Making sense, making good, or making meaning? Cognitive distortions as targets of change in offender treatment.

Most structured sex-offender programs are based on a cognitive-behavioural model of behaviour change. Within this overarching theoretical paradigm, extensive use of cognitive distortions is seen as a central core symptom among sex offenders. However, the literature on cognitive distortions lacks a clear and consistent definition of the term. It is unclear whether cognitive distortions are consciously employed excuses or unconscious processes serving to protect the offender from feelings of guilt or shame. In this article, the dominant cognitive-behavioural interpretation of cognitive distortions is contrasted with two alternative interpretations. One is based on an attributional perspective and the notion of attributional biases. The other explanation is based on a narrative approach focusing on the action elements of cognitive distortions, that is, as something people do rather than something they have. Clinical implications of these alternative conceptualizations are discussed and illustrated throughout by a case example.