Treatment responsivity in violent offenders
thesisposted on 27.02.2017, 04:07 by O'Brien, Kate
Decades of research evaluating offender intervention programs have produced evidence demonstrating that correctional programs can reduce recidivism. However, these programs rarely work for all offenders, signifying a need to investigate the variables that impact treatment effectiveness. This thesis examines whether individual offender characteristics mediate the effectiveness of treatment. Responsivity factors are idiographic characteristics that purportedly impede an offender’s ability and/or desire to engage in treatment, and may operate as important intermediary factors that determine whether change occurs within an individual as a consequence of treatment. Despite their significance, responsivity factors have received scant empirical attention and have been overlooked in comparison to the other principles of effective rehabilitation, namely Risk and Need. In particular, few studies have examined whether individual responsivity characteristics act as barriers to treatment participation in violent offenders. Understanding precisely why treatment is effective for some offenders, and not others, is an important question that remains unanswered. In order to further improve practice, and enhance the effectiveness of interventions, it is necessary to identify the factors that impact program efficacy to elucidate how treatment works, for whom and why. Given the paucity of research investigating the role of responsivity factors among violent offenders, a series of empirical studies were undertaken to examine whether individual responsivity characteristics influence immediate, proximal and/or distal treatment outcomes in violent offenders. Responsivity characteristics across the three empirical studies included psychopathy (Psychopathy Checklist: Screening Version, PCL:SV), denial and minimisation of violent offending (Denial and Minimisation Checklist, DCMI-III), measures of motivation to engage in treatment, and guilt and shame associated with violent offending. The thesis commences with a review of the theoretical and empirical literature regarding responsivity factors and therapeutic outcomes in violent offender intervention programs. For the empirical component of this research, data was collected from 115 moderate- to high-risk violent offenders assessed for eligibility to attend a prison-based violence intervention program between 2005 and 2010 (in Victoria, Australia). Data collection proceeded in two phases: (i) an archival file analysis - offenders’ therapeutic, prison management and parole board files were systemically reviewed to code data regarding responsivity characteristics, performance within treatment and therapeutic outcomes; (ii) recidivism data - information about new violent charges for each offender was compiled from official criminal history records held by Victoria Police. An initial empirical study was undertaken to investigate whether specific responsivity factors measured prior to entry to treatment inhibited or facilitated allocation to, engagement in and subsequent completion of a violence intervention program. A series of correlation and regression analyses indicated most factors were not associated with commencement of a violence intervention program; however, all responsivity factors demonstrated a significant relationship with engagement in treatment. That is, psychopathy and denial or minimisation of violence inhibited engagement in treatment, whereas motivation to participate in treatment, and feelings of guilt and shame associated with offending behaviour were positively correlated with level of engagement. In turn, within treatment behaviours (e.g. inappropriate or disruptive behaviour in group) and psychopathy predicted program dropout, whereas external motivation to engage in treatment predicted treatment completion. The second empirical study in this thesis investigated whether responsivity characteristics measured prior to entry to treatment directly predicted violent recidivism, and/or moderated the effectiveness of violent offender treatment. Although treatment completion and most responsivity factors were not predictive of violent recidivism following release from prison, results indicated that psychopathic personality traits interacted with treatment engagement to negatively impact recidivism outcomes. That is, offenders with high levels of psychopathy and poor engagement in treatment had significantly higher violent recidivism rates compared to all other offenders. Finally, two further empirical studies were undertaken to investigate whether responsivity factors change in treatment, and determine whether indicators of therapeutic change represent a reduction in risk for violence. Despite observing significant change on all indicators of treatment progress (i.e. Violence Risk Scale scores, denial and minimisation, victim empathy and awareness, and change in psychometric measures of criminal thinking and anger experiences), only enhancement in victim empathy following treatment and higher motivation to change offending behaviour post-treatment were associated with reductions in violent recidivism. Taken together, these findings suggest that individual responsivity characteristics have the potential to impact engagement in treatment, and thus moderate the efficacy of interventions to reduce violence risk. Rather than being viewed as personal deficiencies that prohibit therapeutic change, responsivity factors should be conceptualised as factors that are amenable to intervention, especially when treatment is matched to the specific motivational, affective, cognitive, and behavioural characteristics of an individual.