Treatment readiness in violent offenders : the influence of cognitive factors on engagement in violence programs

Advances in offender rehabilitation theory have led to the development of a clear framework of the factors that need consideration for an offender to be ready for therapy and thus gain maximum benefits. Here, we examine in greater detail the role of cognition in readiness for rehabilitation in violent offenders. We assess how cognitive processes and distortions common in violent offenders may affect and hamper rehabilitation readiness. Methods for remediation of cognitive factors that diminish readiness, including motivational interviewing, are discussed. We conclude that cognitive factors are critical in the assessment of readiness in violent offenders and therapeutic efforts to enhance engagement.

The multifactor offender readiness model

There has been a resurgence of interest in the rehabilitation of offenders. Research has consistently shown that rehabilitation programs for offenders, when they adhere to general principles of program design and delivery, will achieve significant reductions in recidivism. In this paper, we suggest that even greater reductions in recidivism can be achieved when readiness is addressed at the level of the individual offender, the program, and the context. A comprehensive understanding of readiness allows for fuller engagement in treatment, thus increasing probability of good treatment outcomes. We describe person, program, and context factors in a model of offender treatment readiness and discuss implications of the model for both assessment of offenders and for modification of low readiness.

Repairing the rupture : restorative justice and the rehabilitation of offenders

Restorative justice is a social justice movement that aims to deal with consequences of crime through repairing and restoring relationships of three key stakeholders: victims, offenders, and communities. Unfortunately, it is often unclear where offender rehabilitation fits within the constructs of repair and reintegration that drive this justice paradigm. An analysis of the relationship between restorative justice theory and offender rehabilitation principles reveals tensions between the two normative frameworks and a lack of appreciation that correctional treatment programs have a legitimate role alongside restorative practices. First, we outline the basic tenets of the Risk–Need–Responsivity Model and the Good Lives Model in order to provide a brief overview of two recent models of offender rehabilitation. We then consider the claims made by restorative justice proponents about correctional rehabilitation programs and their role in the criminal justice system. We conclude that restorative justice and rehabilitation models are distinct, although overlapping, normative frameworks and have different domains of application in the criminal justice system, and that it is a mistake to attempt to blend them in any robust sense.

Time for a change : applying the Good Lives Model of rehabilitation to a high-risk violent offender

In this article we operationalise the theoretical concepts of the Good Lives Model (GLM) of offender rehabilitation by providing a step-by-step framework for assessment, formulation, treatment planning, and monitoring with a high-risk violent offender residing in the community. The case study illustrates how the GLM can be applied to complement and enhance traditional Risk-Management interventions and shows how the GLM's clinical relevance extends from sex offending to broader offending typologies.

Narratives of recovery from traumatic injury: issues in the nursing care of patients in rehabilitation

Patients who sustain multiple orthopaedic injuries through trauma frequently undergo lengthy rehabilitation. There is little information available about how patients experience hospital rehabilitation programs. In particular, not much is known about factors that inhibit or facilitate the rehabilitation process. This paper describes a qualitative study that explored the rehabilitation  experiences of thirteen patients who had serious orthopaedic injuries.  In-depth interviews revealed issues about good and bad care, the importance of mateship, getting through the day and living with pain. In addition, participants spoke of the impact that the accident and resulting injuries had on their relationships, their experience of loss, how difficult it was to manage everyday issues and the ways in which the accident changed them. The findings of the study have been set into a framework of therapeutic emplotment, a novel way to view the role of the rehabilitation nurse.

Financial, family, and social factors impacting on cardiac rehabilitation attendance

Background
Attendance in phase 2 cardiac rehabilitation program after acute myocardial infarction is poor.

Objective
To identify and explore the demographic factors that influence peoples’ decisions to attend cardiac rehabilitation programs.

Methods
A descriptive-interpretive design was used. Semi-structured interviews were conducted with 10 people post infarction in Victoria, Australia after their first scheduled appointment to attend outpatient cardiac rehabilitation. The interview transcripts were thematically analysed.

Results
The perceived relevance of cardiac rehabilitation related to the context of people’s lives, namely their financial, family and social situation, and how important program outcomes were seen to be relevant to this context.

Conclusion
The findings of this study suggest that there are a proportion of people unlikely to attend outpatient cardiac rehabilitation programs following an AMI despite encouragement to attend. It may be unrealistic to aim for 100% referral and uptake into cardiac rehabilitation programs and therefore an inappropriate endpoint by which to evaluate such programs.

Outpatient cardiac rehabilitation attendance in England

Abstract
PURPOSE:
Cardiac rehabilitation is an effective but underprovided treatment for patients recovering from acute cardiac events. The geographical spread of provision has not been investigated recently in any country. This study aimed to investigate the level of participation in cardiac rehabilitation programs of patients following myocardial infarction or revascularization (eligible patients) and the geographical equity of attendance.
METHODS:
Questionnaire data were collected from all cardiac rehabilitation centers in England for the year 2003/2004. The number of patients attending rehabilitation was compared with eligible patients across the 9 Government Office Regions of England as indicated by Hospital Episode Statistics.
RESULTS:
Nationally, 29% of eligible patients attended rehabilitation, while within various regions, the proportion of eligible patients participating in rehabilitation ranged between 14% (95% CI, 13.2-14.3) and 37% (95% CI, 36.6-37.6). Participation also differed significantly by primary cardiac event: myocardial infarction, 25%; percutaneous coronary intervention, 24%; and coronary artery bypass surgery, 66% (P < .001).
CONCLUSION:
The participation rate of eligible patients in cardiac rehabilitation was low in all regions. There were large differences between regions with widely varying incidence of attendance in different parts of the country.

UnitingCare West Outreach Services and the Good Lives Model of offender rehabiliation

UnitingCare West is a not-for-profit community services organisation committed to achieving justice, hope and opportunity for all, and works to support and empower in particular those most in need in the WA community. Through its program Outreach Services, it delivers a specialist re-entry service for sex offenders and men serving life and indeterminate sentences. The program has recently been reviewed by Dr Andrew Day from the Centre for Offender Reintegration, Deakin University with input from Dr Tony Ward, University of Victoria, Wellington, New Zealand. In this paper we describe the aims of the review, the process and findings and our ongoing work in developing a rationale for the service that is underpinned by the Good Lives Model (GLM) of offender rehabilitation. More generally, the presentation will seek to understand the needs of offenders who re-enter the community following long-term imprisonment in relation to those areas of need identified in the GLM.

Reducing the risk of re-offending among Australian indigenous offenders : what works for whom?

This paper discusses the application of the “what works” approach to the rehabilitation of indigenous Australian offenders. It is suggested that those from indigenous cultures may not share some of the theoretical assumptions that underpin the “what works” approach, potentially leading to discussion about the cultural appropriateness of rehabilitation programs. Finally, some options are presented about how cultural differences might be understood in ways that facilitate the further development of rehabilitation programs for indigenous peoples.

The rehabilitation of indigenous prisoners : an Australian perspective

The massive problems experienced by Indigenous Australians in their encounters with the criminal justice system have been well documented and widely discussed. This paper applies the Risk, Needs and Responsivity Model of rehabilitation to Indigenous offenders. While much of the review is devoted to a discussion of Australian Indigenous offenders, the issues raised are likely to be relevant to Indigenous groups from other countries and, possibly, ethnic minority offenders more generally. We concluded that whilst the model clearly has value, rehabilitation programs would benefit from a careful consideration of issues relating specifically to the Risk, Needs and Responsivity of Indigenous offenders.

Assessing offender readiness to change problems with anger

It is widely acknowledged that offender rehabilitation outcomes can be improved by attending to responsivity issues, including the readiness and motivation of offenders to undertake and engage in treatment. The measurement of responsivity, readiness and motivation in offenders, however, has received relatively little research attention. In this paper we focus on anger management programmes and evaluate the utility and psychometric properties of a measure of stages of change in relation to changing anger - the Anger Readiness to Change Questionnaire (ARCQ). Using data from a large sample of offenders undergoing anger management interventions, we investigated the construct validity, convergent validity and predictive validity of the ARCQ. We conclude the ARCQ may have utility as a measure for selecting offenders who are suitable for anger management interventions.

Pathways to sex offending

The research of the thesis aimed to contribute to the theoretical understanding of the various pathways that offenders follow in committing sexual offences. Using grounded theory a theoretical model was generated which described four major pathways to sexual offending. Quantitative analyses revealed that offenders who take different pathways differ significantly in respect of their risk of recidivism, demographic variables, rape myth acceptance and aggression. The portfolio considered the limitations of sex offender treatment programs for treating sex offenders with histories of childhood sexual abuse and presented four case studies.

Interventions to improve empathy awareness in sexual and violent offenders : conceptual, empirical, and clinical issues

Interventions that seek to increase empathy are a common feature of programs offered to sexual and violent offenders. Yet, there is little empirical evidence to suggest that they contribute positively to program outcomes. This paper explores the rationale for the delivery of empathy training with violent offenders, describes some of the most commonly used approaches, and reviews the current evidence base relating to effectiveness. It is concluded that while there are strong theoretical grounds for identifying empathy deficits as an important area of criminogenic need, there are considerable difficulties in establishing the extent to which the interventions offered in this area might be considered to be successful in reducing risk.

Rehabilitation : beyond the risk paradigm

Providing a succinct summary and critique of the scientific approach to offender rehabilitation, this volume for students of criminology, sociology and clinical psychology gives a comprehensive evaluation of both the Risk-Need-Responsivity Model and the Good Lives Model." "Rehabilitation is a value-laden process involving a delicate balance of the needs and desires of clinicians, clients, the State and the public. Written by two internationally renowned academics in rehabilitation research, this book argues that intervention with offenders is not simply a matter of implementing the best therapeutic technology and leaving political and social debate to politicians and policy-makers.