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1.A 22-year-old man on charges of theft and deception: ‘I’ve got nothing to lose, my lover meant more to me than anything and now he’s gone.’

2.A 20-year-old man on charges of conspiracy to rob: ‘What’s the point? I’m not going to be able to get a job anyway.’

3.A 52-year-old man convicted of indecent assault on teenage females: ‘I can’t say what I felt. I didn’t think I’d done anything wrong.’

Dependency

Some clients believe that they simply cannot get through life without continuing with the offence behaviour. For example, an indecent exposer: ‘Things got dull. I felt I needed to do it again.’ Or another exhibitionist: ‘I’m over-sexed. I have stronger feelings than other boys so I have to do something about it.’

Ellis (1979) postulates that this dependency reaches the level of demand in sexual offenders. He suggests that they demand excessively of themselves, of others, and of the world.

In some offenders this dependency may extend to the relationship with the therapist. Not only does the client believe he cannot get through life without continuing with offence behaviour, but he believes he cannot get through life without the help of others. This may become particularly clear when the question of stopping the offence behaviour arises. The desire for help exceeds any realistic requirements the client may have, and can jeopardise the formation of reasonable goals and maintenance of any degree of change which is achieved during therapy. Indeed, should therapy begin without the cognitive basis of this destructive type of dependency being addressed and changed, temporary relief from the problem only serves to reinforce the notion that the offender needs help and is not capable of change without outsider involvement. Moreover, if they have tended to conclude that they are inadequate or a failure as a result of previous failed attempts at change, this distortion may also be reinforced by such a process. For example, an exhibitionist had received various forms of therapy over the course of sixteen years. The client described to the therapist his reasons for requesting help again as follows:

C:I’ve always gone to the doctor afterwards.

T:Why do you do that?

C:To get some help to stop me doing it.

T:What sort of help do you want?

C:Any treatment that works. I need something new.

Emery (1980) has developed a procedure for enhancing self-reliance in cases such as this, using cognitive methods.

Misattribution

Another common cognitive pattern involves clients attributing all blame or responsibility to themselves, or to others. These clients are unable to consider the various contributions to the picture made by their circumstances, their learning history, and by chance. It is particularly useful with offenders who hold the second type of misattribution, i.e. blaming others, to address and question this early in the involvement of the practitioner. Once again, a distorted attribution of this kind left unchanged may interfere with the offender’s motivation for therapy and their potential to discontinue a repeated offence pattern. Examples from one client of such misattribution are:

‘It’s the way I was brought up.’

‘I’m stuck with a personality I don’t accept.’

‘She ought to realise when I’ve started doing it again.’

Howells (1982) has discussed the possible role of attributing negative events to others in mediating aggressive behaviour.

Levels of involvement

There are three main levels of involvement in work with offenders at which cognitive techniques may be of use.

1.Analysis of the offence behaviour; conceptualising the problem.

2.Assessing degree of change and the need for therapy.

3.Therapy itself.

Practitioners with offenders will recognise these levels of intervention with which they may have some involvement. The issue of the stage of involvement in the offence history is a separate one. Offenders may present for help without any

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involvement of the law. They may present prior to a court appearance. The practitioner may become involved subsequent to a criminal trial, and in a penal or other institution, or in the community. The involvement may be voluntary or statutory. It is possible at any of these stages for the practitioner to be involved at one or more of the levels described.

Analysis of the offence

Conceptualisation is one of the most important steps in completing an analysis of the client’s offence behaviour. This means putting the problem in context. The most useful cognitive techniques to aid in this process are those involving the identification of automatic thoughts, meanings, and images before, during, and after the offence. There are a number of basic methods for eliciting these cognitions—the raw material for cognitive therapy. They may be obtained by asking for them during the therapy session. For example, on observing the client suddenly drop his head and look despondent:

T:What’s running through your head right now?

C:I’m a freak. People like me should be locked up.

Alternatively, the client may be asked to write down what they were telling themselves between sessions, if the relevant emotion or behaviour arises, or if they find themselves able to recall an incident clearly. For example, concerning a burglary:

Before: ‘They shouldn’t be allowed so much money.’ During: ‘No one will ever see me.’

After: ‘At least I’m good at something.’

Imagery can be used to help a client recall a past situation and emotion during a session, and they may then be asked to pinpoint the automatic thoughts ‘as if they were happening right now’. Inductive questioning can be used to establish what something means to a client. For example, a client awaiting trial for indecent assault on male teenagers is helped to recall one of the incidents.

T: And what do you notice about him? C: He’s smiling at me.

T: How are you feeling right now? C: Sort of friendly and affectionate. T: What are you saying to yourself? C: I can’t snub a child. He’d be hurt.

T: What does it mean that he’s smiling at you?

C: Children are attracted to me. They come straight towards me. I’m popular.

This cognitive material can be considered along with situational, emotional and behavioural data in order to formulate the most comprehensive hypothesis possible about the determinants and maintenance of the offence behaviour and the surrounding problems. The practitioner can then go on to test the hypothesis by behavioural experiment within or between sessions, even if therapy is not being considered.

Assessing change; deciding on the need for therapy

Clearly, whatever the level of involvement is to be, an analysis and conceptualisation of the offence behaviour must be completed. In addition, the practitioner may be asked to consider the need for therapy or to provide therapy, either before or after a trial. Alternatively, therapy may be requested without the courts being involved.

There are two basic considerations to be made in reaching this decision:

1.Are any of the situations, cognitions, emotions, or behaviours which played a part in the aetiology and occurrence of the offence behaviour, according to the functional analysis hypothesis, open to change? Are the means available to facilitate this? Is therapist involvement the best, most efficient, effective, and least damaging way to achieve the required changes?

2.Have the necessary changes according to the analysis already begun? Or are they completed? If the client reports that this is the case, can this be substantiated?

Many behavioural strategies have been identified which have been successful in achieving behaviour change for a variety of problems. These strategies may be adopted naturally by an offender to help himself, or he may have been advised of them. Examples of such strategies are self-monitoring, stimulus control procedures, contingency management, developement of alternative behaviours, self-control procedures, learning of new skills.

The effective use of these strategies must be assessed in order to help in treatment decision making, and cognitive techniques can be of assistance in this process. As with offence analysis, techniques for identification of thoughts, images, and

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meanings may be most helpful first where behavioural change is reported to have occurred through non-cognitive means, but is reflected in cognitive change. For example, a client who had been convicted for underwear theft and voyeurism:

C: I’m confident I won’t do it again. T: How can you be sure?

C: I’ve proved I can ignore it.

T:OK. But what if a better opportunity presents itself? [Imagery.] Imagine you are coming home from the pub after a few beers. It’s a warm night. There’s no one around. You know you are going to pass the woman’s house you’ve been to before. Here it is. There’s washing on the line. You can see some underwear. It’s only a couple of yards away. What’s running through your mind right now?

C:It doesn’t excite me now—the idea of it. I’ve caused upset and worry to myself and others. It would split me up from my friends who have stood by me. I’ve tested myself. I’ve been out to look and I still don’t feel tempted.

Second, the offender may have changed their own thinking patterns and attitudes, and in this instance it is most substantive if thoughts can be identified retrospectively, for situations both before and after the reported changes. For example, a man convicted of burglary:

C:I wanted to draw attention to myself. I wanted to make people feel sorry for me. I was obviously the centre of attraction. But I didn’t fit into the community. I’ve never had anyone to go to, but no one was going to care about me like that. I’ve got a lot to offer other people, but I don’t know whether to for fear of rejection. I’ve come so far I can’t stop now. I can’t afford another failure—I’ve done enough failing for one life.

Third, techniques for identifying automatic thoughts have been found to be useful if inconsistencies in thought patterns can be detected. A client may say that his behaviour has changed but indicate that his automatic thoughts remain the same. Alternatively he may report one aspect of his thinking to be different, but overlook another which appeared to be important in the analysis of the offence. For example, a man convicted of indecent assault on teenage girls:

C: If there had been sex in the marriage it wouldn’t have happened. Trouble with the wife built it up. T: How did that make you feel?

C:I was being rejected. I’ve never been good enough for her. But she’d never say sorry if she was wrong—not once in ten years.

This man claimed that he was no longer at risk of committing further offences because he had made a new relationship with a woman. However, he was unable to consider what might happen should she ‘reject’ him also. The thought that this might be a possibility was in itself too frightening.

Another young man, convicted of indecent exposure, had changed one theme in his automatic thinking—from: ‘They wear tight jeans to turn men on. It means they want sex’, to: ‘They’re not after sex. They’ve got other things to do. Maybe it’s because they want to look nice’. Another theme remained unchanged along the following lines:

C: They appreciate me exposing myself. They like it. It excites them. T: What does that make you feel?

C: I’m important and powerful if they have a reaction to me. It’s no good if they show no sign of excitement. T: What do you mean?

C: Well, if they stay calm or ignore me; ignoring’s the worst. T: And what does it mean if they don’t ignore you?

C: They like me. It shows they care about me. I make them feel better. I’m useful.

A further cognitive behavioural technique is helpful at this level of intervention, when some degree of change has been reported. Clients are encouraged to take a scientific approach to their problems, whereby changes are considered to be hypotheses until they are reality tested. Behavioural experiments can be designed in collaboration with the client to test the changes reported to have taken place. Such experiments can be suggested as advantageous to the client rather than putting them under pressure to succeed, since they also need to know if the changes are not as effective or durable as they had thought. By presenting this rationale, and relating the desirability of firm evidence of change to the client’s own targets and goals, it is possible to encourage the client to test their new behaviours and/or cognitions in situations they previously avoided, or indeed to create new situations purely as a test.

Cognitive therapy

The use of cognitive therapy itself will be illustrated by a full case description. The example covers the use of general cognitive therapy strategies, and specific techniques. It illustrates some of the particular cognitive themes in offendertherapist interaction. An analysis is formed, a treatment decision is made, and hypotheses are tested and modified. Therapy