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Relapse Prevention with Intellectually Disabled Sexual Offenders

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Sexual Abuse: A Journal of Research and Treatment

Abstract

The adaptation of relapse prevention theory to sexual offending (W. D. Pithers, J. K. Marques, C. C. Gibat, & G. A. Marlatt, 1983) has represented an important movement in cognitive-behavioural treatment for sexual offenders. However, this model of relapse prevention has been criticised for its limited view and oversimplification of the relapse prevention process (R. K. Hanson, 2000; T. Ward & S. M. Hudson, 1996). As a result, T. Ward and S. M. Hudson (2000a) have developed a multiple pathway model of the relapse prevention process based on self-regulation theory. Although this model continues to be empirically validated on sexual offenders (J. A. Bickley & A. R. Beech, 2002; T. Ward, S. M. Hudson, & J. C. McCormick, 1999), there has been no empirical research regarding the application of this theory to intellectually disabled sexual offenders. This paper discusses whether the characteristics of offenders in each of the relapse offence pathways, as described by T. Ward and S. M. Hudson (2000a), may be similar to the characteristics of intellectually disabled sexual offenders. From a review of the literature, it appears that the intellectually disabled sexual offender may be most likely to offend via the approach—automatic pathway or the avoidant-passive pathway. The potential treatment implications of the self-regulation model for intellectually disabled sexual offenders is discussed, as well as the need for empirical evaluation with regards to the application of this model to the intellectually disabled sexual offender population.

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References

  • Andrews, D. A. (1996, September). Criminal recidivism is predictable and can be influenced: An update. Forum on Corrections Research, 8(3). Retrieved June 30, 2004, from http://www.csc-scc.gc.ca/text/pblct/forum/e083/e083ind_e.shtml

  • Ashman, A. F., & Conway, R. N. F. (1989). Cognitive strategies for special education: Process-based instruction, Florence, KY: Taylor & Francis/Routledge.

    Google Scholar 

  • Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory, Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  • Baumeister, R. F., & Heatherton, T. F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7(1), 1–15.

    Google Scholar 

  • Bickley, J. A., & Beech, A. R. (2002). An investigation of the Ward and Hudson pathways model of the sexual offense process with child abusers. Journal of Interpersonal Violence, 17(4), 371–393.

    Article  Google Scholar 

  • Bickley, J. A., & Beech, A. R. (2003). Implications for treatment of sexual offenders of the Ward and Hudson model of relapse. Sexual Abuse: A Journal of Research and Treatment, 15(2), 121–134.

    Article  Google Scholar 

  • Boer, D. P., Gauthier, C., Watson, D. R., Dorward, J., & Kolton, D. J. C. (1995, March). The assessment and treatment of intellectually disabled sex offenders: The Regional Psychiatric Centre (Pacific) “Northstar” treatment and relapse prevention program. Paper presented at the 1995 Conference on National Sex Offender Strategy. Retrieved June 30, 2004, from http://www.csc-scc.gc.ca/text/pblct/sexoffender/conference/confe_e.shtml#E9E1

  • Boer, D. P., Gauthier, C. M., Watson, D. R., Dorward, J., & Kolton, D. J. C. (2001). The Assessment and Treatment of Intellectually Disabled Sex Offenders: The Regional Psychiatric Centre (Pacific) “Northstar” Treatment and Relapse Prevention Program. Retrieved February 13, 2002, from http://www.csc-scc.gc.ca/text/facilit/institutprofiles/stonymountain_e.shtml

  • Carver, C. S., & Scheier, M. F. (1981). Attention and self-regulation: A control theory approach to human behavior, New York, NY: Springer-Verlag.

    Google Scholar 

  • Carver, C. S., & Scheier, M. F. (1990). Principles of self-regulation: Action and emotion. In E. T. Higgins & R. M. Sorrentino (Eds.), Handbook of motivation and social behaviour (pp. 3–52). New York: The Guilford Press.

    Google Scholar 

  • Chaney, E. F., O'Leary, M. F., & Marlatt, G. A. (1978). Skill training with alcoholics. Journal of Consulting and Clinical Psychology, 46, 1092–1104.

    PubMed  Google Scholar 

  • Clare, I. C. H., & Murphy, G. H. (1998). Working with offenders or alleged offenders with intellectual disabilities. In E. Emerson, C. Hatton, J. Bromley, & A. Caine (Eds.), Clinical psychology and people with intellectual disabilities (pp. 154–176). Chichester: John Wiley & Sons.

  • Cochran, W., & Tesser, A. (1981). The “what the hell” effect. Some effects of goal proximity and goal framing performance. In M. Leonard & A. Tesser (Eds). Striving and feeling: Interactions among goals, affect, and self-regulation (pp. 99–120). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.

  • Glaser, W., & Deane, K. (1999). Normalisation in an abnormal world: A study of prisoners with an intellectual disability. Journal of Offender Therapy and Comparative Criminology, 43, 338–350.

    Google Scholar 

  • Haaven, J. L., & Coleman, E. M. (2000). Treatment of the developmentally disabled sex offender. In D. R. Laws., S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders (pp. 369–388). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Haaven, J., Little, R., & Petre-Miller, D. (1990). Treating intellectually disabled sex offenders: A model residential program. Orwell, VT: Safer Society Press.

    Google Scholar 

  • Hanson, R. K. (2000). What is so special about relapse prevention? In D. R. Laws, S. M. Hudson, & T. Ward (Eds), Remaking relapse prevention: A sourcebook (pp. 27–38). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Hayes, S. (2002, June). Adaptive Behaviour and Background Characteristics of Sex Offenders with Intellectual Disabilities. Paper presented at the International Association for the Scientific Study of Intellectual Disabilities, Inaugural Conference of IASSID Europe, University College Dublin, Dublin.

  • Hudson, S. M., Ward, T., McCormack, J. C. (1999). Offense pathways in sexual offenders. Journal of Interpersonal Violence, 14(8),779–798.

    Google Scholar 

  • Lane, S. L. (1991). Special offender populations. In G. D. Ryan & S. L. Lane (Eds.), Juvenile sexual offending: Causes and consequences (pp. 229–232). Lexington: Lexington Press.

    Google Scholar 

  • Laws, R. D. (1999). Relapse prevention: The state of the art. Journal of Interpersonal Violence, 14(3), 285–302.

    Google Scholar 

  • Laws, R. D. (2003). The rise and fall of relapse prevention. Australian Psychologist, 38(1), 22–30.

    Article  Google Scholar 

  • Lindsay, W. R. (2002). Research and literature on sex offenders with intellectual and developmental disabilities. Journal of Intellectual Disability Research, 46(1), 74–85.

    Article  PubMed  Google Scholar 

  • Lindsay, W. R. (2004). Sex offenders, conceptualization of the issues, services, treatment and management. In W. L. Lindsay, J. L. Taylor, & P. Sturmey (Eds.). Offenders with developmental disabilities (pp. 163–185). Chichester, UK: John Wiley & Sons.

  • Lindsay, W. R., Law, J., Quinn, K., Smith, A. H. W. (2001). A comparison of physical and sexual abuse: Histories of sexual and non-sexual offenders with intellectual disability. Child Abuse and Neglect, 25(7), 989–995.

    Article  PubMed  Google Scholar 

  • Lindsay, W. R., Neilson, C., Morrison, F., & and Smith, A. (1998). The treatment of six men with a learning disability convicted of sex offences with children. British Journal of Clinical Psychology, 37(1), 83–98.

    PubMed  Google Scholar 

  • Mann, R. E., & Thornton, D. (2000). An evidence-based relapse prevention program. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders (pp. 341–350). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Mann, R. E., Webster, S. D., Schofield, C., & Marshall, W. L. (2004). Approach versus avoidance goals in relapse prevention with sexual offenders. Sexual Abuse: Journal of Research and Treatment, 16(1), 65–75.

    Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1980). Determinants of relapse: Implications for the maintenance of behavior change. In P. O. Davidson & S. M. Davidson (Eds.), Behavioral medicine: Changing health lifestyles (pp. 410–452). New York: Brunner/Mazel.

    Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention: maintenance strategies in the treatment of addictive behaviours (pp. 3–71). London: The Guilford Press.

    Google Scholar 

  • Marshall, W. L. (1996). Assessment, treatment, and theorizing about sex offenders: Developments during the past twenty years and future directions. Criminal Justice and Behavior, 23(1), 162–199.

    Google Scholar 

  • Marshall, W. L., & Anderson, D. (1996). An evaluation of the benefits of relapse prevention programs with sexual offenders. Sexual Abuse: Journal of Research and Treatment, 8(3), 209–221.

    Google Scholar 

  • Marques, J. K., Day, D. M., Nelson, C., & Miner, M. H. (1989). The sex offender treatment evaluation project: California's relapse prevention program. In D. R. Laws (Ed.), Relapse prevention with sexual offenders (pp. 205–246). New York: The Guilford Press.

    Google Scholar 

  • Marques, J. K., & Nelson, C. (1989). Understanding and preventing relapse in sex offenders. In M. Gossop (Ed.), Relapse and addictive behaviour (pp. 96–106). New York, NY: Tavistock/Routledge.

    Google Scholar 

  • Nankervis, K., Hudson, S., Smith, D., & Phillips, A. (2000, August). Prevention of sexual offending amongst adolescents with an intellectual disability: Identifying the risks. Paper presented at 11th World Congress of the International Association for the Scientific Study of Intellectual Disabilities. Paper retrieved June 29, 2004, from http://mams.rmit.edu.au/6i386ewjk92kz.pdf

  • Nezu, C. M., Nezu, A. M., & Dudek, J. A. (1998). A cognitive behavioural model of assessment and treatment for intellectually disabled sexual offenders. Cognitive and Behavioural Practice, 5, 25–64.

    Article  Google Scholar 

  • Parry, J. C., & Lindsay, W. R. (2003). Impulsiveness as a factor in sexual offending by people with mild intellectual disability. Journal of Intellectual Disability Research, 47(6), 483–48.

    Article  PubMed  Google Scholar 

  • Pithers, W. D. (1990). Relapse prevention with sexual aggressors. In W. L. Marshall, D. R. Laws, H. E. Barbaree (Eds.), Handbook of sexual assault (pp. 343–361). New York: Plenum Press.

    Google Scholar 

  • Pithers, W. D., Cumming, G. F., Beal, L. S., Young, W., & Turner, R. (1989). Relapse prevention: A method for enhancing behavioral self-management and external supervision of the sexual aggressor. In B. Schwartz (Ed.), Sex offenders, Issues in treatment (pp. 292–310). Washington DC: National Institute of Corrections.

    Google Scholar 

  • Pithers, W. D., Marques, J. K., Gibat, C. C., & Marlatt, G. A. (1983). Relapse prevention with sexual aggressives: A self-control model of treatment and maintenance change. In J. G. Greer & I. R. Stuart (Eds), The sexual aggressor: Current perspectives on treatment (pp. 214–239). New York: Van Nostrand Reinhold.

    Google Scholar 

  • Polascek, D. L. L. (2003). Relapse prevention, offense process models, and the treatment of sexual offenders. Professional Psychology: Research and Practice, 34(4), 361–36.

    Google Scholar 

  • Polascek, D. L. L., & Hudson, S. M. (2004). Pathways to rape: Preliminary examination of patterns in the offence processes of rapists and their rehabilitation implications. Journal of Sexual Aggression, 10(1), 7–20.

    Google Scholar 

  • Polascek, D. L. L., Hudson, S. M., Ward, T., & Siegert, R. J. (2001). Rapists' offense processes: A preliminary descriptive model. Journal of Interpersonal Violence, 16, 523–544.

    Google Scholar 

  • Sobsey, D. (1994). Violence and abuse in the lives of people with disabilities- The end of silent acceptance? Baltimore: P. H. Brookes.

    Google Scholar 

  • Thornton, D. (1997). Is relapse prevention really necessary? Paper presented at the meeting of the Association for the Treatment of Sexual Abusers, Arlington, VA.

  • Vizard, E. (1989). Child sexual abuse and mental handicap: A child's psychiatrist perspective. In H. Brown & A. Craft (Eds.), Thinking the unthinkable- Papers on sexual abuse and people with learning difficulties, London: FPA Education unit.

  • Ward, T., & Hudson, S. M. (1996). Relapse prevention: A critical analysis. Sexual Abuse: A Journal of Research and Treatment, 8, 177–200.

    Google Scholar 

  • Ward, T., & Hudson, S. M. (1998). A model of the relapse process in sexual offenders. Journal of Interpersonal Violence, 13, 700–725.

    Google Scholar 

  • Ward, T., & Hudson, S. M. (2000a). A self-regulation model of relapse prevention. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders (pp. 79–101). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Ward, T., & Hudson, S. M. (2000b). Sexual offenders' implicit planning: A conceptual model. Sexual Abuse: A Journal of Research and Treatment, 12(3), 189–202.

    Article  Google Scholar 

  • Ward, T., Hudson, S. M., & Keenan, T. (1998). A self-regulation model of the sexual offense process. Sexual Abuse: A Journal of Research and Treatment, 10(2), 141–157.

    Article  Google Scholar 

  • Ward, T., Hudson, S. M., & McCormick J. C.(1999). Offence pathways in sexual offenders. Journal of Interpersonal Violence, 14(8), 779–798.

    Google Scholar 

  • Ward, T., Louden, K., Hudson, S. M., & Marshall, W. L. (1995). A descriptive model of the offense chain in child molesters. Journal of Interpersonal Violence, 10, 452–472.

    Article  Google Scholar 

  • Ward, T., & Siegert, R. J. (2002). Towards a comprehensive theory of child sexual abuse: A theory knitting perspective. Psychology, Crime, and Law, 9, 319–351.

    Google Scholar 

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Correspondence to John L. Rose.

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Keeling, J.A., Rose, J.L. Relapse Prevention with Intellectually Disabled Sexual Offenders. Sex Abuse 17, 407–423 (2005). https://doi.org/10.1007/s11194-005-8052-6

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