What Should a Rehabilitation Theory Look Like?

A good theory of offender rehabilitation should specify the aims of therapy, provide justification of these aims in terms of the theory's core assumptions about etiology and the values underpinning the approach, and identify clinical targets. Treatment should proceed in the light of these assumptions and goals (Ward & Marshall, 2004). Etiological theories and practice models are conceptually linked by an overarching theory of rehabilitation. For example, there is a close relationship between deficit models of sexual offending and problem-based clinical practice by virtue of the RNR theory of rehabilitation and its attendant RP treatment framework. The RNR theory connects assumptions about the causes of sexual offending (i.e., psychological deficits), the type of interventions that should be used (i.e., problem reducing), and most significantly, the way these interventions should be implemented (i.e., to reduce or manage risk). In RP the focus is on moderating or reducing risk factors, not enhancing an individual's capacity to live a more fulfilling life.

A good rehabilitation model should also specify the style of treatment (e.g., skills based, structured, etc.), inform therapists about the appropriate attitudes to take toward offenders, address motivation, and clarify the role and importance of therapeutic alliance. These features of treatment are often ignored by standard RP approaches and viewed as concerns about process rather than substance or content.

We suggest that motivating offenders and creating a sound therapeutic alliance are pivotal components of effective treatment. In addition, therapists cannot quarantine ethical or moral issues from therapeutic ones when working with sex offenders (Ward, 2002). The fact an offender has harmed another human being and been punished is likely to evoke therapist beliefs about the nature of unjustified harm (i.e., evil), forgiveness, and revenge. Therapists' attitudes toward the offender are strongly influenced by their conception of the nature and value of human beings, and the extent to which engaging in harmful actions diminishes that value.

A seminal paper by Bill Marshall (1996) argues the importance of regarding sex offenders as human beings with the same intrinsic value as any other individual, irrespective of the wrongs they have committed. Therapist attitudes toward sex offenders emerge from an analysis of the relationship between the character of the offender (i.e., the source of harmful actions) and his or her criminal acts. Focusing on harmful actions means therapists are likely to form a pejorative view of the individual. In contrast, if therapists see offenders as possessing intrinsic value because of their status as human beings—based on their autonomy, potential for change, or some other quality—then respect for the person but condemnation of the offense is more likely to arise.

We suggest the position individuals take on this issue partially depends on their view of human nature; first, some will believe human beings are essentially good and only commit harmful actions if they fail to cultivate more prosocial values and the ability to achieve their goals (human goods) in adaptive and socially acceptable ways. Second, some people are fundamentally bad, born criminals and initiators of harmful acts. Third, people are equally capable of beneficial or harmful actions by virtue of their natural dispositions and characteristics.

A mixed view of human nature involving both dispositions to behave in ways that increase and reduce human welfare is most consistent with the scientific evidence. Individuals have tendencies to behave altruistically and aggressively toward fellow human beings. There is an asymmetrical relationship between our good-producing and evil-avoiding activities (Kekes, 1990). The latter involves making sure people do not act in certain ways, while the former involves changing the world in a way that is beneficial for a person. The former is positive and the latter negative. Clinicians should not restrict therapeutic actions simply to the production of human goods or meeting needs; they must also focus on the avoidance of harm (i.e., risk management). Giving someone capabilities to seek goods may also reduce their disposition to inflict harm. It is important to keep both goals in mind when working with sexual offenders as on their own neither is sufficient to reduce reoffending. This is a way of integrating a risk management rehabilitation perspective with a good lives approach (see later discussion).

It is crucial to distinguish between the actions of sexual offenders and the respect owed to them because of their status as human beings (Cordner, 2002). The perception of offenders as worthwhile because they are human agents or persons and thus of fundamental value should partially determine therapy.

Therapist attitudes toward offenders have two distinct, although related, foci: (1) their value and dignity as human beings and rights to live good lives and (2) as individuals who have inflicted harm on other people. Both attitudes allow space for therapeutic growth and are based on the idea that while punishment should give a moral message to the offender and confront him with the harm he has inflicted on victims, it should not involve seeking revenge.

Forgiveness is also important; the fact that someone has been punished and is in therapy to alter his sexually aggressive behavior means he is likely to have to grapple with the realization he severely harmed another human being. Once an offender takes responsibility for the harm done to his victim(s) (and secondary and tertiary victims—see later discussion), he is likely to desire some form of forgiveness. Govier (2002) argues forgiveness means a person can move on and seek to transform himself, making it a critical element in the process of behavior change.

It is not always possible to forgive the offender on behalf of his primary victim (Govier, 2002). Perhaps this is because it feels as if the victim of a sexual offense is the only person who has the right to offer forgiveness, and if we take that right away, we are acting as if the victim's rights are unimportant and exacerbating his or her previous experience of being disregarded. Therapists working with sex offenders must manage this complexity of working with one damaged person while not undermining the experience of the victim(s).

There are arguably distinct levels of victimization ranging from the primary (the direct recipient of harm), secondary (family and close friends), and finally, tertiary levels (e.g., the community as a whole). If you accept that tertiary victims can play an important role in forgiveness, and that forgiveness is often necessary for an offender to accept responsibility and to turn his life around, then it can be a critical therapeutic response. It is unclear whether it is ever appropriate for therapists to take on this role, although an argument can be made for its utility and value. The point is that it is not possible for therapists to sidestep this issue. The attitude they adopt toward the offender reflects their implicit (rarely explicit) forgiveness (or lack of forgiveness) of the individual in question and the belief that he is entitled to be treated with respect because of his value as a person.

Thus therapists' interactions with offenders are partly based on their views of the nature of person, the source of harm, forgiveness, and their implications for the worth of the offender and his right to live a different kind of life. The GLM fits in well with a constructive view of punishment as it is based on a more positive view of human nature and the intrinsic value of human beings. This point has been powerfully argued by Margalit (1996):

Even if there are noticeable differences among people in their ability to change, they are deserving of respect for the very possibility of changing. Even the worst criminals are worthy of basic human respect for the possibility that they may radically reevaluate their past lives and, if they are given the opportunity, may live the rest of their lives in a worthy manner. (p. 70)

Offenders are viewed as individuals who have committed wrongs and who may have enduring dispositions to do so again. The aim of intervention is not to seek revenge, but rather therapists should act in a way that allows the offender to vindicate himself (Govier, 2002) by actively engaging in therapy and also by helping him live a better life. Revenge only results in the infliction of further suffering (a wrong) in response to a prior wrong and runs the risk of reinforcing offense-related risk factors such as grievance/persecution beliefs. By revenge we are referring to punitive actions directed toward offenders by clinicians because they are perceived to be bad people, undeserving of forgiveness or a chance at a new life. These actions may involve aggressive confrontation, a failure to reward or praise efforts at behavior change, negative interpretations of problematic group behavior or lack of progress, or simply the failure to do the best for a given individual. These observations are entirely consistent with research on the impact of therapist and process factors in treatment outcome. Marshall et al. (2003) have concluded that increasing sexual offenders' self-esteem, working collaboratively with offenders in developing treatment goals, and the cultivation of therapist features such as displays of empathy and warmth, and encouragement and rewards for progress, facilitate the change process. We suggest it is easier to achieve these things if a therapist has a positive view about sex offenders based on the preceding considerations. Therapist and process variables reflect underlying assumptions about forgiveness, intrinsic value, and the nature of unjustified harm.

The degree to which offenders perceive the therapist to be trustworthy is also likely to be a function of these basic attitudes toward the offender and other members of the group (Potter, 2002). We tend to find individuals trustworthy if they take care of things that we, and others, care about or value (e.g., feelings, hopes, and desires; Potter, 2002). Trustworthy therapists have a responsibility to communicate that they are trustworthy to offenders, to be aware of their own values and attitudes and to critically evaluate them, and to be sensitive to the offender's particular situation (Potter, 2002). Therapists should not naively believe everything the offender reports during therapy while also not being unduly suspicious and confronting; rather they should take a middle position. Trust is essential to the development of the therapeutic alliance (Ackerman & Hilsenroth, 2003).

Personal identity for offenders in the process of behavior change is also important. Maruna (2001) examined the differences between offenders who desist or persist in committing further crimes and found that effectively rehabilitated individuals established a coherent, prosocial identity. This required the construction of a narrative that made sense of their earlier crimes and experiences of adversity and created a bridge between their undesirable life and the adoption of new ways of living. The capacity of individuals to seek meaning and direct their actions in the light of reasons and values constitutes an essential aspect of human functioning according to the good lives perspective (Ward, 2002; Ward & Maruna, 2007).

An adequate theory of rehabilitation should have the conceptual resources to create a bridge between etiology and treatment; specify treatment targets; provide a rationale and theoretical basis for the importance of forming positive attitudes toward offenders and clarify the role of a therapeutic alliance; deal with agency and identity; be strength based; explain the relationship between risk and goods (adopt the twin foci of seeking to equip offenders to live good lives but also to minimize and control risk); have a rich conceptualization of human nature and the related issues of values and motivation; and provide concrete suggestions for the assessment and treatment of sex offenders.

Good Lives Model of Offender Rehabilitation

The GLM of offender rehabilitation is a strength-based approach and seeks to give offenders the capabilities to secure primary human goods in socially acceptable and personally meaningful ways (Kekes, 1989; Rapp, 1998; Ward & Stewart, 2003a). Primary goods are actions, states of affairs, characteristics, experiences, and states of mind that are viewed as intrinsically beneficial to human beings and are sought for their own sake rather than as means to some more fundamental ends (Deci & Ryan, 2000; Emmons, 1999; Schmuck & Sheldon, 2001). In this model, humans are by nature active, goal-seeking beings who are engaged in the process of constructing a sense of purpose and meaning in their lives. This is hypothesized to emerge from the pursuit and achievement of a number of primary human goods (valued aspects of human functioning and living) that collectively allow individuals to flourish and achieve high levels of well-being. In the GLM, the identification of risk factors is a critical part of assessment as they alert clinicians to obstacles or problems in the way offenders are seeking to achieve valued or personally satisfying outcomes. For example, social isolation indicates difficulties in the way the goods of intimacy and community are sought and may indicate skill deficits and/or a lack of social opportunities and resources.

The core idea is that all meaningful human actions reflect attempts to achieve primary human goods (Emmons, 1999; Ward, 2002) irrespective of education, intelligence, or class. Primary goods are viewed as objective and are tied to certain ways of living that if pursued involve the actualization of potentialities that are distinctively human. Individuals can, therefore, be mistaken about what is really of value and what is in their best interests. Primary goods emerge out of basic needs while instrumental or secondary goods provide concrete ways of securing these goods. For example, the primary good of excellence in work that provides mastery experiences can be achieved by working as a mechanic, psychologist, or teacher. Secondary goods are available to individuals by way of the numerous models and opportunities for attaining goods in everyday life (i.e., types of relationships, work) and dictate the form these goods take in specific contexts. The choice to seek a particular cluster of secondary goods will be determined by an offender's preferences, strengths, and opportunities. One individual might realize the primary good of work and mastery (mastery experiences are components of excellence at work) working as a mechanic, while another might train as a computer operator. Secondary goods put flesh on the bones of the more abstract primary goods; when the attainment of goods is difficult the problem often resides in the type of secondary goods utilized. Thus, a person might seek the primary good of intimacy in a relationship characterized by violence, controlling behavior, and emotional distance. Such a relationship choice will clearly not realize the primary good of intimacy. The different types of goods sought by individuals are packaged together in lifestyles, reflecting the priority given to specific types of goods and also the chosen ways of realizing them. It must be noted that in the course of their development, individuals may simply be socialized into accepting specific ways of living rather than intentionally shaping their lives according to a rationally derived plan. However, in Western democratic societies the notion of free choice with respect to values and beliefs is fundamental, so it is expected that all individuals, at least in a nominal sense, have the capacity to alter their lifestyle and are held responsible for the choices they make. In a real sense, they are able to shape their lives to a significant degree, within the constraints posed by social, biological, and individual factors.

There is a consensus (in Western culture at least) regarding the lists of primary human goods noted in psychological and social science research (Cummins, 1996; Emmons, 1999), evolutionary theory (Arnhart, 1998), practical ethics (Murphy, 2001), and philosophical anthropology (Nussbaum, 2000; Rescher, 1990). Based on this literature (especially the work of Murphy, 2001), Ward and colleagues (e.g., Laws & Ward, 2011; Ward, Mann, & Gannon, 2007) have identified 11 classes of primary human goods: (1) life (including healthy living and functioning), (2) knowledge, (3) excellence in play, (4) excellence in work (including mastery experiences), (5) excellence in agency (i.e., autonomy and self-directedness), (6) inner peace (i.e., freedom from emotional turmoil and stress), (7) friendship (including intimate, romantic, and family relationships), (8) community, (9) spirituality (in the broad sense of finding meaning and purpose in life), (10) happiness, and (11) creativity (Ward & Gannon, 2006, p. 79). Each of these primary goods can be broken down into subclusters or components; in other words, the primary goods are complex and multifaceted. For example, the primary good of relatedness contains the subcluster goods of intimacy, friendship, support, caring, reliability, honesty, and so on.

The possibility of constructing and translating conceptions of good lives into actions and concrete ways of living depends crucially on the possession of internal (skills and capabilities) and external conditions (opportunities and supports). The specific form a conception takes depends on the actual abilities, interests, and opportunities of each individual and the weightings he gives to specific primary goods. The weightings or priorities allocated to specific primary goods is constitutive of an offender's personal identity and spells out the kind of life sought, and the kind of person he would like to be. As human beings naturally seek a range of primary goods or desired states, it is important that all classes of primary goods are addressed in a good lives plan (GLP); they should be ordered and coherently related. If an offender decides to pursue a life characterized by service to the community, a core aspect of his identity will revolve around the primary goods of relatedness and community. Their sense of mastery, meaning, and agency will all reflect the overarching goods of relatedness and community and their associated subclusters of goods (e.g., intimacy, caring, reliability, honesty). The resulting GLP should be organized in ways that ensure each primary good has a role to play and can be secured or experienced by the individual concerned. A GLP that is fragmented and lacks coherence is likely to lead to frustration and harm to the individual concerned, as well as leading to a life lacking an overall sense of purpose and meaning (Emmons, 1996). Additionally, a GLP is always context dependent—there is no such thing as the right kind of life for any specific person; there are always a number of feasible possibilities, although there are limits defined by circumstances, abilities, and preferences (Kekes, 1989; Ward & Maruna, 2007; Ward & Stewart, 2003b).

Psychological, social, and lifestyle problems emerge when GLPs are faulty in some way. In the case of criminal behavior, it is hypothesized there are four major types of difficulties: (1) problems with the means used to secure goods, (2) a lack of scope within a GLP, (3) the presence of conflict among goals (goods sought) or incoherence, or (4) a lack of the necessary capacities to form and adjust a GLP to changing circumstances (e.g., impulsive decision making).

Taking into account the type of GLP problem an offender has, a treatment plan should be explicitly constructed taking into account an offender's preferences, strengths, primary goods, and relevant environments, and specify exactly what competencies and resources are required to achieve these goods. This crucially involves identifying the internal and external conditions necessary to implement the plan and designing a rehabilitation strategy to equip the individual with these required skills, resources, and opportunities. Such an approach to offender rehabilitation is significantly contextualized, and promotes the importance of personal identity and its emergence from daily living. It is also value laden in the sense that primary human goods represent outcomes that are beneficial to human beings and their absence harmful (to the individual and to others). Therefore, rehabilitation should be tailored to the individual offender's particular GLP and only seek to install the internal and external conditions that will enable its realization. The detection of dynamic risk factors or criminogenic needs signals there are problems of scope, coherence, inappropriate means, and planning deficits. Risk analysis simply informs therapists there are problems in the way offenders seek human goods. Treatment should proceed on the assumption that effective rehabilitation requires the acquisition of competencies and external supports, and opportunities to live a different kind of life.

Implications for the Assessment of Sexual Offenders

If the GLM is adopted as a foundation for sexual offender treatment, assessment is important—in particular, risk, treatment needs, and responsivity factors (i.e., the personal factors such as IQ, personality, and learning style that affect the way in which he will respond to treatment). A typical assessment package for sexual offenders includes structured interviews focusing on personal history, relapse knowledge (e.g., Beckett, Fisher, Mann, & Thornton, 1988) and personality (e.g., the Psychopathy Checklist–Revised; Hare, 1991); a battery of psychometric tests measuring areas related to risk of sexual recidivism such as impulsivity, offense-supportive attitudes, and socio-affective functioning; a psycho-physiological assessment such as phallometric testing (Marshall & Fernandez, 2000); IQ testing; and behavioral observation.

Assessors may be trained in the technical aspects of psychometric assessment, such as the importance of not acting in any way that could influence the client's responses. In order to adhere to these principles, the assessor often does not attempt to build a relationship with the offender, but presents assessment tasks in as neutral a way as possible. The sexual offender client often responds to this presentation with suspicion, as he has no indication the process of assessment is adapted to his personal needs or issues. In the 1980s, due to concerns sex offenders were likely to manipulate the assessment and treatment process, specialists were guided to expect “the client will have goals that the therapist does not share and the therapist is expected to override the client's wishes” (Salter, 1988, p. 87). In practice, this assumption could lead to reluctance by therapists or assessors to discuss the purpose of assessment or to invite the client's thoughts and ideas about his needs.

Such an approach to assessment is not consistent with the GLM. The GLM leads to a prediction a person will be most responsive to an intervention that is tailored to his own personal goals and needs. Sexual offender assessment should be seen as an intervention in its own right, as a process that is capable of bringing about change. For instance, a well-conducted collaborative risk and need assessment (see later discussion) can lead a client to start thinking about change or to gain insight into his problems. Assessment can also lead to change in a person's environment. For example, an assessment that concludes that a particular offender is both high risk and high need can lead to the offender being moved to more secure conditions or receiving an increased level of social punishment. Therefore, the assessment process should be treated with the same level of care as the treatment intervention. In doing so, attention should be paid to both the style and content of assessments.

Implications for the Treatment of Sexual Offenders

Principles that must underlie the construction of a sex offender treatment program using the GLM are as follows:

1. Many sex offenders have experienced adversarial developmental experiences as children, and should be seen as individuals who have lacked the opportunities and support necessary to achieve a coherent GLP.
2. Consequently, sexual offenders lack many of the essential skills and capabilities necessary to achieve a fulfilling life.
3. Sexual offending represents an attempt to achieve human goods that are desired but where the skills or capabilities necessary to achieve them are not possessed. Alternatively, sexual offending can arise from an attempt to relieve the sense of incompetence, conflict, or dissatisfaction that arises from not achieving valued human goods.
4. Certain human goods seem to be more strongly associated with sexual offending: agency, inner peace, and relatedness.
5. The risk of sexual offending may be reduced by assisting offenders to develop the necessary skills and capabilities to achieve the full range of human goods through prosocial means.
6. Treatment is an activity that should add to a sexual offender's repertoire of personal functioning, rather than an activity that simply removes a problem or is devoted to managing problems, in order to avoid offending. Treatment should aim to return individuals to as normal a level of functioning as possible, and only place restrictions on activities highly related to the problem behavior.

We believe the GLM conceptualization of sexual offending therefore differs in several important ways from the traditional sexual offender treatment model. These differences will now be elaborated.

Updates

The GLM has continued to attract interest internationally (see Willis, Ward, & Leveson, 2014; Willis, Yates, Gannon, & Ward, 2013).

Conclusion

In this chapter we have presented a new theory of offender rehabilitation and applied it to sex offenders. The good lives model is a strength-based approach and proposes that the major aim of treatment is to equip offenders with the necessary internal and external conditions required to implement a GLP in their particular set of circumstances. In the GLM, risk factors are viewed as distortions in these conditions and are not expected to provide the sole focus of rehabilitation. Instead there is a twin focus on establishing good lives and avoiding harm. In our view, this theory has the conceptual resources to provide a comprehensive guide for therapists in the difficult task of treating sex offenders and making society a safer place.

Summary Points

• Offenders, like all human beings, have multiple natural needs, such as needs to be loved, to be valued, to function competently, to be part of a community, and to live meaningful lives.
• To lose sight of this fact is to risk becoming simply agents of social control rather than also facilitators of hope.
• Risk management is necessary for effective change but is not sufficient.
• The best way to lower sexual offending recidivism rates is to equip offenders with the internal and external resources to live more fulfilling lives.

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