Tuesday, March 19, 2013

Which is “Better”? Risk-Need-Responsivity and the Good Lives Model

There has been much saber-rattling in some quarters about GLM “versus” RNR. While on a bad day it can seem like it evolved from the Ultimate Fighting Club, for many of us it has been like watching close friends having an extended disagreement. In my mind, it should be about processes and not polarities. - David Prescott
When I was an undergrad I had my first opportunity to observe an academic turf war between behavioral and cognitive psychologists. Students trying to absorb the big picture were largely baffled and perhaps amused that polarized professors seemed to believe these branches of psychology were mutually exclusive. Perhaps such turf wars are an interesting study in another area of psychology – social psychology.

There have been spirited discussions over the last decade about what the basic tenets and essential differences are between two evolving models for sexual offender treatment: Risk-Need-Responsivity (RNR) and the Good Lives Model (GLM). Given that both models appear to be credible and valid, are supporters perhaps competing unnecessarily for prominence?

The truth is there is room for many theories and models for the assessment, treatment, and management of sexual offenders. It’s a big tent. Given that myth and misinformation about sexual offending run rampant in the management of sexual offenders, it seems an unfortunate distraction that there is a sense we have to choose between these two beneficial models.

For those interested in reading more about how the principal authors of RNR and Good Lives distinguish their models, these recent journal articles are enlightening:
Although Tony Ward has offered critiques on the strengths and limitations of the RNR principles, articles such as Ward, Melser, & Yates (2007) and Wilson & Yates (2009) are anything but “anti-RNR.”

Some of the debate centers on whether RNR focuses too much on avoidance goals at the expense of approach goals; or whether GLM principles are useful in the assessment of risk. Recent writings on GLM specifically address the need to match programs on the RNR principles, and offer ways to conceptualize this. Certainly, there is more to RNR than risk management; just as there is more to GLM than simply promoting “good lives.” There are, perhaps, many ways to utilize the principles of RNR and GLM, and still adhere to the models. How clinicians and programs go about this can vary significantly.

Those of us that have been around for enough years have seen basic principles of psychology worked and re-worked in various combinations, resulting in many different therapeutic models. David Burns sold a gazillion books on Feeling Good by explaining principles of psychology and human nature in the most basic and hopeful terms. Albert Ellis suggested a simple paradigm of actions, beliefs and consequences that helped explain how our cognitions and behaviors interact with our feelings and experiences. Concepts of Narrative Therapy add a rich and colorful context for reframing life’s scripts. Marsha Linehan combined personal and professional experiences with well-established therapeutic concepts and tools to give us a treatment model with a snappy new name – Dialectical Behavior Therapy. Multi-Systemic Therapy has demonstrated that an ecological approach to recovery can be very effective with adolescents. Motivational Interviewing is indispensible with involuntary clients. The goals of lifestyle balance and self-determinism outlined in the Saskatchewan NewStart model of life skills were early precursors (among others) to those found in current strength-based and GLM-type approaches.

Past and current therapeutic models, including those used in the treatment of sexual offenders, are all permutations of well-established principles of psychology and sociology, uniquely assembled like building blocks. Putting theory and concepts into a model, and developing a model into a professional paradigm are exquisitely complex. Clinicians who provide treatment to those who have sexually abused would be wise to be well-armed with many theories, concepts, and models, as well as possessing an ability to individually customize treatment to the needs of clients.

There are differences and similarities between RNR and GLM. Perhaps most importantly, they both promote a strength-based, pro-social approach to treatment. And, in doing so, they both provide an important counterbalance to the tendency in our field toward an overly-simplistic understanding of psychopathology as both the etiology of sexual offending and the narrow focus of treatment. Do these models really compete? Not in ways that really matter. They both support a humanizing, ecological approach to the unique assessment and treatment of individuals who have sexually abused.

Some might characterize the debate as ‘apples and oranges’ – maybe we can simply agree on ‘fruit.’ Beyond some academic questions about their origins, evolutions, and differences, GLM and RNR really are complementary. There is some likelihood and, perhaps, a little irony that both GLM and RNR are probably better off for the critiques from the other. In the end, there is little doubt that both RNR and GLM are valuable aids for both professionals and clients. Indeed, in amalgamation with other treatment theories, concepts, and models, they both contribute to a more effective therapeutic milieu. The beneficiaries are better lives AND safer communities which, also contrary to popular belief, are not mutually exclusive.

Jon Brandt, MSW, LICSW
 (Note: Don Andrews passed away after writing, but before publishing, his 2011 article; it might be considered his last word on RNR. The (2011) link above is to the Criminal Justice and Behavior abstract. CJB has made the full articles to Ward, Yates, and Willis (2012) and Wormith, Gendreau, and Bonta (2012) free on their website. The full articles are also available to ATSA members through the ATSA website.)
David Prescott and Robin Wilson contributed to this blog.

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