Garant followed 140 men – all of whom who had committed sexual crimes against minors – for five to eight years. The men had undergone treatment while incarcerated, followed by group therapy after release, often as a condition of parole.
Garant first examined cognitive distortions before and after treatment. Cognitive distortions are erroneous beliefs or reasoning that may be used to justify the offence, such as downplaying its seriousness, blaming the victim or trivializing the consequences.
Garant found a reduction in such rationalizations at the end of treatment.
He then investigated the reasons for the change and considered three possible factors: motivation to change, the group therapy climate and the therapeutic alliance. The last appeared to be most significant.
A relationship develops
The therapeutic alliance refers to the quality of the relationship that develops between the person in treatment and the therapist.
It involves factors such as trust, responsiveness, collaboration, openness to feedback and the ability to receive comments without feeling attacked.
The quality of the therapeutic alliance was measured using a standard psychometric tool, the 24-point California Psychotherapy Alliance Scale (CALPAS).
Participants self-rated various aspects of their relationship with their therapist: the quality of the bond, receptiveness to comments and their perception of the support they received.
A humanistic approach
Garant concluded that a humanistic approach to therapy not only helps reduce cognitive distortions but also lowers the recidivism rate.
“The discourse surrounding these individuals has often revolved around labels: sex offenders, child molesters,” Garant said.
“In a therapeutic setting, this attitude can hinder the therapeutic alliance, and if a person is constantly reduced to their offence, they may eventually internalize this identity and regard it as their inescapable fate.”
Techniques that can promote the therapeutic alliance include reflecting and reframing, avoiding a dynamic of confrontation and guilt, and most importantly not reducing the individual to their deed.
“It isn’t about downplaying the seriousness of the crime,” Garant said. “These are very serious offences. The majority of our subjects committed sexual offences against family members.
"But the person has been tried, served a prison sentence and undergone treatment. Now we have to focus on their potential.”
