Treating Sex Offenders by Sarah Brown

Author:Sarah Brown [Brown, Sarah]
Language: eng
Format: epub
Tags: Social Science, Criminology
ISBN: 9781134029495
Google: LlMnfbC3OFwC
Publisher: Routledge
Published: 2013-07-04T04:47:28+00:00

Relapse prevention

Marlatt (1982; see also Marlatt and Gordon 1985) originally developed the relapse-prevention model in the area of addictions (i.e. the study of addiction to alcohol, drugs and so on) and its main concern was the maintenance of treatment-induced abstinence. As Laws (1995) explained, Marlatt argued that the probability of treatment success was greatest at the end of treatment; however, within a year, relapse rates of 80 per cent could be observed. Marlatt reasoned that if a programme addressing the issue of relapse could be added to the end of the original treatment, then the effects of the treatment could be maintained; and thus, the number of relapses reduced.

Relapse-prevention programs teach people to recognize ‘warning signs,’ patterns of behaviour (including thoughts, feelings and actions) that increase the risk of relapse. By learning alternative ways of coping with urges in high-risk situations for relapse, clients are better equipped to prevent backsliding or to recover from lapses if they occur.

(Marlatt 1992: 159, cited in Laws 1995: 43)

This approach was extended to sex offenders by Pithers and his colleagues (Pithers et al. 1983, 1988; Pithers 1990, 1991). Marshall and Eccles (1996) argued that this approach provided a model for cognitive-behavioural treatment that was compatible with, and incorporated, much of the work that was already being conducted. In addition, it provided a cohesive framework within which the various elements of treatment could be understood. As described previously, Marlatt originally intended relapse prevention to be a strategy for treatment maintenance (Laws 1995); however, it has become common to incorporate relapse-prevention components into treatment programmes (see Hudson et al. 1995; Marshall and Eccles 1996; Beech and Fisher 2002), or even to use relapse prevention for the framework for an entire programmes (see for example, Marques et al. 1989; Pithers, Martin et al. 1989), although Polaschek (2003) queries whether these two approaches differ significantly. However, as can be seen from the programme descriptions in Chapter 3, more recently in some jurisdictions there has been a return to Marlatt’s original conception, with the development of ‘relapse-prevention’ or ‘maintenance’ programmes, delivered in a package of treatment programmes.

Bandura et al.’s (1977) model of self-efficacy is particularly influential in this approach. This model suggests that target behaviour is more likely to be performed if the individual believes that he/she has the skills necessary to perform the behaviour (efficacy expectations), and that the performance of this behaviour will lead to a positive outcome (outcome expectations). Bandura and colleagues suggested that the strength of self-efficacy determines whether or not a client will attempt to change his/her behaviour, how much effort he/she will put into it and how easily they will give up in the face of obstacles. Thus, a relapse-prevention approach encourages the practice of coping strategies to increase the strength of self-efficacy. In addition, as outlined earlier, Marshall (1996a) argued that creating a therapeutic context that enhances a sense of self-worth is essential, as this will manifest in increased self-esteem, the ready acquisition of coping skills and increased self-efficacy expectations.

According to Pithers’

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