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Violent Cognitions Violent Cognitions

TX Forensic Mental Health Conf. #5 Cognitive Self Change

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Texas Forensic Mental Health Conference Presenter: Dr. SalterPresentation: Cognitive Self Change#5

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Page 1: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Violent CognitionsViolent Cognitions

Page 2: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Interpretive TheoryInterpretive Theory

N = 55 incarcerated offendersN = 55 incarcerated offenders

5 institutions in 2 states5 institutions in 2 states

(Athens, 1997)(Athens, 1997)

Page 3: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Pathways to Violence:Pathways to Violence:Interpretive TheoryInterpretive Theory

Physical DefensePhysical Defense FrustrativeFrustrative MaleficMalefic Frustrative/MaleficFrustrative/Malefic

(Athens, 1997)(Athens, 1997)

Page 4: TX Forensic Mental Health Conf. #5 Cognitive Self Change

DefenseDefense

Victim is going to attack himVictim is going to attack him

Victim is attacking himVictim is attacking him

Page 5: TX Forensic Mental Health Conf. #5 Cognitive Self Change

““He just kept looking. Then I started He just kept looking. Then I started thinking he was out to do something thinking he was out to do something to me. He pulled out a knife and to me. He pulled out a knife and made for me, and I shot him once in made for me, and I shot him once in the arm. He kept on coming, so I the arm. He kept on coming, so I had to finish him off.”had to finish him off.”

(Athens, 1997, p. 34)(Athens, 1997, p. 34)

Page 6: TX Forensic Mental Health Conf. #5 Cognitive Self Change

FrustrativeFrustrative

Victim is or will resist his intentionsVictim is or will resist his intentions

E.g., rape, robbery car theftE.g., rape, robbery car theft

Victim has some intention he wants Victim has some intention he wants to resistto resist

E.g., calling policeE.g., calling police

Page 7: TX Forensic Mental Health Conf. #5 Cognitive Self Change

““My friend and I were punching the My friend and I were punching the safe when a real young cop came in safe when a real young cop came in with his gun drawn and said, ‘You’re with his gun drawn and said, ‘You’re under arrest. Put your hands up.’ under arrest. Put your hands up.’ The first thing I thought was, ‘Here is The first thing I thought was, ‘Here is ten years and I don’t want to do any ten years and I don’t want to do any more fucking time.’”more fucking time.’”

(Athens, 1997, p. 38)(Athens, 1997, p. 38)

Page 8: TX Forensic Mental Health Conf. #5 Cognitive Self Change

““I plain and simple needed to get some I plain and simple needed to get some good, hot, kinky sex but resented good, hot, kinky sex but resented having to rely on the generosity of having to rely on the generosity of women to hit on their pussies. . . My women to hit on their pussies. . . My days of begging . . . Were over.”days of begging . . . Were over.”

(Athens, 1997, p. 10)(Athens, 1997, p. 10)

Page 9: TX Forensic Mental Health Conf. #5 Cognitive Self Change

FrustrativeFrustrative

““The way she moved made my rocks The way she moved made my rocks shake. I had to have her. So I shake. I had to have her. So I pretended to look for my dog. . . She pretended to look for my dog. . . She was polite but bitchy, you know. . . was polite but bitchy, you know. . . She goes, yea like get lost. Now I She goes, yea like get lost. Now I don’t give a fuck, you know. I reach don’t give a fuck, you know. I reach for her neck. Fuck you, I goes and for her neck. Fuck you, I goes and drag her inside the fuck’en shed.”drag her inside the fuck’en shed.”

(Stevens, 2001, p. 40)(Stevens, 2001, p. 40)

Page 10: TX Forensic Mental Health Conf. #5 Cognitive Self Change

““A young woman came in with a bad cut on A young woman came in with a bad cut on her arm. . . From the way she talked and her arm. . . From the way she talked and acted, I got the impression she made acted, I got the impression she made men come after her. She was conceited men come after her. She was conceited and all wrapped up in herself. . . I tried to and all wrapped up in herself. . . I tried to get something going but her nose was get something going but her nose was too far up in the air.”too far up in the air.”

(Athens, 1997, p. 8) (Athens, 1997, p. 8)

Page 11: TX Forensic Mental Health Conf. #5 Cognitive Self Change

MaleficMalefic

Victim belittling himVictim belittling him

Victim evil or maliciousVictim evil or malicious

Page 12: TX Forensic Mental Health Conf. #5 Cognitive Self Change

MaleficMalefic

““We came to an intersection and We came to an intersection and slowed down when this big black slowed down when this big black dude in a Thunderbird coming the dude in a Thunderbird coming the other way cut us off in the other way cut us off in the intersection while he made a turn. intersection while he made a turn. Then he drove by us with a big grin Then he drove by us with a big grin on his face throwing the bone.”on his face throwing the bone.”

(Athens, 1997, p. 39)(Athens, 1997, p. 39)

Page 13: TX Forensic Mental Health Conf. #5 Cognitive Self Change

MaleficMalefic

““That dirty jive n___ flipping me off and That dirty jive n___ flipping me off and grinning – now he thinks he’s one grinning – now he thinks he’s one bad n____.”bad n____.”

(Athens, 1997, p. 39)(Athens, 1997, p. 39)

Page 14: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Dynamics of CrimeDynamics of Crime

Fixed Line of IntentionFixed Line of Intention Restraining JudgmentRestraining Judgment

Can’t winCan’t winVictim acquiescesVictim acquiesces Deference to 3Deference to 3rdrd party party Fears relationship lossFears relationship lossFear getting caughtFear getting caught

Overriding JudgmentOverriding Judgment

Page 15: TX Forensic Mental Health Conf. #5 Cognitive Self Change

“’“’You, no-good tramp, dirty whore, you You, no-good tramp, dirty whore, you better tell me where in the hell you have better tell me where in the hell you have been.’ She said, “You are acting like been.’ She said, “You are acting like nothing but a bum. I’m not going to tell nothing but a bum. I’m not going to tell you anything. I thought to myself, ‘I’m you anything. I thought to myself, ‘I’m going to beat the damn truth out of that going to beat the damn truth out of that no-good, rotten bitch.’ . . But then I no-good, rotten bitch.’ . . But then I thought that if I went that far, she might thought that if I went that far, she might leave me, so I dropped it.”leave me, so I dropped it.”

(Athens, 1997, p. 48(Athens, 1997, p. 48

Page 16: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Creation of ViolenceCreation of Violence

Violent SubjugationViolent Subjugation

Personal HorrificationPersonal Horrification

Violent CoachingViolent Coaching

Page 17: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Criminogenic NeedsCriminogenic Needs

CriminogenicCriminogenic Non Non CriminogenicCriminogenic

Antisocial AttitudesAntisocial Attitudes Self-EsteemSelf-Esteem

Antisocial FriendsAntisocial Friends AnxietyAnxiety

Substance AbuseSubstance Abuse DepressionDepression

ImpulsivityImpulsivity

Page 18: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Targeting Criminogenic NeedsTargeting Criminogenic Needs

-0.05

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

Targets 1 - 3Noncriminogenic Needs

Targets 4 - 6CriminogenicNeeds

Gendreau, French & Taylor, 2002

Page 19: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Self Esteem Vs. Criminogenic Self Esteem Vs. Criminogenic NeedsNeeds

-0.1-0.05

00.050.1

0.150.2

0.250.3

0.350.4

Self Esteem

CriminogenicNeeds

Page 20: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Cognitive SkillsCognitive Skills

vsvs

Criminal ThinkingCriminal Thinking

Page 21: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Cognitive SkillsCognitive Skills

Problem DefinitionProblem Definition Problem SolvingProblem Solving Perspective TakingPerspective Taking Stop and ThinkStop and Think Generating AlternativesGenerating Alternatives Testing SolutionsTesting Solutions

Page 22: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Cognitive Self-ChangeCognitive Self-Change

Jack BushJack Bush

Page 23: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Cognitive Self-ChangeCognitive Self-Change

Thinking Controls BehaviorThinking Controls Behavior

When Thinking Changes, Behavior When Thinking Changes, Behavior ChangesChanges

Page 24: TX Forensic Mental Health Conf. #5 Cognitive Self Change

““We don’t demand that offenders We don’t demand that offenders change. We do require that they change. We do require that they learn how to change.”learn how to change.”

Page 25: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Each GroupEach Group

Cognitive Check-InsCognitive Check-Ins

Thinking ReportsThinking Reports

Page 26: TX Forensic Mental Health Conf. #5 Cognitive Self Change

TimingTiming

Check-InsCheck-Ins 3 to 5 minutes3 to 5 minutes

Thinking ReportsThinking Reports 1 hour1 hour

Page 27: TX Forensic Mental Health Conf. #5 Cognitive Self Change

4 Steps in Cognitive Self 4 Steps in Cognitive Self ChangeChange

1.1. Report thoughts, feelings, attitudes Report thoughts, feelings, attitudes and beliefs.and beliefs.

2.2. Recognize how they lead to hurtful Recognize how they lead to hurtful actions.actions.

3.3. Use new thoughts, attitudes and Use new thoughts, attitudes and beliefs that lead away from trouble.beliefs that lead away from trouble.

4.4. PracticePractice

Page 28: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Cognitive Check InsCognitive Check Ins

1.1. Situation of inappropriate behavior Situation of inappropriate behavior or temptation of inappropriate or temptation of inappropriate behaviorbehavior

2.2. Report thoughts, feelings, attitudes Report thoughts, feelings, attitudes & beliefs& beliefs

3.3. How they put them at riskHow they put them at risk

4.4. Describe alternative thinking or Describe alternative thinking or could have usedcould have used

Page 29: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Cognitive Check InsCognitive Check Ins

Offenders only do Steps 1 & 2 until Offenders only do Steps 1 & 2 until proficientproficient

Only then add Step 3 Only then add Step 3 Offenders only do Steps 1, 2 and 3 Offenders only do Steps 1, 2 and 3

until proficientuntil proficient Then add Step 4Then add Step 4

Page 30: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Thinking ReportThinking Report

Situation/Thoughts/Feelings/AttitudesSituation/Thoughts/Feelings/Attitudes

Offender presents draftOffender presents draft

Page 31: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Thinking ReportThinking Report

SituationSituation

““An officer told me to pick up a piece An officer told me to pick up a piece of paper on the floor at chow. I got of paper on the floor at chow. I got angry and cursed at him. I got a DR angry and cursed at him. I got a DR for disrespect and disobeying a for disrespect and disobeying a direct order.”direct order.”

Page 32: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Thinking ReportThinking Report

ThinkingThinking ““Fuck you, you fucking want-to-be Fuck you, you fucking want-to-be

cop.cop. If you want it picked up bad If you want it picked up bad

enough, pick it up yourself.enough, pick it up yourself. I have a good mind to drive you I have a good mind to drive you

right where you stand.right where you stand. If you ask me instead of telling me If you ask me instead of telling me

then maybe I’d pick it up, asshole.”then maybe I’d pick it up, asshole.”

Page 33: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Thinking ReportThinking Report

FeelingsFeelings

Anger, victimized, singled outAnger, victimized, singled out

Attitudes/BeliefsAttitudes/Beliefs

Cops are assholes. I have a right Cops are assholes. I have a right to be respected.to be respected.

Page 34: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Additional ThoughtsAdditional Thoughts

1.1. ““You get off on telling people what You get off on telling people what to do.to do.

2.2. I’m sick of being insulted around I’m sick of being insulted around here.here.

3.3. All these cops are alike.All these cops are alike.

4.4. I can’t take any more of this shit.”I can’t take any more of this shit.”

Page 35: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Additional FeelingsAdditional Feelings

BelittledBelittled

DisrespectedDisrespected

Page 36: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Additional Attitudes & BeliefsAdditional Attitudes & Beliefs

““The only way to get respect is to let The only way to get respect is to let people know you’ll hurt them if they people know you’ll hurt them if they don’t. Without the ability to be don’t. Without the ability to be violent, no one will respect you. violent, no one will respect you. When someone orders e to do When someone orders e to do something, they are disrespecting something, they are disrespecting me.”me.”

Page 37: TX Forensic Mental Health Conf. #5 Cognitive Self Change

How Thoughts Led to BehaviorHow Thoughts Led to Behavior

Clear TransitionClear Transition

““We have a pretty good picture of how We have a pretty good picture of how Marcus was thinking and feeling. Marcus was thinking and feeling. Now let’s do Step 2. Let’s look at Now let’s do Step 2. Let’s look at how these thoughts and feelings led how these thoughts and feelings led to the behavior.”to the behavior.”

Page 38: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Key Pieces Leading to RiskKey Pieces Leading to Risk

Which thoughts led to behavior?Which thoughts led to behavior?

Ask group.Ask group.

Ask offender if he agrees.Ask offender if he agrees.

Page 39: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Key PiecesKey Pieces

ThoughtsThoughts

1. “Fuck you, you fucking want-to-be 1. “Fuck you, you fucking want-to-be cop.cop.

2. You get off on telling people what to 2. You get off on telling people what to do.do.

3. I’m sick of being insulted around 3. I’m sick of being insulted around here.here.

4. I can’t take any more of this shit.”4. I can’t take any more of this shit.”

Page 40: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Key PiecesKey Pieces

FeelingsFeelings

Anger, belittled, disrespectedAnger, belittled, disrespected

Page 41: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Key PiecesKey Pieces

Attitudes & BeliefsAttitudes & Beliefs

““The only way to get respect is to let The only way to get respect is to let people know you’ll hurt them if they people know you’ll hurt them if they don’t. Without the ability to be don’t. Without the ability to be violent, no one will respect you. violent, no one will respect you. When someone orders me to do When someone orders me to do something, they are disrespecting something, they are disrespecting me.”me.”

Page 42: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Key PiecesKey Pieces

Trigger

1st Key Thought

Next Key Thought

Next Key Thought

Criminal Act

Page 43: TX Forensic Mental Health Conf. #5 Cognitive Self Change

“Fuck you, you want-to-be cop.”

“You get off . . .”

Feeling disrespected

“I’m sick of being insulted . . .”

Feeling disrespected & angry

“I can’t take . . .”

“I cursed him.”

Page 44: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Steps of Thinking ReportSteps of Thinking Report

1 Identifies additional thoughts/feelings1 Identifies additional thoughts/feelings

2 How They led to troublesome behavior2 How They led to troublesome behavior

a) Identification of key “risk a) Identification of key “risk pieces”pieces”

b) Connection between risk b) Connection between risk pieces pieces

3) Replace old thinking with new thinking3) Replace old thinking with new thinking

Page 45: TX Forensic Mental Health Conf. #5 Cognitive Self Change

What the process isWhat the process is

ReportingReporting

thoughts, feelings & attitudesthoughts, feelings & attitudes

Page 46: TX Forensic Mental Health Conf. #5 Cognitive Self Change

What the Process Isn’tWhat the Process Isn’t

ExplainingExplaining

DescribingDescribing

JustifyingJustifying

Thoughts, feelings and attitudesThoughts, feelings and attitudes

Page 47: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Language:Language:What Not to SayWhat Not to Say

Don’t give them examplesDon’t give them examples Don’t interpretDon’t interpret Don’t tell then what you would have Don’t tell then what you would have

been thinking/feelingbeen thinking/feeling Don’t use your words instead of Don’t use your words instead of

theirstheirs

Page 48: TX Forensic Mental Health Conf. #5 Cognitive Self Change

What to Ask Other Group What to Ask Other Group MembersMembers

Does this look like it was all the Does this look like it was all the thoughts and feelings?thoughts and feelings?

What could you ask to help him What could you ask to help him remember more?remember more?

Page 49: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Language:Language:How You Say It MattersHow You Say It Matters

Can you remember any more Can you remember any more thoughts . . thoughts . .

I’m not sure what you mean by . . . I’m not sure what you mean by . . . Can you explain it to me?Can you explain it to me?

What was the very first thought What was the very first thought (feeling) you had . . .(feeling) you had . . .

Did these thoughts go with particular Did these thoughts go with particular feelings? How do they fit together?feelings? How do they fit together?

Page 50: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Language:Language:How You Say It MattersHow You Say It Matters

Was there a feeling that went with Was there a feeling that went with this thought? (a thought with the this thought? (a thought with the feeling?)feeling?)

Was there a thought/feeling that fit Was there a thought/feeling that fit between the ones you’ve listedbetween the ones you’ve listed

Was there a kind of attitude behind Was there a kind of attitude behind these thoughts (feelings)?these thoughts (feelings)?

Do you have a general belief about Do you have a general belief about this kind of situation? What does it this kind of situation? What does it sound like?sound like?

Page 51: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Completion CriteriaCompletion Criteria

A completion of a set of specified A completion of a set of specified taskstasks

Achievement of “competency” in Achievement of “competency” in each step each step

Completion of a minimum time in Completion of a minimum time in treatmenttreatment

Page 52: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Personal Risk Management Personal Risk Management PlanPlan

Past acts of violence and crime, Past acts of violence and crime, circumstances, thoughts, feelings, attitudes, circumstances, thoughts, feelings, attitudes, beliefsbeliefs

Past relapse behaviorsPast relapse behaviors Description and examples of current, Description and examples of current,

everyday situations that trigger risk thinkingeveryday situations that trigger risk thinking Goals and plans for minimizing future risk of Goals and plans for minimizing future risk of

violence and crimeviolence and crime

Page 53: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Goals and PlansGoals and Plans

Specific plans for avoiding risk situationsSpecific plans for avoiding risk situations

Coping strategies when in risk situationsCoping strategies when in risk situations

Description and examples of new thinkingDescription and examples of new thinking

How new thinking will be used in risk How new thinking will be used in risk situations and every day situationssituations and every day situations

Page 54: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Elements of ProgramElements of Program

Check-InsCheck-Ins Thinking ReportsThinking Reports Individual Journal AssignmentsIndividual Journal Assignments Fearless Criminal InventoryFearless Criminal Inventory Personal Risk Management PlanPersonal Risk Management Plan

Page 55: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Staff TasksStaff Tasks

Prepare for each groupPrepare for each group Review each groupReview each group Document each groupDocument each group Conduct regular progress reviewsConduct regular progress reviews Focus intently on processFocus intently on process

Page 56: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Progress ReportsProgress Reports

2 to 3 months2 to 3 months Formal meetingFormal meeting Prepare Summary FormPrepare Summary Form Go over progress and deficitsGo over progress and deficits ½ hour +½ hour +

Page 57: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Treatment CompletionTreatment Completion

Complete tasksComplete tasks

Thinking reportsThinking reports

Cognitive check-insCognitive check-ins

Group presentationsGroup presentations

Journal assignmentsJournal assignments

Special tasksSpecial tasks

Page 58: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Length of ProgramLength of Program

6 to 22 months6 to 22 months

Page 59: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Stage IStage I 6 months credit6 months credit

4 subskills4 subskills

Risk Management PlanRisk Management Plan

State IIState II 12 months credit12 months credit

Apply skillsApply skills

Work Risk ManagementWork Risk Management

Page 60: TX Forensic Mental Health Conf. #5 Cognitive Self Change

Impact of Cognitive Self-Change Impact of Cognitive Self-Change ProgramProgram

LengthLength New Accusations After New Accusations After YearsYears

Of TimeOf Time 11 22 33(Months)(Months)

7 +7 + 25%25% 42%42% 46%46%

1 – 61 – 6 49%49% 67%67% 80%80%00 49%49% 71%71% 77%77%

(Bush, 1995)(Bush, 1995)