The importance of the therapeutic alliance when working with men who have committed a sexual offence

Publication Date07 Aug 2017
AuthorCarollyne Youssef
SubjectHealth & social care,Criminology & forensic psychology,Criminal psychology,Sociology,Sociology of crime & law,Deviant behaviour,Public policy & environmental management,Policing,Criminal justice
The importance of the therapeutic alliance
when working with men who have
committed a sexual offence
Carollyne Youssef
Purpose While there is general agreement in the literature regarding the importance of the therapeutic
alliance (TA) in psychological interventions with people, the forensic context raises some unique challenges.
The purpose of this paper is to discuss how these challenges are managed within a therapeutic context.
Design/methodology/approach This paper consists of a literature review examining the following: the
significance of the TA in interventions with forensic clients, especially men who have committed a sexual
offence and the impact on treatment efficacy and change; therapist characteristics as well as some of the
obstacles and challenges present in a correctional setting, which can impact on the TA and; the role of
transference and countertransference in relation to these forensic clients.
Findings Through the literature review, there is a discussionregarding how some of the common obstacles
within correctional settings can be overcome, and how certain therapist qualities should be interpreted.
Originality/value This paper will discuss some of the practical applications of certain recommended
therapeutic factors within a correctional setting, challenging some of the common misconceptions and
limitations. Furthermore, transference and countertransference, topics which are seldom discussed, will be
considered in this paper.
Keywords Rehabilitation, Therapeutic relationship, Sex offenders, Therapeutic alliance,
Countertransference, Transference
Paper type General review
The therapeutic alliance (TA) is a fundamental component of the therapeutic process. Over the past
few decades, the importance of therapist characteristics including the TA has been emphasised in
the literature (Marshall and Burton, 2010; Marshall et al., 2011). Despite the TA being identified as
essential within therapeutic interventions, it appears that therapistsunderstanding of the TA
remains unclear as does an understanding of how to develop an effective TA particularly with men
who have committed a sexual offence (Kozar and Day, 2012; Ross et al., 2008). This appears to be
further complicated when working with forensic clients generally, but those who have offended
sexually, more specifically. It is the aim of this paper to revisit the conceptualisation of the TA and
how it maymanifest practically,especiallyfor those workingwith men who have committeda sexual
offence. The importance of the TA for treatment engagement and outcome, client change, as well
as the therapist characteristics which enhance the TA will be considered. A review of the potential
obstacles to therapists working with forensic clients, such as system factors, common approaches
to those who have offended, dualroles and confusion about effective therapist qualities will follow.
Finally, the importance of transference and countertransference within the therapeutic relationship
will also be discussed, which is seldom conside red with the forensic population.
TAs origins were psychodynamic in nature, first mentioned by Freud (1912) in his work
examining transference and countertransference as significant aspects for process and change
in psychoanalysis. TA remained rooted in psychodynamic theory until further work, which has
Received 18 September 2016
Revised 6 October 2016
30 October 2016
Accepted 10 November 2016
Carollyne Youssef is a
Forensic Psychologist at
Corrective Services NSW,
Australia; and is a PhD
Candidate at Deakin University,
Burwood, Australia.
VOL. 7 NO. 3 2017, pp. 206-220, © Emerald Publishing Limited, ISSN 2009-3829 DOI 10.1108/JCP-09-2016-0027

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