Sexual Abuse: A Journal of Research and Treatment, Vol. 17, No. 2, April 2005 (
Therapist Style in Sexual Offender Treatment:
Inﬂuence on Indices of Change
W. L. Marshall
This paper describes the results of our review of the broad process literature as well
as summarizing two studies examining the inﬂuence of the therapist in generating
changes in treatment targets among sexual offenders. We conclude that displays
of empathy and warmth by the therapist as well as the provision of rewards for
progress and some degree of directiveness, maximize the beneﬁts derived from the
procedures employed in treating sexual offenders. We also suggest the need for
ﬂexibility and encourage program designers not to so overly detail their treatment
manuals that the inﬂuence of the therapist is minimized.
KEY WORDS: therapist inﬂuence; sexual offenders; process features.
In the early days of modern behavior therapy, its advocates adopted the
position that specifying the procedures implemented in treatment was all that was
necessary to exhaustively account for all relevant aspects of treatment (Kazdin,
1978). Indeed, it appears that this emphasis on procedures entailed the idea that
the therapist exerted little or no inﬂuence. Perhaps this was historically necessary
in order for behavior therapists to uniquely identify their nascent movement, but it
did have the effect of all but consigning an interest in the role of the therapist to the
scrapheap of history as far as behavior therapists were concerned. Although this
was not entirely true, it was not until the publication of a book by Schaap, Bennun,
Schindler, and Hoogduin (1993) that research on the therapeutic relationship
in behavior therapy was given signiﬁcant status. Schaap et al. found 40 papers
considering the importance of the therapist in behavior therapy, although many
of these were simply position papers. In the literature on cognitive behavioral
treatment of sexual offenders, we (Marshall, Fernandez, et al., 2003) were able to
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2005 Springer Science+Business Media, Inc.