Motivating offenders to change in therapy: an organizing framework

Objectives. Motivating offenders to change in therapy is an important aspect of effective offender treatment, yet despite this, offenders' motivation to change has received little close attention in the academic and professional literature. This situation is a result of an over-emphasis on the risk management model of rehabilitation, and a consequent failure to construe motivation within an overarching theory of offender rehabilitation.

Method. We present a social cognitive model of offender motivation — the Good Lives Model (GLM) — that provides a framework for incorporating factors that have been shown to be of importance in enhancing offender motivation. This is based upon the notion that all humans strive to achieve primary goods that are intrinsically rewarding and essential to well-being. Where offenders are concerned, criminogenic problems relate, not to the goods offenders seek, but to the way they seek them. Any treatment approach should take this into account and focus positively on equipping people with the skills required to achieve goals rather than simply look to manage risk. The motivational construct that we use here is that of goals. In the GLM, goals are the less abstract depictions of primary human goods and it is with these that people are typically engaged in their day-to-day activities and lives. Looking at therapeutic goal-setting, methods and styles of therapy, and therapist approaches, we derive theoretically-based key issues in motivating offenders to change in therapy.

Conclusion. In conclusion, we present a summary of 12 strategies and techniques that will not only help practitioners enhance their therapeutic effectiveness, but hopefully also act as a catalyst in the development of research on offenders' motivation to change.

Dignity and human rights in correctional practice

Interventions with offenders have a normative layer as well as a scientific basis and therefore it is not possible to quarantine ethical questions from discussions of best practice. My aim in this paper is to provide an expanded ethical canvass from which to approach correctional practice with offenders. The cornerstone of this broader ethical perspective will be the concept of human dignity and its protection by human rights norms and theories. I also explore the relationship between responses to crime and offender rehabilitation based on an enriched theory of punishment that is sensitive to offenders’ moral equality and their attendant rights.

A human rights-based practice framework for sexual offenders

Human rights create a protective zone around people and allow them the opportunity to further their own valued personal projects without interference from others. In our view, the emphasis on community rights and protection may, paradoxically, reduce the effectiveness of sex offender rehabilitation by ignoring or failing to ensure that offenders' core human interests are met. In this paper we consider how rights-based values and ideas can be integrated into therapeutic work with sex offenders in a way that safeguards the interests of offenders and the community. To this end we develop a rights-based normative framework (the Offender Practice Framework: OPF) that is orientated around the three strands of justice and accountability, offender needs and risk, and the utilization of empirically supported interventions and strength-based approaches. We examine the utility of this framework for the different phases of sex offender practice.

Reconstructing the Risk–Need–Responsivity model : a theoretical elaboration and evaluation

In this paper, we examine the theoretical strengths and weaknesses of the Risk–Need–Responsivity (RNR) model of offender rehabilitation. We briefly discuss the nature of rehabilitation theories and their core components and then review the three source theories associated with the RNR Model. Following this we set out to reconstruct the RNR model in light of this analysis, essentially arguing that there are at least three components to any rehabilitation theory: (a) primary aims, values and principles; (b) etiological and methodological assumptions; and (c) practice implications. We then evaluate the theoretical and empirical adequacy of the RNR model. Finally, we conclude the paper with a few comments on the policy, research, and clinical implications of our evaluation (and reconstruction) of this important rehabilitation model.

The ethics of punishment : correctional practice implications

Correctional practitioners work within a context that is heavily influenced and constrained by punishment policies and practices. The overlap between the normative frameworks of punishment and offender rehabilitation creates a unique set of ethical challenges for program developers and therapists. In this paper we set out to briefly outline three major punishment theories and draw out their implications for correctional practitioners. First, we discuss the nature of punishment and the problems it poses for practitioners and all citizens in liberal democracies. Second, consequential, retributive, and communicative justifications of punishment are succinctly described and their clinical implications analyzed and some limitations noted. Finally we conclude with some suggestions for ethical practice in correctional settings.

Striving for a good life : the good lives model applied to released child molesters

The good lives model (GLM) is a strengths-based approach to offender rehabilitation in which treatment aims to equip offenders with the skills and resources necessary to satisfy primary goods, or basic human values, in personally meaningful and socially acceptable ways. The aim of the present research was to explore the practical utility of the GLM with a sample of released child molesters, and investigate the relationship between primary goods attainment and overall re-entry conditions (in terms of accommodation, social support and employment). Semi-structured interviews were conducted with 16 child molesters at one, three and six months following their release from prison. As expected, participants endorsed the majority of GLM primary goods with high importance, and positive re-entry experiences were associated with increased goods attainment. Implications for clinicians, policy makers and society as a whole are discussed.

Case management in community corrections : current status and future directions

Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence relating to the effectiveness of different approaches. It is concluded that models of correctional case management that are clearly informed by the principles of risk, need, and responsivity, and which encourage case managers to form strong and meaningful relationships with their clients, are likely to be the most effective.

You won’t know if you don’t ask discrepancy and ambivalence in attitudes toward behavior change

Background: Behavior change is challenging following an acute cardiac event, and commonly, individuals are ambivalent. Aim: The objective of this study was to describe the experience of behavior change of survivors of an acute cardiac event. Method: Semistructured interviews were undertaken with 25 participants attending 3 cardiac rehabilitation programs. An inductive process of qualitative thematic analysis was used to analyze the transcripts. Results: Analysis revealed ambivalence to change, misconceptions, and confusion about terminology. Discrepancies between what participants felt they should be doing and what they actually were doing reflected their ambivalence. Further inconsistencies were reflected in participants' misunderstandings and confusion regarding disease processes and management of heart disease. Conclusions: These findings reflect the misconception and ambivalence regarding behavior change that individuals experience. Clinicians may require greater skills in detecting conflicting or ambivalent discourse to support patients through sustainable health behavior change.

Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

Background The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated.
Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined.
Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD.

Rural living and health-related quality of life in Australians with Parkinson's disease

Introduction: The motor and non-motor symptoms associated with idiopathic Parkinson’s disease (PD) may compromise the health-related quality of life (HRQOL) of some individuals living with this debilitating condition. Although growing evidence suggests that PD may be more prevalent in rural communities, there is little information about the life quality of these individuals. This study examines whether HRQOL ratings vary in relation to rural and metropolitan life settings.
Methods: An analytic cross-sectional study was conducted to compare the HRQOL of two separate samples of people with PD living in metropolitan Melbourne and rural Victoria. The metropolitan sample consisted of 210 individuals who had participated in the baseline assessment for an existing clinical trial. The rural sample comprised 24 participants who attended community-based rehabilitation programs and support groups in rural Victoria. Health-related quality of life was quantified using the Parkinson’s Disease Questionnaire-39 (PDQ-39).
Results: The HRQOL of participants in rural Australia differed from individuals living in a large metropolitan city (p=0.025). Participants in rural Australia reported worse overall HRQOL, after controlling for differences in disease duration. Their overall HRQOL was lower than for city dwellers. Rural living was also found to be a significant negative predictor of HRQOL (β=0.14; 95% CI -1.27 to -0.08; _p=0.027).
Conclusion: The findings of this study suggest that some people with PD living in rural Victoria perceive their HRQOL to be relatively poor. In order to minimise the debilitating consequences of this disease, further studies examining the factors that may contribute to the HRQOL of individuals living in rural and remote areas are required.

Violent offending, masculinity and age: exploring the role of developmental processes in adulthood

While the link between violent crime and masculinity is often implicitly assumed, to date, research has not specifically investigated beliefs about violence and masculinity at different stages of the adult life-course. This thesis explored the role of maturational processes in the way beliefs about masculinity and violence may differ in early and middle adulthood. Results of a quantitative study did not uncover statistically significant differences between younger and older adult violent offenders on a measure of criminal thinking. However, results of an interpretative phenomenological analysis indicated that beliefs about masculinity may differentially influence violent crime at different stages of adulthood. The results of these two studies provide a foundation for arguing that beliefs about violence and masculinity change throughout the life-course, and that masculinity in particular may be important treatment target in contemporary rehabilitation programs.

Program outcomes in youth justice outcomes: the PLUS+ program review

This report provides a methodology to assess the outcomes of rehabilitation programs that are delivered to young offenders in South Australia. A method of assessing change is described that can be applied across a number of different programs, but is illustrated in relation to one particular program, the PLUS+ program. PLUS+ is a group-based cognitive skills program which employs cognitive-behavioural methods of problem-solving, skills-training, and self-management to rehabilitate young offenders. It is one of the most intensive and best established programs to have been implemented in South Australia. Based on a review of this program a number of recommendations are made to enhance the future delivery and evaluation of PLUS+.

Correctional psychology and the desistance paradigm: commentary for the special issue of Criminal justice and behavior

Let me begin this commentary by suggesting that many of the ideas contained in this special issue will be important to the future of correctional psychology. Although each of the authors offer different perspectives on the role that the criminal justice system has to play in the process of desistance from crime, they all identify the importance of a valueoriented analysis to effective offender rehabilitation. Their focus is on promoting desistance at all points of the justice process; from how the legal system can promote therapeutic outcomes through to the provision of post-release support services and the need for community engagement. By approaching the tasks of both rehabilitation and reintegration from a values perspective, they have been able to identify a range of novel and innovative approaches that have the potential to make a real difference. Even more encouragingly, these draw on resources that may already be available to correctional psychologists and yet are often underutilized. In addition, the confidence, and indeed the optimism, expressed in these articles provides a refreshing counter to suggestions that contemporary correctional practice has become pre-occupied with the need to “manage” offenders and for professionals to focus on fulfilling their administrative obligations (see Hardy, 2014).

Canadian Society for Exercise Physiology position stand : the use of instability to train the core in athletic and nonathletic conditioning

The use of instability devices and exercises to train the core musculature is an essential feature of many training centres and programs. It was the intent of this position stand to provide recommendations regarding the role of instability in resistance training programs designed to train the core musculature. The core is defined as the axial skeleton and all soft tissues with a proximal attachment originating on the axial skeleton, regardless of whether the soft tissue terminates on the axial or appendicular skeleton. Core stability can be achieved with a combination of muscle activation and intra-abdominal pressure. Abdominal bracing has been shown to be more effective than abdominal hollowing in optimizing spinal stability. When similar exercises are performed, core and limb muscle activation are reported to be higher under unstable conditions than under stable conditions. However, core muscle activation that is similar to or higher than that achieved in unstable conditions can also be achieved with ground-based free-weight exercises, such as Olympic lifts, squats, and dead lifts. Since the addition of unstable bases to resistance exercises can decrease force, power, velocity, and range of motion, they are not recommended as the primary training mode for athletic conditioning. However, the high muscle activation with the use of lower loads associated with instability resistance training suggests they can play an important role within a periodized training schedule, in rehabilitation programs, and for nonathletic individuals who prefer not to use ground-based free weights to achieve musculoskeletal health benefits.