Dr Joseph Allan Sakdalan1, Dr Bonnie Albrecht1
1Forensicare
Abstract:
Schema therapy is an integrative therapy that can aid in the conceptualisation and intervention of the underlying belief systems (i.e., early maladaptive schemas) and socioemotional patterns (i.e., modes) of individuals who engage in sexual offending.
Schema therapy was developed in recognition of the lack of response to CBT/TAU protocols, especially with PD presentations, complex trauma and attachment disruption. Personality dysfunction disrupted attachment, and trauma is each prevalent within sexual offending populations and are arguably not adequately tended to via some TAU approaches.
Consideration of forensic-specific modes conceptualised by Bernstein and Arntz (2007) has supported the adaptation of Schema Therapy to working with offending populations. There are promising outcomes for ST over TAU in RCT and single case studies in forensic populations. The use of ST has been associated with trending reductions in the risk of violence and more/quicker progression to leaves, compared to TAU, in a sample of forensic patients with violent offence histories and personality disorders (Bernstein et al., 2021). Further, a single case study of a forensic patient convicted of rape and with high psychopathy ratings have shown promising resistance from further criminal offending in the three years of post-schema therapy intervention (Chakhssi et al., 2014).
This paper will discuss these research findings in more detail and outline how core components of schema therapy—such as limited reparenting, imagery, and chair-work-based experiential exercises—can be used when treating this population and how such practices can still support a ‘what works’ (i.e., risk, need, responsivity) approach to offender intervention.