Offered by: The Family Centre, Edmonton, AB Funding: Safer ... · PDF fileFunding: Safer...

Preview:

Citation preview

Offered by: The Family Centre, Edmonton, ABFunding: Safer Communities Grant,

Government of Alberta

2

Primary investigators:Karen M Nielsen, PhD, RSW (Clinical) Ann Marie Dewhurst, PhD, R. Psych

Sanjiv Sharivstava, PhD

11/25/2010Fredericton, 2010

3

Current Programs: Criminal justice system focus Focused on avoidance of negative

actions = What not to do. Shame-based Treatment outcomes often vague Drop out rates are high Recidivism rates are high

11/25/2010Fredericton, 2010

4

◦ Current offender rehabilitation theory◦ Positive in orientation◦ Focused on client-centred change◦ Respectful of clinical process◦ Allowing for ongoing evaluation of

client and program◦ Inclusive of a multicultural perspective.

11/25/2010Fredericton, 2010

5

The Outcome Rating Scale and Group Session Rating Scale (http://www.scottdmiller.com/).◦ The ORS asks clients about their

progress toward their goals.◦ The GSRS provides information

about the client’s experience of the group session.

Feedback from clients results in shifts in program delivery. ◦ Focus is on client engagement.

11/25/2010Fredericton, 2010

6

A positive strength based approach

Dynamic risk factors leading to abuse/ offending behavior are distortions in the internal and external conditions required to gain a desired human goods,

This approach identifies the basic skills and capacities necessary to engage in treatment (i.e. treatment readiness)

Addresses the question of clinicians’ attitudes toward client’s and the relationship between these attitudes and factors such as forgiveness, evil, and the therapeutic alliance (Ward & Brown, 2004).

11/25/2010Fredericton, 2010

7

Good Life Factors:◦ Life, ◦ Knowledge, ◦ Excellence in work/play,◦ Agency, ◦ Inner peace, ◦ Relatedness, ◦ Community,◦ Spirituality, ◦ Creativity, ◦ Happiness

11/25/2010

Abusive behaviour is a result of a poorly defined Good Life Plan.

Ward and Brown (2004) describe four major types of difficulties that support abusive behaviour:◦ Problems with the means used to secure goods◦ A lack of scope within a good lives plan◦ The presence of conflict among goals (goods

sought) or incoherence ◦ A lack of the necessary capacities to form and

adjust a GLM to changing circumstances (e.g. impulsive decision making).

11/25/2010 8Fredericton, 2010

Orientation group Assessment package Individualized feedback/ risk assessment

/goal setting process Development of GLP Referral to group ◦ Continuous intake

11/25/2010 9Fredericton, 2010

10

◦ Hostility - Buss-Perry Hostility Scale◦ Personality – Personality Assessment Inventory◦ Executive Function - BRIEF

11/25/2010Fredericton, 2010

Self-awareness and self-management skills

Effective conflict resolution skills and emotional communication skills

Ethics and moral decision making Consciousness raising regarding power

in relationships

11/25/2010 11Fredericton, 2010

New members may join group at the start of any module

Modules are four sessions in length / 90 minutes per session

Modules are self-contained and may be taken in any order.

Organic design – 3 sessions of content/processing – 1 session of review and closure for those leaving.

11/25/2010 12Fredericton, 2010

The session format will follow these steps: Discussion of re-group reflection Discussion of module material Application of new learning Reflection on gains from the session

11/25/2010 13Fredericton, 2010

Clients are self-referred or family-mandated.

Only 6/86 have a court mandate to participate in a “batterer’s program” or “anger management program”

Most come as a result of a recent event that prompted a family crisis

11/25/2010 14Fredericton, 2010

64% of the men coming into the program score above T>60 level on the PAI Treatment Rejection scale.

◦ Suggests that they are generally satisfied with themselves and see little need for major changes in their behaviour

◦ People who score high on this scale tend to have little motivation to enter therapy and are at risk for early termination

◦ Finding is in keeping with the literature and validates our inclusion of the ORS/SRS as treatment strategies.

11/25/2010 15Fredericton, 2010

16

79% of our clients reported their highest scores (T= 60-69) on the following 5 PAI scales Stress, Aggression, Borderline features, Antisocial and Depression.

Of those 56% scored at T>70 (2 standard deviations above the mean - typically considered a clinically significant score on four of these scales - the Antisocial scale drops off for these higher scoring, more distressed men.

11/25/2010Fredericton, 2010

17

Experience significant impact from current or recent stressors in areas of family, health, employment, finances and other major life areas;

Have characteristics and attitudes related to anger, hostility and aggression including a history of aggression and attitudes conducive to aggressive behaviour;

Experience unstable and fluctuating interpersonal relations, impulsivity, affective lability and instability and uncontrolled anger;

Have a a history of authority problems, egocentrism, lack of empathy and loyalty, and excitement seeking and

Report feelings of depression.Trauma symptoms is the 6th most prominent scale.

11/25/2010Fredericton, 2010

18

The BRI = Behavioral Regulation Index◦ Represents individual’s ability to control his/her

behaviour and emotional responses.

T=60-69 T=70+ Total #

Impulse 26 23 49

Shift 29 24 53

Emotional Control

41 28 69

Self-monitoring

35 28 63

11/25/2010Fredericton, 2010

Anger – reduced 1.3 sd Physical Aggression - reduced 1.25 sd Hostility – reduced .9 sd Verbal Aggression -reduced .6sd

1911/25/2010Fredericton, 2010

Some themes are emerging◦ Arousal management is helpful and

meaningful◦ People besides their partner noticed and

gave feedback to the men on their behaviour changes◦ Men report more connection to their

children

2011/25/2010Fredericton, 2010

karenn@athabascau.caAnnmarie.valerian@shaw.ca

Phone: 780-485-5119Fax: 780-485-5191

2111/25/2010Fredericton, 2010

Recommended