CBT

Is it possible to help criminals with psychological interventions?

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Recent reports in the press suggest yes – but not in a good way.

In fact research shows that rather than make them better citizens it just helps them to be better at criminal activity.

In the latest reverse researchers at the George Mason University in Virginia tested Mindfulness Meditation on 259 prisoners. They were shown how to meditate focussing on their thoughts and accepting negative feelings.

They were tested before and after the sessions to assess their criminal tendencies and chances of re-offending. The results?

It actually made offenders more likely to blame others and psychologists said there was a direct link between mindfulness and the conditions likely to cause criminal behaviour.

It failed to bring prisoners out of “criminal thinking patterns” and actually made them worse because mindfulness encourages people not to judge themselves, which may have led offenders to avoid responsibility for their actions.

And this is a treatment accepted by the NHS for anxiety and depression with 20 or more apps you can use on your smart phone. Yet the warning sign were there. Mindfulness doesn’t work well with men.

Researchers at Brown University found gender differences in the effect of mindfulness meditation. “The mechanisms are highly speculative at this point, but stereotypically, women ruminate and men distract,” said a Dr Briton.

And in the UK the Ministry of Justice has shut down two Sex Offender Treatment Programmes (SOTPs) including a six months psychological group therapy programme designed to rehabilitate rapists and paedophiles. These have cost £100 million since being set up in 1991.

An independent study of the programmes found that it only made the criminals more dangerous and they had an above-average re-offending rate.

For example paedophiles who took the course had a 25% higher re-offending rate over a 10-year period especially those convicted of attacking children.

The programmes included CBT (which the Ministry believes to be the most effective way of reducing offending behaviour) and group discussions to help the sex offenders to understand their crimes and increase their awareness of victim harm. 

A former consultant on the programme who resigned told the Mail on Sunday that they weren’t adapting the course in line with new knowledge and many delivering the programme weren’t qualified but chaplains, prison officers and other para-professionals.

You can imagine that some in the group would relish the re-telling of their crimes and/or learn from others’ experiences.

Some years ago I remember reading about attempts to teach psychopaths to have more empathy and be more emotionally intelligent. It turned out that it just made them better at convincing victims they could be trusted. I couldn’t find the original source of that and it was a few years ago but in my search I came across Dr George Simon’s blog on this topic.

He wrote: “Times were when empathy training was a required component of most treatment programs for sexual offenders and predators. But the evidence indicated that providing such training had no effect on recidivism rates.

Moreover, some evidence emerged that teaching psychopathic predators about empathy only gave them increased knowledge about the vulnerabilities and sensitivities of others, which, in turn, they were prone to use to become even more adept predators“. (George Simon blog – already tweeted).

And more recent research shows that psychopaths do have an “empathy switch” but choose not to use it leading some scientists to believe it could help their rehabilitation. They need to revisit earlier work in this area if they believe that.

Given that some of these criminals will have personality disorders – notoriously difficult to deal with therapeutically – it comes as no surprise to me that these interventions show such poor outcomes.

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Developing Resilience

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Research among elite performers found that they had a number of characteristics in common. As well as being intelligent, disciplined and bold, with strong practical and interpersonal skills, they bounced back from adversity.

Jim Collins describes in his new book “How the mighty fall” people who are exasperatingly persistent and never give up. They are not necessarily the brightest, most talented, or best looking, but they are successful because they know that not giving up is the most important thing they do. He says; “success is falling down and getting up one more time, without end”.

Early research on resilience focussed on survival in extreme situations (and we still see examples in the recent events in Japan). However resilience is now seen as a more regular phenomenon and the evidence is mounting that most people recover from traumatic events and regain their emotional equilibrium fairly quickly.

In doing so they may use seemingly dysfunctional coping strategies, for example boosting their egos almost to the point of narcissistic behaviour. Or they may choose to repress negative thoughts or emotions – what some psychologists might see as denial. George A Bonanno calls this “coping ugly”.

In his research after 9/11, Hurricane Katrina and the SARS epidemic, he found that up to 2/3 of survivors experienced few if any symptoms and after 6 months there were only about 10% who needed help.

Until recently disaster sites would be inundated with counsellors offering critical incident stress debriefing, something now considered unnecessary and possible harmful. And after the 2004 Indian Ocean tsunami the World Health Organisation actually warned against using this technique. It only takes one person in a group to react badly to re-living the trauma for the whole group to be affected.

Linked theoretically with positive psychology and CBT resilience is partly about filtering negative messages, to enable you to take a more realistic perspective, and partly about being single-minded about what you can and cannot control.

It is also linked to personal attributes such as calmness in stressful situations, reflection on performance through feedback, and learning systematically from both success and failure. Resilient people generally:

  • Recognise what they can control and influence and do something about it, rather than worry about what they can’t
  • Stay involved rather than becoming cynical or detached or simply walking away
  • Work with others to shape the environment and influence things that affect them most
  • Act as a source of inspiration to others to counter self-destructive behaviour

So it’s not just about “bouncing back” and carrying on where you left off before. It’s about reflecting and learning from what has happened and then getting back to business.

So can you learn to be more resilient? Clarke & Nicholson, authors of “Bounce back from whatever life throws at you”, think so and set out a 10-point plan.

  1. Visualise success
  2. Boost your self-esteem
  3. Enhance your efficacy – take control
  4. Become more optimistic
  5. Manage your stress
  6. Improve your decision-making
  7. Ask for help
  8. Deal with conflict
  9. Learn
  10. Be yourself

And the US Army certainly thinks so as well. Martin Seligman, father of positive psychology, is currently delivering a multi-million dollar contract to teach over 1 million soldiers how to be more resilient and using a “train the trainer” approach to train NCOs how to cascade the programme.

Based partly on the Penn University resilience programme the Comprehensive Soldier Fitness Programme incorporates large chunks of positive psychology eg looking at character strengths, emotional intelligence elements such as empathy, self-awareness and impulse control, and CBT techniques such as Ellis’s ABC model.

Because it also incorporates elements about family and spirituality it may appear to have more in common with life-coaching than executive coaching but it is designed to reinforce the warrior ethic and to make better leaders.

Research shows that resilient people can have a positive effect on the well-being of organisations and their employees so it’s well worth organisations developing such capabilities.

If you want a free report on character strengths go to: http://www.viacharacter.org/

Stressful days are here again

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According to MIND, the mental health charity, half a million people are so stressed by their jobs that they believe it is making them ill and 5 million feel very or extremely stressed by their work. 2/3 of workers report feeling the “Sunday Blues” ie feeling anxious the day before they return to work.

MIND says both employers and employees should stop seeing mental health problems as a sign of weakness and that companies should promote a culture where problems can be discussed openly with supportive well-being policies.

An employee resource pack is available on the Time to Change website.

And you know things are getting bad when accountants are taking up therapy. Grant Thornton have rolled out a well-being programme based on cognitive behaviour therapy (CBT). First introduced on intervention courses it is reportedly now being used continuously to “proactively support partners’ health”. The course looks at psychological well-being, identifying and managing stress, fitness and nutrition, and provides 1:1 sessions.

If you can’t afford that kind of support do try de-stressing daily wherever you are.

See also earlier post on stress and women