Part II: Supervising and Treating Persons Who Have Sexually Harmed
BONUS MINI EPISODE.
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This is part two of a two part mini in service discussing supervision and treatment strategies with persons who have sexually harmed and the fit of these strategies with social work values and practice.
This episode provides a brief overview of:
- Relapse Prevention
- Risk-Need-Responsivity, and the
- Good Lives models
My review is primarily to provide a discussion on the basic fit of these models with the core values of social work, and not for the purposes of critiquing the models or their effectiveness in treating persons who have sexually harmed.
Relapse prevention has been used to treat those with substance dependency issues for decades. Most social workers are familiar with its basic tenets, even if they have never worked with persons who have sexually harmed. It is also relatively easy and acceptable to modernize programs using it to better fit with social work values and beliefs. While the model does have some research support for its use with persons who have sexually harmed, it makes an assumption that is flawed. Specifically, it assumes that all people want to stop their problematic behavior. Research has shown that some, emphasis on some, persons who have sexually harmed accept or like what they do and have no intention of stopping. While offense cycles and safety plans have incalculable value for those invested in treatment, they offer little to those approaching an offense. Offense cycles can, however, be used to diagram the offense pattern for those staff charged with monitoring or supervising and this may improve response time.
Risk-need-responsivity (RNR) is a correctional treatment protocol first adapted and standardized by Andrews, Bonta, and Hoge in 1990. RNR espouses three principles that improve efficiency and treatment outcomes, and better ensures public safety. These include:
- Allocate resources to those who present the greatest risk to public safety;
- Target criminogenic needs; and
- Deliver evidence-based treatment in a manner from which the respondent can derive maximum benefit in the briefest amount of time
The model advocates economy or resources and evidence-based practice. It argues that communities are safer when treatment is directed at the individuals most at risk of recidivism, as well as the criminogenic factors most associated with offending behavior.
It’s fit with social work is strained by the model’s heavy focus on criminogenic factors, rather than human needs. By doing so, the model, arguably, dismisses other unfavorable behaviors and outcomes. For example, practitioners of the model would be concerned with a recipients use of alcohol primarily due to its relationship with offending behavior. The effects of substance abuse on maintaining employment, relationships, health, etc., are a secondary concerns best handled following release. Further, because the model is popular in correctional settings, much of the research continues to use terms, such as sex offender, that equate the person and the behavior.
Good Lives, made popular primarily through the work of Tony Ward, is a strength-based model that utilizes techniques found in motivational interviewing. The model also argues that rather than risk, human needs should remain the focus of treatment. As such,the model is an excellent fit with social work practice. However, much of the research on the model, like that on Risk-Need-Responsivity, continues to use jargon inconsistent with social work values. On face-value the model’s name, Good Lives, suggests clinicians are making a promise that simply can’t be kept. More importantly, the fact that persons who have sexually harmed likely face considerable difficulties upon release, social workers have a responsibility to not only demonstrate dignity and respect of the person, especially any person who completes treatment, but also to advocate with and on their behalf to ensure that they have access to necessary services and can meet basic human needs upon release. This points to a need for a more generalist micro/macro perspective.