Introduction
The use of polygraph examinations has again captured
the attentions of ATSA’s listserv in recent days, albeit with some interesting
twists. Historically, debates have centered on balancing the right against client
self-incrimination versus the seemingly valuable information it provides. There
remain the scientific elements of validity and reliability, with adherents of
each perspective believing that the science touted by those with other
perspectives is flawed. During this discussion, however, it has been noteworthy
that participants who live in areas of the US where the polygraph is used most
extensively have come to question its use, especially with juveniles. Are times
changing?
1) The backdrop: Where does
the polygraph fit into the treatment of traumatized and otherwise vulnerable
clients?
The recent ATSA listserv discussion began with a
request for research that would inform whether it is appropriate to use the
polygraph with an 11-year-old. The average response, including from those who
use the polygraph routinely, was no. It is interesting to recall a study by Craig
and Molder in 2003, who polygraph examiners in law enforcement and found
that while many expressed concern with its use with those under 12, the
majority of examiners made no modifications to their practice when testing
juveniles.
To the present, no one has published a study that
seeks to clarify peoples’ experiences with these examinations. This seems important.
For instance, research has shown that adolescents involved in the legal system
often present with a startling array of trauma
histories, brain injuries, and other mental health issues. Recent trends in
juvenile justice have emphasized trauma-informed
systems of care, and the importance of trauma-informed care is beginning to
catch on in the adult world as well. Where does the polygraph fit into
trauma-informed care?
Although it is easy to see sex offenders, particularly in prison
environments, as hardened individuals, it is easy to overlook their
vulnerabilities. Jill Levenson, Gwenda Willis, & the author have recently
published two studies of the rates of childhood adversity in adult male and female
sex offenders. James Reavis, Jan Looman, and their colleagues published a
similar paper, asking the important question, “How long must we live before we
possess our own lives?” Many, especially those working in prison environments,
have noticed that their clients in sex-offender treatment do not present as
highly vulnerable, shrinking violets. On the other hand, there is a question of
whether the wrong treatment approach (which might involve the polygraph) with
the wrong client might actually exacerbate the trauma-related cognitive schemas (e.g., dangerous
world, negativity) that therapists are attempting to redirect in
treatment.
A case in point might
be the 23-year-old client with a mild autism spectrum disorder. Socially
isolated and awkward, he views the world as a dangerous and threatening place
where the closest he will ever come to rewarding relationships is through
contact with children. Depending on how he views his treatment team, a
polygraph examination under the wrong conditions might well reinforce his core
beliefs that he will never fit in anywhere and might just as well persist in
trying to have close relationships exclusively with children. On the other
hand, treatment aimed at improving his interpersonal competence at the same
time as allowing him the chance to develop and rehearse his skills at managing
risk factors may be more beneficial.
Of course, a final
consideration is that the polygraph is not necessarily verifying ground truth.
The research is full of studies regarding the problems of false confessions and the fallibility of memory. The author is one of many professionals who
have had clients make false confessions hoping that it would speed their
treatment progress. The teachable moment of these experiences is to establish a
treatment culture in which honesty and commitment are valued more than the
appearance of compliance with expectations.
2)
What are we trying to
change in treatment?
The trauma-related points
may seem small to many, but are important to consider. In the case example
above, it may be that treatment is more effective, particularly in an era of
scant resources, when it focuses on the development of skills rather than on
preparing for an examination that will provide the impression that a client has
become more honest. Is it possible that one-size-fits-all approaches to the
polygraph can actually make matters worse by focusing on less relevant areas
and slowing the pace of treatment for some in institutions where treatment
slots are in short supply? What level of disclosure is good enough for
treatment to be effective?
In a fascinating
study, Shamai and Buchbinder explored the client
perceptions of a treatment program for violent men. From the abstract: “The
findings revealed that most of the men experienced therapy as positive and
meaningful and underwent personal changes, especially the acquisition of
self-control. Deeper analysis of the data, however, shows that the men still
used a power scheme in understanding and creating relationships with others,
especially with their woman partner.”
In other words, the program produced some changes, but left the underlying
structure of their relationships untouched. Further, the authors found that in
many ways the program modeled the same power dynamics they were seeking to
change. Is it possible that in some cases our programs, by coercing
confessions, are modeling the same dynamics of power and control that we are
seeking to change in our clients?
Even beyond these considerations, questions and
controversies abound. The author published an article on the polygraph
with juveniles in 2012 for the ATSA Forum newsletter that made points that are
relevant to the treatment of adults as well. These include that more
information is not necessarily better information and that compelling
disclosure is not necessarily the same as building the capacity for honesty.
Since that article’s publication, Roger Cook, one of
the authors cited in it has produced an interesting study
with his colleagues that points to many of the complexities involved in
polygraph with adults. Sadly, there has been only one recent
study with juveniles. It examined the
information gleaned through the use of polygraph with juveniles. In it, juveniles reported sexual abuse of an
average of 1.42 people. After a polygraph examination process, they reported
sexual abuse of 2.15 people, or roughly 2/3 of an additional person abused.
Given the legal and psychological complexities at stake, there is a real
question of to what extent this really is helpful information. Some believe
they couldn’t do their work without the polygraph. Others state quite clearly
that their clients in treatment are honest enough that they are able to make
acceptable changes to their lives such that sexual abuse becomes unnecessary
and undesirable to them at all times. Perhaps professionals should consider
soliciting feedback from their clients to assess whether the process as well as
the content of polygraph exams is more helpful or intimidating. Of course, such
an endeavor requires first ensuring an adequate culture
of feedback. Further, it is likely that there is a great deal of
variability between polygraph examiners in terms of how their examinees
perceive them (the same
is true of therapists).
3) How are we trying to
change our clients?
It’s worth mentioning briefly that research has shown
that the most effective therapists in our field and in
related fields are warm, empathic, rewarding and directive. Karen
Parhar and her colleagues noted that the more coercive the treatment
experience (and there are gradations of coercion), the less like treatment is
to be effective. What can treatment programs employing polygraph learn from
these findings? How does the polygraph fit in? How might the behaviors of
individual polygraph examiners play a role in treatment outcome?
4) What are some of the
broader questions we should consider?
Of course, all of these issues beg even larger
questions; let’s broaden the discussion. In 2004, Andrew Harris and Karl
Hanson, describing a long-term
recidivism study involving 4,724 adult sex offenders, observed that:
After 15 years, 73% of sexual offenders had not been charged with,
or convicted of, another sexual offence. The sample was sufficiently large that
very strong contradictory evidence is necessary to substantially change these
recidivism estimates.
The numbers for juveniles are arguably even more encouraging.
Although official records are likely underestimates of the true rate of
re-offense, what seems clear is that simply being processed through the legal
system goes a long way to preventing future abuse. Other studies have found
that re-offense is reduced by around 40% for those who complete treatment
programs, including those that don’t use polygraph.
Based on this, perhaps professionals should reconsider
using the polygraph as a standardized component of treatment programs, consider
the potential downside impacts, consider under what conditions it may become an
advisable component of treatment (if at all), and devise individualized plans
for the specific circumstances under which they will use it.
5) So how do people change,
anyway?
Maybe it’s time to ask what we know about how people
actually make longstanding changes to their lives. After all, we already have
strong evidence regarding the principles of effective correctional treatment and
the components of
effective treatment goals. Tying these threads together, you might want to
ask yourself: Have you ever made a big change to your life? Did you make that
change with the help of a therapist? If so, did you need to disclose each time
you had engaged in behaviors related to the change you were making? Would you
have done so completely and honestly if your therapist said it was vital to
accurate diagnosis and treatment? In order to make that change, was it more
helpful to review the details of the past, or to make an outline of how you
wanted to live your life. In other words, what was the active ingredient in
making and sustaining this change?
Another way of thinking about this is to recall that
other forms of treatment don’t require full disclosure in order to improve
functioning. Addicts needn’t disclose every time they took drugs or alcohol,
people with eating disorders don’t need to disclose each instance of binging
and/or purging, and although some might think these are imperfect analogies, it
is also true that violent men don’t need to disclose each instance of violence
in order to adopt a non-violent lifestyle.
Clearly, the above are bold statements, and yet I make
them with the intention of asking what is actually necessary to build healthier
lives and safe communities. To what extent do we professionals require full
disclosure to meet our own needs for certainty? Have we ever asked those who
have been harmed by abuse whether they want full disclosure of past acts or
simply enough of an honest discussion that they can make meaningful amends and
build a safer future? If there is anything to be learned from working with
people who have been sexually abused, it’s that they need to be able to
disclose and heal from their abuse in their own time and in their own way. Even
in trauma work, there is little evidence that one needs to disclose what
happened in order to move forward with one’s life. Indeed there is some recent evidence that recalling
every transgression might be counter-therapeutic.
There will doubtless be more controversies and more
research involving the polygraph. As the field sorts through these issues,
perhaps we can all consider whether we have adopted an as-yet empirically
unsupported paradigm regarding the importance of complete confession, and
whether we are having trouble separating our values from our knowledge about
what actually works. Those who provide treatment without the polygraph often
come to view disclosure as an ongoing process and not necessarily an event.
Ultimately, by adopting a full-disclosure paradigm based
more on values than research, and despite the myriad problems of confession,
false confession, and memory problems, even when our clients themselves can be
highly vulnerable, one has to wonder; have we created mindsets from which we
cannot escape?
Conclusion
Obviously, having clients willingly disclose the
entirety of their past offending makes the therapist’s work easier. However, it
seems worth exploring whether holding back people in treatment who really do
want to build better lives for themselves because they can’t pass a polygraph
exam is really worth the financial and other human costs. Whose needs are we
ultimately meeting? What goals are we
trying to achieve? And what steps can we
take to ensure that our interventions do not themselves cause harm?
David S. Prescott, LICSW
There cannot be effective treatment without complete patient-provider confidentiality. The work is otherwise a charade.
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