The Efficacy of Principle-Based Correctional Counseling for Improving the Self-Control and Mental Health of People Incarcerated for Sexual Violence

Abstract

This study is the first to test the efficacy of principle-based correctional counseling (PBCC) for improving the self-control and mental health of people incarcerated for sexual violence (SV). A total of 132 males incarcerated for SV were assigned to a treatment group that received cognitive behavior therapy (CBT) supplemented with intensive PBCC and a waitlist control group that received only CBT. Results using paired t-tests and an analysis of covariance (ANCOVA) to control for pretest scores showed that compared with the control group, treatment participants showed a significant increase in affective well-being and a significant decrease in low self-control, depression, anxiety, and anger.

Keywords

sexual violence principle-based correctional counseling cognitive behavior therapy self-control affective well-being

Sexual violence (SV) remains a serious mental health and social problem in the United States and the United Kingdom (Moster et al., 2008). In the United States, the National Intimate Partner and Sexual Violence Survey (NISVS; Breiding et al., 2014) reported that during their lifetime, approximately 19.3% of women experience rape or attempted rape and 43.9% experience another form of SV such as sexual coercion, unwanted sexual contact, and noncontact unwanted sexual experiences. The NISVS also reported that during their lifetime, approximately 6.7% of men are forced to penetrate someone, 5.8% experience sexual coercion, 10.8% experience unwanted sexual contact, and 13.3% experience noncontact unwanted sexual experiences. Children are also victims of SV with an estimated 1 in 25 boys and 1 in 7 girls experiencing some form of SV before age 18 (Townsend & Rheingold, 2013).

For the United Kingdom and Wales, the 2016 National Crime Recording Standard (NCRS; Flatley, 2016) reported the highest SV figures ever recorded by the police and the largest annual percentage increase in SV since the introduction of the NCRS in 2002. According to the NCRS, there were 88,106 police-recorded sex offenses in the year ending in March 2015, an increase of 37% compared with the previous year. Within the overall increase, the number of offenses of rape increased by 41%, and the number of other sex offenses increased by 35%.

Self-Control, Affective Well-Being, and SV

Self-control has been defined as the capacity to alter and regulate predominant response tendencies resulting in the inhibition of undesirable behaviors while promoting desirable ones (de Ridder et al., 2018). Gottfredson and Hirschi’s (1990) general theory of crime posits that low self-control is the central determinant of criminal behavior. The general theory argues that when an opportunity for criminal activity is perceived by people with low self-control, these people are more likely than people with high self-control to engage in criminal behavior and ignore the long-term consequences of this behavior because they have little internal constraint. Gottfredson and Hirschi (1990) characterized people with low self-control as “impulsive, insensitive, physical (as opposed to mental), risk-taking, short-sighted, and non-verbal” (p.90). Research has generally supported Gottfredson and Hirschi’s view that self-control plays a significant role in predicting the commission of a variety of criminal offenses including SV (e.g., Franklin, 2011; Pratt & Cullen, 2000; Schreck, 1999). The consensus of numerous studies is self-control also plays a significant role in predicting future offending outcomes for SV-prone people (e.g., Beaumeister et al., 1994; Franklin et al., 2012; Ha & Beauregard, 2016; Hansen et al., 1995; Pratt & Cullen, 2000; Tangney et al., 2004; Vohs & Faber, 2007).

Affective well-being has been defined as the frequency and intensity of positive and negative emotions and moods (Luhmann et al., 2012). Considerable research shows a positive association between affective well-being and self-control (e.g., Hofmann et al., 2013). Specifically, greater levels of affective well-being are linked to higher levels of self-control (e.g., de Ridder et al., 2018; Wiese et al., 2017). It appears that people who experience more positive emotions such as hopefulness and love and fewer negative emotions such as depression, anxiety, and anger tend to exhibit higher levels of self-control (e.g., Hofmann et al., 2012, 2013). In sum, based on well-documented positive associations between self-control and criminal behavior and self-control and affective well-being, the authors speculate in the study that follows that via improving the self-control and affective well-being of SV-prone people, the likelihood they will engage in SV can be lessened.

Interventions for People Prone to SV

Since the 1990s, the number of people incarcerated for SV has steadily increased, and most are eventually released back into the community without receiving any treatment (Yates, 2013). The need for effective interventions for people incarcerated for SV, and SV-prone people under other forms of justice system supervision, remains a pressing issue in the United Kingdom and the United States (McGrath et al., 2010). Over the past two decades, there has been a substantial increase in research regarding the efficacy of interventions designed to prevent SV and reduce its recurrence. The consensus of several meta-analytic studies regarding best treatment practices for SV-prone adults and juveniles (e.g., Hanson et al., 2009; Lösel & Schmucker, 2005; Luong & Wormith, 2006; MacKenzie, 2006) is that, on average, cognitive behavior therapy (CBT) is the most effective intervention. However, the effect sizes for CBT reported in these studies are typically low to moderate, and studies regarding the long-term effects of CBT yield mixed conclusions (Hanson et al., 2002; Lösel & Schmucker, 2005; MacKenzie, 2006; Prentky et al., 2006).

The authors posit that a major reason for the limited impact of CBT for SV-prone people is that CBT is not grounded in Principles that explain how people’s psychological life experiences are created. By Principles, we do not mean tenets, guidelines, or other commonly used definitions (e.g., principles of risk, need, and responsivity). Rather, we are referring to the root meaning of Principles; fundamental truths that explain how something works, or why something happens. We posit there are Principles that account for people’s psychological life experiences and, absent sufficient understanding and direction of these Principles, the efficacy of CBT for SV-prone people will continue to be limited. In this regard, we first describe a Principle-based mental health education intervention for SV-prone people called principle-based correctional counseling or PBCC (Kelley, 2011). Then we attempt to distinguish PBCC from CBT. Finally, we present a preliminary study that is the first to test the efficacy of supplementing CBT with intensive PBCC for improving the self-control and affective well-being of people incarcerated for SV.

PBCC

PBCC is derived from the insights and writings of Banks (1998, 2001, 2005), Mills (1995), and G. Pransky (1998). Banks (1998) proposed that people’s psychological life experiences (e.g., feelings, perceptions, and states of mind) are formed from within via their use of three universal Principles which he referred to as Mind, Consciousness, and Thought. Banks’s view of these Principles has been described in detail elsewhere (e.g., Kelley & Pransky, 2013; Kelley et al., 2015a, 2015b, 2016b; J. Pransky, 2003; J. Pransky & Kelley, 2014, 2017). In brief, Banks referred to Mind as the intelligent life energy that powers Consciousness and Thought which all people use to form their psychological life experiences. Banks (1998, 2001, 2005) referred to Thought as people’s ability to think, the Mind-powered agency that all people use to generate thoughts that enter their consciousness and become their psychological experiences. Banks referred to Consciousness as the Mind-powered agency that all people use to be conscious, to take in life, to have experience, and to be aware of that experience. In addition, Consciousness animates people’s thoughts through their physical senses and creates their psychological experiences. In sum, Banks asserted that people’s psychological lives are created from the “inside-out” via Thought and Consciousness. In other words, Thought combining with Consciousness gives people the only experience they can have. In turn, people’s behavior is always perfectly aligned with how their lives appear to them via their use of the Principles of Thought and Consciousness, powered up via the Principle of Mind.

Innate Mental Health

Banks (1998, 2001, 2005) further asserted that at their core or essence, people are mentally healthy stating, “Mental health lies within the consciousness of all human beings, but it is shrouded and held prisoner by our own erroneous thoughts” (p. 41). This innate health includes affective well-being and resilient functioning available to everyone throughout life because this is people’s natural state that manifests via a quiet or clear mind. In other words, whenever one’s personal mind clears, the default setting of affective well-being and resilient functioning manifests. The only thing that can obscure this health is people’s own disordered personal thoughts believed and taken to heart in the moment.

PBCC Versus CBT

According to Yates (2013), CBT for SV-prone people is grounded in the view that SV stems from, “. . . behavioral and cognitive patterns developed and maintained as a result of modeling, observational learning, and reinforcement of behavior, attitudes, and cognition” (p. 90). CBT attempts to teach SV-prone individuals various skills, techniques, and beliefs designed to help them change “antisocial” attitudes; challenge “dysfunctional” schemas (e.g., sexual entitlement); resolve conflicts; solve problems; improve sexual, intimate, and social relationships; manage negative affective states; develop adaptive cognitive processes; and reduce deviant sexual arousal (Hanson et al., 2009; Losel & Schmucker, 2005).

PBCC, on the contrary, does not focus on the content or products of SV-prone people’s thinking (e.g., cognitive styles, beliefs, and schemas). Nor does PBCC attempt to challenge the disordered thoughts of SV-prone people or attempt to teach them strategies to challenge, refute, reframe, or recondition their thoughts. Nor does PBCC attempt to moderate the symptoms of mental ill health of SV-prone people by teaching them coping strategies or relapse prevention techniques. Rather, PBCC strives to draw-out the mental health and resilient functioning it posits exists undamaged within SV-prone people by assisting them in gaining sufficient understanding of the way the Principles of Mind, Consciousness, and Thought operate to create their (and everyone else’s) psychological experience. PBCC assists SV-prone people to recognize how insufficient understanding and innocent misuse of these Principles obscures their innate well-being/common sense/self-control and creates and maintains their propensity to engage in SV and how, through sufficient understanding of the Principles, they can use them in their best interest and reduce their propensity to engage in SV.

To accomplish this, rather than focusing on thought content, PBCC focuses on the Principle of Thought and strives to improve SV-prone individuals’ thought recognition, the realization that Thought enlivened by Consciousness is the only experience people can have. PBCC also strives to assist SV-prone people to grasp innate health via a clear mind; the realization that people already have within them all the mental health/common sense/self-control they need; that this health surfaces whenever the personal mind clears; and that the only thing that can obscure this health is people’s own disordered personal thinking unrecognized and believed in the moment.

PBCC for SV-prone People

The authors offer the following conceptual formula to clarify the logic and focus of PBCC for SV-prone people (Kelley & Pransky, 2018):

Propensity for SV = \frac{Personal Norm + Habit + Arousal Level}{Understanding + Perspective + Common Sense / Self - Control}

We posit that the three factors in the formula’s numerator combine to create SV: (a) Personal Norm—the degree to which a person believes SV is acceptable, (b) Habit—the degree to which SV is a person’s habitual response; and (c) Arousal—the extent of a person’s desire or impulse, in the moment, to engage in SV. The formula suggests the following: Personal norm (i.e., the extent to which people believe SV is an acceptable thing to do) can place people on the road toward SV. Habit (i.e., the extent to which people are drawn to SV as their means of release) can start people down the road. Arousal (i.e., the extent to which people feel compelled to engage in SV in any moment) can often propel people down the road. We propose that the commonality in these three factors is that SV-prone people generally see each factor as a “reality” they do not realize they have created with their own thinking, which their own consciousness makes look and feel absolutely real to them, which is what makes them act.

Regarding personal norm, habit, and arousal, people can be at various levels of understanding and perspective in-the-moment. For example, if a person believes SV is acceptable, has no desire to stop, and is consumed by arousal in the moment, they will likely engage in SV. On the contrary, if the same person believes that engaging in SV is unimaginable and does not have a propensity to engage in that kind of behavior—for instance, if aroused, their habit may be to simply masturbate instead, causing no harm to others—it would be highly unlikely for them to perpetrate SV. A wide range of levels of understanding and perspective exist between these two extremes. For example, if a person believes “SV is not okay. I really want to stop, but occasionally I get aroused and can’t help myself,” then on occasion, they may engage in SV. The examples that follow are best read from the bottom up, for as each level moves up, it represents higher levels of in-the-moment perspective:

Personal Norm About SV

SV is horrible. Under no circumstances is it right.

SV is not good.

SV is not okay, but I slip sometimes.

Something doesn’t feel right about SV, but . . .

SV is the way to be and to act.

Habit of SV

SV is out of the question for me. I can’t even imagine it.

I am absolutely committed to stopping.

This is not right and I really, deeply would like to stop.

I’m nervous about doing this bad thing and I would like to stop.

Something about it doesn’t feel quite right, and I’d kind of like to stop, but I can’t help myself.

I have no desire to stop committing SV.

Arousal Level

Love and peace—Great love for all; harming others is inconceivable; we are all connected as one.

Compassion—If I take advantage of someone, that person will be hurt. It is not good or right.

Neutral—No feeling, not aroused at all.

Attraction—I appreciate how this person looks or their energy.

Twinge—I feel a tiny pull toward wanting this person.

Desire—I want this person.

Compelled—I feel pulled to go after this person.

Driven—I must go after this person, no choice.

The authors further posit that the three factors in the formula’s denominator combine to prevent SV: (a) Understanding—the extent to which a person understands that the source of each factor in the numerator is their own creation of thought made to feel real by their own consciousness; (b) Perspective—the extent to which a person realizes this (i.e., has this understanding) in the moment; and (c) Common Sense/Self-control—the extent to which a person listens to and is guided by their own internal compass (i.e., innate common sense) of knowing what is right. The extent of a person’s understanding and perspective in the moment regarding each factor in the numerator, plus this person’s ability to connect with their own common sense/self-control, can move them off the road to SV. To help people change from a proclivity toward SV, they need to understand that the source of the three factors that underlie SV is their own thinking and to realize how each of these factors is altered by how their thinking makes it appear. The authors posit that the extent to which SV-prone people realize, in the moment, that each factor in the numerator is a product of their own thinking made to look real via their own consciousness, the more likely they will access the affective well-being/common sense/self-control necessary to eclipse their habitual behavior and avoid SV.

The authors propose that this is what has limited the effectiveness of CBT to reduce the incidence and prevalence of SV. No matter what new skills, techniques, and beliefs are mastered by SV-prone people, the way these people view a situation or a potential victim in general, plus the understanding and perspective they have in the moment is what will determine their level of affective well-being/common sense/self-control, in the moment, and their likelihood of engaging in SV. Put another way, even if the factors in the model’s numerator exist, the degree to which a potential SV perpetrator has understanding and perspective, in the moment, that what they are experiencing is not reality, but only their own thoughts producing one of numerous possible realities will determine whether they engage in SV. No matter what thoughts SV-prone people have about norm, habit, and arousal, if they gain sufficient understanding of the “inside-out” creation of people’s psychological life experiences and have perspective in the moment to tap into this understanding, the level of all three factors in the numerator will descend, and the likelihood of SV will diminish.

The Study

Purpose and Hypotheses

The purpose of the study that follows is to test the efficacy of supplementing CBT with intensive PBCC for improving the self-control and affective well-being of people incarcerated for SV. It is first expected that PBCC will be a catalyst for improving these people’s: (a) thought recognition or the realization that people’s every psychological experience is created from within via Thought and Consciousness, and (b) innate mental health via a clear mind or the realization that people already have within them all the mental health (e.g., affective well-being and self-control) they need, which is readily available via a clear mind. The hypotheses we tested in the study are:

Hypothesis 1: Compared with the control group, participants receiving PBCC will show a significant increase in thought recognition.

Hypothesis 2: Compared with the control group, participants receiving PBCC will show a significant increase in understanding innate mental health via a clear mind.

Also, we expect that, on average, participants receiving PBCC will show a decrease in low self-control, leading to the third hypothesis we tested in the study:

Hypothesis 3: Compared with the control group, participants receiving PBCC will show a significant decrease in low self-control.

Finally, we expect that, on average, participants receiving PBCC will show increased affective well-being. The hypotheses we dervied from this expectation that are tested in the study are:

Hypothesis 4: Compared with the control group, participants receiving PBCC will show a significant increase in affective well-being.

Hypothesis 5: Compared with the control group, participants receiving PBCC will show a significant decrease in depression.

Hypothesis 6: Compared with the control group, participants receiving PBCC will show a significant decrease in anxiety.

Hypothesis 7: Compared with the control group, participants receiving PBCC will show a significant decrease in anger.

Location

The location of this study is HM Prison Rye Hill in Willoughby, Warwickshire, United Kingdom (UK). The prison is a privately owned category “B” training prison for sentenced male adults convicted of a sex offense(s). The capacity of the prison is 625. Prison treatment services are provided by a drug and alcohol recovery team (DART) working within the prison in a separate unit. DART requires all prison residents to participate in the Sexual Offender Treatment Program (Mews et al., 2017), an 18-month intensive program for SV offenders which employs a CBT model designed to increase sexual knowledge, modify thinking patterns that may have previously been used by these offenders to excuse and justify their behavior, develop the ability to recognize risk factors, and generate strategies for living successful lives without offending in the future.

In 2015, Beyond Recovery (BR), a Community of Interest Company in Birmingham, United Kingdom, provided a proposal to Rye Hill DART to offer intensive PBCC to their residents as a supplement to their required CBT-grounded treatment. DART agreed to allow BR to provide six of their staff a 3-day intensive PBCC training to raise their awareness of PBCC and how it differs from CBT. Following this training, DART allowed BR to offer PBCC to prison residents as an elective “immersion” class spanning three consecutive days.

Intervention

Between July 2016 and December 2017, BR conducted 10 3-day intensive PBCC classes. Each class was facilitated by two BR practitioners both with 4 to 6 years of experience teaching PBCC to individuals under justice system supervision. Each PBCC class included the following modules: building rapport; exploration of “reality”; separate realities; exploration of thought, insight, and consciousness—where do they come from?; exploring feelings/moods/behavior; exploring innate health/natural intelligence; exploring infinite potential; exploring mental clarity versus a busy mind; stepping into the unknown; implications of the Principles for life in prison; and living outside of prison. The program format allowed flexibility for the facilitators to trust their own common sense to guide each session. Sessions were typically conversational, exploratory, and reflective rather than traditional lecturing/teaching. The main goal of each session was to improve participants’ (a) thought recognition—that Thought enlivened by Consciousness is the only experience people can have, and (b) understanding of innate mental health via a clear mind—that people already have within them all the mental health they need, that this inner health will surface whenever the personal mind clears, and that the only thing that can obscure this health is people’s own disordered personal thoughts believed in the moment.

PBCC teachers realize that even the most chronic SV-prone people have mental health/common sense/self-control within them. Rather than viewing these people as incomplete or damaged and trying to fix them with the right beliefs, skills, or techniques, effective teachers relate to them as already whole and complete. By focusing on the health in these individuals, they attempt to point them in the direction of this health and help them realize how they have innocently obscured this health with their own disordered personal thoughts. PBCC teachers also recognize the innocence in the behavior of these individuals no matter how deviant or dysfunctional. They realize these individuals are doing the best they can based on how their thoughts make their lives appear to them. We posit that these people can sense this awareness in their teachers, which helps relax their thinking and enhance their learning curves. When SV-prone individuals are at ease and light-hearted, the grip of their disordered thinking begins to loosen, their defenses begin to break down, and insights are more likely regarding the operation of the Principles of Mind, Consciousness, and Thought.

Once PBCC teachers create rapport with participants within a relaxed, light-hearted climate, they attempt to assist them to realize the health that exists within them and how they have innocently obscured it with their own disordered personal thoughts. Basically, this teaching includes helping SV-prone people realize (a) it is not what happens to them that creates their experience, but rather what they make of what happens to them with their own thinking; (b) they are connected to and can be guided by innate well-being and resilient functioning if their minds are calm and clear enough to hear it; and (c) they have the power to see their lives differently and therefore to live more healthy, productive lives.

Method

Treatment Groups

Between July 2016 and December 2017, DART case managers referred 132 residents to intensive PBCC. Each resident was currently participating in the prison’s mandatory Sexual Offender Treatment Program grounded in CBT. Each resident willingly agreed to participate in intensive PBCC as a supplement to the required CBT-based intervention. These residents were assigned to a treatment group (n = 67) that received intensive PBCC and a waitlist control group (n = 65) that received only CBT. Based on chi-square tests, there were no statistically significant differences between the control and treatment groups on the demographic variables of age (χ² = 1.36, p = .64), ethnicity (χ² = 2.33, p = .42), residence (χ² = .37, p = .52), education level (χ² = 1.28, p = .86), and marital status (χ² = 2.72, p = .44). Also, there were no differences of note between treatment and control participants on offense type and sentence length.

Treatment participants completed the study’s measures at pretest at the start of their first PBCC session and at posttest at the end of their final PBCC session on day 3. During comparable 3-day periods, DART case managers administered and collected the study’s measures, pretest and posttest, for control participants. All study participants continued to participate in the required CBT-based Sexual Offender Treatment Program, while only the treatment participants received intensive PBCC.

Measures

Three Principles Inventory (3PI; Kelley, 2011). The 3PI contains 17 items measuring thought recognition (e.g., “The only feelings I can have are created by my thinking”) and innate health/common sense via a clear mind (e.g., “No matter what my circumstances, wisdom is always available to me”). The 3PI has shown good predictive validity regarding several mental health factors (e.g., affective well-being, self-efficacy, purpose in life) for people under justice system supervision (e.g., Kelley et al., 2016a, 2017a, 2017b, 2019). Each item is scored on a Likert-type scale ranging from 1 (disagree completely/no exceptions) to 6 (agree completely/no exceptions). Item responses are summed to obtain a total 3PI score.

Low Self-Control Scale (LSCS; Grasmick et al., 1993). The LSCS contains 24 items, four items for each of the following six characteristics of self-control conceived by Gottfredson and Hirschi (1990): impulsivity, physical activities, risk seeking, self-centered, simple tasks, and volatile temper. Low self-control operationalized by this scale (total score) has consistently been linked to various types of deviance including sexual assault (Nagin & Patermoster, 1993) and appears to be particularly attractive for use with perpetrators of SV (Delisi et al., 2003). The reliability and validity of the scale has been extensively examined within the literature (e.g., Grasmick et al., 1993; Piquero & Tibbetts, 1996). Scale items are scored with Likert-type scale responses (e.g., strongly disagree to strongly agree).

Warwick-Edinburgh Mental Well-Being Scale-Short Form (WEMWBS-SF; Tennant et al., 2007). The WEMWBS-SF was developed at the Universities of Warwick and Edinburgh and comprises seven items that relate to an individual’s state of mental well-being. The WEMWBS has good psychometric properties (Stewart-Brown et al., 2009). In the validation of WEMWBS, Tennant et al. (2007) examined the relationships between the WEMWBS and other measures of positive mental health and mental ill health and reported relatively high correlations with the positive well-being measures (correlations ≥ 0.7) and moderate, negative correlations with the measures of mental ill health. Each item is worded positively and together they cover most, but not all, attributes of mental well-being including both hedonic and eudemonic perspectives. Responses are made on a 5-point Likert-type scale ranging from 1 (none of the time) to 5 (all the time). Item responses are summed to obtain a total WEMWBS-SF score.

PROMIS Depression Short Form (PR-Dep-SF; PROMIS Health Organization, 2013). PROMIS measures of mental health components (e.g., depression, anxiety, and anger) (Tennant et al., 2007) are based on DSM-V symptomology and have undergone rigorous testing for evidence of differences by respondent characteristics (e.g., sex, age, and education) (Pilkonis et al., 2014). Results to date demonstrate that the PROMIS measures function as well as or better than legacy measures as demonstrated by improved reliability and evidence of increased sensitivity to clinical change (Broderick et al., 2013). For each measure, respondents report the degree to which they have been bothered by each symptom. The PR-Dep-SF contains 8-items (e.g., “I felt worthless”) of which we used five items scored using a Likert-type scale ranging from 1 (never) to 5 (always). Item responses are summed to obtain a total score.

PROMIS Anxiety Short Form (PR-Anx-SF; PROMIS Health Organization, 2013). The PR-Anx-SF contains 7-items (e.g., “I felt fearful”) of which we used six scored using a Likert-type scale ranging from 1 (never) to 5 (always). Item scores are summed to obtain a total score.

PROMIS Anger Short Form (PR-Ang-SF; PROMIS Health Organization, 2013). The PR-Ang-SF contains 5-items (e.g., “I felt angry”) scored using a Likert-type scale ranging from 1 (never) to 5 (always). We used all five items, and scores are summed to obtain a total score.

Results

The following internal review boards approved the study: the Northamptonshire County Council; Public Health and Wellbeing Committee; the HM Prison Rye Hill Drug Strategy Committee; and the Phoenix Futures Substance Misuse Services Board. The study included 132 male participants of which 67 composed the treatment group and 65 composed the control group. The descriptive statistics for the experimental groups are presented in Table 1. The groups did not differ significantly on age, ethnicity, and education. The mean age for the treatment group was 37.28 (SD =10.171) years, and 37.58 (SD = 10.350) years for the control group. Regarding ethnicity, 77.6% of the treatment group and 76.2% of the control group self-identified as white British. Within the treatment group, 32.8% reported having completed some senior school, and 26.9% of the control group reported having completed the same level of schooling. The offenses committed by participants included rape of adult women, rape of children and babies, molestation, and gang sexual crimes. Some participants were also convicted of additional crimes such as drug dealing and importation, robbery, and assault. Sentence length for participants ranged from 4 years to life, with some participants serving consecutive sentences. There were no differences of note between treatment and control participants on offense type and sentence length.

Table 1.

Descriptive Statistics for Treatment and Control Groups.

Variable	Treatment		Control
Variable	N	%	N	%
N	67	50.8	65	49.2
Mean age	37.28		37.58
Gender
Male	67	50.8	65	49.2
Ethnicity
White British	52	77.6	30	46.2
African	3	4.5	1	1.5
Asian	2	3.0	1	1.5
Other	10	14.9	3	4.6

There was significant variation in each of the outcome measures (i.e., none were constants). In addition, the Cronbach’s alpha values, a measure of internal reliability for the index outcome variables, were higher than .70. Independent t-tests were computed between the control and treatment groups on the six pretest outcome variables and the six posttest outcome variables to determine whether each group showed a significant change on any of the six outcome variables from the pretest to the posttest, where the experimental group was exposed to CBT and intensive PBCC and the control group was exposed only to CBT. The results are presented in Table 2. For the control group, there was no significant change from pretest to posttest for the variables of 3PI, WEMWBS, LSC, PR-Dep, PR-Ang, and PR-Ang. For the experimental group, there was a significant change from the pretest to the posttest on all six outcome variables. Specifically, following their exposure to PBCC these participants showed a significant increase in 3PI and WEMWBS. Conversely, after their exposure to PBCC, these participants showed a significant decrease in LSC, PR-Dep, PR-Anx, and PR-Ang.

Table 2.

Paired t-Test Results for the Control and Experimental Groups on the Outcome Variables.

Variable	Control group				t-Value
Variable	M	SD	M	SD	t-Value
3PI	54.86	5.08	54.83	5.84	0.050
WEMWBS	22.28	4.85	21.62	5.46	1.59
LSCS	62.12	7.19	62.40	6.97	0.676
PR-Dep	8.22	3.39	8.12	3.38	0.294
PR-Anx	6.63	3.31	6.80	3.17	−0.644
PR-Ang	6.75	3.37	6.55	3.39	0.622
	Experimental group				t-Value
	M	SD	M	SD	t-Value
3PI	54.13	6.15	66.30	10.45	−8.76**
WEMWBS	20.54	5.56	25.84	5.70	−9.48**
LSCS	61.30	7.33	63.93	7.62	3.99**
PR-Dep	8.57	3.38	6.63	3.51	4.84**
PR-Anx	6.85	3.03	5.46	2.79	4.47**
PR-Ang	6.81	3.21	5.13	2.32	5.06**

Note. SD stands for standard deviation. A negative t-value means that there was an increase from the pretest to the posttest, and a positive t-value means that there was a decrease from the pretest to the posttest. The number of participants in the control group was 65 and the number of participants in the experimental group was 67. WEMWBS = Warwick–Edinburgh Mental Well-Being Scale-Short Form; LSCS = Low Self-Control Scale.

p ≤ .05. **p ≤ .01.

Analysis of covariance (ANCOVA) was conducted to determine whether the differences between the control and experimental groups continued once the pretest scores were considered, and the results are reported in Table 3. For each of the six outcome variables of 3PI, WEMWBS, LSC, PR-Dep, PR-Anx, and PR-Ang, there was a significant difference between the control and treatment groups. Specifically, following their exposure to PBCC, participants showed a significant increase in 3PI and WEMWBS. Conversely, after their exposure to PBCC, these participants showed a significant decrease in LSC, PR-Dep, PR-Anx, and PR-Ang. Based on both statistical tests, it is concluded that Hypotheses 1 and 2 (3PI), 3 (LSC), 4 (WEMWBS), 5 (PR-Dep), 6 (PR-Anx), and 7 (PR-Ang) are supported.

Table 3.

ANCOVA for the Outcome Variables Controlling for Pretest Scores.

Outcome variable	SS	df	MS	F value	Significance	R ²
3PI						.37
Intercept	1,991.86	1	1,991.86	29.61**	.00
Pretest	711.32	1	711.32	10.57**	.00
Group	4,550.63	1	4,550.63	67.65**	.00
Corrected	13727.97	131
WEMWBS						.59
Intercept	372.12	1	372.12	24.96**	.00
Pretest	2,129.52	1	2,129.52	142.85**	.00
Group	995.05	1	995.05	66.75**	.00
Corrected	4,640.24	131
SCS						.66
Intercept	294.17	1	294.17	15.92**	.00
Pretest	4,556.23	1	4,556.23	246.54**	.00
Group	158.79	1	158.79	8.59**	.00
Corrected	7,016.99	131
PR-Dep						.43
Intercept	72.54	1	72.54	10.05**	.00
Pretest	613.38	1	613.38	84.96**	.00
Group	97.54	1	97.54	13.51**	.00
Corrected	1,618.55	131
PR-Anx						.53
Intercept	61.14	1	61.14	13.80**	.00
Pretest	587.50	1	587.50	132.60**	.00
Group	72.66	1	72.66	16.40**	.00
Corrected	1,218.06	131
PR-Ang						.44
Intercept	101.89	1	101.89	20.39**	.00
Pretest	447.14	1	447.14	89.47**	.00
Group	69.26	1	69.26	13.86**	.00
Corrected	1,158.33	131

Note. The number of participants in the control group was 65, and the number of participants in the experimental group was 67. ANCOVA = analysis of covariance; PI = principles inventory; WEMWBS = Warwick–Edinburgh Mental Well-Being Scale; SCS = self-control scale.

p ≤ .05. **p ≤ .01.

Discussion

This study is the first to investigate the efficacy of supplementing CBT with intensive PBCC for improving the affective well-being and self-control of people incarcerated for SV. We speculated that supplementing CBT with intensive PBCC designed to assist these people to grasp new insights regarding the operation of the Principles of Mind, Consciousness, and Thought would result in improved self-control and affective well-being for participants compared to those receiving only CBT. The results appear to support each of our hypotheses. Hypotheses 1 and 2 were supported. Compared to the control group, participants receiving CBT supplemented with intensive PBCC showed a significant improvement in thought recognition and innate health via a clear mind.

Hypothesis 3 was also supported. Compared with the control group, participants receiving intensive PBCC showed a significant decrease in low self-control. This finding appears noteworthy as the consensus of research cited earlier is that people with low self-control are more likely to engage in sexually impulsive behavior and that self-control plays a significant role in predicting future offending outcomes for SV-prone people. PBCC defines self-control as realizing, in the moment, that one’s experience is of one’s own via thought. We posit that absent this understanding, how SV-prone people perceive their circumstances and potential victims appears “real” to them in the moment. What they actually “see,” however, is a momentary “reality” created via their own thinking enlivened via their own consciousness. If these people do not realize this fact, they will behave in whatever “reality” they experience. However, if they realize this fact, they will be less likely to relate to their momentary thinking, perceptions, and feelings as the way things really are and will be less likely to act on them. We posit that when people SV-prone realize this and can access this understanding in the moment, the precursors to SV will decrease. In other words, unless these people are helped to question what they perceive as a fixed “reality” they must act on, they will see no other way than to follow their thinking or continually fight against it.

Hypothesis 4 was also supported. Compared with the control group, participants receiving intensive PBCC showed a significant increase in affective well-being. This finding also appears noteworthy as the consensus of research cited earlier is that people who experience more positive emotions (i.e., higher affective well-being) tend to exhibit higher levels of self-control. This finding was expected because, on average, when people realize the connection between their thinking and their psychological experiences, they are less likely to relate to their thoughts, feelings, and perceptions as “the reality” or “the truth.” Rather, they are more likely to “see” these experiences as “separate personal realities” created by their own thinking and made to appear real in the moment by their own consciousness. Thus, they are less likely to become gripped by these experiences and act on them.

Hypotheses 5, 6, and 7 were also supported. Compared with the control group, participants receiving intensive PBCC showed a significant decrease in depression, anxiety, and anger. Again, these findings appear noteworthy as the consensus of research cited earlier shows that people who experience fewer negative emotions tend to show higher levels of self-control. In this regard, over half of prison residents in the United States, United Kingdom, and Wales experience chronic depression and/or anxiety (Burki, 2017). These findings were expected because, on average, SV-prone people have little insight regarding the “inside-out” formation of people’s psychological experiences and, thus, generally perceive themselves as victims of external events and circumstances. On the contrary, when these people realize the “inside-out” creation of everyone’s psychological experiences, depression, anxiety, and anger begin to look more like thought-events, rather than dismal, frightening, or unfair life circumstances. Sedgeman (2005) stated:

When people realize the one-to-one connection between thought and experience, they gain perspective on life. Changes in their experience of reality no longer look as though they were randomly caused by outside events or forces. . . . Seeing the emergence of experience from thought appears to bring people peace of mind, no matter what they are thinking. Understanding Principles gives the power of experience to the person, not to life events. (p. 3)

Limitations

Like most studies, this study has limitations. First, all the analyses in this study were bivariate, and study participants were not randomly assigned to experimental groups. Also, to minimize selection bias, this study did not determine whether there were differences of note (e.g., motivation to change) between the 67 residents who completed intensive PBCC and the 65 control participants. Also, it is possible that the unique community of prison aided (e.g., less distractions or temptations than found in the community) or detracted (fear of victimization while in prison or negative pressure from fellow residents not in the treatment program) from the effects of PBCC. It is also possible that treatment studies with people in prison need to include outcome measures that evaluate other dimensions of functioning such as posttraumatic stress disorder or adverse childhood experiences. Future studies are needed to determine whether PBCC has other positive effects such as reducing prison misconduct and future SV and other recidivism. Furthermore, while a follow-up evaluation of participants was requested by the researchers, prison administration (citing security concerns) would not approve a follow-up which would have enabled a better test of treatment efficacy over time. Another limitation of this study was that only self-report outcome measures were used (i.e., absence of posttreatment diagnostic interviews). Additional studies are also needed to determine whether PBCC could be successful with SV-prone residents at other prisons, including those in other nations and among SV-prone people receiving community supervision (e.g., probation or parole).

Conclusion

The authors posit that most perpetrators of SV truly believe they must act this way in life. They do not know any other way to be. They cannot see any other way. They are stuck at that low level of consciousness which looks and feels and tastes like reality to them. No one can talk them out of it. Whenever they are aroused and see an opportunity they will go there. They have little self-control. They experience little affective well-being. However, if these people can “see” that this way of viewing their world and their victims is not reality but is really an illusion created from their own thinking, this insight can shock them out of everything they thought was reality. They may still get those thoughts regarding SV, but they know they do not have to act on them because they are just habits of thinking that do not mean anything. The grip these thoughts have on them loosens. What they are left with is more affective well-being, common sense, and self-control.

This preliminary study tested the efficacy of supplementing CBT with intensive PBCC for improving the affective well-being and self-control of people incarcerated for SV. The findings show that compared with a control group receiving only CBT, participants receiving CBT and intensive PBCC showed a significant increase in understanding the operation of the Principles of Mind, Consciousness, and Thought (i.e., thought recognition and innate health via a clear mind) and a significant increase in affective well-being. Furthermore, these participants showed a significant decrease in low self-control, depression, anxiety, and anger. While more studies are needed to test the efficacy of PBCC for people incarcerated for SV, the findings of this preliminary study appear to warrant the attention of SV researchers and practitioners.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Thomas M. Kelley

Author Biographies

Thomas M. Kelley, PhD is professor emeritus in the Emeritus Academy at Wayne State University, in Detroit, MI. Tom’s research focuses primarily on the universal Principles of Mind, Consciousness, and Thought and flourishing mental health. Tom has published over 100 peer-referred chapters and papers, many in high-impact journals such as American Psychologist, Crime and Delinquency, Criminal Justice and Behavior, and Spirituality in Clinical Practice. Tom is also a licensed psychologist with a private three principles-based clinical practice at Reflections Counseling Center, in Troy, MI.

Jacqueline Hollows, MSc is the founder of BR CIC, a nonprofit organization whose mission is to revolutionize the way addictions, mental health, and offending behavior are viewed and treated. Through sharing an understanding of how our experience of life is created from our own minds, the pioneering work that BR does has the potential to reform the criminal justice system from the inside out. She is a co-author of research papers evidencing BR’s approach and is a regular contributor to a prison newspaper, InsideTime (readership c60,000).

Jack Pransky, PhD is founder/director of the Center for Inside-Out Understanding and an internationally recognized trainer, coach, counselor, and consultant who, since 1991, has been studying and teaching The Three Principles. He has authored several books about the inside-out nature of life, which have received wide acclaim for being among the best Principles-based books. Jack is a trainer of trainers, a coach of coaches, and a counselor of counselors. In 2001, his book, Modello, received the Martin Luther King Storyteller’s Award for the book best exemplifying King’s vision of “the beloved community,” and in 2004, Jack won the Vermont Prevention Pioneer’s Award.

Alena Kryvanos, MS, is a fourth-year clinical psychology doctoral candidate and has been committed to providing comprehensive care to diverse populations through the integration of clinical practice, empirical research, and teaching. Through her training, academic coursework, and research, she has focused on building expertise in severe mental illness and trauma care. She has a passion for conducting research to inform clinical care among marginalized, trauma-affected populations. Her dissertation focuses on examining mechanisms of intimate partner violence perpetration using a gender-informed lens to understand long-term, multifaceted consequences for both survivors and perpetrators.

Sarah Bowen, PhD is a licensed clinical psychologist, and associate professor at Pacific University, in Portland, OR. Her research focuses primarily on mindfulness-based therapies for relapse prevention, with specific focus on mechanisms of change, including negative affect, thought suppression, and craving. She has authored numerous articles and book chapters on this and related topics. She has worked in private and county treatment agencies, criminal justice institutions, and VA Medical Centers, and offers professional research and clinical trainings worldwide. She is particularly interested in improving treatment quality and access for dual-diagnosis and underserved populations.

References

Banks

(1998). The missing link. Lone Pine.

Banks

(2001). The enlightened gardener. Lone Pine.

Banks

(2005). The enlightened gardener revisited. Lone Pine.

Beaumeister

R. F.

Heatherton

T. F.

Tice

D. M.

(1994). Losing control: How and why people fail at self-regulation. Academic Press.

Breiding

M. J.

Smith

S. G.

Basile

K. C.

Walters

M. L.

Chen

Merrick

M. T.

(2014). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization—National Intimate Partner and Sexual Violence Survey, United States, 2011. MMWR Surveillance Summaries, 63(8), 1–18.

Broderick

J. E.

DeWitt

E. M.

Crane

P. K.

Forrest

C. B.

(2013). Advances in patient-report outcomes: The NIH PROMIS measures. EDM Forum Community, 1(1), Article 12.

Burki

(2017). Crisis in UK prison mental health. Lancet Psychiatry, 4(12), 904, https://dx-doi-org.web.bisu.edu.cn/10.1016/S2215-0366(17)30446-7

Delisi

Hochstetler

Murphy

D. S.

(2003). Self-control behind bars: A validity study of the Grasmick et al. scale. Justice Quarterly, 20(2), 241–263.

de Ridder

Kroese

Gillebaart

. (2018). Whatever happened to self-control? A proposal for integrating notions from trait self-control studies into state self-control research. Motivation Science, 4(1), 39–49.

10.

Flatley

(2016). Crime in England and Wales: Year ending March 2016. Office of National Crime Statistics.

11.

Franklin

C. A.

(2011). An investigation of the relationship between self-control and alcohol induced sexual victimization. Criminal Justice and Behavior, 38(3), 263–285.

12.

Franklin

C. A.

Bouffard

L. A.

Pratt

T. C.

(2012). Sexual assault on the college campus: Fraternity affiliation, male peer support, and low self-control. Criminal Justice and Behavior, 39(11), 1457–1480.

13.

Gottfredson

M. R.

Hirschi

(1990). A general theory of crime. Stanford University Press.

14.

Grasmick

H. G.

Tittle

C. R.

Bursik

R. J.

Arneklev

B. J.

(1993). Testing the core empirical implications of Gottfredson and Hirschi’s general theory of crime. Journal of Research in Crime and Delinquency, 30, 5–29.

15.

O. K.

Beauregard

(2016). Sex offending and low self-control: An extension and test of the general theory of crime. Journal of Criminal Justice, 47, 62–73.

16.

Hansen

R. K.

Scott

Steffy

R. A.

(1995). A comparison of child molesters and nonsexual criminals: Risk predictors and long-term recidivism. Journal of Research in Crime and Delinquency, 32(3), 325–337.

17.

Hanson

R. K.

Bourgon

Helmus

Hodgson

(2009). A meta-analysis of the Canada effectiveness of treatment for sex offenders: Risk, need, and responsivity. Public Safety Canada.

18.

Hanson

R. K.

Gordon

Harris

A. J. R.

Marques

J. K.

Murphy

Quinsey

V. L.

, et al (2002). Final report of the collaborative outcome data project on the effectiveness psychological treatment for sex offenders. Sexual Abuse, 14, 163–194.

19.

Hofmann

Luhmann

Fisher

R. R.

Vohs

K. D.

Baumeister

R. F.

(2013). Yes, but are they happy? Effects of trait self-control on affective well-being and life satisfaction. Journal of Personality, 82, 265–277.

20.

Hofmann

Schmeichel

B. J.

Baddeley

A. D.

(2012). Executive functions and self-regulation. Trends in Cognitive Sciences, 16(3), 174–180.

21.

Kelley

T. M.

(2011). Thought recognition and psychological well-being: An empirical test of principle-based correctional counseling. Counseling and Psychotherapy Research, 11(2), 140–147.

22.

Kelley

T. M.

Hollows

Savard

Lambert

E. G.

Pransky

(2017b). Teaching health vs. treating illness: The efficacy of three principles correctional counseling with people in an English prison. Journal of Offender Therapy and Comparative Criminology, 62(9), 2831–2856.

23.

Kelley

T. M.

Hollows

Savard

Pransky

(2019). The efficacy of intensive three principles correctional counseling for improving the mental health/resilience of people in an English prison. Journal of Offender Rehabilitation, 58(8), 661–677.

24.

Kelley

T. M.

Pransky

(2013). Principles for realizing resilience: A new view of trauma and inner resilience. Journal of Traumatic Stress Disorders & Treatment, 2. https://dx-doi-org.web.bisu.edu.cn/10.4172/2324-8947.1000102

25.

Kelley

T. M.

Pransky

(2018). A new principle-based view of intimate partner violence and its prevention. Partner Abuse: New Directions in Research, Interventions, and Policy, 9(1), 58–74.

26.

Kelley

T. M.

Pransky

Lambert

E. G.

(2015a). Inside-out or outside-in: Understanding spiritual principles versus depending on techniques to realize improved mindfulness/ mental health. Journal of Spirituality in Mental Health, 17(3), 153–171.

27.

Kelley

T. M.

Pransky

Lambert

E. G.

(2015b). Realizing improved mental health through understanding three spiritual principles. Spirituality in Clinical Practice, 2(4), 267–281.

28.

Kelley

T. M.

Pransky

Lambert

E. G.

(2016a). Realizing improved mindfulness/flow/mental health through understanding three spiritual principles. Journal of Spirituality in Mental Health, 19(2), 133–150.

29.

Kelley

T. M.

Pransky

Lambert

E. G.

(2016b). Understanding spiritual principles or depending on techniques to realize and sustain optimal mental health. Journal of Spirituality in Health, 18(3), 217–238.

30.

Lösel

Schmucker

(2005). The effectiveness of treatment for sex offenders: A comprehensive metanalysis. Journal of Experimental Criminology, 1, 117–146.

31.

Luhmann

Hawkley

L. C.

Eid

Cacioppo

J. T.

(2012). Time frames and the distinction between affective and cognitive well-being. Journal of Research in Personality, 46, 431–441.

32.

Luong

Wormith

S. J.

(2006). The effectiveness of psychological sex offender treatment: A meta-analysis. Department of Psychology, University of Saskatchewan.

33.

MacKenzie

D. L.

(2006). What works in corrections: Reducing the criminal activities of offenders and delinquents. Cambridge University Press.

34.

McGrath

R. J.

Cumming

G. F.

Burchard

B. L.

Zeoli

Ellerby

(2010). Current practices and emerging trends in sexual abuser management: The Safer Society 2009 North American Survey. Safer Society Press.

35.

Mews

DiBella

Purver

(2017). Impact evaluation of prison-based core Sex Offender Treatment Program (Ministry of Justice Analytical Series). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/623876/sotp-report-web-.pdf

36.

Mills

R. C.

(1995). Realizing mental health: Toward a new resiliency. Sulzburger & Graham Publishing.

37.

Moster

Wnuk

D. W.

Jeglic

E. L.

(2008). Cognitive behavioral therapy interventions with sex offenders. Journal of Correctional Health Care, 14(2), 109–121.

38.

Nagin

D. S.

Patermoster

(1993). Enduring individual differences and rational choice theories of crime. Law and Society Review, 27(3), 467–496.

39.

Pilkonis

P. A.

Dodds

N. E.

Johnston

K. L.

Maihoefer

C. C.

Lawrence

S. M.

(2014). Validation of the depression item bank from the Patient-Reported Outcomes Measurement Information System (PROMIS) in a three-month observational study. Journal of Psychiatric Research, 112(9). https://doi.org/10.1016/j.jpsychires.2014.05.010

40.

Piquero

Tibbetts

(1996). Specifying the direct and indirect effects of low self-control and situational factors in offenders’ decision making: Toward a more complete model of rational offending. Justice Quarterly, 13(3), 481–508.

41.

Pransky

(1998). Renaissance of psychology. Sulzburger & Graham.

42.

Pransky

(2003). Prevention from the inside-out. Author House.

43.

Pransky

Kelley

T. M.

(2014). Three principles for realizing mental health: A new psycho-spiritual view. Journal of Creativity in Mental Health, 9, 53–68.

44.

Pransky

Kelley

T. M.

(2017). How the formless comes into form: A process by which Universal Mind powers consciousness and thought to create people’s psychological lives. Cogent Psychology, 4, 1307633. https://doi.org/10.1080/23311908.2017.1307633

45.

Pratt

T. C.

Cullen

F. T.

(2000). The empirical status of Gottfredson and Hirschi’s general theory of crime: A meta-analysis. Criminology, 38(3), 931–964.

46.

Prentky

Schwartz

Burns-Smith

(2006). Treatment of adult sex offenders. VAWnet, National Online Resource Center on Violence Against Women, Pennsylvania Coalition Against Domestic Violence.

47.

PROMIS Health Organization. (2013). LEVEL 2—Depression/Anxiety/Anger—Adult (PROMIS Emotional Distress—Depression—Short Form). American Psychological Association.

48.

Schreck

C. J.

(1999). Criminal victimization and low self-control: An extension and test of a general theory of crime. Justice Quarterly, 16(3), 633–654.

49.

Sedgeman

(2005). Health realization/innate health: Can a quiet mind and a positive feeling state be accessible over the lifespan without stress relief techniques? Medical Science Monitor, 11, 47–52.

50.

Stewart-Brown

Tennant

Platt

Parkinson

Weich

(2009). Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): A Rasch analysis using data from the Scottish Health Education Population Survey. Health and Quality of Life Outcomes, 7(1), Article 15. https://doi.org/10.1186/1477-7525-7-15

51.

Tangney

J. P.

Baumeister

R. F.

Boone

A. L.

(2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72(2), 271–324.

52.

Tennant

Hiller

Fishwick

Platt

Joseph

Weich

, et al (2007). The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS): Development and U.K. validation. Health and Quality of Life Outcomes, 5(1), 63.

53.

Townsend

Rheingold

A. A.

(2013). Estimating a child sexual abuse prevalence rate for practitioners: Studies. Darkness to Light. www.D2L.org

54.

Vohs

K. D.

Faber

R. J.

(2007). Spent resources: Self-regulatory resource availability affects impulse buying. Journal of Consumer Research, 33(4), 537–547.

55.

Wiese

C. W.

Tay

Duckworth

A. L.

D’Mello

Kuykendall

Hofmann

, et al (2017). Too much of a good thing? Exploring the inverted-U relationship between self-control and happiness. Journal of Personality, 86, 380–396.

56.

Yates

P. M.

(2013). Treatment of sexual offenders: Research, best practices, and emerging models. International Journal of Behavioral Consultation and Therapy, 8(3–4), 89–95.