"The one to one relationship between an offender and their probation officer or program practitioner can be a powerful vehicle for change to reduce reoffending"
The last post on the Therapeutic Working Alliance discussed Bordin’s Tripartite Model of the Therapeutic Working Alliance. It described the three essential and inter-related components of: an agreement on goals (the identification of the purpose and aim of the support or intervention provided); negotiations of task (the specific activities required to facilitate change) and a strong 'bond' (the development of a bi-directional trusting and respectful relationship). It also discussed the concept of ‘strains’ or ‘ruptures’ in the alliance that occur when the bond is not sufficiently strong, or there is a disagreement about the goals or tasks of treatment, the forms that ruptures can take and how to recognise and respond to them.
Developing the concept and application, this post focusses more specifically on the therapeutic alliance in the criminal justice system. I recently read a journal article from Kozar and Day (2017) entitled “The therapeutic alliance in offending behavior change programs” that explored the perceptions of practitioners who deliver Offender Behaviour Programs (OBPs) about the application to programme delivery of Bordin’s tripartite model.
It is worth noting that whilst many alliance theorists recommend taking a‘collaborative stance’, and the National Offender Management Service has previously recommend that practitioners (especially in fields such as substance use) should take the position of a 'collaborative partner', and collaborative, goal-oriented non-directive approaches are often seen as the most effective with reluctant or involuntary clients and can reduce non-compliance with offenders, within criminal justice interventions it may be better to conceptualise the process as one of ‘negotiation’ rather than ‘collaboration’, especially where perceptions of coercion into treatment may be greater, and negotiation may more accurately describe the process required for effective treatment engagement.
The Development of a Model of the Therapeutic Alliance in Offending Behavior Programs
Kozar and Day propose that three distinct modes of practice can be identified and they relate these to Bordin’s tripartite model and describe the central techniques involved. This is also outlined in the table below.
The Educative Mode
This mode describes the process of delivering program manual content and responding to ruptures in the alliance principally through reinforcing boundaries, encouraging compliance, and the application of behavioural techniques.
The main goal for those working in this mode is purely to impart information, ensure that program information and tasks are delivered as intended in the program manual (program adherence) and that any problematic behavior is “managed” to assist this end.
Three forms of management are used to achieve this:
- the development and enforcement of group rules;
- the reinforcement of structures and boundaries in a group such as re-directing clients back to intended tasks;
- and the use of behavioural techniques such as swapping seats, or asking clients to scribe on a white-board to reduce potential disruption.
The Engagement Mode
The engagement mode emphasises a more person-centred model of working with clients that is responsive to their individual needs (similarly to the ‘Need’ element of Risk-Need-Responsivity Model). Practitioners therefore strive to be sensitive to factors such as anti-authoritarian attitudes, self-entitlement, and interpersonal problems, in addition to factors such as literacy, cognitive capacity, and mental health symptoms.
Tasks in this mode are based on undertaking activities modified from the program manual to achieve relevant therapeutic goals for clients relating to their dynamic risk factors. A key practitioner activity also concerns adopting a therapeutic stance to optimise engagement achieved using the following strategies:
- fostering the quality of the therapeutic relationship through demonstration of positive characteristics such as empathy, respect, and validation, and often seen as important within criminal justice interventions, practitioner legitimacy;
- fostering treatment engagement such as taking a collaborative approach to agreeing the ‘goals’ and ‘tasks’ involved in interventions, and explaining the ‘treatment rational’;
- and the use of change strategies such as motivational interviewing techniques.
It should be noted that whilst practitioners should work with client defined goals wherever possible, and the overriding aim of work should be to reach an agreement on goals, this will not always be possible, especially with involuntary clients. Further, particularly within the criminal justice system, some of the goals may have been set by third parties and may relate to behaviours that the client either does not recognise as problematic, or does not wish to change. In such cases, practitioners should be up-front about goals that may need to be addressed, negotiate how they can be addressed and explore the benefits of doing so, whilst also addressing the goals that the client chooses. An important component of this process is referred to as ‘Role Induction’. Whereas cognitive behavioural apporaches are the most common in offending behaviour responses, solution focused approaches may also be more useful where clients do not want to be there or where there are other reasons why the bond may be poor.
The Therapeutic Mode
The third mode, the therapeutic mode, describes an approach to developing a strong therapeutic alliance that aims to achieve therapeutic transformation to enhance the reduction of risk of re-offending. Here the central ‘vehicle of change’ to reduce reoffending is the one to one relationship between offender and practitioner or supervisor.
Three types of strategy are used by practitioners:
- direct analysis of the quality of the therapeutic relationship by actively seeking client feedback and through acknowledging and exploring client difficulties with the intervention and support of the processes of change;
- raising awareness in relation to clients’ behavior to facilitate change such as illuminating offense-paralleling behavior;
- the promotion of skill building such as encouraging clients to express their emotional states in sessions.
|Goal||Learn Cognitive-Behavioural skills from the program manual||Acquire skills relevant to dynamic risk factors||Develop insight into offending behaviours|
|Task||Clients participate in activities from the program manual and adhere to group rules||Clients participate in adapted activities from the program manual and are encouraged to make changes relating to risk factors||Clients develop insights by being open to the practitioner's interpretation and trying out behavioural skills in-session|
|Bond||Practitioner and client develop a bond underpinned by respect for rule compliance||Practitioner and client achieve a bond in which trust and respect are developed allowing program material to be embraced||Practitioner and client develop a strong professional bond that may be tested because of the challengin nature of the intervention, but strengthened when issues are resolved|
Delivery of program content from the manual.
Group rules and boundaries of behavior (e.g. refering to group rules when they are not being adhered to)
Foster the therapeutic relationship (e.g. validation)
Foster treatment engagement (e.g. explain rationale for a task)
Use change strategies (e.g. encourage self-reflection)
Analyze the therapeutic relationship (e.g. explore problems in the relationship)
Awareness raising (e.g. offer interpretations of in-session behavior)
Skill-building (e.g. encourage changes to in-session behavior)