“I’ve Got the Energy to Change, But I Haven’t Got the Energy for This Kinda Therapy”: A Qualitative Analysis of the Motivations Behind Democratic Therapeutic Community Drop-Out for Men With Sexual Convictions

• Author: Katie Duncan,Belinda Winder,Nicholas Blagden,Christine Norman
• DOI: http://doi.org/10.1177/0306624X20956957
• Published date: 01 September 2022
• Date: 01 September 2022
• Subject Matter: Articles

https://doi.org/10.1177/0306624X20956957

International Journal of

Offender Therapy and

Comparative Criminology

2022, Vol. 66(12) 1213 –1236

© The Author(s) 2020

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DOI: 10.1177/0306624X20956957

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Article

“I’ve Got the Energy to

Change, But I Haven’t Got

the Energy for This Kinda

Therapy”: A Qualitative

Analysis of the Motivations

Behind Democratic

Therapeutic Community

Drop-Out for Men With

Sexual Convictions

Katie Duncan1, Belinda Winder1,

Nicholas Blagden1, and Christine Norman1

Abstract

Prison-based democratic therapeutic communities (TCs) provide an alternative to

mainstream prison, where prisoners can work on psychological difficulties and address

offending behavior. Research demonstrates TCs are effective at reducing reoffending

rates for residents who stay in therapy 18+ months, and those who drop out of

TCs offend at a significantly higher rate than those who complete therapy. Thus, it is

important to reduce attrition in TCs. No research has yet explored the explanations

for TC drop out offered by those with sexual convictions. The present study uses

Interpretive Phenomenological Analysis to qualitatively explore the accounts of men

with sexual convictions (n = 7) who dropped out of a TC in a UK prison. Results

highlight that issues surrounding external responsivity, therapeutic relationships,

and treatment readiness were salient in the participants’ accounts of drop out. This

research has implications for TCs seeking to better understand and address attrition

of people with sexual convictions.

1Nottingham Trent University, UK

Corresponding Author:

Belinda Winder, Sexual Offences, Department of Psychology, School of Social Sciences, Crime and

Misconduct Research Unit, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1

4FQ, UK.

Email: belinda.winder@ntu.ac.uk

956957IJOXXX10.1177/0306624X20956957International Journal of Offender Therapy and Comparative CriminologyDuncan et al.

research-article2020

1214 International Journal of Offender Therapy and Comparative Criminology 66(12)

Keywords

therapeutic community, sexual offence, attrition, IPA, prison, rehabilitation

Introduction

Prison-based democratic therapeutic communities (TCs) are a rehabilitative interven-

tion for prisoners who exhibit elevated levels of psychological disturbance (Shine,

2001). They aim to reduce criminogenic risk and address the psychological symptoms

associated with personality disorder (Dolan, 2017). Residents with sexual convictions

and those with other crimes, such as violent offences, live together on integrated

wings, and the responsibility for decision-making is shared among residents and staff

(Akerman, 2019). TCs provide a unique social climate in which every facet of prison

life is integral to the process of rehabilitation (Brookes, 2010). Outside of formal ther-

apy groups, the community is an agent of change (Day & Doyle, 2010). Residents

monitor and challenge each other’s behavior in a “culture of enquiry” (Shuker, 2013,

p. 347), and social learning processes ingrained in interactions between residents and

staff create a “living-learning” experience (Kennard, 2004, p. 296). Indeed, Woessner

and Schwedler (2014) reported that positive ratings of prison climate were signifi-

cantly associated with prosocial changes in dynamic risk factors for prisoners residing

in a social therapeutic prison, and research has demonstrated that prisoners who com-

plete 18+ months of therapy within TCs demonstrate lower reconviction rates than the

general prison population (Cullen, 1994; Miller & Brown, 2010). Based on this evi-

dence, the minimum expected length of stay for many TCs is 18 months; though, offi-

cial therapy completion could take several years, depending on the individual and their

needs (Independent Monitoring Board, 2020).

Birgen (2004) argues that the context in which therapy takes place is an aspect of

external responsivity, and this context may be particularly important when it relates to

prisoners with sexual convictions, who are seen by the rest of the prison population

(and society) as “the lowest of the low” (Griffin & West, 2006). Research has demon-

strated that responsivity to therapeutic interventions is bolstered by a climate where

prisoners with sexual convictions feel safe (Blagden et al., 2016) and supported by

staff (Stasch et al., 2018). Notwithstanding these findings, research by Schmucker and

Lösel (2015) demonstrated through a large-scale meta-analysis that treatment pro-

grams for sexual offending exhibited significant mean treatment effects only in the

community, not in prisons. The evaluation of the previous Sex Offender Treatment

Program by Mews et al. (2017) showed no reduction on subsequent sexual recidivism

by individuals who had completed the SOTP in prison. These findings suggest the

typical prison environment is less conducive to therapeutic change.

However, evidence indicates TCs can be successful in a prison setting (Ross &

Auty, 2018). Jensen and Kane (2012) found that completing a TC had a significant

effect on reducing the likelihood of rearrest for prisoners. Marshall (1997) conducted

a large-scale evaluation of the effectiveness of TCs for people with sexual convictions.

In his 4 year follow-up he found that 18% of treated individuals (with two or more