G-map’s Adaptation of the GoodLives Model for Use With Young People who Display Harmful Sexual Behaviour

Laura Wylie NOTA SCOTLAND Stirling, 2014

The G-map ProgrammeThe G-map Programme

•Based in Manchester•Have worked with 1000+ young people since 1988•Provide assessment, individual therapeutic programmes of work, group work, family work, consultancy and training•Currently working with young people aged 7-21 yrs •Spectrum approach

G-map’s JourneyG-map’s Journey

•NOTA •Authors of AIM •2013 : The Good Lives Model for Adolescents Who Sexually Harm (Edited by Bobbie Print), Safer Society Press

What is a Good Life?

The Good Lives Modelwww. goodlivesmodel.com

The Good Lives ModelThe Good Lives Model

• The GLM is linked to the notions of human dignity and rights, and takes a positive psychological approach to intervention with harmful sexual behaviour

• ‘Primary Goods’ –aspects of life sought for their intrinsic value

• Secondary Goods (means) - provide concrete ways of securing primary goods e.g. a job, a friendship, playing sport

For a comprehensive overview of the GLM see Ward & Brown (2004), Ward & Gannon (2006), Ward, Mann & Gannon (2007), Ward & Marshall (2004), Ward & Stewart (2003).

Ward’s 11 Primary Goods Ward’s 11 Primary Goods

• Life (healthy living and functioning)

• Knowledge (how well informed one feels about things of personal importance)

• Excellence in play (hobbies and recreational pursuits)

• Excellence in work (including mastery experiences)

• Excellence in agency (autonomy, power and self-directedness)

• Inner peace (freedom from emotional turmoil and stress)

• Relatedness (including intimate, romantic and familial relationships)

• Community (connection to wider social groups)

• Spirituality (finding meaning and purpose in life)

• Pleasure (feeling good in the here and now)

• Creativity (expressing oneself through alternative forms)

The Development of the GLM-AThe Development of the GLM-A

G-map has undertaken an informed and structured adaptation of the GLM to enhance its accessibility and resonance with young people - Focus group, service user feedback, piloting, continued refinement

G-map’s Eight Primary NeedsG-map’s Eight Primary Needs

Emotional Health (self esteem, emotional safety, managing feelings)

Physical Health (sleep, diet, hygiene, physical safety)

Sexual Health (sexual knowledge, sexuality, sexual development)

Having Fun (thrill /excitement, play)Achieving (status, knowledge, competence)Being my own person (independence, autonomy, self management,

control of others / situations)

Having a Purpose & Making a Difference (spirituality, fulfilment, hope, and generosity)

Having People in My Life (attachment, intimate, romantic, family, social and community relationships)

Language Used in the GLM Language Used in GLM-APrimary goods My needs

Secondary goods How I meet my needs

Overarching need My most important need

Internal conditions (internal capacity) The strengths and skills I have to help me meet my needs

External conditions (external capacity) How others can help me meet my needs

Internal obstacles The things about me that get in the way of meeting my needs

External obstacles The things around me that get in the way of meeting my needs

Conflict Which of my needs fight against each other?

Scope Which needs do I neglect?

Integrating the GLMIntegrating the GLM

From referral …

…to transition … and beyond

Does ‘doing’ Good Lives mean not ‘doing’ RNR (Risk, Need, Responsivity principles, Andrews,Bonta & Hoge, 1990)?

Does doing Good Lives mean overlooking risk???!!!

“We have been so busy thinking about how to reduce sexual crimes that we have overlooked a rather basic truth: recidivism may be further reduced through helping offenders to live better lives, not simply targeting isolated risk factors” (Ward et al 2006)

Safer Society Press (2009) – 1379 programmes surveyed in USA & Canada showed little evidence that focusing on criminogenic needs alone results in reduced re-offending

The GLM provides a strong theoretical rationale and canaccommodate the major RNR principles

The GLM conceptualises empirically identified needs as internal and externalobstacles – these constitute dynamic risk factors which become the target of GL intervention

Dual focus on risks and strengthsDual focus on risks and strengths

• Growing consensus: Rich (2011) “treatment and rehabilitation built on correcting deficits is not likely to be as successful or affirming as treatment built on highlighting and reinforcing strengths”.

• HSB - Griffin et al (2008) made observation that some of the young peoples strengths functioned as protective factors - they mitigated the effects of risk (e.g. availability and use of emotional confidante could reduce the young person’s propensity to self-soothe via maladaptive strategies such as HSB).

MotivationalMotivational

Qualitative study, G-map practitioners and service users (2012).

One young person said; “I’ve done things in the past that I couldn’t talk about . . . because it hurt too much . . . when I saw how my behavior fitted with the Good Lives Model I felt relieved that it was understandable . . . and it was easier to talk about it to others who understood.”

Another young person said that his mother’s involvement in the Good Lives Support Network helped improve their relationship to the extent that she supported and encouraged him whereas before she had “hated, cried, and shouted at me.”

2012 - Harkins, Flak, Beech & Woodhams compared the GLM approach with HSB with standard relapse prevention (RP) approach (based on RNR principles).

Comparisons examined :-•Attrition rates•Change in targeted areas & achievement of a post-intervention profile•Views of therapists and participants.

Attrition rates and achieved change similar across the 2 programmes, i.e. equally effective, BUT practitioners and participants reported the experience of the GLM approach in a much more positive, future-focused manner in comparison to RP. Leigh Harkins continues to develop this multi-national research project.

What will the implications for longer-term recidivism be??

Just a thought….

Does the focus on strengths which permeates the GLM help front-line workers to develop and maintain those therapeutic qualities associated with enhancing treatment effectiveness…warmth, reward, encouragement, empathy? (E.g. W. L. Marshall; G. A. Serran; Y. M. Fernandez; R. Mulloy; R. E. Mann; D. Thornton, 2003).

The GLM/GLM-A facilitate the engagement of the young person’s family and other key systems in the process of change A systemic approach with adolescents has been linked with reducing recidivism & longer-term desistance(e.g. Borduin et al, 2009)

The inclusion of the young person’s family as members of the Good Lives support network confirms to parents that they are viewed as important contributors to intervention planning and ensures that they understand the young person's needs

• Individualism and personal identity are preserved, including young person’s cultural, learning and social needs

• Applicability to broad range of populations. G-map use with LD, females, diverse risk profiles

A Framework - not a stand alone Framework - not a stand alone modelmodel

A Good Lives assessment represents one element of assessment and problem formulation, we also need to draw on existing Pathways Models, use psychometric measures and use established and effective risk assessment tools

The GLM informs intervention planning, but does not tell us where to begin, where to end, or what to do in the middle! We need to make clinically relevant decisions which consider:-

• Effective intervention modalities• Responsivity issues • Sequencing which is considerate of neurobiological impact factors• Resilience/Protective factors

Case Study – Ben, aged 14Case Study – Ben, aged 14

Ben’s offence was against an adult female who had mental health difficulties and took place when he was 13 years old. On the day of the offence the victim was outside her home in a state of confusion and asked Ben to check inside her home to make sure there were no intruders. When the victim thanked Ben for his help he approached her and began to suck her breast, telling her he loved her, and asking if he could stay. Ben received a 4 year custodial sentence. After a successful appeal he received a three year supervision order and was placed out of area in a specialist residential facility.

A Good Lives AssessmentA Good Lives Assessment

• Requires gathering information specific to the time of the HSB. G-map have developed a semi-structured interview for this purpose. Kingston, and Ward (2009) also recommend semi-structured interview.

• Encompasses the prioritization of needs, the means by which the young people met their needs, the appropriateness of them, associated internal and external obstacles and resources, conflict, and lack of scope

• Alternative ways of collecting the information:- photographs/images, drawings, storyboarding, time lines, raps

Working towards my New Life

Cared for siblings

Lonely

rejection

A jobMy HSB

Music

Friends

Girl friend

Masked my feelings

Good Lives Plan

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What do we know about my old life that might be relevant to my harmful sexual behaviour?

About me Around me

What needs did my harmful sexual behaviour meet?

Which of my needs seems most important? (Overarching need)

How do I currently meet the needs that connect to my sexually harmful behaviours? (means)Appropriate Inappropriate

Which of my needs do I neglect now, if any? (scope) Which of my needs fight against each other now, if any? (conflict)

How else can I meet my needs?

In the short term? In the longer term?

What do I need to change about me to help stop me harming others sexually? (internal obstacles)

What do we want to change around me to help stop me harming others sexually? (external obstacles)

What strengths do I have to help myself?(internal resources)

What things/people are around to help me?(external resources)

Attending to flaws in Ben’s GLPAttending to flaws in Ben’s GLP

Conflict – Ben had learned to be strongly independent and self-reliant, and this got in the way of him investing trust in others as a forerunner to forming close relationships, resulting in emotional loneliness.

Ben’s GLP for the next 12 weeksBen’s GLP for the next 12 weeks

What do I need to keep myself and others safe

(Informed by risk assessment, individualised risk management plan, and underpinned by multi-agency decision-making)

What I and others need to do before my next planning meeting (achievable and measurable steps)•Me•G-map workers•Care staff•Education staff•Social Worker•Family

Good Lives Needs Linked to Ben’s Harmful Sexual Behavior

Outcomes from Psychometric Assessment

Outcomes from Risk Assessment (AIM2)

• Emotional health• Having people in my life

(belonging)

• Age appropriate sexual knowledge

• Internal locus of control• Below average level of

self-esteem• High degree of

emotional loneliness• Problems in general

family functioning

• Low Concern/Medium strength

• Low - Medium level of supervision required

• Additional risk of other pro-criminal behaviours

Therapeutic InterventionTherapeutic Intervention

Ben’s GL needs: Emotional Heath, Belonging

Focus in therapy included:- developing emotional safety (e.g. safe place) and emotional regulation skills (e.g. guided relaxation, biofeedback techniques, mindfulness); compassionate mind training; Life history and trauma; understanding and managing HSB; attachment and interpersonal relationships.

The Good Lives Support NetworkThe Good Lives Support Network

• Care staff – Supporting Ben in accessing activities which would help him meet his GL needs, in particular belonging and emotional health needs (e.g. rugby team). Key worker, offering consistency and support. Ben also participated in an on-site relaxation group, learning and practicing relaxation techniques with peers

• SW/YOT – regular visits to maintain relationships, worked with G-map to undertake victim awareness work

• Education – Creative projects which promoted self-esteem and encouraged collaboration with others, meeting other GL needs e.g. achievement, fun

• Family – Re-established contact with siblings; Mother supported to visit Ben (this remained an area of difficulty)

Transition Planning for BenTransition Planning for Ben

Timely inclusion of a young person’s longer-term support network so that they have sufficient opportunity to understand the individual's needs. Specialist Foster Carers identified, matched to Ben, trained and supervised by G-map.

Graduated ending of therapeutic involvement - continued supervision of foster carers for time limited period.

Ensuring relevant and developmentally appropriate community resources available to the young person & that goals are realistically linked to environment in which the young person will eventually live – Sports team, mainstream school, part-time job, mending bikes, family life, USING AN EMOTIONAL CONFIDANTE!

Update on Ben – now aged 20Update on Ben – now aged 20

• Living independently but in proximity to foster family, regular contact (rumoured to bring his washing round!)

• Part of local community – ‘home’• Positive and secure attachment demonstrated with foster

family – emotional investment and trust • Attended college – good results – apprenticeship in car

mechanics at local garage – wants to have his own garage• Established circle of friends and better social life than me• Reports feeling safe, happy and loved• No further concerns in relation to HSB• In stable and intimate relationship with peer-age female, 3

years duration (after initial dilemma of not knowing if he wanted to date her or her twin sister….)

The GLM/GLM-A - Empirical The GLM/GLM-A - Empirical SupportSupport

• As a framework of offender rehabilitation the GLM is growing in influence and usage (McGrath et al 2010) and when compared with RP approaches the GLM has a ‘stronger theoretical basis supporting its integration in sex offender treatment programmes’ (Willis et al 2012). However, as a relatively new theory, the GLM does not have the same empirical evidence base as models such as the RNR model .

• Since the GLM-A has undergone a process of development and revision over the past few years it has only recently been possible to begin to evaluate it.

Preliminary Findings:-Preliminary Findings:-

• The GLM-A may increase the likelihood of desistance and thus reduce re-offending through improving young people’s internal locus of control and enhancing their overall personal resiliency, including their sense of relatedness and mastery (Griffin, 2013).

• Using a sample of 20 young people aged 14 to 18 years, the AIM2 assessment (Print, Griffin, Beech, Quayle, Bradshaw, Henniker, and Morrison 2007) was used to assess dynamic risk both prior to and following interventions underpinned by the GLM-A framework. When compared with pre-intervention scores, a significant reduction to dynamic risk was found following intervention, indicating that undertaking a program of therapeutic work that utilized the GLM-A may reduce overall risk of future harmful sexual behavior (Griffin, 2013).

The The GLAT GLAT (Good Lives Assessment Tool)

GLAT - developed, piloted, and refined by G-map for evaluation of the GLM-A. Comprises:

• (1) assessment tool to be completed by practitioners; • (2) questionnaire to be completed by young people; • (3) questionnaire to be completed by parents/carers. Designed for age 12 to 18, although can be adapted for other populations.

• The GLAT is completed in relation to each of the identified primary needs and is completed offence-stage, pre-intervention, 6 monthly, end of intervention, and post-intervention.

• GLAT revised in 2012, so not yet been possible to achieve a sample size large enough to permit reliable inferences about intervention change or test properties. A small-scale inter-rater reliability study – 7 practitioners trained to complete the GLAT and 9 active cases. Outcome suggests the tools appear to be capturing intervention change.

• Sparking interest internationally, plans for online version, need contributors in order to expand sample size and build evidence base.

YOU CAN HELP!

Early IndicationsEarly Indications

Needs emerging as associated with the young person’s harmful sexual behavior are: having people in my life (93%); emotional health (93%); and sexual health (66%). The needs that appear to be prioritized by young people and those that are related to harmful behaviors can be grounded within the wider literature and research, e.g. attachment, trauma and sexual health research.

G-map Services 1 Roebuck Lane Sale CheshireM33 7SY

Tel : 01619764414

Email; office@g-map.org

Key PublicationsKey Publications• Print, B. (2013). The good lives model for adolescents who sexually harm.

Brandon, VT: Safer Society Press.• Wylie, L. A., and H. L. Griffin. (2013). G-map’s application of the Good

Lives model to adolescent males who sexually harm: A case study. Journal of Sexual Aggression, 19, 345-356.

• Ward, T & Maruna, S. (2007) Rehabilitation: Beyond the risk paradigm, Routledge.

• Ward, T. & Gannon, T.A. (2005). Rehabilitation, etiology, and self-regulation: The comprehensive good lives model of treatment for sexual offenders. Aggression and Violent Behaviour.

• Ward, T. & Mann, R. (2004). Good lives and the rehabilitation of offenders: A positive approach to sex offender treatment. In A. Linley & S. Joseph (Eds.). Positive psychology in practice. Wiley.

• Ward, T. & Stewart, C. A. (2003). The treatment of sex offenders: Risk management and good lives. Professional Psychology: Research and Practice, 34, 353-360. Bobbie Print - The Good Lives Model -

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