OFFENDERS 105

Given these considerations, however, few therapists would regard ‘lack of motivation’ in clients suffering from emotional disorder or behavioural problems as sufficient reason for not entering into therapy or for termination of therapy. Indeed, depressed clients often present with this as a primary problem. It is not usual to leave unquestioned such statements as ‘I didn’t feel anything’ or ‘I’ve already changed’. Conversely, the incentive for the client to embark on the process of change is carefully assessed and considered. ‘Of course I want to change!’ is usually not enough. Cognitive behaviour therapy utilises procedures to facilitate engagement in therapy, and also involves techniques to help in conceptualisation of clients’ presentation, including their motivation to change. It would therefore seem to have particular usefulness when considering the issues of consent and motivation with offenders. This will be illustrated later in the chapter.

Cognitive-behavioural techniques with offenders

General strategies

Explaining the role of cognitions

An integral part of cognitive behaviour therapy is the description of the cognitive model which the practitioner gives to the client. The connection between feeling and thinking is explained didactically, or by using handouts or metaphor. Examples of the client’s own thoughts and feelings are sought. The aim is to make the model explicit and unambiguous to the client. One effect of this may be to help in the identification of the client’s own idiosyncratic thought patterns. Should the intervention go on to include active therapy, the rationale for treatment can be described.

Developing trust

When working with offenders, sometimes more than with some other populations, it is essential for the practitioner to develop the client’s trust. The client is likely to view the practitioner with suspicion and to assume their perspectives are opposed. In order to gain access to the client’s intimate and personal cognitive processes, the practitioner must be seen by the client as credible and trustworthy. Practitioners may achieve this by aligning themselves as closely as possible with the client’s views and goals, without at the same time appearing to condone the behaviour. This is a process which should begin in the first contact with the client, and continue throughout intervention. Bancroft (1979) has provided useful guidelines for facilitation of the therapist-offender relationship.

Collaboration

The practitioner should engender a spirit of collaboration with the client from the outset. The emphasis is on a team approach to understanding and perhaps changing the client’s behaviour. The practitioner relies on the client to supply accurate raw data, as the client relies on the practitioner to use their expertise to act on the client’s behalf or to help bring about change. Mutual feedback becomes a standard element of each contact.

Common cognitive patterns in interaction with offenders

There are a number of patterns of interaction which commonly occur in the relationship between practitioner and offender. These patterns can be understood in terms of the offenders’ tendency to think and behave in particular ways. It may be helpful to be aware of these patterns as typical cognitive distortions at the start of the interaction, in order for sessions to be less likely to be sabotaged by them.

Self-defeat

Offenders often seem to be immovably determined to keep behaving in ways that are destructive to their own best interests. They seem predisposed to repeat the same vicious circle of offending, often in the face of punishment, and confrontation or insightful ‘therapeutic’ observation from professionals or others. Ellis (1979) describes these people as rebellious and treatment-resistant. He suggests that the immediate gratification gained by their behaviour overrules any motivation to change. Although this is undoubtedly true in some cases, an alternative approach can be taken. This focuses on distortions prevalent in thought patterns, and then on specific behaviours linked to these which prevent the client from achieving self-fulfilment. It may be that by defining and correcting these blocks to the client’s own goals, the practitioner and client can collaborate towards enduring change of these resistant patterns. The following are examples of such self-defeating cognitions: