The responsivity principle also specifies that the intervention must take into consideration individual characteristics that impact on the offender’s ability to benefit from treatment (Andrews & Bonta, 2010). Within this context, gender is a general responsivity issue that permeates all aspects of treatment (Blanchette & Brown, 2006). Andrews and Bonta (2010) have identified the fundamental characteristics of staff that have demonstrated value regardless of the therapeutic context or client population. While they apply to all offenders, there is evidence that these staff characteristics are particularly important when providing treatment to female offenders (van Wormer, 2010). These characteristics include:
The ability to convey acceptance, caring and concern for the client: These qualities are conveyed in the therapist’s tone of voice and manner of emphasizing words and help the therapist relate to the women in clear, open, caring, and enthusiastic ways.
Accurate empathy: The ability to see the world through the client’s point of view. This does not imply that the therapist agrees with the point of view. It simply means that the therapist is able to understand, without necessarily agreeing with, the position of the client. Within this context, it is important to not confuse acceptance of and empathy for the offender with unconditional acceptance of the offender’s distorted views of herself, her offending, and others. The latter is actually counter-therapeutic for the women in treatment. Accurate empathy also helps the therapist with the important tasks of distinguishing between rules and requests, monitoring, reinforcing compliance, and ensuring they are not engaging in interpersonal dominance of the woman.
Genuineness: The therapist is honest with him/herself as well as with the client. The therapist must also convey this genuineness to the client. This entails not only providing positive reinforcement, but also telling a woman in treatment what she does not want to hear. Such comments, however, are always provided in a nonjudgmental way that communicates genuine concern for the client.
Rapport: When rapport is established, the woman sees the therapist as someone who is “tuned into” her feelings and attitudes; who is sympathetic, empathic and understanding; who is accepting of the client and all her faults; and with whom she can communicate. Rapport not only helps toward establishing the therapeutic relationship, it also helps the women accept feedback from the therapist and understand that a healthy relationship may entail disagreements and challenges.
Also acknowledging the importance of a gender-sensitive approach to the treatment of women offenders, Van Wormer (2010) proposes an organizing framework she describes as a “five-stage gender-based empowerment scheme” (p. 189) that she considers essential for effective treatment with women offenders. These stages include: building a therapeutic relationship; enhancing motivation for change; teaching coping skills; promoting healing; and enhancing generativity, which means making a contribution to others. Over the course of treatment, these overlapping processes will help the woman recognize, address and manage the issues that have led to her offending behaviour, develop healthier lifestyles, and reach out to others that will help her sustain her new life.
20.3.5 Relational Theory and Implications for Treatment
Because the lives and experiences of women differ from those of men, these problems tend to manifest themselves in gender-specific ways and contexts. Gender-responsive treatment therefore requires that the female-specific manifestations of these problems are understood, and the gendered contexts that surround them are taken into account when providing services to female offenders. While healthy connections are important for all human beings, they appear to play a particular role in the psychological and emotional wellbeing of women (Gilligan, 1982). In comparison to men, women tend to have greater needs for healthy connections to significant others including children and family, as well as the broader community. In addition, women’s ability to deal with stress is greatly improved when supportive social networks are available. As such, female offenders typically require much more extensive support than men to improve their general functioning and manage stress (Rumgay, 2004). As was evident in the various pathways to offending among women, healthy connections with others and healthy supportive social networks are features typically lacking among female offenders. Interventions for female offenders should therefore be based on a relational model that provides these women with previously lacking positive relationships experiences.
As explained by Covington and Bloom (2006), a relational model entails the recognition that women’s psychological needs are best met when women learn to establish and maintain meaningful connections with others in their lives rather than simply separate themselves from problematic relationships. This model is based on research showing that while all humans seek both connection with and differentiation from others, women need more connections whereas men require more differentiation (Gilligan, 1982). Female offenders tend to have particular relational deficits and their offending behaviour is often tied to either their romantic relationships or their own victimization histories. Within treatment, an overarching goal of a relational approach is the identification and resolution of relational issues connected to the treatment targets. Treatment also includes the provision of opportunities for women to “test” their new relationship skills in non-threatening ways, particularly when the focus is on their ability to develop and maintain a more stable life with less dependence on unhealthy others. Contextually, the relational model also provides a safe and supportive environment in which a woman can experiment with appropriately challenging others and being appropriately challenged. This particular aspect is important to help counteract the passive acceptance or normalization of abuse within relationships commonly found among female offenders, thereby helping them develop and practice new boundary and other relationship skills needed to establish healthy and abuse-free connections with others.
Because of the gendered nature of women’s lives and experiences, the inclusion of women in male offenders’ treatment programs is not recommended. The evidence indicates that women benefit more in the short and long term from single-gender programs when dealing with deeply personal issues connected to their problematic behaviour (Claus, Orwin, Kissin, Krupski, Campbell, & Stark, 2007). Mixed-gender groups can be utilized during later phases (e.g. maintenance programs) after the woman has made sufficient progress on offense-related issues such as intimacy and dependency problems, substance abuse issues, and/or victimization-related problems and she is able to establish the appropriate boundaries needed for healthy relationships (Covington & Bloom, 2006). As an aside, single-gender groups appear to be more helpful to men as well. Smith-Lovin and Brody (1989) have found that men in single-gender therapy groups stayed on topic and were more supportive of each-other than those in mixed-gender groups. In those groups, men interrupted women much more frequently than other men, and did so to establish dominance. As a result, they demonstrated less support toward both male and female group members, and the flow of ideas would become interrupted – which is clearly not desirable when dealing with therapeutic issues. Further, findings indicate that gender composition of groups does impact the content and style of group interactions; both men and women become less effective in their communication patterns in such circumstances (Hodgins, El-Guebaly, & Addington, 1997). Hence, women would have much greater difficulties establishing the important supportive relationships they need to improve their lives in mixed-gender groups. It is by understanding and attending to these gender differences that therapeutic services for female offenders will truly be gender-responsive.
20.3.6 A Final Note on Interventions for Female Offenders
The high prevalence of victimization issues among female offenders has led to the development of gender-informed treatment programs that take into therapeutic account the interrelationships between trauma and criminogenic factors. This approach recognizes that a traumatic experience such as childhood sexual victimization is associated with a wide range of difficulties that tend to persist in adulthood, and af
fect multiple domains of functioning, including cognitive, affective, relational, and sexual (Briere & Jordan, 2009). For example, substance abuse is a well-established criminogenic factor for both male and female offenders. Among women, however, substance abuse problems have a stronger relationship with recidivism (Andrews et al., 2012), indicating a gender-specific manifestation of this problem. This gender specificity occurs because female offenders tend to develop their substance abuse problems in response to their early victimization before they became involved in criminal behaviour (Blanchette & Brown, 2006). Consequently, successful resolution of substance abuse problems among female offenders frequently necessitates the concurrent resolution of trauma (Saxena, Messina, & Grella, 2014).
Gender-informed interventions for female offenders therefore require that not only a relational model of treatment be adopted but also that trauma issues are taken into consideration using a trauma-informed approach. This integrated treatment approach takes into account the interrelated levels of trauma, mental health issues, substance abuse and other criminogenic problems in order to maximize the woman’s ability to develop new and healthier behavioral competencies (Covington & Bloom, 2006; Saxena et al., 2014). Evidence indicates that this type of approach maximally reduces the likelihood of recidivism among general and violent female offenders (Gobeil, Blanchette, & Stewart, 2016; King, 2017) but only among those who have victimisation and trauma histories. Adding a trauma-informed approach component to interventions for women without such histories, however, may actually be detrimental to their treatment progress (Saxena et al., 2014). These findings indicate that a blanket application of identical interventions for all female offenders is not useful. Careful treatment planning is needed to ensure that the woman’s treatment needs are appropriately matched with the relevant interventions.
CASE STUDY 20.2 TRACY
Tracy is a 26-year-old woman convicted of aggravated assault for the stabbing of her boyfriend. The offense occurred when Tracy and the victim, her boyfriend of 18 months, got into a verbal altercation, which escalated into a physical fight during which Tracy grabbed a knife and stabbed him.
Tracy was raised by both parents until the age of 14, when her father left the family. Alcohol consumption was constant in her childhood home. While intoxicated, her parents would physically fight with each other. The children would also be physically abused. At age 11, for a period of several months, Tracy was sexually abused by her uncle. She began consuming alcohol at age 12 and began consuming prescription medication (OxyContin) at age 15. Tracy has only a grade 10 education. Her employment history is sporadic and includes primarily waitressing and sales. Tracy has been fired from positions and has left positions without a new job. Prior to the offense, Tracy had been involved in a number of relationships, all of which were characterized by substance abuse and mutual violence. Emotionally, Tracy experiences much anger, aggressiveness, and negative feelings as a result of her childhood and substance abuse issues. She has difficulty controlling her anger, particularly when under the influence of substances. She also demonstrates poor judgment and has a tendency to act violently and impulsively without thinking of the consequences of her actions.
20.4 SUMMARY
Prevention and intervention efforts should start early to help at-risk adolescent females or females with early-onset antisocial behaviour. Early intervention strategies should promote an array of social and personal skills as well as help improve the mental health of these adolescents to increase the likelihood of a successful transition to adulthood.
When designing treatment programs for adolescent females with antisocial behaviour, potential iatrogenic effects of interventions should be considered (e.g. in group settings where contagion is likely to occur because deviant youths are placed together). Further experimental and longitudinal studies are needed to tests the effectiveness of interventions targeting females with antisocial behaviour and disseminate the most promising programs.
It may not be necessary to design and implement distinct programs for boys and for girls with antisocial behaviour. However, programs integrating components that may be specifically relevant for girls (e.g. comorbid mental health problems, history of trauma and abuse, sexual history, and relational aggression) should be fostered.
Adult female offenders are responsible for approximately 20% of all criminal behaviour. They are responsible, however, for a smaller proportion of officially reported violent and sexual offenses. Further, they tend to have much lower rates of recidivism than males, particularly when only violent or sexual recidivism is considered.
Women exhibit different aetiological pathways into criminal offending, some of which involve severe histories of childhood and adult victimization and the presence of related mental health issues. There exists a subgroup of female offenders who tend not to have victimization histories and who exhibit much more gender-neutral than gender-specific characteristics.
Healthy connections are particularly important for women’s emotional and psychological wellbeing. Gender- and trauma-informed interventions may be necessary in order to fully attend to the relational needs of female offenders while ensuring that the relevant criminogenic factors are addressed. Blanket applications of a specific treatment for all women are not recommended; treatment should be tailored to the woman’s specific needs.
ESSAY/DISCUSSION QUESTIONS
Based on the information provided in the Case Study 20.1:
On what trajectory should we classify Kate?
What are the risk and protective factors?
What interventions should we propose to help Kate and her son?
Based on the information provided in Case Study 20.2:
On what pathway should we classify Tracy?
What are her criminogenic factors?
What interventions should we propose to help Tracy?
ANNOTATED READING LIST
Blanchette, K., & Brown, S. L. (2006). The assessment and treatment of women offenders: An integrated perspective. Chichester, UK: John Wiley & Sons. This book provides the most comprehensive empirically-based overview of theories, assessment and treatment practices with adult female offenders.
Chesney-Lind, M., & Shelden, R. G. (2014). Girls, delinquency, and juvenile justice (4th ed.). Malden, MA: Wiley Blackwell. This textbook pulls together literature on delinquency in girls, and covers topics such as the nature of their delinquency, their involvment in gangs, their experiences in the juvenile justice system and promising interventions.
Moffitt, T. E., Caspi, A., Rutter, M., & Silva, P. A. (2001). Sex differences in antisocial behaviour: Conduct disorder, delinquency, and violence in the Dunedin Longitudinal Study. New York: Cambridge University Press. This book presents rich research findings on sex differences in antisocial behaviour based on a cohort of boys and girls followed longitudinally from early childhood to early adulthood.
van Wormer, K. (2010). Working with female offenders: A gender sensitive approach. Chichester, UK: John Wiley & Sons. This book describes how to address gender-specific issues when providing treatment to female offenders.
REFERENCES
Andrews, D. A. & Bonta J. (2010). The psychology of criminal conduct (5th ed.). Cincinnati, Ohio: Anderson.
Andrews, D. A., Bonta, J., & Wormith, J. S. (2004). The Level of Service/Case Management Inventory (LS/CMI). Toronto, Ontario, Canada: Multi-Health Systems.
Andrews, D. A., Guzzo, L., Raynor, P., Rowe, R. C., Rettinger, J., Brews, A., & Wormith, S. (2012). Are the major risk/need factors predictive of both female and male reoffending? A test with the eight domains of the level of service/case management inventory. International Journal of Offender Therapy and Comparative Criminology, 56, 113–133.
Archer, J., & Coyne, S. M. (2005). An integrated review of indirect, relational, and social aggression. Personality and Social Psychology Review, 9, 212–230.
Ballou, M., Matsumoto, A., & Wagner, M. (2002). Toward a feminist ecological theory of human nature: Theory building in response
to real-world dynamics. In M. Ballou & L. S. Brown (Eds.), Rethinking mental health and disorder: Feminist perspectives (pp. 99–141). New York: Guilford Press.
Bardone, A. M., Moffitt, T. E., Caspi, A., Dickson, N., & Silva, P. A. (1996). Adult mental health and social outcomes of adolescent girls with depression and conduct disorder. Development and Psychopathology, 8, 811–829.
Benda, B. B. (2005). Gender differences in life-course theory of recidivism: A survival analysis. International Journal of Offender Therapy and Comparative Criminology, 49, 325–342.
Blanchette, K., & Brown, S. L. (2006). The assessment and treatment of women offenders: An integrated perspective. Chichester, UK: John Wiley & Sons.
Bonta, J., Rugge, T., & Dauvergne, M. (2003). The reconviction rate of federal offenders (User Report 2003–02). Ottawa: Public Safety Canada.
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