/Skill Streaming
symbolic coding
symbolic model
symbolic rehearsal
therapeutic communities
vicarious reinforcement
Social Learning Theory
Modeling is a critical component of learning. Our skills, be they athletic, verbal, social, or otherwise, are not solely the product of trial-and-error learning. In truth, we observed other athletes or writing styles that we appreciated, or we remembered the social skills of those whom we perceived as popular. Then we imitated the skills of those role models and, through practice and reinforcement, we became increasingly proficient in using these skills.
The modeling provided by others serves several functions. They are: a demonstration of actual behavior, a prompt to tell us when to use the behavior, a motivation to use the newly acquired skill, and as a disinhibition to trying new skills. Negative role models can serve as a guide to behaviors that are not socially productive. This section notes that modeling is key to the learning of criminal behavior.
The environment is a key element in the social learning paradigm. Positive or negative social settings do much to determine the developmental outcome of an individual or a group.
Social learning has a strong cognitive component (i.e., one’s thoughts, beliefs, values, and perceptions) taken into account. Indeed, much of our learning involves the cognitions that prompt and support our behavior or appraise the stimuli that are presented to us.
Who Makes a Good Role Model?
A growing body of research shows us the qualities of good role modeling. The individual factors that differentiate individuals who will be imitated from those who are not likely to be imitated include: attractiveness, competence, extent to which the person is rewarded, and quality of the relationship.
Additional studies have indicated that factors such as enthusiasm, openness, and flexibility can greatly influence the power of an effective role model. Pages 170-171 list 12 “anticriminal modeling” principles.
The Process of Observational Learning
Learning, from the observational learning perspective, is much more complex than is assumed in either classical or operant conditioning. To illustrate this process, Albert Bandura posits a sequence of factors that affect the success of observational learning. The process of observational learning is as follows: attentional process, retention process, motor reproduction process, and motivational process. In effect, modeled goal behaviors result in future demonstrations of goal behaviors.
This model assumes that a goal behavior has already been modeled. Second, the adoption of complex goal behaviors is based on their degree of self-efficacy, or confidence in one’s ability to perform. Finally, the higher the functional value or usefulness of the modeled goal behavior, the more likely it is to be adopted.
Social Learning Interventions in Corrections and Prevention
As a program in itself and as a component of other programs, social learning and modeling forms the mainstay of many correctional treatment and prevention endeavors. This section offers two illustrations of the use of social learning and modeling. The first is Parent Management Training (PMT) which can effectively reduce behavioral problems in schools, homes, and foster homes and can help reduce delinquency; a recent meta-analysis finds reductions in recidivism of approximately 22 percent for PMT and similar behavioral parent training programs. The second is Structured Learning Training/Skill Streaming which seeks to teach essential prosocial skills; typically includes modeling, role-playing, performance feedback, and generalization training, and is also showing favorable results.
True/False Questions
1. Reinforcement contingencies are very important in determining what behaviors observers are willing to perform spontaneously.
2. People attend more to models they like than to models they do not like.
3. The use of therapeutic communities as a treatment strategy in the correctional system primarily emphasizes the criminogenic aspects of an inmate’s personality.
4. Practicing the modeled goal behavior can occur symbolically.
5. The most common form of motor rehearsal is role playing.
6. Covert modeling is a process that encourages the inmate to visualize his or her performance of the behaviors they want to perform.
7. Generalized training encourages youthful offenders to practice newly learned skills on each other.
8. Role-playing provides an opportunity to rehearse a skill immediately after it has been modeled.
9. Transfer training identifies a number of techniques for identifying new antisocial behaviors.
Multiple-Choice Questions
1. The counselor’s praise of an inmate’s acquisition of a socially appropriate behavior is called:
a. vicarious reinforcement.
b. external reinforcement.
c. self-reinforcement.
d. covert modeling reinforcement.
2. Skill Streaming is a component of a treatment package called:
a. Attribution Replacement Training.
b. Aggression Replacement Training.
c. Anger Replacement Training.
d. Antisocial Replacement Training.
3. _________ is the theorist who is, in large part, responsible for developing modeling theory.
a. B.F. Skinner
b. Albert Ellis
c. Albert Bandura
d. Aaron Beck
4. _________ is a behavioral strategy that relies on learning from the behavior of others.
a. A token economy
b. Extrinsic reinforcers
c. Behavioral contracting
d. Modeling
5. As found in research on Parent Management Training (PMT), which of the following is not one of the ways in which poor parental discipline contributes to child behavioral problems?
a. punishing too severely
b. punishing inconsistently or coercively
c. ignoring good behavior
d. failing to set limits
6. In contrast to operant conditioning, social learning:
a. does not use reinforcements to increase the likelihood that a target behavior will be repeated.
b. operates largely through observation processes.
c. examines unconscious motivations for behavior.
d. denies the impact that antisocial friends may have on eliciting antisocial behavior.
7. Which of the following variables determines how much influence a model will have?
a. the functional value of the behaviors observed
b. the observer’s perceptual set toward the model
c. characteristics of the model, such as attractiveness
d. all of the above
8. For observational learning to occur, the learner must:
a. attend to the model.
b. mentally retain what is observed.
c. have the ability and skill to perform the act.
d. all of the above are essential
9. From the social learning perspective:
a. behavior is consistent across situations.
b. individual perceptions of situations are more relevant than objective perceptions of situations.
c. feelings determine actions.
d. assessment emphasizes a wide range of situations.
10. According to social learning theory, problems in behavior arise primarily through:
a. vicarious conditioning processes.
b. faulty expectations.
c. observational learning.
d. all of the above
11. Modeling techniques were first developed to treat:
a. antisocial behavior.
b. emotion-based problems.
c. schizophrenia.
d. children.
12. Which of the following is not mentioned as an organizational consideration for implementing a social learning program?
a. hiring treatment providers who can empathize with clients, a desired characteristic for being a skilled role model
b. providing an agency-wide environment that models prosocial behavior
c. no antisocial clients are admitted to the program because they would model criminal behavior to the program participants
d. the program schedule should allow sufficient time for role-playing
13. Transfer training:
a. helps clients to generalize newly learned behaviors outside of the treatment setting.
b. includes role-playing in a variety of situations.
c. may involve overlearning material.
d. all of the above
14. Effective behavior rehearsal or practice:
a. occurs only when the client physically goes through the motions of the new skill.
b. depends on the client’s ability to thoroughly replicate the new skill.
c. should be substituted by role-playing during the third treatment session.
d. is enhanced when the client engages in accurate self-observation.
Short-Answer and Discussion Questions
1. What characteristics make a person an appealing role model?
2. How are social learning models similar to the radical behavioral perspective?
3. How do social learning models differ from or extend radical behavioral approaches?
4. Explain three of the parameters suggested by Andrews and Bonta (1994) for anticriminal modeling.
5. Identify the important components or steps of the social learning process.
6. Explain how the tenets of the social learning perspective are relevant to hiring decisions in corrections.
7. What does Bandura mean when he uses the term self-efficacy?
8. Define the following terms:
a. live or symbolic model
b. covert modeling
c. participant modeling
d. general imitation
e. specific imitation
9. What factors can hinder clients from generalizing newly learned goal behaviors to environments outside of the treatment setting?
10. What techniques help to ensure that newly learned goal behaviors are generalized to environments outside of the treatment setting?
11. When selecting appropriate clients for a social learning program, what client characteristics should be examined? In other words, what factors make clients good (or bad) candidates for a social learning program?
12. How is deterrence related to social learning?
13. What relationship skills must a person possess in order to be an effective role model?
14. Think for a minute about the most effective teachers you have had over the years. In what ways did their classes demonstrate the principles of effective modeling? How did they utilize the various steps of the social learning process?
15. What is the rationale behind teaching the skills listed in Figure 8.2 (see text) to offenders?
16. What is meant by “anticriminal modeling”? In what ways do case managers or counselors sometimes inadvertently demonstrate criminal modeling?
17. According to PMT, what are the skills of good parenting?
Chapter 9
Cognitive Therapies
Patricia Van Voorhis and David Lester
Key Concepts and Terms
activating experience
Aggression Replacement Training (ART)
all-or-nothing thinking
Anger Control Training (ACT)
catastrophizing
cognitive
cognitive-behavioral approaches
cognitive restructuring
cognitive skills
criminal personality groups
disqualifying the positive
gender-responsive programming
irrational belief
jumping to conclusions
Living Skills
magnification
mental filter
modeling
moral education programs
moral dilemmas
overgeneralization
physiological cues
rational belief
Rational Emotive Therapy
reducers
role-playing
self-efficacy
self-instructional training
self-statements
self-talk
shoulding
Skill Streaming
social learning
stages of moral judgment
preconventional reasoning
conventional reasoning
postconventional reasoning
stress inoculation training
“stinking thinking”
thinking errors
trigger
Cognitive Restructuring Approaches
Rational Emotive Therapy
Albert Ellis, the founder of Rational Emotive Therapy, holds that his cognitive theory is concerned with emotions and thoughts that impair our existence. The source of distress in an individual results from a series of irrationally held beliefs about themselves, others, and the world in which they live. According to Ellis, rational beliefs increase positive feelings and minimize pain; irrational beliefs decrease happiness and maximize pain.
Examples of irrational beliefs held by many clients are: all-or-nothing thinking; overgeneralization; mental filter; disqualifying the positive; magnification or catastrophizing; jumping to conclusions; and shoulding. Erroneously learned, these irrational ways of thinking create a debilitating cycle of pain and distress.
The Techniques of Rational Emotive Therapy
Rational Emotive Therapy centers on irrational cognitive structures as they operate in the present. The counselor may use any technique that will assist the client in learning to think rationally. Some effective techniques are: role playing, modeling, bibliotherapy stories, behavior therapy techniques, discussions, debates, homework, and audiovisual aids. The goal of RET is to minimize anxiety (self-blame) and hostility (blaming others) in the client.
Applications to Offenders
This section provides a case study cited by Ellis (1979) in which he treated an exhibitionist. From this case study, Ellis points out both his theory and his technique.
Criminal Personality Groups
Much research has gone into attempts to identify the dysfunctional cognitive patterns of offenders. The focus of this section is on the research of Yochelson and Samenow. In their work with offenders at St. Elizabeth’s Hospital, they identified more than 50 “thinking errors.” The text discusses 16 of the irrational assumptions about self, life, and others. The section then provides 16 correction techniques to counter irrational thinking and behaving.
The authors caution that consistent with the risk principle, offenders who do not evidence criminal thinking should not be admitted to cognitive-restructuring programs.
Cognitive Skills Approaches
Cognitive restructuring seeks to change the content of reasoning; cognitive skills programs seek primarily to change the structure or process of one’s reasoning. Content focuses on what people are thinking. Cognitive skills approaches focus on what people are not thinking. They look at the sequence and configurations of thoughts. Two examples of cognitive skills training are noted. Self-Instructional Training seeks to lead the client through his or her distress by teaching “self-talk.” Stress Inoculation Training encourages the client to engage in self-encouragement and self-reinforcement to promote a sense of self-efficacy. Many cognitive models are also called cognitive-behavioral approaches and use modeling and role-playing consistent with the social learning approach.
Cognitive Skills Programs for Offenders
Research shows us that, through a variety of causes (e.g., poverty, abuse, inadequate schooling, and other problems), many offenders have not acquired the cognitive skills needed for effective social adaptation. Treatment strategies in cognitive skills programs attempt to correct these deficiencies through games, journal activities, reasoning exercises, didactic teaching methods, audiovisual aides, and group discussions. Generalization training is crucial, and targets may also include living skills and even vocational training.
Moral Education Approaches
The moral education approaches combine social learning, moral education, and cognitive skills models. Human beings progress from the relatively concrete cognitive reasoning structures of children to the more flexible thinking of adults. Kohlberg’s Stages of Moral Judgment form a cognitive developmental classification system and provide staged explanations of how moral thinking occurs.
Aggression Replacement Training (ART)
ART builds on the assumption that internalized values provide a consistent benchmark for prosocial decisions and actions. ART consists of three components: Skill Streaming, Anger Control Training, and the use of Moral Education groups that discuss dilemmas developed by Kohlberg. The EQUIP program for juvenile offenders combined a model similar to ART with a group approach known as the Positive Peer Culture and evaluations have shown effectiveness.
Cognitive Behavioral Programs for Women Offenders
Most programs discussed above were developed for male offenders and evaluated on male offender populations; little attention was given to the risk factors that better describe women’s pathways to crime. Program curricula are now being redesigned to be more gender-responsive, in contrast to the “one size fits all” approach, and evaluation research is beginning to show favorable results.
Cognitive-Behavioral Programs and their Effectiveness—Much Depends on Program Integrity
Two meta-analyses of cognitive-behavioral programs note that the most effective treatment programs were small demonstration projects. As these programs expanded to larger groups, treatment integrity was negatively affected and treatment effectiveness was diminished. The authors and others conclude that policy makers and practitioners should ensure that cognitive-behavioral programs are delivered according to their design to ensure program quality and treatment integrity.
Participation Exercises
Three exercises have been developed for use in the classroom: (1) Rational Emotive Therapy,
(2) Criminal Thinking, and (3) Cognitive Skills.
True/False Questions
1. “Cognitive” refers to thinking processes.
2. In cognitive therapy, the counselor tries to teach the client in a small number of sessions how to change his or her thinking patterns and how to solve problems more constructively.
3. In the past decade, cognitive treatment modalities have been pushed aside in favor of more up-to-date psychoanalytic and person-centered therapies.
4. Rational Emotive Therapy is concerned with emotions and thoughts that impair our existence.
5. In Rational Emotive Therapy, disqualifying occurs when one re-labels positive experiences as “not counting” for one reason or another.
6. An important aspect of Rational Emotive Therapy is the client’s early history, unconscious thoughts and desires, and nonverbal behavior.
7. Yochelson and Samenow identified more than 50 “thinking errors” in their work with offenders at St. Elizabeth’s Hospital.
8. The cognitive therapies require active and directive counselors who challenge and confront clients with their irrational thoughts and irresponsible behavior.
9. “Moving On” is a cognitive curriculum that alters the treatment targets to be more responsive to female offenders.
10. Most of Kohlberg’s work was with female inmates in programs referred to as the Just Community.
11. Moral Reconation Therapy is a cognitive-behavioral program that is growing in popularity, but evaluation results have been unimpressive.
12. Cognitive therapies should be gender-responsive to improve outcomes for women offenders.
13. Cognitive restructuring focuses on the process of one’s reasoning.
Multiple-Choice Questions
1. According to Burns’s “irrational ways of thinking,” you exaggerate the importance of something when you:
a. overgeneralize.
b. catastrophize.
c. jump to conclusions.
d. resort to shoulding.
2. Burns states that by dwelling on negative details and leaving out the positive aspects, ______ occurs.
a. disqualifying
b. magnification
c. mental filtering
d. catastrophizing
3. Which of the following is not a cognitive therapy?
a. Self-instructional training
b. Rational Emotive Therapy
c. Punishing Smarter Strategies
d. Aggression Replacement Training
4. In the curriculum titled Problem Solving, participants are instructed on “the conflict cycle,” which helps them understand how:
a. to make the right choice of what to do.
b. to define the problem and determine resolution.
c. their thinking can lead to consequences.
d. to differentiate facts from opinions.
5. Which of the following statements is not one of Yochelson and Samenow’s “thinking errors” of offenders?
a. They develop an “I can’t” attitude toward their own responsibilities.
b. They refuse to accept responsibility.
c. They appear to understand what constitutes trustworthy behavior.
d. Many cannot seem to accept criticism.
6. Which of the following statements is not one of Yochelson and Samenow’s corrections techniques?
a. Pointing out the ways in which the offender may be refusing to accept responsibilities
b. Attempting to ignore and downplay “power thrusts”
c. Teaching appropriate skills of anger management
d. Teaching offenders that trust must be earned and call attention to instances in which the offender is betraying the trust of others
7. All-or-nothing thinking has been noted by counselors to be particularly characteristic of:
a. alcoholics.
b. drug addicts.
c. bulimics.
d. all of the above
8. According to Rational Emotive Therapy, irrational thinking skills result in:
a. magnification or catastrophizing.
b. all-or-nothing thinking.
c. overgeneralization.
d. all of the above
9. The primary goal of Albert Ellis’s Rational Emotive Therapy is to:
a. challenge and confront the client’s incorrect and maladaptive beliefs.
b. identify maladaptive schemas or patterns of cognitive distortion that may be resulting in unhappiness and/or depression.
c. expose clients to stress under controlled conditions so that they can gain more effective ways of coping.
d. learn a functional approach to social problem solving.
10. According to cognitive theory, anxiety is reinforced because:
a. a previously neutral stimulus is paired with a frightening event.
b. self-defeating thoughts increase anxiety.
c. avoidant behavior is rewarded by anxiety reduction.
d. modeling increases anxiety.
11. Cognitive skills programs that include Living Skills have provided offenders with a foundation for later modules such as:
a. community reintegration.
b. parenting skills.
c. managing their finances.
d. all of the above
12. Participants in cognitive skills programs are taught the importance of cognitions, for example:
a. thinking bad thoughts always leads to criminal action.
b. what we do in our minds controls what we do in our lives.
c. what the general community thinks of the actions of the individual.
d. none of the above
13. In the final stage of Postconventional Reasoning:
a. decisions are predicated on the desire to avoid punishment.
b. decisions reflect a desire to maintain social institutions.
c. ethical principles and respect for others are used to generate moral decisions.
d. moral reasoning reflects an application of the “Golden Rule.”
Short-Answer and Discussion Questions
1. What is the theory behind the cognitive therapies?
2. Why do you think these therapies are so popular today?
3. Think of occasions when you have been angry, depressed, or had some other strong emotion. Can you recall what thoughts went through your mind? Write them down. Can you dispute them? That is, can you point out the irrational elements in them and change them according to Rational Emotive Therapy?
4. Describe the theory and techniques of moral education interventions.
5. What concepts are encompassed by the term cognitive?
6. Explain the difference between a cognitive restructuring program and a cognitive skills program.
7. What role do criminal thinking errors play in crime causation? Are these errors similar for men and women?
8. Discuss the conventional reasoning phase of Kohlberg’s Stages of Moral Judgment.
9. How effective are cognitive-behavioral programs with female offenders? Is gender-responsive programming important? Why?
10. Discuss the A (action), B (belief), C (consequence) model of Rational Emotive Therapy.
11. What does Albert Ellis mean by the term “irrational belief”?
12. What does Albert Ellis mean by the term “rational belief”?
13. Discuss the goals of cognitive skills training for offenders.
14. What is a moral dilemma? Discuss the use of moral dilemmas as part of the Moral Education component of Aggression Replacement Training.
15. Why are cognitive treatment strategies generally preferred over psychoanalytic approaches for treating offenders?
16. In what ways are social learning principles and techniques applicable to cognitive skills approaches to offender treatment?
17. List five cognitive skills needed for effective social adaptation that are characteristically absent or deficient in many offenders.
Chapter 10
Family Therapy
Patricia Van Voorhis and Michael Braswell
Key Concepts and Terms
behavioral and social learning models
boundaries
communication therapy
double bind
disengaged boundaries
dyads
enmeshed system
family structure
family system
family therapy
homeostasis
individuate
metacommunication
Multisystemic Treatment
mystification
object relations
permeability
psychodynamic family therapy
reframing
rigid boundaries
roles
scapegoat
Strategic Family Therapy
Structural Family Therapy
subsystems
therapeutic paradox
working through
Introduction
Aspects of the family environment and the quality of family life are frequently cited factors in the development of criminal behavior. Families play a role in producing criminal behavior in a variety of ways, including failure to form adequate parent-child attachments, improper socialization of children, inadequate parenting skills, and dysfunctional styles of interaction. The importance of the family extends beyond the etiology of behavior to concern for what happens after conviction or adjudication of a family member. The family system has a reality that is more than the sum of its individual parts. Family therapy holds that individuals cannot be understood apart from their interactions with group, social, and cultural forces in their environments.
History and Overview of Family Therapy
Family therapy as a therapeutic intervention system spans a brief 30 years. The earliest approaches to family therapy were problem-centered efforts to cure illnesses, particularly schizophrenia. Later years witnessed the development of several distinct treatment models. Family therapy is viewed today as a significant field of mental health whose focus is to address the problems that result from the manner in which individuals perceive and manage their relationships. Currently, family therapy is divided into two major schools of thought: psychodynamic and system-based technologies. In each of these, despite their differences, the family is seen as a system of complex interactions.
Psychodynamic Family Therapy
The most important focus in psychoanalytic family therapy is on object relations or the influence of early interactions with parents on current relationships. As with individual psychoanalysis, psychodynamic family therapists strive to uncover, clarify, and interpret unconscious material from the past.
Communications Family Therapy
Communications therapists, and the strategic therapists who evolved from the communications model, typically work from a systems perspective. The goals of communication therapy require therapists to take deliberate actions to modify poor patterns of communication and interaction.
Structural Family Therapy
Salvador Minuchin, borrowing heavily from systems theory, believes that the goal of Structural Family Therapy is to alter the patterns of family subsystems and their boundaries. In Minuchin’s theory, structure refers to the stable and enduring interactions that occur in family settings. Structural Family Therapy also examines boundaries between numerous family subsystems.
Behavioral and Social Learning Models
Authorities recognize numerous behavioral differences between delinquent and nondelinquent families. Because behavior is learned, it can be unlearned. At the Oregon Social Learning Center, a treatment modality is teaching parenting skills that radically alter current reinforcement patterns. Functional Family Therapy, a short-term behavioral family intervention, has as its goal the improvement of family functioning through fostering reciprocity among family members, developing effective communication skills, and by teaching family members how to effectively deal with circumstances that bring about delinquent and other high-risk behaviors. The Strengthening Families Program is an approach that strengthens the skills of parents, children, and the family as a whole.
Multisystemic Treatment
Multisystemic treatment (MST) emphasizes the importance of assessing and treating child and adolescent conduct disorders by addressing a broad spectrum of family problems. The treatment of family systems from this approach must consider all factors that contribute to the child’s behavioral problems. MST maintains that the family system may not always be the sole cause of dysfunctional behaviors of individuals within the system and that there may be a need to use multiple family approaches. MST offers multiple modalities of treatment. Nine principles guide the MST approach (text, pp. 231-232). This approach seeks to be flexible and recognizes that different combinations of risk factors are at work with different families. Thus, particularly with families dealing with adversity, the “wraparound” services model makes sense. In these models, families participating in counseling or treatment are less likely to be overwhelmed by having to meet other essential needs on their own.
Family Therapy and Criminal Justice Applications
The more well-known theoretically based programs discussed in the preceding section do not typify most correctional programs. Most interventions tend to be eclectic. In the correctional setting, family therapy is likely to be part of an overall treatment plan. In the correctional setting, family therapy is used to treat a number of family issues, including: child abuse, spouse abuse, substance abuse, and adjustment to incarceration. Each of these issues is discussed in turn.
True/False Questions
1. Improper socialization of children is just one of the many ways in which families play a role in producing criminal behavior.
2. The day-to-day business of criminal justice agencies does much to threaten the stability of families.
3. Fortunately, the correctional client improves during treatment and often takes that improvement with him or her into the family setting on the outside, improving it as well.
4. The family is often the key to long-term change, because in most instances it exercises its influence over the entire life span.
5. Family therapy has been encouraged throughout history by such major figures as Freud, Rogers, and others.
6. “Homeostasis” is the term used to define a steady state of equilibrium or stability.
7. The perspective of the family as a system represents a new paradigm in psychotherapy—a dramatic shift from linear to circular causality in which the individual can no longer be viewed as an individual personality formed by discrete events from his or her past.
8. The earliest forms of family therapy were conducted from a structural perspective.
9. Many of the family therapy models use intervention principles based on social learning theory.
10. Most intervention programs are eclectic and combine techniques that fit the needs of both the family and the therapist.
11. Family structure is a term pertaining to the unstable and dysfunctional interactions that occur within family systems.
12. An offender’s return to law-abiding life is less complicated than the issue of whether his or her family adjusts to his or her arrest and disposition.
13. The field of family therapy is fundamentally critical of more narrow, individualistic models of therapy.
14. Family therapy was originally designed to work with schizophrenics.
15. Despite the uniqueness of each of the family therapy models, they share a belief that the family should be viewed as a system.
16. In strategic therapy, parents are instructed in more general principles of child management to identify normative child behaviors and to utilize effective reinforcement tactics, such as negotiation and compromise.
17. The goals of the family therapy model are to improve system reciprocity, alter delinquent circumstances, and clarify the impact of object relations within the subsystem.
18. Evaluations of multisystemic treatment show that this approach is effective for treating serious juvenile offenders.
Multiple-Choice Questions
1. Which of the following is not an example of a family therapy model?
a. Psychoanalytic family therapy
b. Classical conditioned family therapy
c. Structural family therapy
d. Communications family therapy
2. Which of the following therapies has the goal of altering the patterns of family subsystems and their boundaries in order to encourage stable and enduring interactions in family settings?
a. Communications family therapy
b. Psychoanalytic family therapy
c. Structural family therapy
d. Social learning models
3. In _________, the most important focus is on object relation or the influence of early interactions with parents on current relationships.
a. communications family therapy
b. psychodynamic family therapy
c. Structural Family Therapy
d. social learning models
4. The second level of communication, which can convey as much information as the verbal content of conversation, is known as:
a. nonverbal language.
b. intracommunication.
c. metacommunication.
d. neocommunication.
5. The process by which family members distort the experiences of other members by denial or relabeling is known as:
a. metacommunication.
b. mystification.
c. the double bind.
d. therapeutic paradox.
6. Issues of formation of trusting relationships, delays of gratification, separation and individuation, and “working through” are primarily examples of which family therapy model?
a. Communications
b. Psychodynamic
c. Structural
d. Social learning
7. In response to increasing concern about child abuse, family therapists and researchers have targeted a number of concerns. Which of the following is not one of the concerns of family therapists?
a. Family dynamics that promote abuse
b. Marital discord
c. Idiosyncratic and nomothetic characterological deficits
d. Parental vulnerability to stress
8. Freud, Rogers, and others discouraged the use of family therapy because:
a. they were afraid that family secrets might be discussed.
b. they saw such a move as contaminating the client-therapist relationship.
c. longitudinal studies convinced them that family therapy was ineffective.
d. international governing bodies refused to fund research on family studies.
9. According to the text, the major difference in family therapy models is primarily in their:
a. dislike of each other.
b. accusations that the other has poorly constructed longitudinal studies.
c. treatment focus, or the type of family problem that is addressed in therapy.
d. none of the above
10. Family therapy is primarily based on which of the following types of thinking?
a. Linear
b. Abstract
c. Preoperational
d. Circular
11. When family therapists use the term “system,” they mean:
a. the interaction between the id, ego, and superego.
b. family strength is based on social distance from one another.
c. families are seen as having a unity that is greater than the sum of the individual personalities comprising the system.
d. the family is dysfunctional as a result of poor economic conditions and role confusion.
12. When a family has a “sick” member, the family therapist assumes that:
a. the “sick” member is treated for individual neurotic symptoms.
b. the “sick” member is scheduled for structured group therapy.
c. the family system, rather than the “sick” member, is the object of treatment.
d. none of the above
13. When a family therapist uses the term “homeostasis,” he or she means:
a. a fear of living in the same home.
b. the importance of scheduling family activities.
c. the importance of a democratically run home.
d. a balanced, steady state of equilibrium within the family.
14. What did Murray Bowen mean when he maintained that troubled families can become “fused” into an undifferentiated mass?
a. They all have poor id and superego functions.
b. Each family member is totally separate from the other.
c. Such families have very strong social boundaries and communication processes.
d. Such families demonstrate “stuck-togetherness” that results in each family member having lost his or her uniqueness.
15. Which of the following therapies has the goal of altering the patterns of family subsystems and their boundaries in order to encourage stable and enduring interactions in family settings?
a. Communications family therapy
b. Psychoanalytic family therapy
c. Structural Family Therapy
d. Social learning models
16. The goals of _________ family therapy are to take deliberate actions to modify poor patterns of communication and interaction, especially regarding patterns that maintain destructive behavioral or psychological symptoms in one of the family members.
a. psychoanalytic
b. communications
c. structural
d. interactive
17. The family therapy model that is expressly cited in the text as being effectively utilized in developing effective communication skills, and by teaching family members how to effectively deal with circumstances that bring about delinquent behavior is:
a. Minuchin’s family systems model.
b. psychodynamic family therapy.
c. the family functional model.
d. none of the above
18. Involving family members in the rehabilitation of offenders makes sense for which of the following reasons?
a. It curbs family violence.
b. It assists an offender on his or her return to society.
c. both a and b
d. none of the above
19. Given its demonstrated effectiveness, it is interesting to note that family therapy:
a. is widely used in the criminal justice system.
b. is not widely used, given the prevalence of family problems.
c. has not demonstrated its effectiveness in treating offenders and their families.
d. while effective, is not cost-effective to the criminal justice system.
20. When using family therapy in a crisis situation, the first goal is to:
a. bond with the family.
b. consult with Dr. Hamm.
c. stop the violence.
d. have a group hug.
21. Studies of the use of family therapy within the criminal justice system have noted that this treatment approach is used primarily with:
a. stalkers and perverts.
b. military prisoners at Ft. Leavenworth.
c. alcoholics and other drug abusers.
d. child molesters and comatose inmates.
Short-Answer and Discussion Questions
1. How does the day-to-day business of criminal justice agencies threaten the stability of families? What, if anything, could be done to alleviate this problem?
2. What are some of the target areas of family therapies? What are the key areas that are typically the focus of family therapy, and what areas are being neglected?
3. What are the major family therapy models? Briefly discuss their basic goals and objectives. What has contributed to the successful or unsuccessful attempts to implement family therapy programs in correctional settings?
4. Define the following terms:
a. homeostasis
b. scapegoat
c. double bind
d. mystification
5. Discuss the importance of object relations to psychodynamic family therapy.
6. Discuss the importance of the “double bind” to the communications model of family therapy.
7. The enmeshed family system on one hand is warm and supporting, and on the other hand is counterproductive of personal independence. Why?
8. Compare and contrast psychoanalytic family therapy and individual psychoanalytic therapy (discussed in Chapter 3 of the text) in terms of the goals and techniques of the approaches.
9. How does Multisystemic Therapy extend family therapy?
10. Bowen (1978) maintains that pathological families create dysfunctional system boundaries and communication processes. What is meant by system boundaries? Explain one type of unhealthy boundary presented in the discussion of Structural Family Therapy.
11. Present the treatment goal and techniques of Patterson’s social learning model of family therapy.
12. Why is the family “system” such a powerful unit? How could such a system contribute to an adolescent becoming delinquent? How could such as system help rehabilitate a delinquent family member?
13. Compare the communications model of family therapy with the structural model. What are the advantages and disadvantages of each? Which do you prefer?
14. What are the advantages of Multisystemic Family Therapies over some of the other models discussed in the chapter?
15. Discuss the use of family therapy interventions with child abuse. What kind of interventions seem to work best with this problem area?
16. How could a family therapy program be useful with incarcerated offenders and their families? What would be some unique aspects and limitations of such a program?
Chapter 11
Treating Sexual Offenders
David Lester and Gail Hurst
Key Concepts and Terms
aversion therapy
aversive imagery
behavioral strategies
clinical interview
cognitive strategies
covert sensitization
empathy training
extinction
masturbatory conditioning
penile plethysmography
physiological strategies
relapse prevention
role-playing
Sex Offender Aftercare Program
Sex Offender Treatment and Evaluation Project
social skills training
The Role of Assessment
Thorough assessments of sexually offending clients’ needs and readiness to receive treatment provide pertinent information concerning their social history, psychological and social problems, sexual development, and sexual patterns of offending. There are problems in assessment related to the functionality of the information gained through intrusive assessments and the degree to which clients may attempt to deceive the staff about social histories and psychological states. Classification of sexual offenders should provide information useful for research into the causation of sexual offending, for helping police identify potential offenders, and for guiding treatment strategies. Initial clinical interviews, penile plethysmography, problems in assessment concerns, classification, and risk assessment of sex offenders are discussed relative to their implications for treatment and public safety.
Treatment Approaches
The major objective in the treatment of sex offenders is the cessation of offending. Currently, those working with sex offenders realize that they are treating a heterogeneous population requiring a multidimensional approach and a wider range of treatment approaches, including organic (physiological) strategies and behavioral strategies, cognitive and cognitive behavioral strategies, and relapse prevention.
Physiological Strategies
Physiological strategies include the use of antiandrogens, which result in a decrease or complete loss of sexual drive. Other types include surgical castration and stereotactic brain surgery. Psychotropic and anti-epileptic medications are also being used respectively to control male aggressive hypersexuality, and to stabilize impulsivity/compulsivity. Ethical concerns and effectiveness of organic treatments discussed.
Behavioral Strategies
Presently, most treatment programs for sex offenders use behavioral and cognitive strategies to reduce deviant arousal, as well as to shape and enhance appropriate arousal patterns. The behavioral strategies include: aversion therapy, covert sensitization or aversive imagery, and masturbatory conditioning.
Cognitive Strategies
Cognitive approaches, designed to change errors in an offender’s thinking, are frequently used to treat sex offenders and are now more commonly provided in conjunction with behavioral strategies. These include: empathy training, role-playing, and social skills training. Research has shown that treatment programs should focus on cognitive distortions in general, and not solely on those related to sexual offenses. This section concludes with a discussion of the Sex Offender Treatment and Evaluation Project (SOTEP) and the Sex Offender Aftercare Program (SOAP).
Relapse Prevention
Relapse prevention is designed to teach clients strategies that are useful in dealing with interpersonal conflict, negative emotions, and other high-risk situations that lead to relapse. The primary goals of relapse prevention are to help the offender maintain and enhance the changes produced by the treatment strategies, and ensure that offenders continue to use the skills that they have learned after treatment is completed. The strength of relapse prevention lies in its emphasis on helping the offender to understand and recognize the psychological and situational factors that place him or her at risk of offending.
Other Program Components
Multifaceted and comprehensive treatment strategies, group therapy, and male/female therapist combinations discussed.
Recent Trends in Research and Assessment
Four trends in research and assessment have been noted in recent years: the increase in the scope of offending (e.g., role of the Internet); the focus on special needs offenders (e.g., schizophrenics, mentally retarded sex offenders); types of victims; and improved assessment of risk factors and recidivism prediction.
Effectiveness of Treatment Programs
The effectiveness of treatment programs has yet to be demonstrated, although some programs seem promising as valuable tools in sex abuse treatment. Hall (1995) has identified several elements that contribute to successful intervention. The elements that contributed to treatment success included a high base rate of recidivism, length of follow-up after the program, and outpatient status. Treatment programs using cognitive behavioral strategies and hormonal treatments seemed to be more effective than programs using behavioral strategies. If treatment programs for sexual offenders are to be useful, they must be methodologically sound and may include progress during treatment as a measure of effectiveness. Recent meta-analyses are indicating that adherence to the Principles of Effective Intervention, especially needs and responsivity (see Chapters 7 and 14), are related to more favorable outcomes.
True/False Questions
1. The majority of sex offenders commit their crimes for the same reasons.
2. Research indicates that present treatment programs are more effective than those used prior to 1980.
3. The Internet provides offenders with increased access to potential victims.
4. Hormonal treatments are rarely used in the United States due to the lack of evidence supporting their effectiveness.
5. Most of the common behavioral strategies for sex offenders are based on classical conditioning.
6. The use of aversive therapy is widely praised for meeting the combined goals of punishing sex offenders while treating them.
7. It is recommended that cognitive approaches be somewhat confrontational.
8. Social skills training should occur early in therapy to assist inmates in experiencing the impact of their deviant behavior.
9. Sexual abusers who participate in cognitive and behavioral therapy groups show no change in recidivism rates when compared to non-treated inmates.
10. The strength of relapse prevention lies primarily in its emphasis on the importance of object relations and transference.
11. The research consistently finds that sex offender registration laws have a deterrent effect on first-time and previously convicted offenders.
12. The use of polygraph investigations with sex offenders has been shown to be completely reliable.
13. Many sex offenders do not fit well into generic classification schemes.
14. Dynamic risk assessments (i.e., measuring risk and needs) for sex offenders still appear to be in the developmental stages.
15. Organic therapy has been shown to be a sufficient standalone treatment for sex offenders.
Multiple-Choice Questions
1. A thorough assessment of an offender’s psychological and social history will indicate:
a. family relationships.
b. emotional difficulties.
c. significant life events.
d. all of the above
2. Which of the following items is not examined when assessing a client’s sexual development?
a. toilet training experiences
b. adjustment to puberty
c. history of sexual victimization
d. attitudes toward sex
3. Penile plethysmography:
a. is controversial because its use involves the presentation of deviant stimuli.
b. is one of the most reliable ways to determine whether a person is a sexual offender.
c. measures a person’s arousal patterns by recording brain wave activity while the person sleeps.
d. all of the above
4. Which of the following is an element associated with effective treatment programs for sexual offenders?
a. The program is short enough that intervention does not affect his or her employment responsibilities.
b. The program takes place in a maximum-security prison.
c. The program minimizes barriers to program completion.
d. none of the above.
5. _________ is a therapeutic intervention that pairs inappropriate sexual stimuli with imagined aversive consequences.
a. Application therapy
b. Covert sensitization
c. Flooding
d. Role-playing
6. The use of shock treatment is most closely associated with which of the following treatments?
a. Covert sensitization
b. Aversive imagery
c. Aversion therapy
d. Systematic reinforcement therapy
7. _________ introduces positive reinforcements, in which deviant fantasies are replaced with non-deviant fantasies.
a. Aversive therapy
b. Aversive reinforcement strategies
c. Masturbatory conditioning
d. Systematic role reinforcement conditioning
8. _________ focuses on the effect that victimization has on survivors.
a. Role-playing
b. Social skills training
c. Mirroring
d. Empathy training
9. _________ is a therapeutic intervention that challenges offenders’ cognitive distortions.
a. Empathy training
b. Role-playing
c. Covert desensitization
d. Aversion therapy
10. Relapse programs are designed to:
a. reduce interpersonal conflict.
b. reduce negative emotions.
c. reduce high-risk situations.
d. all of the above
11. The treatment strategy that is the most appropriate for changing beliefs and attitudes that serve to maintain deviant behaviors is:
a. cognitive.
b. psychoanalytic.
c. behavioral.
d. plethysmography.
12. DiGiorgio-Miller (2007) found that deviant sexual fantasies in adolescent sex offenders were positively associated with the:
a. number of victims.
b. presence of hostility.
c. number of offenses.
d. all of the above
13. Cognitive strategies designed to challenge offenders’ distorted thinking include:
a. empathy training.
b. role-playing.
c. social skills training.
d. all of the above
Short-Answer and Discussion Questions
1. What information regarding the likelihood of treatment success is gained by assessing masturbatory fantasies?
2. Explain two problems associated with the use of penile plethysmography.
3. Why is it important to assess offenders throughout treatment rather than only at the beginning?
4. List four factors that have demonstrated better ability to distinguish between sex offenders and nonoffenders than penile plethysmography.
5. How could the use of a polygraph supplement treatment for sex offenders? How might its use be problematic (e.g., why might polygraph results be unreliable)?
6. If it is determined that for a particular offender, his or her attitudes and values that disinhibit and serve to maintain sexual offending behavior are the primary influence on his or her offending, which of the treatment strategies mentioned in the chapter is most appropriate? Why?
7. Aversive approaches condition people to avoid/eliminate behaviors by associating the particular behaviors with unpleasant stimuli. How might aversive therapies be supplemented during treatment to minimize relapse after program completion?
8. Describe one of the cognitive strategies designed around challenging offenders’ distorted thinking.
9. Discuss the importance of the clinical interview.
10. How are classification and treatment related?
11. What ethical issues are involved in treating sexual offenders?
12. Why is relapse prevention an important adjunct to treatment for sex offenders?
13. Compare and contrast organic and behavioral treatment strategies.
14. What are the advantages of group therapy over individual therapy for sex offenders?
Chapter 12
Treating Substance Abuse in Offender Populations
Patricia Van Voorhis, Myrinda Schweitzer, and Gail Hurst
Key Concepts and Terms
Abstinence Violation Effect (AVE)
aversion therapies
behavioral family therapies
classical conditioning
cognitive-behavioral approaches
communications therapy
community reinforcement approach
contingency contracts
covert sensitization
culturally competent
disease model
drug courts
educational model
enabled
family systems model
harm reduction
high-risk situations
identified patient
interventions
methadone maintenance
Multisystemic Family Therapy
operant conditioning
peer encounters
psychodynamic family therapies
relapse prevention
relational model of self
self-efficacy
self-help groups
social learning approaches
sponsors
Stages of Change
support groups
temperance model
theory of addiction
theory of trauma
theory of women’s psychosocial development
therapeutic communities
Models of Substance Abuse
Interventions for substance abuse differ in terms of their definitions of who the substance abuser is and how he or she came to become addicted to alcohol or other drugs. Miller and Hester (1995) distinguish among 11 models of substance abuse interventions: moral model, temperance model, disease model, educational models, characterological model, conditioning model, social learning/cognitive-behavioral model, biological models, general family systems model, sociocultural models, and public health model. In practice, interventions for substance-abusing offenders are likely to be eclectic. Even so, some of the models differ dramatically on certain issues. Cost and other factors influence the availability, intensity-level, and completion rates of substance abuse treatment.
Psychodynamic Approaches: Psychodynamic treatment of substance abuse tends to focus on developmental and structural deficits, such as limited ego control. Using many of the same techniques discussed in Chapter 3, therapists are likely to target the client’s denial about his or her substance abuse, try to uncover the sources of the client’s dependence on alcohol or other drugs in order for the client to shift that dependence upon others temporarily, and examine developmental influences on ego and superego development.
Psychodynamic therapy is most appropriate to more verbal clients who are tolerant of insight-oriented approaches. When psychodynamic therapy is used, it is often preferred that the client participates in a combination of individual and group approaches, and that the therapy is supplemented with other models.
Radical Behavioral Approaches: Radical behavioral therapies seek to reverse processes that encourage and maintain addiction by controlling the stimuli that encourage substance abuse and by reinforcing controlled drinking, abstinence, and other prosocial substitute behaviors. Classical and operant conditioning strategies include aversion therapies, contingency contracting, token economies, covert sensitization, stimulus controls, and community reinforcement. While some of these approaches stand alone, others are components of additional programs, such as therapeutic communities or relapse prevention programs.
Social Learning and Cognitive-Behavioral Approaches: Social learning and cognitive-behavioral approaches compose the most recent advances in substance abuse treatment. The fundamental tool for change within these approaches is the role model who acts as a source for imitation and provides feedback as clients learn new cognitive skills and patterns.
Therapeutic Communities
Therapeutic communities (TCs) are in-patient forms of treatment in which clients spend three months to one year in a residential setting. The goals of TCs are to change negative patterns of behavior, thinking, and feeling that act as predispositions to substance abuse and to resocialize addicted offenders. It is believed that the environment of the TCs should be characterized by consistency, empathy, positive peer influence, and firm but nonpunitive confrontation. The most effective TCs also provide community-based aftercare following release.
Coping and Social Skills Training
Coping and social skills training programs for substance-abusing offenders target skill deficiencies, including problem solving, self-efficacy, and skills pertinent to social competence and emotional control. The skills may be taught through the following steps: providing a rationale for acquiring the new skill, presenting guidelines for using the skill, modeling ineffective then effective responses to a sample situation, role-play, reinforcement for effective demonstration of the skills, feedback, client’s comment, and rehearsal of the skills in increasingly difficult situations.
Relapse Prevention Training
Relapse prevention is a subset of skills training that focuses on maintaining changes brought about during treatment. Underlying most relapse prevention programs is Bandura’s theory of self-efficacy, which states that offenders who are confident in their skills for coping with a high-risk situation are less likely to relapse. These programs recognize that the path to recovery can include lapses that can increase the likelihood of relapse by reducing self-efficacy and motivation. As such, relapse prevention programs focus on helping offenders prevent lapses from reducing self-efficacy. Techniques used in relapse prevention training include identification of high-risk situations and developing and rehearsing plans for coping with the high-risk situations.
The importance and applicability of family therapy approaches (psychodynamic, behavioral, systems, communication, and Multisystemic) to treatment and relapse prevention also reviewed. The fundamental assumption of the family therapy approaches is that the substance-abusing client is a part of an entity that is affected by each component of the system. In addition to the family therapy models listed above, families dealing with substance abuse may benefit from support groups, interventions, and confrontations.
Drug Courts
Drug courts emerged in the late 1980s to deal with the influx of cases generated by the “war on drugs.” Some divert offenders contingent on completion of therapy; some suspend sentence on those contingencies. Drug courts are intended to offer a more reasonable and less costly response to substance abuse than incarceration. Drug courts are administrative rather than therapeutic entities. These courts have shown some effectiveness in reducing drug-related offenses.
The Importance of Support Groups
Self-help and support groups, such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Adult Children of Alcoholics, are considered helpful in focusing on a variety of issues, including self-esteem, coping with loneliness and social stigma, and dealing with feelings. Similarities and differences between the prototype of support groups, AA, and cognitive and behavioral approaches to substance abuse treatment are discussed in this section.
Pharmacological Approaches
Pharmacological approaches such as methadone maintenance appear to focus on harm reduction rather than abstinence. By substituting opiates with methadone, this form of outpatient treatment minimizes the effects of withdrawal and at the same time offers services such as vocational training and drug counseling to meet secondary goals of improving productivity, social behavior, and psychological well-being.
Responsivity Considerations
A program attends to the responsivity of its clients in two ways: when it chooses programs that are suitable to the offender populations (general); and when it recognizes client characteristics that will likely affect the client’s ability to participate in the program (specific), and subsequently matches clients with appropriate programs or program components. Four types of client responsivity differences are considered important in the treatment of the substance-abusing offender: (1) motivation for change (differences in readiness to change substance-abusing behaviors); (2) comorbidity (individual conditions that are related to substance abuse); (3) ethnicity (needs and strengths specific to diverse populations); and (4) gender.
The role of motivational interviewing in determining an offender’s “stage of change” is discussed and demonstrated in this section. The need to stabilize co-occurring disorders prior to beginning substance abuse treatment and the need for attention to gender-responsive risk and responsivity factors is also examined.
Continuity of Care
Continuity of care refers to a recent push to go further and provide a seamless continuum of care based on evidence-based practices for offenders addicted to alcohol and other drugs (VanderWaal et al., 2008). This systems approach recognizes that substance abuse is a chronic problem which is highly correlated with criminal behavior. This requires a coordination of services between criminal justice agencies and treatment providers to accomplish treatment goals, and can be facilitated with comprehensive evaluations, effective case management, inter-agency collaboration, and aftercare services.
Effectiveness of Substance Abuse Interventions
Among the various approaches to treating substance-abusing offenders, the most effective programs appear to be based on behavioral, cognitive-behavioral, and social learning models. While no single program is effective with everyone, it has been found generally that some treatment is better than no treatment. Therapeutic communities have demonstrated particular success with offender populations. Specific program components associated with increased effectiveness are a structured environment that promotes self-discipline and commitment to treatment and program integrity.
True/False Questions
1. As a rule, longer periods of therapy are associated with substantial improvements in post-treatment outcome.
2. Relapse prevention programs may incorporate classical conditioning, social learning, and cognitive skills components.
3. Although the techniques used by the moral model and pharmacological approaches differ, their core philosophies are very similar.
4. According to the Stages of Change, treatment goals should differ according to clients’ readiness to change.
5. Support groups such as AA are grounded in a psychological model of therapy.
6. It is recommended that programs for treating substance-abusing offenders be eclectic.
7. Empirical research indicates that social learning models tend to be inappropriate for substance-abusing offenders because the offenders are surrounded by peers who abuse alcohol and other drugs.
8. Because lapses in recovery are associated with decreases in self-efficacy, often no treatment for substance abuse is preferred to treatment in general.
9. Perhaps the most beneficial aspect of therapeutic communities is the persistent confrontation by others that have also struggled with addiction.
10. The “war on drugs” substantially contributed to prison population growth and to the presence of substance abusers within these populations.
11. General responsivity addresses the client’s characteristics that are likely to affect his or her ability to participate in a treatment program.
12. Motivational interviewing is an offender-centered, directive method for enhancing intrinsic motivation to change.
13. Co-occurring disorders do not generally pose impediments to successful substance abuse treatment.
14. The continuity of care perspective recognizes that substance abuse is a chronic and multifaceted problem.
Multiple-Choice Questions
1. The disease model of substance abuse:
a. is consistent with the tenets of Alcoholics Anonymous.
b. contends that biological makeup plays an important role in determining whether a person is likely to become addicted to alcohol.
c. is inconsistent with the harm reduction philosophy of methadone maintenance.
d. all of the above
2. The characterological model states that substance abuse is the result of:
a. personality problems.
b. peer influences.
c. biology.
d. poor education.
3. Which of the following statements is not a technique used by the radical behavioral approach to substance abuse treatment?
a. Free association
b. Stimuli manipulation
c. Community reinforcement
d. Gaining alternative sources of pleasure
4. Which of the following is associated with effective treatment of substance abusers?
a. Unstructured environment to promote creativity
b. Program takes place in a maximum-security prison
c. Behavioral components
d. none of the above
5. Family _________ therapy targets dysfunctional family roles.
a. behavioral
b. systems
c. psychodynamic
d. nuclear
6. Which of the following is neither characteristic of nor consistent with Alcoholics Anonymous?
a. Acknowledgement of “defects of character”
b. Targeting problematic thinking
c. Psychological model of therapy
d. Disease model
7. Some of the models of substance abuse differ dramatically on such issues as:
a. whether abstinence is required.
b. who is responsible for the addiction.
c. whether the addict is a moral individual.
d. all of the above
8. The _________ Model contends that alcoholism and other addictions are learned behaviors.
a. Conditioning
b. Social Learning/Cognitive-Behavioral
c. both a and b
d. none of the above
9. Which of the following is not a coping skill or alternative approach to high-risk situations?
a. Anger management
b. Assertiveness
c. Relaxation training
d. Intelligence
10. Through behavioral family therapies, families learn to:
a. rearrange contingencies.
b. develop each others’ self-efficacy.
c. become alert to factors that stimulate drinking.
d. all of the above
11. Interventions and confrontations serve to:
a. motivate uncooperative addicts to change.
b. provide opportunities for family members to explain how an addict’s behavior has hurt them.
c. allow friends and employers of addicts to express their concerns about the addict’s behavior.
d. all of the above
12. Client responsivity characteristics important to substance abuse include:
a. motivation for change
b. comorbidity
c. ethnicity and gender
d. all of the above
13. Which of the following strategies offers staff a set of skills to help move an individual through the Stages of Change?
a. Harm reduction
b. Community reinforcement approach
c. Motivational interviewing
d. Relapse prevention
Short-Answer and Discussion Questions
1. What is the function of an outpatient, non-methadone treatment program?
2. Explain the difference between the disease model and biological models.
3. What is meant by harm reduction in the context of substance abuse? Which models of substance abuse are inconsistent with this philosophy?
4. Discuss the variety of client characteristics presented as responsivity considerations in the treatment of substance abuse.
5. Select one of the family therapy approaches discussed in the text and explain the techniques and goals of the approach.
6. In what ways can role models be instrumental in the treatment of substance abuse?
7. Outline the basic steps to skills training as presented by Monti et al. (1995).
8. Discuss the role of self-efficacy in relapse prevention.
9. Discuss at least four types of coping skills relevant to dealing with high-risk situations.
10. How are characteristics such as race, gender, and social status pertinent to treatment decisions?
11. Discuss the three theoretical perspectives of the treatment approach for female offenders proposed by Covington (2002).
12. Discuss how the notion of “continuity of care” in the treatment of substance abuse is consistent with “wraparound” type family services outlined in Chapter 10.
13. Why do the continuity of care perspective and inter-agency collaboration make sense on theoretical grounds in the treatment of substance abuse? What is the role of aftercare in these models?
Chapter 13
Treating Antisocial Offenders
Jennifer L. Mongold, Michael Braswell, and David Lester
Key Concepts and Terms
Antisocial Personality Disorder
Antisocial Personality Questionnaire
Attention Deficit Hyperactivity Disorder
biopsychosocial model
brain abnormalities
Cleckley’s core traits
conduct disorder
family therapy
Four As
group therapy
life skills training
low-arousal theory
marital therapy
psychotherapy
psychopathy
Psychopathy Checklist-Revised
Psychopathy Personality Inventory
serotonin
sociopath
Structured Clinical Interview for DSM-III-R
Personality Disorders
testosterone
Temperament and Character Inventory
Therapeutic Community
Introduction
Antisocial Personality Disorder (APD) is a mental disorder in which persons are manipulative, aggressive, impulsive, remorseless, and often engage in criminal behavior. APD is derived from Cleckley’s (1941) classic work on psychopathy.
Diagnosis and Assessment
APD begins with a childhood diagnosis of conduct disorder, yet the diagnosis is reserved only for adults. Once persons with APD reach middle age, criminal behaviors associated with their APD tend to diminish while other aspects of their life, such as interpersonal problems, are still evident.
Assessment of APD is made difficult by the deceitful nature of the disorder. Assessment tools such as the DSM-IV-TR, Psychopathic Personality Inventory, Antisocial Personality Questionnaire, Psychopathy Checklist-Revised, Structured Clinical Interview for DSM-III-R Personality Disorders, the Four As, and the Temperament and Character Inventory are used to diagnose APD.
What Does Antisocial Personality Disorder Look Like?
Epidemiology: While the lifetime prevalence of APD in the general population is between 3.1% and 3.6%, the prison population prevalence has been estimated to be 11.9% to 61.5%. The age group most commonly associated with this disorder ranges between ages 25 to 44 years. It may be rarer in older populations due to high mortality rates associated with high levels of impulsivity and risky behaviors. Males have a three times greater risk of being diagnosed with APD than females, and APD rates are also different between racial categories. There are other co-occurring disorders and problems that are commonly associated with APD such as substance abuse, anxiety, depression, schizophrenia, suicide, and other legal problems. APD also tends to aggravate the symptoms of these other disorders.
Factors Contributing to Antisocial Personality Disorder
Etiology: Biological factors such as high levels of testosterone, low-arousal theory, brain abnormalities, and ADHD have been found to be related to the diagnosis of APD. High levels of the neurotransmitter serotonin is associated with impulsivity and suicidal behavior, whereas people with APD traits also tend to exhibit decreased serotonin functioning.
Psychosocial factors such as child abuse and neglect, divorce, no familial supervision, and lack of parental attention are also correlated with APD.
Treatment Approaches
Psychopharmacological treatments are used to address and treat the behaviors of APD instead of the causal aspects of the disorder. Most of the prescribed medications are used to treat things such as hostility, impulsivity, and aggression. Examples of these drugs include lithium, serotonin reuptake inhibitors, divalproex sodium, valproic acid, phenytoin, and quetiapine.
Psychosocial treatments include psychotherapy, life skills training, group therapy, family therapy, marital therapy, and therapeutic communities.
Martens (2004) posits that through a combination of capable therapists, psychotherapy, neurological treatment, favorable circumstances such as friendships, and the aging process, people with psychopathic personality traits can be successfully treated.
This section closes with a discussion of factors about the therapeutic setting that will inhibit treatment outcomes as well as those that will create a more effective treatment program.
True/False Questions
1. The terms antisocial personality, psychopath, and sociopath effectively mean the same thing.
2. Cleckley’s Core Traits of psychopathy indicate that suicide is prevalent in psychopaths.
3. In early adulthood, APD usually shows itself through criminality.
4. The incidence of criminal behavior is less prevalent for the middle-aged person suffering from APD.
5. The Psychopathy Checklist–Revised is the most common measure of psychopathic personality traits in APD.
6. The lifetime prevalence of APD in the prison system is less than that of the general population.
7. Low-arousal theory states that people with APD have lower heart rates, which often leads to sensation-seeking behaviors.
8. There is no evidence to support the idea that family life problems, including divorce or lack of parental attention, influence APD.
9. Psychopharmacological treatments for APD are used mainly to address the causal aspects of the disorder.
10. People with APD may benefit from psychotherapy.
11. Therapeutic communities are a common and effective way of reducing impulses and behaviors in the offender population.
12. The neurotransmitter serotonin plays a role in anger, aggression, mood, sexuality, and sleep.
Multiple-Choice Questions
1. One difference in the characteristics described in Cleckley’s Core Traits and the DSM-IV-TR criteria for APD is:
a. deceitfulness.
b. that suicide is rarely carried out.
c. remorselessness.
d. All of these are differences.
2. The rate of violent recidivism for offenders with APD is approximately:
a. 10%.
b. 30%.
c. 50%.
d. 80%.
3. Which of the following is not an assessment tool used in the diagnosis and treatment of offenders with APD?
a. Psychopathy Checklist–Revised
b. Inventory of Psychopathic Traits
c. Structured Clinical Interview for Personality Disorders
d. Antisocial Personality Questionnaire
4. _________ is the assessment tool that is used most frequently.
a. Psychopathy Checklist–Revised
b. Inventory of Psychpathic Traits
c. Structured Clinical Interview for Personality Disorders
d. Antisocial Personality Questionnaire
5. The lifetime prevalence of APD in the general population is approximately:
a. 3%
b. 15%
c. 25%
d. 50%
6. Douglas et al.’s research into suicide in persons with APD reveals that this characteristic of APD is the cause of the high rates of suicide in this population:
a. Remorselessness
b. Aggressiveness
c. Impulsivity
d. Interpersonal problems
7. The idea that there is no single cause for APD is called the:
a. Biological Model for Psychology.
b. Psychosocial Model.
c. Psychological Model.
d. Biopsychosocial Model.
8. Psychotropic medications prescribed for those with APD commonly address which characteristic of the disorder?
a. Aggression
b. Hostility
c. Impulsivity
d. All of the above
9. Within the therapeutic setting, certain factors come together to create a more effective treatment program. Which of the following is such a factor?
a. Patient’s ability to form an alliance with the counselor
b. Patient’s ability to avoid aggressively acting out
c. Patient’s ability to avoid using defenses
d. All of the above
10. Which of the following is not a psychosocial approach in the treatment of offenders with APD?
a. Psychotherapy
b. Life Skills Training
c. Psychopharmacotherapy
d. Therapeutic Communities
Short-Answer and Discussion Questions
1. Describe the criteria for APD listed in the DSM-IV-TR and Cleckley’s psychopathy traits. What are the key differences and similarities between the two?
2. What are the assessment tools used to diagnose APD?
3. Explain why the lifetime prevalence of offenders suffering from APD might differ from the non-offending population.
4. List and describe the biological factors that can contribute to APD.
5. Which therapeutic interventions have been demonstrated to be successful treatments for APD?
6. What aspects of the therapeutic setting create a successful intervention?
7. What characteristics of the offender might make effective treatment difficult to attain?
8. Discuss why the nature of APD can make diagnosing and assessing the disorder as challenging as the disorder itself.
9. List and describe various differences in APD across age, race, and gender groups.
10. Discuss how co-occurring disorders can confound the problems of the person with APD and vice versa.
11. List and describe environmental/psychosocial factors that can contribute to APD.
12. Why might group therapy or insight-oriented therapies not be appropriate for certain individuals with APD?
13. What behaviors does the neurotransmitter serotonin play a role in?
Chapter 14
Correctional Treatment: Accomplishments and Realities
Paula Smith, Paul Gendreau, and Claire Goggin
Key Concepts and Terms
actuarial versus clinical subjective/intuitive assessment
appropriate versus inappropriate interventions
Correctional Program Assessment Inventory–
2000 (CPAI-2000)
dosage
meta-analyses
principles of effective intervention
punishing smarter strategies
relapse prevention
responsivity principle
risk principle
static versus dynamic risk factors
therapeutic integrity
Accomplishments
A major accomplishment in the offender rehabilitation area is that so much useful knowledge has been generated in a relatively short period. At present, there are at least a dozen quantitative reviews available on rehabilitation. Assessments of these have been undertaken for the purpose of generating a set of principles of effective intervention.
Results of the Meta-Analyses
Meta-analysis calls for precise measurements of program effectiveness. In order to distinguish effective programs from non-effective programs, researchers use the following paradigms: “appropriate” interventions and “inappropriate” interventions. Results show that about 64% of rehabilitation programs studied show reduced recidivism rates.
The Principles of Effective Intervention
This section discusses 10 principles of effective intervention. The 10 principles cited apply to both juvenile and adult male offenders, and, on the basis of rather limited evidence, to females and minority groups. Cognitive-behavioral interventions are consistently found to be more successful in reducing recidivism over other treatment modalities. Program implementation has been found to be strongly associated with treatment effectiveness in community-based residential programs.
What Does Not Work
This section sets forth three programmatic features underlying inappropriate strategies.
The Realities of Correctional Treatment
While it is one thing to document that certain types of treatment programs can show a meaningful effect on reducing offender recidivism, another reality exists: how representative are the success stories of the total number of rehabilitation programs?
To address this concern, researchers use the Correctional Program Assessment Inventory–2000 (CPAI- 2000). This program is based on the available “what works” literature.
Results of the CPAI Research
The CPAI was administered to 170 adult offender substance abuse programs in the United States and to 135 similar programs in Canada. Unfortunately, the pessimistic conclusions drawn from earlier studies remained the same. The shortcomings in programs listed in this section occurred at least 50% of the time. These include: implementation, client preservice assessment, program characteristics, staff characteristics, and evaluative procedures. It seems that the correctional system must now focus on better education and training if it is to produce a new generation of offender treatment programs that will be better able to benefit the clientele and protect the public.
True/False Questions
1. There is no research that can distinguish successful programs from unsuccessful programs.
2. Research has found the cognitive-behavioral treatment modality to be an effective intervention.
3. Nondirective counseling approaches have traditionally been those that promoted a “good” relationship and have been found quite effective as intervention strategies.
4. Meta-analyses indicate that at best we can expect reductions in recidivism of 10%, even for programs with therapeutic integrity.
5. Programs based on “punishing smarter strategies” have been unmitigated failures.
6. Meta-analysis has been deemed less than useful in measuring program effectiveness.
7. Results of studies using the Correctional Program Assessment Inventory–2000 indicate that most rehabilitation programs incorporate relapse prevention strategies.
8. Research on effective intervention strategies concludes that well-designed mono-modal treatments far exceed the effectiveness of multi-modal treatment strategies.
9. Relapse prevention program models have been found to be highly effective in treating sex offenders and substance abusers.
10. Results of studies using the Correctional Program Assessment Inventory–2000 in the United States and Canada indicate that the Canadians are more successful in their attempts to lower recidivism rates among sex offenders and substance abusers than are the Americans.
Multiple-Choice Questions
1. Appropriate treatment programs:
a. produce slight increases in recidivism.
b. can expect to produce reductions in recidivism as great as 75 percent.
c. have been found to reduce recidivism by 25 to 30 percent.
d. are by definition located in the community rather than an institution.
2. The risk principle:
a. states that medium- to high-risk offenders benefit more from treatment than low-risk offenders.
b. states that low-risk offenders are the ideal clients for intensive interventions.
c. is a means of calculating the precise likelihood that an offender will commit one crime relative to the risk of committing a different crime.
d. demonstrates poor construct validity.
3. The Correctional Program Assessment Inventory–2000:
a. allows program directors to predict which offenders will recidivate.
b. has been criticized by Martinson for being too labor-intensive.
c. has revealed optimistic findings that the majority of programs adhere to the principles of effective intervention.
d. is a means of determining the strengths and weaknesses of programs.
4. Actuarial risk assessments:
a. are typically used by programs lacking therapeutic integrity.
b. are most useful for monitoring treatment effectiveness when static risk factors comprise the majority of the instrument.
c. are enhanced when they include dynamic risk factors that can be affected through treatment to lessen the likelihood of reoffending.
d. have yet to prove to be more useful than clinical assessments.
5. Which of the following approaches to offender treatment are recommended by the principles of effective interventions?
a. radical behavioral, cognitive-behavioral, and social learning
b. psychodynamic, operant conditioning, and family therapy
c. Guided Group Interaction, nondirective phenomenological, and restitution
d. self-help, object relations, and psychodrama
6. According to the principles of effective intervention, programs should target:
a. low-risk offenders.
b. depressed offenders with low self-esteem.
c. behaviors such as IQ that are correlated with criminal behavior and are highly stable over time.
d. dynamic characteristics that are predictive of future behavior.
Short-Answer and Discussion Questions
1. Discuss appropriate and inappropriate interventions. Which is more successful and why?
2. Discuss at least five of the principles of effective intervention presented in your text.
3. Define the term responsivity principle.
4. The Correctional Program Assessment Inventory–2000 (CPAI-2000) is used for what purpose?
5. The Correctional Program Assessment Inventory–2000 (CPAI-2000) found a number of major deficiencies in substance abuse treatment programs. Discuss the problems found in the following areas: (a) program characteristics, and (b) program evaluation procedures.
6. Realistically speaking, how effective can we expect offender treatment programs to be? According to Smith, Gendreau, and Goggin, is this more or less effective than for other interventions in human services?
7. What offender problems and behaviors should programs target for purposes of intervention? What problems should not be targeted?
8. According to Smith, Gendreau, and Goggin, what would be the characteristics of a “high-quality” correctional treatment program?
9. Why should program directors and staff be familiar with treatment effectiveness literature prior to designing a program?
10. What is the difference between clinical assessment and actuarial assessment? Which is more accurate?
11. According to Smith, Gendreau, and Goggin, what types of knowledge should correctional treatment staff possess in order to perform their jobs effectively?
12. Is it more beneficial to assess risk factors that are static or those that are dynamic to identify targets for behavior change? Why?
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