Factors related to motivation to change and therapeutic alliance among men early in treatment following perpetration of child sexual abuse

Abstract

ABSTRACT The objective of this study was to investigate relationships between criminal history, cognitive distortions, social climate, motivation to change and therapeutic alliance at an early stage of treatment among people incarcerated for child sexual abuse. To do so, 223 men (M age = 47, range = 19–76 years) who took part in a treatment programme in Quebec, Canada, following perpetration of child sexual abuse were included in the study. Individual factors (number of prior offences; cognitive distortions), social climate, and their association with motivation and therapeutic alliance were examined. Multiple linear regressions revealed that participants with fewer cognitive distortions who perceived social climate more positively were more motivated to change and had a better alliance with their therapist. Participants with higher motivation also established better therapeutic alliances with programme staff. This study provides new knowledge on two major components of successful treatment and highlights the importance of a positive environment in forming therapeutic alliance. PRACTICE IMPACT STATEMENT Treatment providers should be mindful that the same cognitive distortions that are likely to be treatment targets can also be obstacles to motivation and the development of the therapeutic alliance. In terms of the treatment environment, providing a safe, open, and supportive social climate between inmates and programme staff contributes to higher motivation and better therapeutic alliance.