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Compendium 2000 on Effective Correctional Programming

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CHAPTER 15

Problems of Self-Regulation among Adult Offenders

LYNN STEWART1 and ROB ROWE2


Self-control has been utilised extensively as an explanatory concept in the field of psychology and in forensic psychology in particular. A number of researchers and theorists have linked self-control, as often measured by impulsivity, risk-taking, failure to delay gratification, egocentrism, temper, and limited goal setting, with criminality (Ross & Fabiano, 1985; McCord & McCord, 1959; Wilson & Hernstein, 1985; Gottfredson & Hirshi,1990). Despite its extensive use, there remains a lack of consensus in the literature regarding the definition of self-control or the mechanisms of self-regulation. Instead, impulsivity, seen as a result of a deficiency in the self-regulation process, is frequently used as a catchword to clarify a wide variety of anti-social tendencies that otherwise lack sufficient explanation. In Blackburn's terms, the concept of impulsivity has become an “explanation in need of a phenomenon” (Blackburn, 1993, p. 196).

Recently, Barkley (1997a) has developed a hybrid model of self-regulation based on developments in the area of Attention Deficit Hyperactivity Disorder (ADHD) that could provide the necessary theoretical framework to advance the research in the area. The model accounts for the developmental features of ADHD and is consistent with empirical findings regarding children, adolescents and adults with the disorder. The theory provides an explicit and theoretically sound definition of self-control and identifies the cognitive and behavioural problems in self-regulation that can be expected based on the model. The model is particularly useful because it points to a number of potential targets that could be addressed in treatment programs.

Barkley defines self-regulation as “any response or chain of responses by the individual that serves to alter the probability of the individual's subsequent response to an event and, in so doing, functions to alter the probability of a later consequence related to that event” (Barkley, 1997b, p. 68). According to Barkley, the primary self-regulatory act must be the inhibition of responding. In non-impaired individuals, this period of inhibition allows a delay in the decision to respond that is used for further self-directed executive actions. Self-regulation allows for the direction and persistence of behaviour toward future goals and the ability to reengage in these activities if they have been disrupted. He reasons that this purposeful form of goal directed behaviour might function to maximise future consequences over immediate ones for the individual. Barkley's model (see Figure 15.1) illustrates that higher order executive functions may be disrupted because of an impairment in inhibition.

Figure 15.1 Barkley's (1997) schematic configuration linking behavioural inhibition with the performance of executive functions

.
diagram
.

Barkley (1997a) argues that ADHD is a deficit in behavioural inhibition that affects the normal development of four neurophysiological functions: working memory, the self-regulation of affect and motivation and arousal, internalisation of speech and motor control and sequencing, and behavioural analysis and synthesis. Performance of the executive functions implicates self directed actions; the organisation of behavioural contingencies across time; the use of self-directed speech, rules, or plans; deferred gratification; and goal-directed, future-oriented, purposive, or intentional actions.

Working memory

Working memory allows for individuals to hold several events in mind. This facilitates the cross-temporal organization of behaviour, that is, a linking of hindsight with the anticipation of the future (foresight). It contributes to an “anticipatory” set whereby consequences are anticipated based on past experience. Among offenders, some researchers have identified related problems in:

  • means end thinking, a tendency to respond quickly without thinking;
  • presentation orientation, that increases the chances they will engage in activities that earn them short term gains but have negative consequences in the longer term;
  • conceptual rigidity, that inclines them toward a repetitive pattern of self defeating behaviour; and
  • poor critical reasoning, that makes them vulnerable to the demand characteristics of the immediate situation.

    (Barratt, Stanford, Kent, & Felthouse, 1997; Ross & Fabiano, 1985, Wilson & Herrnstein, 1985, Newman, Patterson, & Kosson, 1987)

Zamble and Quinsey's (1997) study of criminal recidivism among federal offenders illustrated how impulsively many recidivists engage in their reoffences. Over half of the offenders they interviewed reported that the commission of the offence was completed within one hour of deciding to do it.

Self-regulation of affect/motivation/arousal

Self-regulation of affect/motivation/arousal allows for emotional self-control, objectivity and social perspective taking and regulation of arousal in the service of a goal-directed action. Impairments are associated with poor modulation of affect as well as lapses in motivation and lack of perseverance when faced with remote or uncertain rewards.

Internalisation of speech

Internalisation of speech allows for description and reflection, the development of rule-governed behaviour, problem solving and the development of moral reasoning. Self-talk or verbal regulation permits a means of sustaining behaviour across time gaps between the units of behaviour. With language, an individual can understand contingencies (the link between an event a response and consequences) and by formulating rules, he can construct novel complex behaviour chains. This allows him to delay immediate gratification and set longer term plans to reach ultimate goals. Lack of facility to anticipate and formulate rules about the future means that social relationships are impaired which in turn predicts problems in sharing and co-operation and adaptive behaviours such as taking health precautions that are predicated on the valuation of future social consequences over immediate ones. Impairment of these contingencies can lead to response preservation in spite of consequences, difficulty in maintaining motivation when engaged in repetitive tasks and moral reasoning impairment. Among offenders who demonstrated a repetitive pattern of criminal behaviour, Ross and Fabiano (1985) identified problems with impulsivity associated with poor verbal self-regulation, concrete and egocentric thinking that impinged on their ability to appreciate the thoughts and feelings of other values that focussed on how their actions affect them instead of considering their effects on others and impaired interpersonal problem solving skills.

Reconstitution

The reconstitution function allows for an analysis and synthesis of behaviour. Problems would appear in the domain of verbal fluency and in the creation of novel response sequences and long term planning. Among delinquents, significantly higher scores on Performance over Verbal I.Q. subtests on omnibus intelligence measures is a robust finding (Lynam, Moffitt, & Stouthamer-Loeber, 1993). The reconstitution function under-lies the ability to be able to learn from previous contingency arrangements and specify new courses of action in accordance to the contingencies already observed. This would be responsible for behavioural diversity and novelty. Problems with this executive function would relate to a lack of generation of alter-native solutions to problems and inflexibility in behavioural repertoire. Chronic and psychopathic offenders are characterized in part by a repetitive pattern of anti-social acting out in spite of sanctions, that is, failing to learn from experience or to respond to negative feedback and punishment by adjusting behaviour or allying new behaviours (Newman, Patterson, & Kosson, 1987; Cleckley, 1964; Hare, 1991).

Impairments in self-regulation can be adopted to offer a powerful explanatory model of the mechanisms that predispose individuals to develop anti-social tendencies and allow criminal behaviour to persist over a life span. We propose that failure of the self-regulation process is a necessary, although not sufficient, condition for the development of most chronic anti-social behaviour (Rowe, 1997). It is argued that hyperactivity at a young age, and the self-regulation problems that ensue, are the foundation for later behavioural problems that can ultimately lead to chronic offending and/or psychopathy. The trajectory, however, can be changed, or mitigated, through attachment to prosocial institutions (family/school) and peers.

Extent of the problem among federal offenders

The population of serious offenders would be expected to be have high rates of problems with self-regulation. At admission into the federal correctional system, each offender undergoes a comprehensive assessment based on file review and interview. Among the items that compose the assessment, several pertain directly and indirectly to problems in self-regulation. Over 80% of federal offenders are assessed by intake officers as having one or more of the problems related to self-regulation included in Table 15.1. Research indicates that problems in self-regulation are associated with poorer outcomes. As the table highlights, offenders who reoffend within one year after release were significantly more likely to have problems in self-regulation. Conversely, an absence of any problems in the area of self-regulation reduces offenders' probability of reoffending within a year of release. Eighty-eight percent of offenders with no problems in self-regulation remain offence free after one year of release as compared to an expected rate (general survival rate) of 64.2%.

TABLE 15.1 Percentage of federal offenders identified with problems related to self-regulation

.
OIA Indicators
Recidivists*
Non Recidivists
p
.
Lacks direction
75.2
59.9
0.001
Impulsive
80.5
67.2
0.001
Thrill seeking
37.5
27.3
0.001
Poor conflict resolution
75.6
67.4
0.001
Poor regard for others
62.6
52.5
0.001
Low frustration tolerance
53.6
43.7
0.001
Unrealistic goal setting
36.5
27.7
0.001
Non reflective
59.8
50.4
0.001
Poor problem solving
77.8
70.1
0.001
Unable to generate choices
67.7
60.6
0.001
.
* Offenders who have reoffended within one year of release

 

Measures of impulsivity

Tests have been constructed as a means to operationalize impulsivity without an explanation of the mechanisms underlying impulsivity. As such, impulsivity has become defined by the task or tests used to operationalize it. The reliance of the psychological literature on instruments that measure impulsivity without a consensus of definition and a lack of theory in the field is clearly problematic.

In a review of the research on the impulsivity construct, Milich and Kramer (1984) listed three specific problems with the test-specific approach to defining and understanding impulsivity. First, up until the time of their publication, they found that most of the measures failed to offer any incremental validity beyond age and IQ in understanding impulsivity. Second, there was a lack of any empirical convergence in the literature. This suggested that many measures were tapping into different constructs and that some, or all, were failing to tap into the impulsivity construct. Third, there is a dearth of theory driven research. It would seem that the atheoretical nature of the construct of impulsivity is largely responsible for limiting progress in this area (Milich, Hartung, Martin, & Haigler, 1994).

There are a number of inventories in the literature that were specifically designed to assess impulsivity. One of the oldest is the Barratt Impulsiveness Scale (BIS; Barratt, 1994). Barratt's original scale published in 1959 was based on a unidimensional model of impulsiveness. Inaugural items appear to have been selected on the basis of face validity but later selected to be orthogonal to various measures of anxiety. Barratt conceptualized impulsivity as a third order dimension. He stated that impulsiveness includes second and first order dimensions of speed of responding, risk taking, acting without thinking, and inability to plan ahead. Moreover, the construct was hypothesized to be part of a more inclusive class of action-oriented personality pre-dispositions that included extraversion, sensation seeking, and a lack of inhibitory behavioural controls (Barratt & Patton, 1983).

As Barratt's (1983) research progressed, he concluded on an “a priori basis” that there were three main aspects of impulsivity: motor (acting without thinking), cognitive (quick decisions), and non-planning (present orientation). Original analyses (Barratt, 1985) empirically substantiated these three factors and a later factor analysis completed by Gerbing, Ahadi, and Patton (1987) also identified each of these three factors in their overall analysis.

Despite the originally promising findings, the results of the original analysis were not reliable. In particular, the cognitive subfactor alpha coefficient was weak and failed to con-firm the existence of the cognitive subscale (Barratt, 1994; Luengo, Carillo-de-las-Peña, & Otero 1991). Barratt surmised that this sub-trait was difficult to measure with self-report questionnaires because cognition is always inferential and the extent to which impulsive persons can assess their own cognitive functions may be questionable.

In one of the first studies examining whether delinquents and non delinquent samples could be differentiated based on the measures of impulsivity, no significant findings were found in the expected direction on scales including the BIS- 1 (Saunders, Reppucci, & Sarata, 1973). Using the BIS on an inmate sample, Barratt and his colleagues found that subjects diagnosed with Anti-social Personality Disorder could be differentiated from controls on the basis of their impulsiveness scores (Barratt, Stanford, Kent, & Felthous, 1997) while a study in 1992 found higher levels of impulsivity in more versatile criminal offenders (Stanford & Barratt, 1992). Interestingly, inmates could not be differentiated based on their violent pattern of offending (impulsive versus non-impulsive aggression).

In an earlier study, Presse (1984) determined that the BIS (version 10) could not differentiate between non psychopathic and psychopathic inmates, although there was a significant correlation between PCL ratings and the BIS-10. Hare and his colleagues used an earlier version of the Barratt Impulsiveness Scale and found that high scores were associated with high ratings of psychopathy (Hare & Cox, 1978). Wardell and Yeudall's (1980) findings supported this conclusion. Despite some evidence of differences among psychopaths and non-psychopaths on the Barratt scale, Hare did not feel that impulsivity differentiated between psychopathic and non-psychopathic inmates, but proposed that it is more likely to account for differences in criminals and non-criminals (Hare, 1982).

Impulsivity as measured through Eysenck's scale has been reported to differentiate male delinquents from controls (Eysenck & Eysenck, 1977; Eysenck & McGurk, 1980; Putnins, 1982). The scale has also been found to correlate with self-reported delinquency in both men and women adolescent delinquent samples (Silva, Martorell, & Clemente, 1986). In addition, the Eysenck I7 questionnaire was found to be significantly correlated with measures of violent behaviour including previous violent convictions (r = 0.50), psychopathy as measured by the PCL-R (r = 0.52; Seager, 1995), and anti-social behaviour in adults (Eysenck et al., 1985; Goma-i-Freixanet, 1995). The studies of the relationship between psychopathy and self-report measures of impulsiveness, however, suggest that the findings are dependent on the measures used (Presse, 1984).

A more recent addition to self-control measures is the self-report measure developed by Grasmick et al. (1993). This measure was designed as an index of low self-control as defined by Gottfredson and Hirschi (1990). Original analysis (Grasmick et al., 1993) with this scale suggested that low self-control was a unidimensional trait. The authors reported that self-control was predictive of self-reported fraud and use of force but only in interaction with opportunity. That is, lack of self-control only had a significant impact when opportunity was high. Further research has not fully endorsed the use of this measure.

Longshore et al.'s (1996) attempted to validate the use of the Grasmick et al., (1993) self-control scale on a criminal population. Factor analysis identified five subscales that were reason-ably consistent with current notions of the self-control construct. Notable is the fact that impulsivity was not isolated as a separate factor. The total scale, along with several subscales, was modestly associated with self-reported crimes of fraud and force. Overall, the self-control scale was no more closely related to crime than were subscales representing the more specific constructs of risk seeking, temper, and impulsivity/self-centeredness already established in the literature. As such, it appears that issues surrounding the measurement of self-control remain unresolved.

The literature reveals the following consistent problems with self-report inventories of impulsivity:

  • Lack of external criterion measures and biological measures other than other questionnaire scales (Barratt & Patton, 1983).
  • Questionnaire measures of impulsivity are at least significantly intercorrelated but have low order and often insignificant correlations with behavioural or cognitive measures of impulsivity (Barratt, 1983).
  • At present, there is a lack of research into the dynamic nature of these instruments.

It is evident that many techniques that purport to measure impulsivity are not measuring the same construct. The circular nature of the debates will not end until measurement of the concept applies external criterion. Furthermore, a preliminary finding of moderate to high correlations (average r = 0.48) between measures of impulsivity/self control and an impression management inventory with a forensic population suggests that the utility of using self-reported measures of impulsivity is questionable. This also creates some reservations concerning the validity of using self-reported crimes as a criterion measure (Rowe, 2000). Despite some successes in differentiating forensic samples, it is still not clear what exactly self-report measures of impulsiveness are measuring other than correlations with other impulsivity measures or, perhaps, poor self-appraisal/impression management skills. A quick glance at item content indicates that self-report inventories are attempting to measure a stable trait. The utility of these instruments in assessing changes in self-regulation is likely severely limited. Therefore, the validity of using these self-report measures as reflections in self-regulation remains suspect.

BEHAVIOURAL MEASURES

Behavioural methods for the assessment of the impulsivity construct are also plentiful and diverse (see Kindlon et al., 1995). Most concentrate on reaction time type tasks, assessment of an ability to delay or inhibit responding, time perspectives, and interference control. The most recent behavioural measures have conceptualized impulsivity as a form of behavioural disinhibition.

The Matching Familiar Figures test (MFFT) was constructed in 1964 (Kagan, Rosman, Day, Albert, & Phillips, 1964) to measure the contrasting conceptual styles of impulsivity and reflection, but at best has only been able to marginally differentiate offender populations. Reaction time tasks have been used in attempts to measure the impulsivity construct. The concept that people who lack a sufficient self-regulation process make quick decisions or act without thinking has been central to many definitions of impulsivity (Parker, Bagby, & Webster, 1993). It would appear, however, that the relationship between impulsivity and psychomotor activity is quite complex as results from studies with offender populations have been mixed (Barratt, 1985).

One paradigm for the study of self-control is the assessment of the ability to defer a proximal or immediate reward for a greater reward that will be received at some point in the future. In a prospective study with delinquent males it was found that recidivists were more susceptible to choosing an immediate reward when assessed prior to their release than non-recidivists (Roberts et al., 1974). A study conducted with young children measuring the ability to postpone immediate gratification found that such measures predict patterns of competence in the fields of attentiveness and ability to plan ahead more than a decade later (Mischel, Shoda, & Peake, 1988). In addition, Newman's extensive research has consistently found that delay of gratification is useful in discriminating controls from adolescent and adult psychopaths (Patterson & Newman, 1993).

In Gerbing et al.'s report (1987), the average correlation between self-report and behavioural factors of self-regulation measures was 0.03. Helmers' study (Helmers, Young, & Pihl, 1995) also reported near zero correlations between self-report measures of impulsivity, such as Barratt's and Eysenck's scales, and behavioural measures such as the MFFT and go-no-go discrimination tasks. In fact, a composite factor score of self-report impulsivity showed a significant relationship in the opposite direction than expected with some behavioural measures. The failure to find correlations between various impulsivity measures most likely reflects the lack of consensus in the literature about what constitutes impulsivity and the differences in the theoretical approaches to the construct (Parker & Bagby, 1997).

More recent factor analyses have incorporated a variety of new tasks and tests that have been specifically designed for the detection of extraversion, conduct disorder, delinquency, and psychopathy. In 1995, Kindlon et al. attempted to measure the psychometric properties of these types of impulsivity measures with normal and behaviourally disordered children. Most of the behavioural measures were able to differentiate impulsive children from normal controls, while controlling for the effects of age and intellectual aptitude. The study identified two dimensions of impulsivity: cognitive inhibitory control (inhibit a strong competing response) versus a motivational component (insensitivity to punishment/non reward). This confirmed an earlier factor analysis employing multiple tests and measures of impulsivity (White et al., 1994). Both studies emphasize the utility of a variety of newly developed instruments focused on behavioural inhibition and interference control to differentiate amongst delinquent youth. Specifically, the Kindlon et al. (1995) study showed that there was a group of objective impulsivity measures with psychometric properties necessary for longitudinal research that showed promise as revealing the developmental antecedents to juvenile delinquency and adult crime.

Future directions in the assessment of impulsivity

The literature has told us that assessment instruments in self-regulation should be:

  • based on viable theories of self-regulation, behavioural inhibition, or self-control
  • multi-dimensional
  • validated with observable external criteria
  • show temporal stability but be potentially dynamic in nature
  • performance based or behavioural measures
  • independent of impression management concerns or self-appraisal deficiencies.

The lack of consensus regarding the conceptualisation of impulsivity is indisputable. This inconsistency in the use of this concept has certainly found its way into the measurement of the construct. A strong theoretical orientation needs to be provided that can guide future efforts at scale construction in order to expose the links between impulsivity, its various manifestations, and anti-social conduct. For this reason we have turned to Barkley's (1 997b) conceptualization of the self-regulation process. Barkley's model not only attempts to identify the mechanisms that serve the self-regulatory system but also specifically documents the nature of these systems and the structure in which they function.

There does not seem to be an overwhelming array of options to evaluate self-regulation processes of criminal offenders. Future instruments should attempt to measure the performance and abilities of individuals to inhibit task-irrelevant responses, executing goal-directed responses, execute novel/complex motor sequences, persist in goal-directed behaviour, respond appropriately to feedback, exhibit behavioural flexibility, re-engage in a task following disruption, and control their behaviour by internally-represented information. Recent hi-tech innovations in brain imaging provide precise modelling of the functions of the brain in response to stimuli. These advances could one day permit the biological criterion for components of self-regulation for both self-report and behavioural measures.

Treatment implications for adult offenders

If we accept that deficits in self-regulation linked to neurophysiological underfunction are present in chronic offender populations and are implicated in their repetitive anti-social behaviours, a medication regime similar to that prescribed for hyperactive children may be a logical treatment option for these adults as well. There is, however, limited evidence for the utility of any kind of medication to address problems in self-regulation among adult offender populations. Methodological problems of small sample size, lack of control groups and high rates of attrition plague most of the rare studies in the area. Two controlled pharmacological studies in the literature assessing the use of stimulants on adults with ADHD found a positive treatment response analogous to that of treated children, albeit a number of subjects experienced unpleasant side effects (Wender, Wood, & Reimherr, 1991; Greenhill, 1992). Other studies have treated impulsive adults with tranquillisers (Federoff & Federoff, 1992) and anticonvulsants (Barratt & Slaughter, 1998). Cocarro's work links impulsive aggression in adults with low serotonin levels. He and his team have reported on successfully treating impulsively aggressive adults with SSRIs and the non responders (to the SSRIs) with anti-manic medications (Cocarro & Kavoussi, 1997).

Another intervention strategy is to directly train individuals in the cognitive and coping skills they have not developed due to impairments in inhibition. Meta-cognitive strategies for slowing down cognitive processes and training in the development of skills that less impulsive individuals use to achieve their goals (through self-regulation) are components of such intervention programs. Table 15.2 outlines the deficits that should be addressed in a pro-gram designed to treat problems in self-regulation. In addition to these, we have pointed out that problems in self-regulation often lead to an anti-social orientation and an endorsement of beliefs and a lifestyle that are supportive of crime and rejecting of prosocial conventions and values. For this reason, the content of offenders' thinking should be addressed as well as their thinking process.

Barkley does not speculate on treatment strategies for adults, but externalizing the self-control mechanisms by over-learning strategies such as self-regulatory self-talk and identifying behaviour contingencies, that is, the sequencing of behaviours that lead to an outcome, would be one approach.

Meichenbaums' (1977) early work on self-instructional learning pointed the way for those working with clients with problems in self-regulation. He proposed that self-instruction, composed of training in guided self-talk, assisted clients by allowing them to better perform five functions: direct their attention to relevant events; interrupt an automated response to environmental stimuli; search for and select alternative courses of action; use rules and principles to guide behaviour; and maintain a sequence of action in short term memory so that they can be enacted.

Over the last 15 years, cognitive-behaviour interventions that emphasize the training of self-regulatory skills have been identified as the treatment approach most often associated with reductions in offender recidivism (Gendreau & Ross, 1979; Izzo & Ross, 1990; Sherman et al., 1997; Vennard, Sugg & Hedderman, 1997). Reviews that have applied meta-analytic techniques to the evaluation of a large body of published, and in some cases, unpublished, research reports (Andrews et al., 1990; Antonowicz & Ross, 1994; Izzo & Ross, 1990; Lipton, 1998; Lösel, 1995; McGuire, 1995) find an average small (0.08 to 0.15), but significant, treatment effect size for correctional treatment with the cognitive behavioural interventions being cited as among the approaches consistently associated with positive outcomes. Although about 80% of the studies included in the meta-analyses involve juveniles, there are a number of studies involving adult subjects that point to a similar positive trend in the application of this approach. The most optimistic interpreters of the literature estimate that when “appropriate” interventions are applied, effects sizes above 0.30 can be expected (Andrews & Bonta, 1994). This translates into between 10 to 15% differences in recidivism rates between treated and untreated controls (for example, 40% recidivism rates as opposed to 50% or 55% (from McGuire, 1995).

A number of programs that teach thinking skills are now delivered in correctional settings. However, no one program has been so widely adopted as the Cognitive Skills Training or Reasoning and Rehabilitation program as it is also known was developed by Ross and Fabiano. Cognitive Skills has become a core program in the federal Canadian correctional system and it has been implemented world wide in such constituencies as the United States, Europe, Australia, New Zealand, and throughout the British Prison system and the Probation Service in the United Kingdom. The program is the base program in a menu of six Living Skills programs offered to federal offenders within the Correctional Service of Canada. The other programs are Anger and Other Emotions Management, Living Without Family Violence, Parenting Skills, Community Integration and Leisure Education. There are also community maintenance programs for the Cognitive Skills and Anger and Other Emotions programs.

In the Cognitive Skills program each component area is addressed over several sessions with considerable overlap in material designed to provide adequate opportunity to over-learn the skills. The program, consisting of 35 2-hour sessions, is delivered to groups of 4 to 10 offenders, 2 to 4 times per week. The trainers' manual is highly organised and scripted to maximise the standardisation of the program. A key to the successful delivery of the program has been the selection of a variety of training techniques that create an enjoyable classroom experience for the participants. The program avoids a didactic presentation of material. Rather, the trainers -- or coaches, as they are called -- use role plays, video-taped feedback, modelling, group discussion, games, and practical homework review to teach the skills.

FUTURE DIRECTIONS

Although a generally effective intervention that addresses many of the deficits in self-regulation problems identified among high risk or chronic offenders, the Cognitive Skills program does not target all of them (see Table 15.2).

TABLE 15.2 Problems in self-regulation and treatment options to address the deficits

.
Regulatory Behaviour Problems (Barkley)

Possible Treatment Options

.
1. Impairments in working memory. Symptoms problems in means end thinking, external locus of control
  • Training to anticipate consequences
  • Training in problem solving to development a sense of self-control behaviour dictated by the immediate situation. rather than external control
  • Training in setting smaller realistic goals so that behaviour is not dictated by the “here and now”
.
2. Problems in emotional self-control and lapses in motivation and lack of perseverance
  • Teaching counters to self control failure;
  • Self monitoring and other arousal reduction techniques; using verbal self regulation to “stop and think”
  • Developing personal goal setting to increase motivation to adhere to the use of the skills; managing distractions
  • Techniques for self reinforcement and self punishment
.
3. Impairment in the internalisation of speech and consequentially poor self-regulation of behaviour
  • Teaching verbal self-regulation skills to help to identify the event→thinking→feeling→behaviour link and develop and use helpful self talk
  • Development of behavioural rules or strategies to approach inter-personal problems
  • Setting standards of conduct (generation of rules)
.
4. Poor analysis and synthesis of behaviour; failures to use response feedback
  • Identifying the “behavioural chains” so that the sequence involved in the output behaviour is clarified (relapse prevention techniques)
  • Evaluating standards and rules and merging them with long term goals
  • Acquiring feedback
  • Establishing environmental control
..

Treatment effectiveness may be enhanced for higher risk offenders by providing more intensive treatment and longer term follow-up or by through efficient correctional planning. The Correctional Service of Canada (CSC) is fortunate in this regard in that there is an extensive menu of programs designed to address a number of treatment needs and most community parole offices are now funded to provide adequate community follow-up once offenders are released from the institutions. Recently CSC has developed standardized high intensity programs designed to address the treatment needs of the highest risk offenders. Although these programs each address different content areas (Violence Prevention, Family Violence Prevention, Substance Abuse Prevention (in development)), the core components of the programs are devoted to training offenders on most of the cognitive behaviour techniques contained in the Cognitive Skills program but allows for more time for offenders to overlearn the skills and more discussion time to help them understand the application of the techniques to their lives and circumstances. As outlined in Table 15.1, these newly implemented programs train offenders in the skills and strategies that Barkley's model suggests would be lacking in highly impulsive individuals. The high intensity programs train in an enriched range of skills that include many of those contained in the Cognitive Skills as well as:

  • Teaching counters to self-control failure. This involves teaching offenders to observe their thinking that proceeds a violent or abusive act and to counter or replace it so that the thinking decreases instead of escalates the situation.
  • Self-monitoring and other arousal reduction techniques. This involves externalising an awareness of physiological and psychological concomitants of arousal that lead to violence and aggression and training in self-control techniques to manage arousal.
  • Techniques for self-reinforcement and self-punishment. This also involves the development of self-talk that participants are taught to use when they handle a “high risk situation” well and when they did not. The goal, however, is to maximise self-efficacy and therefore to highlight aspects of the coping response that were positive.
  • Teaching verbal self-regulation skills to help to identify the event (A)→thinking (B)→feeling or behaviour (C) link and develop and use helpful self-talk. This is the basis of the “ABC” model of Cognitive Therapy that has been trans-ported into programs involving anger management, a modification of hostile schema or beliefs and attitudes that increase the risk for anti-social behaviours.
  • Setting standards of conduct (generation of rules). In some programs this involves the modelling of prosocial attitudes and conduct by the facilitators while in others it will involve the actual generation of moral and ethical principles derived from group debate and the development and training in goal-directed behaviour consistent with these standards.
  • Identifying the “behavioural chains” so that the sequence involved in the output behaviour is clarified. This involves the explicit sequencing of the offending process so that offenders see that it is not the uncontrollable unstoppable event they claim. At each point in the chain they are taught how they could have intervened to decrease the probability of the “outcome”, that is the aggressive or illegal behaviour.
  • Evaluating personal and societal standards and rules and merging them with long term goals. This involves the development of short and long term goals and the assessment of the goal, and progress toward them using set criteria.
  • Environmental control. For the highest risk offenders the most appropriate intervention will include the imposition of external controls such as intensive supervision, halfway houses and the involvement of community and family supports. It would also include instruction on how to manage your environment. This can be accomplished through the application of self-monitoring behaviour and through self-observation skills, techniques for managing distractions, preparing for success, strategies to self-motivate, as well as techniques for antecedent control, self-reinforcement, and self-punishment.

With expected advances in pharmacological research, future interventions for chronic high risk offenders with diagnosed problems in impulse control might benefit from combining high intensity cognitive behavioural treatment programs with a medication regime that could assist them in modulating their response to the environment.


1 Correctional Service of Canada

2 Carleton University


REFERENCES

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Antonowicz, D., & Ross, R. R. (1994). Essential components of successful rehabilitation programs for offenders. International Journal of Offender Therapy and Comparative Criminology, 38(2), 97-104.

Barkley, R. A. (1997a). ADHD and the nature of self-control. New York, NY: Guilford Press.

Barkley, R. A. (1997b). Behavioural inhibition, sustained attention and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65-94.

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