Polaschek Devon L L, Ross Elizabeth C
Victoria University of Wellington, New Zealand.
Crim Behav Ment Health. 2010 Apr;20(2):100-11. doi: 10.1002/cbm.759.
Examination of the extent of offenders' engagement in change, and in rehabilitation programmes, is important to understanding success or failure following rehabilitation. In treatment programmes, the alliance between therapist and offender, and the therapy process itself appear central to progress offenders make that may reduce their criminal risk. But research with offenders seldom has measured therapeutic alliance and clinical writing suggests that it is difficult to form an alliance with those not ready to change their behaviour; especially with higher risk and psychopathic offenders.
This study outlines the course of the therapeutic alliance in an 8-month treatment programme for high-risk, PCL-psychopathic violent prisoners. It examines relationships between early-treatment therapeutic alliance, therapists' global ratings of motivation to change, and initial stage of change on dynamic risk factors. In addition, it investigates which factors best predict who will complete treatment and change behaviourally during treatment.
In this challenging, high-needs client group, early-programme stage of change, therapists' perceptions of motivation, therapeutic alliance and psychopathy did not predict how much change prisoners made. Regardless of initial levels, prisoners whose alliance increased the most over the course of treatment made the most change.
考察罪犯参与改变及康复计划的程度，对于理解康复后的成败至关重要。在治疗项目中，治疗师与罪犯之间的联盟以及治疗过程本身，似乎是罪犯取得进步从而降低犯罪风险的核心因素。但针对罪犯的研究很少测量治疗联盟，临床文献表明，很难与那些尚未准备好改变行为的人建立联盟；尤其是与高风险和具有精神病态特征的罪犯。
本研究概述了一项针对高风险、具有精神病态特征的暴力囚犯的为期8个月的治疗项目中治疗联盟的过程。研究考察了早期治疗联盟、治疗师对改变动机的总体评分与动态风险因素改变初始阶段之间的关系。此外，研究还调查了哪些因素最能预测谁将完成治疗并在治疗期间发生行为改变。
在这个具有挑战性、需求高的客户群体中，项目早期阶段的改变、治疗师对动机的认知、治疗联盟和精神病态特征并不能预测囚犯的改变程度。无论初始水平如何，在治疗过程中联盟增加最多的囚犯改变最大。
