A Theoretical Framework of Ethics Therapy as a Distinctive Forensic Therapeutic Specialization

• Published date: 01 June 2001
• Author: Willem H. J. Martens
• DOI: 10.1177/0306624X01453009
• Date: 01 June 2001
• Subject Matter: Journal Article

International Journal of Offender Therapy and Comparative Criminology
Ethics Therapy
A Theoretical Framework of Ethics
Therapy as a Distinctive Forensic
Therapeutic Specialization
Willem H. J. Martens
Abstract: In this article, the usefulness of ethics therapy in forensic psychiatric settings is dis-
cussed. Its aims and guidelines and its possible therapeutic approaches are presented. It is the-
orized that ethics therapy will be a valuable addition to the existing therapeutic methods
because of its specific, exclusive, and differentiated attention for and directness to the moral
basis of personality in its behavioral manifestations. Moral and ethics patterns are intrinsic to
people’s personality and largely determine behavior. Without serious and stable moral
improvement, any behavioral changes in the antisocial and criminal individual’s conduct will
be no more than superficial cosmetic interventions, which do not really diminish the risk of
reoffending in those persons.
WHAT IS ETHICS THERAPY?
Ethics and morality are two different concepts. Ethical activity includes every
personal consideration of what is right or wrong. According to Kant, the essence
of ethics revolves around the question: Wass soll man tun? (What should be
done?). By means of ethics one can theorize about virtues and responsibilities,
which are the basis of moral values and norms (morality), and one can determine
his or her behavior in relation to others. Morality is prescribed by society and
includes agreement and codes of conduct, but ethics can be independent of these
influences. Morality and ethics can be regarded as clusters of multidimensional
phenomena. In fact, moral and ethical activity are the result of interactions
between several different but somehow related abilities and factors, such as vari-
ous mental functions like cognition, judgement, social awareness, information
processing, degree of consciousness, conscience, and intelligence or emotional
aspects, like empathy, aspects of the will, authenticity, and even biological aspects
(Martens, in press-b). Ethics therapy is targeted toward moral ethical maturation
of the offender/patient.
Many forensic psychiatric patients suffer from moral and ethical developmen-
tal disorders, which are associated with their criminal and violent behavior. It is
the purpose of ethics therapy to fill the offender’s/patient’s moral and ethical
developmental gap by means of specific therapeutic narrative and contemplation
International Journal of Offender Therapy and Comparative Criminology, 45(3), 2001
383-394
 2001 Sage Publications
383

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International Journal of Offender Therapy and Comparative Criminology
strategies, which are focused on the development of their morally significant abil-
ities, such as conscience, self-knowledge, social awareness and responsibility,
empathy, honesty, and reliability. This can be done only when they are motivated
and when they desire to change. Indeed, ethics therapy is based on a voluntary
introspection process of the offender/patient and a correct and respectful guid-
ance of this process by the ethics therapist. This requires investigation, analysis,
and deep understanding of the origins of the offender/patient’s ideas, moral
beliefs, convictions, and reasoning ability. The basic concept for this kind of ther-
apy is that only deep insight into one’s own character and unconscious behavioral
motives can be the starting point for a profound change toward a moral-ethical
personality. According to Durkheim (1989), the prerequisites of moral and ethical
maturation consist first in the breaking down of the small “I” that rejects pain and
responsibility and that is full of fears. This breaking down of the small “I” is
another significant goal of ethics therapy. Ethics therapy, however, cannot solve
all the problems of the offenders/patients: many social, psychological, and
neurobiological impairments should be the target of other therapeutic approaches.
NORMAL MORAL AND ETHICAL DEVELOPMENT
What, in actual fact, do we really know about the development of moral and
ethical capacities? One of the well-known and most important empirical investi-
gators of moral development is Lawrence Kohlberg. His theory is based on data
from a long-term study of 58 young men interviewed periodically over two
decades (Kohlberg, 1981). According to Kohlberg’s theory, based on empirical
findings, individuals go through as many as six stages of moral reasoning,
grouped into three levels:
• Level 1: Self-Interest
Stage 1: Punishment (ages 0 to 10)
Stage 2: Reward (ages 13 to 14)
• Level 2: Social Approval
Stage 3: Interpersonal Relations (ages 16 to 18) (I won’t do it, because I
want people to like me)
Stage 4: Social Order (ages 20 to 22) (I won’t do it because it would break
the law)
• Level 3: Abstract Ideals
Stage 5: Social Contract (ages 24 to 26) (I won’t do it because I am obliged
not to)
Stage 6: Universal Rights (ages 28 and older) (I won’t do it because it’s not
right, no matter what others say). Only Stage 6 represents the real ethical
developmental stage of an individual.

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Ethics Therapy
385
Although this theory of Kohlberg (1981) and other empirical theories of moral
development are generally accepted and highly esteemed by many scholars, it
seems to this author that these theories all have the same defect: They are too sim-
plistic. Moral and ethical development are not rigid and static processes. Many
persons change stages from period to period and sometimes from moment to mo-
ment. It is even possible that all levels of moral development and related argu-
ments of moral reasoning are combined. Because most of us are sensitive to pun-
ishment (Kohlberg’s Level 1), and we do not have the courage or do not want to
drop out (Kohlberg’s Level 2), arguments of Level 1 and 2 will frequently deter-
mine our moral behavior. Moreover, empirical studies of moral development, like
Kohlberg’s investigation, are focused on some psychosocial dimensions of life
while leaving out other very important psychological, social, and biological di-
mensions (Martens, in press-b). Nevertheless, we can use Kohlberg’s age-related
stages of moral and ethical reasoning as a rough indicator and standard of normal
moral development.
MORAL AND ETHICAL ABNORMALITIES
Moral and ethical abnormalities or incapacities are mostly coupled with incon-
sistencies in the offenders’/patients’ moral system. Those inconsistencies are fre-
quently linked to the offenders’/patients’ unawareness of or lack of interest in
other persons; interpersonal, moral norms or values; and, as noted earlier, to
dysfunctions of morally significant emotions. A lack of moral emotions, in addi-
tion, may be related to neurobiological defects (Damasio, 1994; Martens, 1997, in
press-a; Robinson & Starkstein, 1997; Silver, Hales, & Yudofsky, 1997). A lack of
awareness of and interest in others and interpersonal norms and values is a charac-
teristic of the psychopathic personality disorder. This characteristic is often
related to other traits of this disorder, such as (a) an undeveloped capacity to lead
an inner dialogue, (b) a lack of empathy and remorse, (c) an emotional shallow-
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