This book began as a compilation of 11 menâs stories of an extraordinary accomplishment: their successful desistance from substance abuse and criminal behavior. Beginning from lives defined by criminal acts including assault, robbery, theft, substance abuse, and drug dealing, they each recounted the process they underwent to desist from these activities. From childhoods ravaged by poverty, urban ghettoes, childhood trauma, and family dysfunction to adolescence which began the descent into school truancy, drug addiction, violence, and life within a criminal subculture, their early adulthoods culminated in criminal behavior, victimization, rage, addiction, incarceration, and despair.
But the typical continuation of this life course to long-term incarceration, physical debilitation, and early death stopped there. Each man came to the realization that he no longer wanted to live in this manner and began his search for a way out, a complex and multi-year process often filled with multiple treatment attempts and false starts. The desistance path they each ultimately found was facilitated by relationships with others who helped to make this life change feasible. Many were therapists, counselors, and 12 Step program sponsors.
This work utilizes results from a dissertation submitted as part of a PhD in social work. The qualitative, interview-based study completed for the dissertation explored how men who had stopped engaging in violent behavior thought about and described the role of significant relationships in their desistance process. Special emphasis was placed on the mechanisms functioning within these relationships that initiated this process as well as for the support of ongoing desistance.
Specifics of the studyâs rationale and methodology are located in the Appendix and at the beginning of Chap. 2. For confidentiality purposes, respondents were asked for pseudonyms that were used in all study documentation. These nicknames were retained for use in this book. Direct quotations from sources were edited to remove non-verbal utterances and reworded for clarity. However, care was taken to maintain their meaning. The consent form that study respondents signed before beginning their interviews gave permission for me to use their data for the dissertation and further research works.
At the time of the interview, study participants were living in the community (not incarcerated) and had been sober and crime-free from between several months to a decade or more, representing many different points along the desistance continuum. As the study progressed, several additional factors about the respondents became evident. Potential study participants were accessed through social service agencies providing their treatment, and 10 of 11 also had a history of serious substance abuse. All but one were actively involved in treatment for either substance abuse or mental health or for both. These factors proved crucial to the formulation of this work. Two other major aspects of life and identity presented by the respondents, HIV status and homosexuality, were not explored as part of the study or for this book.
Throughout the interview process and from a retrospective vantage point, respondents were able to piece together the aspects of their significant relationships most important to their desistance processes. Many described relationships with family members such as parents, siblings, partners, children, nieces and nephews, and grandchildren, but just as many credited treatment experiences as critical to their desistance. Sometimes respondents learned life skills or new perceptions that they found to be effective, but mostly, it was the characteristics of the relationships themselves which provided study participants the necessary impetus and capabilities to change their lives. The menâs stories of desistance are presented in Chap. 2.
How specifically did these relationships function to assist respondents in changing their lives? Which mechanisms were at work and in which ways? What happened over time to create these changes?
Study data provided important information about the capabilities necessary for successful desistance to occur: an identity change, the construction of a life story in which the respondent evolved from a criminal to a prosocial community member, and relationships with prosocial others which provided critical affective and cognitive qualities. Respondentsâ desistance processes are detailed in Chap. 4.
Study results analyzing the mechanisms of significant relationships effective in facilitating desistance satisfied the dissertation requirements. However, there was much more to be learned from the menâs narratives. Because their successful desistance processes were so much a product of their treatment experiences, the data could function as a guide in clinical work with these client populations. Hence, analysis of the data was incorporated into this book to develop a practice theory and treatment model for substance abusers and offenders based on the aspects of significant relationships that respondents found effective in helping them to attain desistance from criminal behavior and substance abuse.
Issues in Analyzing and Presenting the Data
One of the major obstacles to utilizing the self-report of offenders and substance abusers as qualitative data and a reliable source to generate conclusions is the respondentsâ propensity for deceitfulness. As a result of this concern, many researchers recommend obtaining confirmation from additional sources as a comparison and validation of self-report data (e.g., Elffers, 2010; Lindegaard, 2010). However, the Institutional Review Board which authorized this study did not permit employing any other source material such as criminal records or treatment documentation. Because the studyâs focus was on an internal psychological process, it was determined that self-report alone would provide sufficient information. Some researchers concur. In discussing interview-based research with offenders, Brookman (2010) asserted, âThe further one moves from observable, factual events towards internal thoughts and perceptions, the less feasible and desirable validation becomesâ (p. 95). Therefore, Curtis (2010) stated that it is possible to collect reliable self-report information from respondents who have engaged in stigmatizing or marginalizing behavior and that âmore often than not they tell the truthâ (p. 152). He said that researchers often get far more cooperation than they expect.
Results of qualitative studies such as this are not designed to be generalized or definitive. Although the desistance processes that study respondents described are utilized in this book to formulate a treatment model, it is not my intention to posit that all substance abusers and offenders will desist if these methods are employed. Substance abuse and criminal behavior can become areas of difficulty for many different reasons and for many different types of clients, and as such, their treatment needs will vary. The populations of those desisting from crime and substance abuse do not all respond to the same types of interventions, nor would they necessarily rely on interpersonal relationships in ways similar to this respondent group.
Generalizing or universalizing data is the task of quantitative methodology, research based on statistical analyses. Given the heterogeneity of the offender and substance abuser populations, I believe that evidence-based treatment derived from quantitatively based outcome studies can inadvertently lead to a âone size fits allâ mentality of treatment intervention. Given the severity of substance abusersâ and offendersâ multiple psychological, behavioral, social, and cultural problems and stressors, one size does not fit all.
Psychodynamic Theory as a Framework to Explore Relational Dynamics
To formulate the practice model for this work, study results were integrated with a psychological theory to provide a framework for explaining and understanding the requisite individual and interpersonal processes leading to desistance. The practice modelâs functions are to apply the theoretical framework to the therapy process and explain how to develop treatment goals. Case examples presented based on the practice theory are drawn from study respondentsâ reports as well as descriptions from my clinical work. In order to remain consistent with the studyâs concentration on the mechanisms of interpersonal relationships in facilitating change, the theory chosen for this theoretical framework had to posit that the therapeutic relationship is the primary factor in psychic change.
Of the available psychologies of the mind, there is only one set of theories that focus clinical attention on the nature of the therapy relationship itself: those operating from a psychodynamic perspective. (For the purposes of this book, the terms psychoanalytic and psychodynamic are used interchangeably.) A central tenet connecting all psychodynamic theories is the assertion that the nature of the client-therapist relationship and the dynamic process between both parties is the main source of psychological and behavioral change (Bass, 2003; Benjamin, 2010; Holmes, 2011).
Psychodynamic theories share additional common ground that applies to the task of developing this practice theory. They maintain a focus on the internal psychological world, personality structure, and unconscious mental processes. They all âinsist on the centrality of meaning-makingâ (Harris, 2010, p. 703). Clients must make sense of themselves and their worlds in order to change their thoughts, feelings, and behavior in a way that feels internally motivated and integrated with who they perceive themselves to be (Rothschild & Gellman, 2009). Gadd and Farrall (2004) stated that cognitive theory is not adequate to explain or understand offender desistance narratives; psychoanalytic theory must be employed to explain the role of unconscious motivation.
A recent addition to the psychoanalytic family, relational analytic theory was chosen as the theoretical framework for this project. Not a standalone theory, it is based on traditional object relations, ego psychology, intersubjectivity, attachment theory, and self psychology principles. An explanation of the tenets, concepts, and terminology applicable to all psychodynamic theory is outside the scope of this work. Those specific to the relational model are summarized in this chapter and more fully presented and explained i...