Re: Denial and treatment

[Larry Wagoner <wagonerl@xxxxxxxxxxxx>]

I have been in a discussion about denial and treatment with a gentleman 
from this list - but I managed to erase his last post and so cannot 
directly reply to him.  So ...

Some of the theoretical foundation for my ideas can be found in:

R. Karl Hansen, Richard A Steffy, Rene Gauthier "Long Term Follow-up of 
Child Molesters: Risk Predictors and Treatment Outcome" (February, 1992)

In discussion of self-report vs actual record of sexual violence, which is 
one element of denial "neither variable significantly contributed ..."
However, a significant correlation between prior offenses and risk to 
re-offend is established.

R. Karl Hansen, Monique Bussier "Predictors of Sexual Offender Recidivism: 
A Meta-Analysis"  (April, 1996)

Denial correlates to risk of reoffending at rate of .03 - the lowest 
correlation.
This article notes that types of prior offenses, and participation and 
completion of treatment are *FAR* better predictors.

Howard Barbaree, Michael Seto, Alexandra Maric "Sex Offender 
Characteristics, Response to treatment, And Correctional Release Decisions 
At The Wadsworth Sexual Behaviour Clinic"

Test scores for denial did not change over the course of treatment.  Also, 
psychological test factors (including denial) did not predict 
post-treatment level of risk to reoffend.

James Bonta "Offender Rehabilitation: From Research To Practice"  (January, 
1997)

Suggests  that the "Risk Principle" be used to determine treatment - that 
is - that treatment focus on those things that actually demonstrate 
risk.  If denial does not correlate to risk of re-offense (and it doesn't) 
then why address it?   Bonta also notes that Cognitive-Behavioral programs 
are the most effective in preventing relapse.

The program in which I work has a set of 27 identified risk factors that we 
focus on.
As a matter of experience, I find that it is not necessary to address 
denial directly.  First, our treatment modality does not necessitate 
that.  Also, I find that in general, most offenders, once they begin to 
internalize the other concepts in our program, tend to abandon their denial 
anyway.

Finally, it occurs to me that in one sense perhaps it is fair to say that 
we directly confront denial.  That sense is this:  We tell offenders from 
the beginning that if they are convicted (and all of ours are) then we 
presume that they are guilty of the convicted offense.  We will not get 
into discussions of whether it happened, whether they were "set up", 
etc.  That is - minimizing, attempting to avoid responsibility, etc., are 
directly confronted by our refusal to accept those things.

I hope this helps somewhat.

-- Larry Wagoner
"Expect A Miracle"