The Role of Psychopathic Traits in the Development of the Therapeutic Alliance Among Sexual Offenders
Abstract
There is a growing body of research demonstrating that the therapeutic alliance (TA) affects outcomes among specialized forensic populations, including sexual offenders. Despite this consensus, researchers continue to question whether higher levels of psychopathic traits are conducive to the formation of a therapeutic relationship for high-risk sexual offenders. Thus, the current study adds to the literature by examining the relationship between the TA and levels of psychopathy among a sample of incarcerated sexual offenders participating in sexual offender treatment. Overall, we found no significant relationships between Psychopathy Checklist–Revised (PCL-R) scores and the Working Alliance Inventory (WAI) for either client or therapist ratings. However, when we excluded those offenders who were participating in aftercare, a significant negative relationship was found between client ratings of the Bonds subscale and PCL-R total scores. Next, after controlling for risk and group status (aftercare/non-aftercare), we found no significant differences between either client or therapist total WAI scores when compared by level of psychopathy as measured by the PCL-R (low, >20; moderate, 20-30; and high, >30). Furthermore, when Factor 1 and Factor 2 scores of the PCL-R were examined individually, neither factor significantly predicted either client or therapist total WAI score after controlling for risk and group status. Findings are discussed as they pertain to the treatment of sexual offenders with elevated levels of psychopathic traits.
Get full access to this article
View all access and purchase options for this article.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Andrews D. A., Bonta J., Wormith J. S. (2006). The recent past and near future of risk and/or need assessment. Crime & Delinquency, 52, 7-27.
Barbaree H. E., Seto M. C., Langton C. M., Peacock E. J. (2001). Evaluating the predictive accuracy of six risk assessment instruments for adult sex offenders. Criminal Justice and Behavior, 28, 490-521.
Beech A. R., Fisher D., Beckett R. C. (1998). An evaluation of the prison sex offender treatment programme (U.K. Home Office Occasional Report). London, England. Retrieved from http://webarchive.nationalarchives.gov.uk/20110218135832/http:/rds.homeoffice.gov.uk/rds/pdfs/occ-step3.pdf
Blasko B. L., Friedmann P., Rhodes A., Taxman F. S. (2015). Success among parolees: The parole officer-client relationship as a mediator of criminal justice outcomes. Criminal Justice and Behavior, 42(7), 722-40.
Blasko B. L., Jeglic E. L. (2016). Sexual offenders’ perceptions of the client-therapist relationship: The role of risk. Sexual Abuse, 28, 271–290.
Blasko B. L., Jeglic E. L., Mercado C. C. (2011). Are actuarial risk data used to make determinations of sex offender risk classification? An examination of sex offenders selected for enhanced registration and notification. International Journal of Offender Therapy and Comparative Criminology, 55, 676-692.
Boccaccini M. T., Murrie D. C., Rufino K. A., Gardner B. O. (2014). Evaluator differences in Psychopathy Checklist–Revised factor and facet scores. Law and Human Behavior, 38, 337-345.
Bordin E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16, 252-262.
Bordin E. S. (1994). Theory and research on the therapeutic alliance: New directions. In Horvath A. O., Greenburg L. S. (Eds.), The working alliance: Theory, research, and practice (pp. 13-37). New York, NY: John Wiley.
Busseri M. A., Tyler J. D. (2004). Client-therapist agreement on target problems, working alliance, and counseling outcome. Psychotherapy Research, 14, 77-88.
Cleckley H. (1976). The mask of sanity (5th ed.). St. Louis, MO: Mosby.
Cooke D. J., Michie C. (1997). An item response theory analysis of the Hare’s Psychopathy Checklist–Revised. Psychological Assessment, 9, 2-13.
DeSorcy D. R., Olver M. E., Wormith J. S. (2016). Working alliance and its relationship with treatment outcome in a sample of aboriginal and non-aboriginal sexual offenders. Sexual Abuse, 28, 291–313.
Doren D. M., Yates P. M. (2008). Effectiveness of sex offender treatment for psychopathic sexual offenders. International Journal of Offender Therapy and Comparative Criminology, 52, 234-245.
D’Silva K., Duggan C., McCarthy L. (2004). Does treatment really make psychopaths worse? A review of the evidence. Journal of Personality Disorders, 18, 163-177.
Forth A.E., Kroner D. (1995). The factor structure of the Revised Psychopathy Checklist with incarcerated rapists and incest offenders. Unpublished manuscript.
Fulero S. M. (1995). Review of the Hare Psychopathy Checklist—Revised. In Conoley J. C., Impara J. C. (Eds.), Twelfth mental measurements yearbook (pp. 453-454). Lincoln, NE: Buros Institute.
Galloway V. A., Brodsky S. L. (2003). Caring less, doing more: The role of therapeutic detachment with volatile and unmotivated clients. American Journal of Psychotherapy, 57, 32-38.
Hanson R. K. (1997). The development of a brief actuarial risk scale for sexual offense recidivism (User Report 97-04). Ottawa, Ontario: Department of the Solicitor General of Canada.
Hanson R. K., Gordon A., Harris A. J. R., Marques J. R., Murphy W. D., Quinsey V. L., Seto M. (2002). First report of the collaborative outcome data project on the effectiveness of psychological treatment for sex offenders. Sexual Abuse, 14, 167-192.
Hanson R. K., Morton-Bourgon K. E. (2004). Predictors of sexual recidivism: An updated meta-analysis. Retrieved from http://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2004-02-prdctrs-sxl-rcdvsm-pdtd/index-eng.aspxf
Hanson R. K., Morton-Bourgon K. E. (2009). The accuracy of recidivism risk assessments for sexual offenders: A meta-analysis. Psychological Assessment, 21, 1-21.
Hanson R. K., Thornton D. (1999). Static 99: Improving actuarial risk assessments for sex offenders (Vol. 2). Ottawa, Ontario: Solicitor General Canada.
Hanson R. K., Thornton D. (2000). Improving risk assessments for sex offenders: A comparison of three actuarial scales. Law and Human Behavior, 24, 119-136.
Hare R. D. (1991). The Revised Psychopathy Checklist. Toronto, Ontario, Canada: Multi-Health Systems.
Hare R. D. (1998). Psychopathy, affect and behavior. In Cooke D. J., Hare R. D., Forth A. (Eds.), Psychopathy: Theory, research and implications for society (pp. 105-137). Dordrecht, The Netherlands: Kluwer Academic.
Hare R. D. (1999). Psychopathy as a risk factor for violence. Psychiatric Quarterly, 70, 181-198.
Hare R. D. (2003). Hare Psychopathy Checklist–Revised (PCL-R) (2nd ed.). Toronto, Ontario, Canada: Multi-Health Systems.
Hare R. D., Clarke D., Grann M., Thornton D. (2000). Psychopathy and the predictive validity of the PCL-R: An international perspective. Behavioral Sciences & the Law, 18, 623-645.
Harris G. T., Rice M. E. (2006). Treatment of psychopathy: A review of empirical findings. In Patrick C. (Ed.), The handbook of psychopathy (pp. 555-572). New York, NY: Guilford Press.
Harris G. T., Rice M. E., Quinsey V. L., Lalumière M. L., Boer D., Lang C. (2003). A multisite comparison of actuarial risk instruments for sex offenders. Psychological Assessment, 15, 413-425.
Hobson J., Shine J., Roberts R. (2000). How do psychopaths behave in a prison therapeutic community? Psychology, Crime, & Law, 6, 139-154.
Horvath A. O., Bedi R. P. (2002). The alliance. In Norcross J. C. (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patient needs (pp. 37-69). London, England: Oxford University Press.
Horvath A. O., Greenberg L. S. (1986). Development of the working alliance inventory. In Greenberg L. S., Pinsoff W. M. (Eds.), Tpsychotherapeutic process: A research handbook (pp. 529-556). New York, NY: Guilford.
Horvath A. O., Greenberg L. S. (1994). The working alliance: Theory, research and practice. New York, NY: Wiley.
Horvath A. O., Greenberg L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223-233.
Karpman B. (1946). Psychopathy in the scheme of human typology. Journal of Nervous and Mental Disease, 103, 276-288.
Lambert M. J., Barley D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training, 38, 357-361.
Langevin R. (2006). Acceptance and completion of treatment among sex offenders. International Journal of Offender Therapy and Comparative Criminology, 50, 402-417.
Looman J., Abracen J., Serin R., Marquis P. (2005). Psychopathy, treatment change, and recidivism in high-risk, high-need sexual offenders. Journal of Interpersonal Violence, 20, 549-568.
Marshall W. L. (2005). Therapist style in sexual offender treatment: Influence on indices of change. Sexual Abuse, 17, 109-116.
Marshall W. L., Serran G. A. (2004). The role of the therapist in offender treatment. Psychology, Crime & Law, 10, 309-320.
Marshall W. L., Serran G. A., Fernandez Y. M., Mulloy R., Mann R. E., Thornton D. (2003). Therapist characteristics in the treatment of sexual offenders: Tentative data on their relationship with indices of behaviour change. Journal of Sexual Aggression, 9, 25-30.
Marshall W. L., Serran G. A., Moulden H., Mulloy R., Fernandez Y. M., Mann R. E., Thornton D. (2003). Therapist features in sexual offender treatment: Their reliable identification and influence on behaviour change. Clinical Psychology & Psychotherapy, 9, 395-405.
Murrie D. C., Boccaccini M. T., Caperton J. D., Rufino K. A. (2013). Field validity of the Psychopathy Checklist–Revised in sex offender assessment. Psychological Assessment, 24, 524-529.
Norcross J. C., Lambert M. J. (2006). The therapy relationship. In Norcross J. C., Beutler L. E., Levant R. F. (Eds.), Evidence-based practices in mental health: Debate and dialogue on the fundamental questions (pp. 208-218). Washington, DC: American Psychological Association.
Nunes K. L., Firestone P., Bradford J. M., Greenberg D. M., Broom I. (2002). A comparison of modified versions of the static-99 and the sex offender risk appraisal guide. Sexual Abuse, 14, 249-265.
Ogloff J.R., Wong S., Greenwood A. (1990). Treating criminal psychopaths in a therapeutic community. Behavioral Sciences and the Law, 8, 181-190.
Olver M.E., Lewis K., Wong S.C. (2013). Risk reduction treatment of high-risk psychopathic offenders: The relatlationship of psychopathy and treatment change to voilent recidivism. Personality Disorders, 4(2), 160-167.
Olver M. E., Nicholaichuk T. P., Gu D., Wong S. P. (2013). Sex offender treatment outcome, actuarial risk, and the aging sex offender in Canadian corrections: A long-term follow-up. Sexual Abuse, 25, 396-422.
Olver M. E., Wong S. C. P. (2009). Therapeutic responses of psychopathic sexual offenders: Treatment attrition, therapeutic change, and long term recidivism. Journal of Consulting and Clinical Psychology, 77, 328-336.
Polaschek D. L. L., Ross E. C. (2010). Do early therapeutic alliance, motivation, and change readiness predict therapy outcomes for high risk violent prisoners? Criminal Behaviour and Mental Health, 20, 100-111.
Quinsey V.L., Rice M.E., Harris G.T. (1995). Actuarial prediction of sexual recidivism. Journal of Interpersonal Violence 10(1), 85-105.
Ross E. C., Polaschek D. L. L., Wilson M. J. (2011). Shifting perspectives: A confirmatory factor analysis of the Working Alliance Inventory with high-risk violent offenders. International Journal of Offender Therapy and Comparative Criminology, 55, 1308-1323.
Safran J. D., Wallner L. K. (1991). The relative predictive validity of two therapeutic alliance measures in cognitive therapy. Psychological Assessment, 3, 188-195.
Salekin R. T. (2002). Psychopathy and therapeutic pessimism. Clinical lore or clinical reality? Clinical Psychology Review, 22, 79-112.
Schiff M., Levit S. (2009). Correlates of therapeutic alliance and treatment outcome among Israeli female methadone patients. Research on Social Work Practice, 20, 380-390.
Serin R. C., Malcolm P. B., Khanna A., Barbaree E. (1994). Psychopathy and deviant sexual arousal in incarcerated sexual offenders. Journal of Interpersonal Violence, 6, 423-431.
Serran G. A., Fernandez Y. M., Marshall W. L., Mann R. E. (2003). Process issues in treatment: Application to sexual offender programs. Professional Psychology: Research and Practice, 4, 368-374.
Seto M. C., Barbaree H. E. (1999). Psychopathy, treatment behavior, and sex offender recidivism. Journal of Interpersonal Violence, 14, 1235-1248.
Skeem J. L., Eno Louden J., Polaschek D. L. L., Camp J. (2007). Assessing relationship quality in mandated community treatment: Blending care with control. Psychological Assessment, 19, 397-410.
Skeem J. L., Monahan J., Mulvey E. (2002). Psychopathy, treatment involvement, and subsequent violence among civil psychiatric patients. Law and Human Behavior, 26, 577-603.
Stiles W. B., Glick M. J., Osatuke K., Hardy G. E., Shapiro D. A., Agnew Davies R., . . . Barkham M. (2004). Patterns of alliance development and the rupture–repair hypothesis: Are productive relationships U-Shaped or V-Shaped? Journal of Counseling Psychology, 51, 81-92.
Strickland G. M., Drislane L. E., Lucy M., Kreuger R. F., Patrick C. J. (2013). Characterizing psychopathy using DSM-5 personality traits. Assessment, 20, 327-338.
Tatman A. W., Love K. (2010). An offender version of the Working Alliance Inventory–Short Revised. Journal of Offender Rehabilitation, 49, 165-179.
Thompson D. F., Ramos C. L., Willett J. K. (2014). Psychopathy: Clinical features, developmental basis and therapeutic challenges. Journal of Clinical Pharmacy and Therapeutics, 39, 448-495.
Thornton D. (1997, September). Structured anchor clinical judgment risk assessment (SACJ). Proceedings of the NOTA Conference, Brighton, UK.
Thornton D., Mann R.E., Williams F.M.S. (2000). Therapeutic style in sex offender treatment. Available from Offending Behaviour Programmes Unit. HM Prison Service, Abell House, John Islip St., London.
Westen D., Novotny C. M., Thompson-Brenner H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 13, 130-631.
Wilson N. J., Tamatea A. (2013). Challenging the “urban myth” of psychopathy untreatability: The high-risk personality programme. Psychology, Crime & Law, 19, 493-510.
Wong S. C. P., Hare R. D. (2005). Guidelines for a psychopathy treatment program. Toronto, Ontario, Canada: Multi-Health Systems.
Cite article
Cite article
Cite article
OR
Download to reference manager
If you have citation software installed, you can download article citation data to the citation manager of your choice
Information, rights and permissions
Information
Published In
Article first published online: March 21, 2016
Issue published: April 2018
Keywords
Authors
Metrics and citations
Metrics
Article usage*
Total views and downloads: 1559
*Article usage tracking started in December 2016
Articles citing this one
Receive email alerts when this article is cited
Web of Science: 6 view articles Opens in new tab
Crossref: 12
- Textbook of Antisocial Personality Disorder
- Factors related to motivation to change and therapeutic alliance among men early in treatment following perpetration of child sexual abuse
- The Risk, Need, and Responsivity Relevance of Working Alliance in a Sexual Offense Treatment Program: Its Intersection With Psychopathy, Diversity, and Treatment Change
- The Complexity of Psychopathy
- The Complexity of Psychopathy
- The Complexity of Psychopathy
- The working alliance and readiness to change in clients who have criminally offended
- Do Changes in Emotional States Predict Therapy Alliance in Dutch Male Offenders in Mandated Clinical Care?
- Treatment of Students with Sexual Deviant or Offending Behaviors: Should College Counseling Centers Go There?
- Determinants of Dropout From Correctional Offender Treatment
- View More
Figures and tables
Figures & Media
Tables
View Options
Access options
If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:
I am signed in as:
View my profileSign out
I can access personal subscriptions, purchases, paired institutional access and free tools such as favourite journals, email alerts and saved searches.
loading institutional access options
ATSA members can access this journal content using society membership credentials.
ATSA members can access this journal content using society membership credentials.
Alternatively, view purchase options below:
Purchase 24 hour online access to view and download content.
Access journal content via a DeepDyve subscription or find out more about this option.
