Relationship of patient shame to working alliance and satisfaction: a preliminary investigation

Purpose: The purpose of this paper is to explore the relationship of two distinct variants of dispositional shame (internal and external shame) with collaborative, purpose-driven aspects of the patient–provider relationship (working alliance) and patient satisfaction. The aim of this research was to conduct a preliminary investigation into the relevance of dispositional shame in a general healthcare population. Design/methodology/approach: In total, 127 community members (mean age 25.9 years) who reported that they had regularly seen a GP over the past year were recruited at an Australian university. Participants were asked to reflect on their relationship with their GP, and completed instruments assessing various domains of shame, as well as working alliance and patient satisfaction. Findings: Non-parametric correlations were examined to determine the direction and strength of relationships, as well as conducting mediation analyses where applicable. Small, negative correlations were evident between external shame and working alliance. Both external and internal shame measures were also negatively correlated with patient satisfaction. Finally, the relationship of external shame to patient satisfaction was partially mediated by working alliance. Practical implications: Both the reported quality of patient–provider working alliance, and level of patient satisfaction are related to levels of dispositional shame in patients, and working alliance may act as a mediator for this relationship. Originality/value: The findings from this preliminary study suggest that internal and external shame are important factors to consider in the provision of medical care to maximise the quality of patient experience and working alliance.Daniel J. Carabellese, Michael J. Proeve, Rachel M. Robert

A preliminary examination of specific risk assessment for sexual offenders against children

Specific risk questions concerning sexual offending, such as risk of offending against male victims given identified female victims, have seldom been discussed in the child sexual abuse literature. Two approaches to specific risk questions are described: (a) conditional probability calculations, and (b) the development of risk assessment instruments. It is concluded that specific risk questions should be addressed by the use of established instruments for assessing risk of general sexual recidivism rather than by the development of additional specific risk assessment instruments. Research supporting risk assessment instruments and cautions about their use are discussed. Finally, the application of risk assessments for sexual offenders and assessments of risk to siblings of incest victims is discussed.Michael Proev

Addressing the Challenges of Remorse in the Criminal Justice System

Remorse in offenders appears in a number of criminal justice domains. It is a mitigating factor in sentencing, influences parole decision making, may be influential in offender rehabilitation, and may be valued in forensic mental health. However, evaluation of remorse presents challenges in relation to evidence for remorse and expectations about its performance. Nevertheless, remorse is embedded deeply in criminal justice. The consideration of remorse in relation to emotions of shame, guilt and regret may offer an approach for evaluating remorse in sentencing and for addressing remorse in offender rehabilitation. This approach to understanding and working with remorse requires further elaboration, development and testing.Michael Proev

A minimal scale for assessment of multiple offending risk in sexual offenders against children

The development of a four-item scale for the prediction of sexual offending against multiple victims is described. The scale is scored from offender age and details of the victim's age, gender, and relationship to victim. The scale showed high inter-rater reliability for the individual items and the scale as a whole. Validity in predicting multiple offending in a community sample of sexual offenders against children and in a sub-sample of voluntarily-referred offenders was moderate. The scale had a positive and moderately large correlation with the RRASOR. The scale may be useful for risk assessment of child molesters in circumstances where minimal collaborative information about sexual offending is available.Michael Proev

CBT, happiness and evidence-based practice

Michael Proevehttp://trove.nla.gov.au/work/3783091

Crossover and stability of victim type in child molesters

PURPOSE. This study examined the degree to which child sex offenders demonstrated crossover in victim choice, as defined by age, gender, and relationship to the offender. It also aimed to explore the direction of the shift in victim type with repeated offending within each of the three domains and to identify variables predictive of crossover behaviour. METHOD. The sample comprised 128 adult male child sexual offenders. All had offended against multiple victims and were attending a community-based assessment and treatment service for sexual offenders at the time of data collection. Variables were gathered, coded, and de-identified from a manual search through clinical casenotes, from client assessment reports as well as from supplementary information consisting of sentencing remarks or other professional reports. RESULTS. More than half of the sample (63.3%, N = 81) demonstrated crossover in victim type across at least one domain. Crossover was 48.0% (N = 59) in the age domain, 22.0% (N = 28) in the gender domain, and 25.8% (N = 33) in the relationship to victim domain. Crossover offending was associated with number of victims but unrelated to frequency of offending or to recidivism risk as assessed by a standard risk assessment instrument. Transitional matrices showed general stability in victim type across offences within the gender and relationship domains, but lower stability within the age domain. CONCLUSIONS. Crossover offending behaviour was found to be frequent in the age domain, but the high frequency of crossover in this domain may be artifactual. Crossover offending was less frequent in the gender and relationship domains, but should be taken into account in risk assessment. Victim type shows stability across multiple offences in the gender and relationship to victim domains. Analysis of victim type across multiple offences should be replicated under conditions where disclosure of offending is maximized.Daphne J. Sim and Michael Proev

Remorse: psychological and jurisprudential perspectives

Invalid ISBN on item: 0754675890 & 9780754675891Remorse is a powerful, important and yet academically neglected emotion. This book, one of the very few extended examinations of remorse, draws on psychology, law and philosophy to present a unique interdisciplinary study of this intriguing emotion. The psychological chapters examine the fundamental nature of remorse, its interpersonal effects, and its relationship with regret, guilt and shame. A practical focus is also provided in an examination of the place of remorse in psychotherapeutic interventions with criminal offenders. The book's jurisprudential chapters explore the problem of how offender remorse is proved in court and the contentious issues concerning the effect that remorse - and its absence - should have on sentencing criminal offenders. The legal and psychological perspectives are then interwoven in a discussion of the role of remorse in restorative justice. In Remorse: Psychological and Jurisprudential Perspectives, Proeve and Tudor bring together insights of neighbouring disciplines to advance our understanding of remorse. It will be of interest to theoreticians in psychology, law and philosophy, and will be of benefit to practising psychologists and lawyers.Michael Proeve and Steven Tudo

Australian and New Zealand university clinical and counselling psychology staff: maintaining practice in academe

Applied clinical and counselling university psychology programs, and thus the staff teaching in these programs, are influential in the development of the applied clinical and counselling psychological workforce of Australia and New Zealand. Just who are the staff training our future clinical and counselling psychologists in Australia and New Zealand? Do these individuals think applied practice positively adds to applied clinical and counselling psychological teaching and do they actually engage in applied clinical or counselling practice themselves? This survey research in a field setting aimed to answer these questions as well as describe the support that university clinical and counselling psychology academics believe the university sector provides for continued applied practice activities. Data were collected using a multiple mailing survey method and resulted in a 30% return rate. Clinical and counselling psychology staff tend to be evenly distributed between genders, mature in age, and Caucasian. Australian and New Zealand clinical and counselling academics are employed primarily at the Lecturer or Senior Lecturer level, believe that continued applied practice benefits their applied teaching, continue to provide applied clinical or counselling services at a moderate level, and report minimal to moderate support by their universities for continued applied practice. Recommendations and suggestions for future research are provided along with a call to support academic staff in their continuing practice efforts.Nadine Pelling and Michael Proev

Shame and guilt in child molesters

Michael Proeve and Kevin Howellshttp://nla.gov.au/anbd.bib-an2688274

Personal and offending characteristics of child sexual offenders who have been sexually abused

A study of 324 sexual offenders against children referred to an assessment and treatment service in South Australia is reported in this article. Sexual offenders who had experienced sexual abuse in childhood were compared with offenders who had not experienced sexual abuse with regard to childhood, relationship, and offending variables. Sexual offenders who had been sexually abused were more likely to report other childhood difficulties, as well as adult homosexual relationships. They were more likely to have a history of nonsexual offending, sexual offending against male victims and against multiple victims, and to have crossed victim boundaries of gender, age, and relationship to their victims. There was little support for a relationship between characteristics of sexual abuse experiences and sexual offending. Further investigation of sexual abuse as a risk factor for sexual offending is recommended.Michael Proeve and Erin Reill