An emerging body of research suggests that sexual offenders’ experience of the group therapy environment likely affects the ultimate impact of treatment. For example, Beech and Fordham (1997) found that sexual offenders’ positive perceptions of the group were linked to change on various recidivism factors. In a related study that assessed 12 groups of sexual offenders in the U.K., Beech and Hamilton-Giachritsis (2005) observed that sex offenders’ ratings of group cohesion were associated with reductions in pro-offending attitudes. According to the authors, despite these data it is not yet known how, and to what extent, perceptions of the group therapy climate are related to sexual offenders’ views of the working alliance with the group therapist. The current study sought to assess this association across a 24-week period in two outpatient groups of sexual offenders. Sexual offenders’ perceptions of group climate were assessed with The Group Climate Questionnaire—Short Form (GCQ-S; MacKenzie, 1983), a self-report instrument designed to obtain perceptions of a group’s therapeutic environment on three subscales: engagement, avoidance, and conflict. Perceptions of therapeutic alliance were assessed with The Working Alliance Inventory-Short Version (WAI-S; Horvath, & Greenberg, 1989), a 12-item measure that yields a general alliance score as well as bond, task, and goal component scores. A repeated measures study design was employed to evaluate sexual offenders’ perceptions of climate and alliance factors across 4 time points. Data revealed three main findings. First, both groups evidenced a highly-engaged group climate, with a mild degree of avoidance and an even lesser degree of conflict endorsed at both time points; avoidance weakened across time for both groups. Second, both groups evidenced high therapeutic alliance scale scores and total alliance scores at each time point, while total alliance scores increased for one group across time but decreased for the other group. Third, in both groups, indices of group climate were associated with indices of therapeutic alliance in the anticipated direction, i.e., a highly-engaged and low -conflict group climate corresponded to a stronger perceived therapeutic alliance on all three components of alliance. Overall, results of this study strongly suggest that the therapeutic alliance in clinical work with sexual offenders, while generally under-emphasized in our opinion, is a significant catalyst for the unique therapeutic factors inherent in the group therapy modality.

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The Association of Group Climate and Working Alliance in Group Psychotherapy with Adult Male Sexual Offenders.
James Tobin, Ph.D., Michelle Vorwerk, PsyD., and Adrienne Meier, M.A.
LaPaz Psychological Group, Laguna Hills, CA
Introduction
Analyses
Discussion
References
Methods Results
Contact Information
1. Aylwin, A.S. (2010). The therapeutic alliance in sex offender treatment: The juxtaposition of violence and care. Retrieved
from ProQuest, UMI Dissertations Publishing. (NR60161)
2. Beech, A. & Fordham, A.S. (1997). Therapeutic climate of sexual offender treatment programs. Sexual Abuse, 9(3), 219-
237.
3. Beech, A. R., & Hamilton-Giachritsis, C. E. (2005). Relationship between therapeutic climate and treatment outcome in
group-based sexual offender treatment programs. Sexual Abuse: A Journal of Research and Treatment, 17 , 127-139.
4. Horath & Greenberg (1989).
5. MacKenzie (1983).
6. Rothman (2007).
7. Zasio, R.D. (1998). The forensic mentally ill: The relationship between perceived therapists’ characteristics and patient
satisfaction with psychotherapy. Retrieved from ProQuest, UMI Dissertations Publishing. (9836029)
Group psychotherapy is the most common form of treatment for
sexual offenders. However, there has been relatively little
attention in the literature on systematically evaluating therapeutic
process factors in this treatment modality, such as perceptions of
the group climate and therapeutic alliance. Preliminary findings
suggest that sexual offenders’ experience of the group
environment and of the therapist may affect the ultimate impact of
treatment. For example, Beech and Fordham (1997) found that
the perceived atmosphere of groups in sex offender treatment
influenced change on various factors associated with recidivism.
According to their work, successful groups are highly cohesive
and well-organized, with leaders encouraging the open
expression of feeling. In a related study in the U.K., Beech and
Hamilton-Giachritsis (2005) observed that sex offenders’ ratings
of group cohesion were associated with reductions in pro-
offending attitudes.
Despite the promise of these data, we do not know much about
the nature of the therapeutic alliance in forensic treatment,
generally, nor in group therapy for sexual offenders, specifically.
Investigative efforts to date suggest the significance of the
alliance in sex offender treatment. Aylwin (2010) assessed
monthly perceptions of the alliance of 95 consecutive male sex
offender admissions to an inpatient treatment program and
identified a gradual consistent increase in the strength of the
alliance across time. Additionally, Rothman (2007) found that the
perceived empathy of therapists was significantly associated with
a range of outcome indices. Finally, Zasio (1998) observed that
perceived positive characteristics of the therapist (e.g., empathy,
encouragement, willingness to listen) were linked to forensic
patients’ perceptions of how helpful and satisfying they viewed
their treatment.
Offenders’ perceptions of group climate were
moderately to strongly associated with ratings of the
alliance in a reasonable direction, i.e., a highly-engaged
and low -conflict group climate corresponded to a
stronger perceived working alliance with the group
leader. An examination of longitudinal associations
indicated that offenders’ engagement and view of
agreement on treatment tasks were the two most
common factors related to variables at later time points.
What’s more, despite the fact that the study assessed
probationers who had been involved in treatment for a
significant period of time, probationers’ view of the
emotional bond with the therapist continued to increase
in intensity. Overall, these results suggest that in group
psychotherapy of sex offenders, engagement in the
clinical process and the quality of the working alliance
with the therapist may be mutually related and co-
determined. It is our hope that this study represents an
important step in sensitizing sex offender clinicians to
the importance of therapy climate and alliance, factors
often under-emphasized when the focus is routinely and
sometimes solely directed toward criminogenic
tendencies and recidivism.
Purpose of the Study
In an attempt to expand upon this literature, the current study
investigated group process and alliance factors in mandated
outpatient group psychotherapy for convicted male sex offenders
on probation. The current study sought to (1) ascertain offenders’
perception of the group climate and alliance across 4 consecutive
time points; (2) determine if significant changes in the group
climate and the alliance occurred across time; and (3) assess the
relations between group climate and alliance within and across
time points.
Methods
Participants
Twelve sex offenders participating in court-mandated sex
offender/sex-specific group therapy were recruited to voluntarily
participate in this study. The penal code classifications among
these offenders primarily included PC243.4(a), PC261.5(c),
PC290(g), PC290(g)(2), and PC314.1. A majority (83.33%) were
registrants and felony offenders (only 2 participants received a
misdemeanor charge). Nine of the 12 participants (75%) were
Caucasian, two (16.67%) were Hispanic or Latino, and one was
categorized as “other.” Participants ranged in age from 20 to 61
years (M =42.5 SD =xx).
Measures
Group Climate. The Group Climate Questionnaire—Short Form
(GCQ-S; MacKenzie, 1983), the most common measure of group
process, is a self-report instrument that contains 12 items, each
rated on a 6-point Likert scale. The measure assesses
perceptions of a group’s therapeutic environment on three
dimensions: Engagement (degree of self-disclosure, cohesion
and work orientation in the group), Avoiding (degree of
withdrawal; reliance on group leader or other group members to
create and manage change) and Conflict (degree of interpersonal
hostility, rejection, and distrust in the group – but not
confrontation). The range of possible scores for this measure is 0
to 6.
Working Alliance. The Working Alliance Inventory-Short Version
(WAI-S; Horvath, & Greenberg, 1989) is a 12-item measure
(each time is rated on a 7-point Likert scale) that assesses both
the therapist’s and patient’s perception of the working alliance.
The measure is based on Bordin’s (1979, 1994) notion of the
alliance construct as consisting of the affective bond between
patient and therapist, agreement on the goals of treatment, and
agreement on treatment tasks/means of achieving these goals.
In accordance with Bordin’s view, the WAI-S yields Bond, Goal,
and Task subscale scores (ranging from 4 to 28) and a total
/aggregate alliance score (ranging from 4 to 28). In this study,
only the sex offenders’ perceptions of the alliance were
assessed.
James Tobin, Ph.D.
Email:
Email address
Phone: (714) -
Email:
Email address
Phone: ( ) -
name
title
Argosy University, Orange County
Perceptions of Group Climate and Alliance Across
Time Means for the three group climate dimensions (Engagement,
Avoiding, and Conflict) and the alliance factors (Bond, Goal, Task
and Total) across the 4 time points appear in the table below:
Sex offenders’ perceptions of the group climate were consistently
positive (high engagement, mild avoiding, and little conflict), as were
ratings of the alliance (Bond, Goal, and Task and Total).
Changes in Group Climate and Alliance Across Time
Across the 24-week course of the study, offenders’ perceptions of
the group climate and alliance were relatively consistent. Repeated
measures ANOVAs indicated only one notable finding: the WAI-S
Bond subscale score increased significantly across time
(F[1,5]=10.80, p=.02) – this doesn’t make sense?? . Post-hoc
pairwise comparisons revealed ????.
Associations Between Group Climate and Alliance
Within and Across Time Points
Overall, there was a moderate to strong relationship between sex
offenders’ perceptions of the group climate and alliance ratings. We
found that GCQ-S Engagement-time 1 ratings significantly and
positively correlated with WAI-S Bond-time 1 and 2, WAI-S Goal-
time 3, WAI-S Task-time 1 and 3, and WAI-S Total-time 1 and 3
ratings. In addition, GCQ-S Conflict-time 1 ratings were3
significantly negatively correlated with WAI-S Goal-time 3 and 4
ratings. When offenders initially endorsed agreement on treatment
tasks/means of achieving these goals (WAI-S-Task-time 1), they
endorsed more engagement at time 2 (r[11]=.54, p=.085).
When we evaluated the dimensions of the GCQ-S, strong positive
associations were found between offenders’ perceptions of Conflict
and Avoiding, both within time points and prospectively, i.e., GCQ-S
Avoiding-time 1 ratings were significantly correlated with GCQ-S
Conflict-time 1, 2, and 3 ratings. For the WAI-S, Task and Bond
subscale ratings were consistently positively correlated within time
points and prospectively (i.e., WAI-S Task-time 1 ratings correlated
with WAI-S Bond-time 3 ratings, r[10]=.79, p=.006 and WAI-S Bond-
time 4 ratings, r[7]=.81, p=.025).
Due to the small number of participants, data were collapsed across
both groups. A repeated measures study design was employed to
evaluate sexual offenders’ perceptions of group climate and alliance
across the 4 time points. The analyses were largely descriptive and
exploratory in nature.
Measure Time 1 Time 2 Time 3 Time 4
GCQ-S
Engagement 3.75 3.92 3.92 3.42
Avoiding 2.42 2.33 3.08 2.75
Conflict 1.67 1.08 0.67 1.25
WAI-S
Task 18.92 21.50 19.58 20.00
Bond 20.08 20.83 20.42 20.83
Goal 36.75 19.42 19.83 19.75
Total 59.08 61.75 59.83 60.67
Procedure
Participants attended weekly 60-minute group psychotherapy
sessions that constituted the treatment component of a
synergistic containment model approach to the management of
sex. For this study, two distinct groups were assessed (with 5
offenders in group #1 and 7 offenders in group #2). The first
author served as the leader for both groups. The group leader
has over 10 years of group therapy experience post-licensure
and used a facilitation approach consisting of psychoeducational,
cognitive-behavioral, supportive, and process-oriented/
psychodynamic interventions. He sought to involve all group
members in discussions, emphasized the exploration of “here-
and-now” relational experience between group members, and
maintained a dual focus on (1) addressing static and dynamic risk
factors linked to sexual re-offending, and (2) improving aspects of
general life functioning based on the Good Lives model. The
GCQ-S and the WAI-S measures were administered after group
therapy sessions across 4 consecutive time points occurring at 6-
week intervals. At the time of the first administration, participants
had attended group therapy sessions for varying amounts of time
ranging from 10 to 64 weeks (M=42.00 weeks , SD =xx).