The Multifactor Offender Readiness Model: Tony Ward, Andrew Day, Kevin Howells, Astrid Birgden

Aggression and Violent Behavior
9 (2004) 645 – 673
The multifactor offender readiness model

Tony Warda,*, Andrew Dayb, Kevin Howellsb, Astrid Birgdenc
a
School of Psychology, Victoria University of Wellington, P.O. Box 600, Wellington, New Zealand
b
Centre for Applied Psychological Research, University of South Australia, North Terrace,
Adelaide 5000, Australia
c
Criminology Department, University of Melbourne, 234 Queensbury St., Carlton Victoria 3052, Australia
Received 16 July 2003; accepted 7 August 2003
Abstract
There has been a resurgence of interest in the rehabilitation of offenders. Research has consistently
shown that rehabilitation programs for offenders, when they adhere to general principles of program
design and delivery, will achieve significant reductions in recidivism. In this paper, we suggest that
even greater reductions in recidivism can be achieved when readiness is addressed at the level of the
individual offender, the program, and the context. A comprehensive understanding of readiness allows
for fuller engagement in treatment, thus increasing probability of good treatment outcomes. We
describe person, program, and context factors in a model of offender treatment readiness and discuss
implications of the model for both assessment of offenders and for modification of low readiness.
D 2003 Elsevier Ltd. All rights reserved.
Keywords: Offenders; Readiness; Recidivism
1. Introduction
There has been a great deal of research and clinical attention paid to the issue of offender
rehabilitation over the last 20 years or so. The innovative work of Canadian, British, and
American researchers has led to the refinement of rehabilitation theory and the formulation of
explicit practice guidelines (e.g., Andrews & Bonta, 1998; Layton-MacKenzie, 2000;
McGuire, 2001). This work has been empirically guided, and indeed, the determination to
* Corresponding author.
E-mail addresses: tward@unimelb.edu.au, Tony.Ward@vuw.ac.nz (T. Ward).
1359-1789/$ – see front matter D 2003 Elsevier Ltd. All rights reserved.
doi:10.1016/j.avb.2003.08.001
646 T. Ward et al. / Aggression and Violent Behavior 9 (2004) 645–673
discern what actually works in the correctional domain has been a striking and welcome change.
The field has literally been transformed and the call to utilize only empirically supported
therapies and strategies increasingly accepted. The emergence of a risk management perspec-
tive and its attendant risk–need model of offender rehabilitation have provided the field with an
organisational framework from within which to guide service providers, policy makers, and
correctional administrators. Thus, evidence-based offender treatments have become an estab-
lished part of efforts to reduce crime, and prison, probation, and forensic mental health services
all now offer such treatments (Day & Howells, 2002; McGuire, 2001).
In this paper, we suggest that even greater reductions in recidivism than those demon-
strated in programs that adhere to evidence-based principles of risk and needs can be made
when programs are able to be responsive to individual needs. While risk–need assessments
can guide decisions regarding both selection of appropriate candidates for treatment and
appropriate targets for treatment (most commonly those areas of need that are functionally
related to the offending), they offer little by way of guidance on how well any intervention is
likely to be received, or on the extent to which programs are able to respond effectively to
individual offender needs. The level of fit between the client and the treatment is increasingly
acknowledged as a critical factor in effective treatment programs (e.g., Sobell & Sobell,
1999), and is evidenced by a growth of interest in integrative models of therapy in clinical
psychology (e.g., Ryle, 1997). Effectiveness of treatment programs is likely to be a result of
both the availability of high quality and responsive treatments and efforts to encourage
individuals to enter and stay in treatment.
We argue that there has been little attempt in the literature to distinguish between three
distinct, although related, constructs: treatment motivation, responsivity, and readiness.
Motivation involves assessing whether or not someone really wants to enter treatment and
therefore is willing to change his or her behavior in some respect (e.g., cease to behave
aggressively). Typical clinical criteria for deciding that offenders are motivated to enter
treatment include expressions of regret for their offenses, a desire to change, and sounding
enthusiastic about the treatments on offer. In an important respect, the judgement that an
offender is motivated for therapy is essentially a prediction that he or she will engage in, and
complete, therapy. In current practice, it is widely accepted that offender motivation
constitutes an important requirement for selection into rehabilitation programs, and therapists
are expected to have the skills to initiate, enhance, and sustain motivation in reluctant
individuals. Ironically, despite a plethora of literature on motivational interviewing and
related interventions, there has been comparatively little attention paid to clarifying the
relevant underlying mechanisms or consideration of the relationship between motivational
states and other aspects of treatment preparedness. Relatedly, there is no consensus as to what
is meant by offenders’ motivation and no systematic examination of the factors that influence
it (McMurran & Ward, submitted for publication).
The responsivity principle is used to refer to the use of a style and mode of intervention that
engages the interest of the client group and takes into account their relevant characteristics,
such as cognitive ability, learning style, and values (Andrews & Bonta, 1998). In other words,
responsivity refers to the extent to which offenders are able to absorb the content of the
program and subsequently change their behavior. Responsivity can be further divided into
T. Ward et al. / Aggression and Violent Behavior 9 (2004) 645–673 647
internal and external responsivity (Andrews, 2001). Attention to internal responsivity factors
requires therapists to match the content and pace of sessions to specific client attributes such
as personality and cognitive maturity, while external responsivity refers to a range of general
and specific issues, such as the use of active and participatory methods. External responsivity
can be divided further into staff and setting characteristics (Kennedy, 2001; Serin & Kennedy,
1997). Within the broad responsivity principle lays an invitation to attend to an offender’s
motivation to engage in therapy and to commit to change. Responsivity, as usually under-
stood in the rehabilitation literature, is primarily concerned with therapist and therapy
features, and is therefore essentially concerned with adjusting treatment delivery in a way
that maximizes learning.
The major problem with the way the responsivity principle has been formulated is that
there has been relatively little attention paid to the underlying constructs or an account of how
the different processes and structures impacting on responsivity are interrelated. In our view,
there has been a failure to realize that the ability to capitalise on therapeutic opportunities also
involves the dynamic interaction between person, therapy, and contextual factors. We suggest
that a robust construct of treatment readiness has the conceptual resources to take these
complex interactions into account.
The concept of readiness was originally articulated in an offender context by Serin (1998)
and Serin and Kennedy (1997), although it has also previously been used in offender
substance use treatment programs (e.g., DeLeon & Jainchill, 1986). It can be broadly defined
as the presence of characteristics (states or dispositions) within either the client or the
therapeutic situation, which are likely to promote engagement in therapy and that, thereby, are
likely to enhance therapeutic change (Howells & Day, 2002). To be ready for treatment means
that the person is motivated (i.e., wants to, has the will to), is able to respond appropriately
(i.e., perceives he or she can), finds it relevant and meaningful (i.e., can engage), and has the
capacities (i.e., is able) to successfully enter the treatment program. Ascertaining whether an
offender is motivated to enter treatment involves assessing their volitional state: Do they
genuinely want and intend to enter treatment?
We argue that the constructs of motivation and responsivity are narrower in scope than that
of readiness and unable to cover the range of conditions that this construct can. In other
words, the construct of readiness is the more inclusive one and incorporates both the
constructs of motivation and program responsivity.
At this point it is necessary to consider the claim that in some formulations of responsivity,
there is a reference to obstacles that prevent engagement in treatment (Serin, 1998), and that the
addition of this feature increases its utility and makes it conceptually equivalent to our
formulation of treatment readiness (see below). We propose that this claim is mistaken and
that the readiness concept is the richer and more useful one. First, readiness refers to the required
conditions for engagement in treatment, while the notion of obstacles refers to a lack of these
factors. In other words, readiness directs individuals to ask what skills, etc., are required for
entry into a program, while the concept of responsivity obstacles simply focuses attention on
what is preventing treatment engagement or responsiveness—a positive feature rather than a
negative feature search. It is easier conceptually to focus on what is required to complete or
engage in a task than on what is preventing such engagement, and also of greater utility. There
are a thousand ways things can go wrong (i.e., obstacles), while it is only necessary to find one
way to solve a problem (i.e., required conditions). Second, the responsivity concept has not
really been developed into a systematic model and as such lacks coherence; it tends to be
operationalised as a list of factors (see Serin, 1998). That is, it is not immediately obvious how
the different factors converge, whereas this is clear in the readiness model. Third, the readiness
model specifies what the required conditions for treatment engagement are and what can go
wrong, whereas the responsivity construct is more ad hoc in nature: the list of obstacles depends
on what empirical research discovers and therefore may change over time. Finally, the readiness
model deals with contextual (e.g., family support, resource availability, relationships) and
temporal issues and is broader in scope. In other words, it is clearer about the internal and
external conditions required to engage in treatment and explains how they are interrelated (it is
also inclusive of responsivity). It is a better model because of its greater scope, coherence,
testability, and utility (fertility).
In summary, while the responsivity principle focuses on obstacles or what is preventing
treatment engagement, readiness is concerned with the conditions required for treatment
engagement. Readiness is positively focused, conceptually easier to apply, broader with its
focus on issues such as family and context, and overall is a more coherent model. In this
paper, we outline the multifactor offender readiness model (MORM). After outlining the
conceptual model in some detail, we discuss its clinical and research implications for the
treatment of offenders.
2. The multifactor offender readiness model
In a recent review paper, Howells and Day (2002) explored the obstacles to the effective
treatment of offenders presenting with anger problems. They identified seven possible
impediments:
1. The complexity of the cases presenting with anger problems. This included the coexistence
of mental disorders with aggressive behavior.
2. The setting in which anger management is conducted.
3. Existing client inferences about their anger problem. For example, inferences indicating
that the anger was viewed as appropriate and justified.
4. The impact of coerced or mandatory treatment.
5. The inadequate analysis of context of personal goals within which the anger problem
occurs. It is possible that the expression of anger could increase the likelihood that
important personal goals are achieved.
6. Ethnic and cultural differences.
7. Gender differences in the experience and expression of anger.
Howells and Day suggest that each of these impediments is associated with different
triggers and experiences, and that the notion of the ‘‘resistant client’’ may simply be a
shorthand and ultimately unhelpful way of describing the combined effects of the above
impediments. Each of the impediments represents a commonly occurring barrier that can stop
offenders from engaging effectively with a treatment program (in this case anger manage-
ment), and consequently benefiting from the treatment. The emphasis on therapeutic
engagement in this perspective highlights the critical role of the therapeutic alliance in the
development of a collaborative therapeutic relationship in working effectively with offenders
to reduce the risk that they will reoffend.
The term therapeutic alliance (also referred to as the working alliance) refers to three
different aspects of the relationship between the client and therapist: the collaborative nature
of the relationship, the affective bond between client and therapist, and the client and
therapists’ ability to agree on treatment goals and tasks (Bordin, 1994; Gaston, 1990). It has
been shown to be a moderate, but significant and consistent, predictor of treatment outcome
across a variety of therapeutic modalities and client groups (Bambling & King, 2001; Horvath
& Symonds, 1991), and we would argue that it is likely to be equally important feature of
effective offender rehabilitation programs. Marshall et al. (2003) have recently identified the
development of an effective therapeutic alliance as essential to effective sexual offender
treatment, and many effective treatments for personality disorder also emphasise the
importance of the alliance (Benjamin & Karpiak, 2001).
2.1. An offender readiness model
We propose that the problem facing practitioners is that the constructs of responsivity and
motivation are not sufficiently rich enough to provide the guidance required to build a sound
alliance with offenders, whereas the construct of treatment readiness can do so. In our view,
low readiness is as much a feature of the therapy context and setting as it is of the internal
characteristics of the client, and that to increase the chances that an intervention will engage
an offender, it is necessary to keep in mind the importance of cognitive factors such as
treatment expectations and appraisals, motivation, external supports, and an appropriate
institutional culture (Howells & Day, 2002). Many of these factors are particularly relevant to
the circumstances facing correctional (particularly imprisoned) clients and would be less
relevant in mental health settings where treatment may be accessed on a voluntary basis. Each
of these factors is contained within our MORM.
We suggest the MORM model of treatment readiness has the conceptual resources not only
to incorporate the impediments to anger management programs described by Howells and
Day (2002), but also to address the deficiencies of a simple motivational or responsivity
approach. In the MORM model, these are indeed important constructs but individually, they
only account for a few of the critical features necessary to effectively engage and retain
offenders in the treatment process. In other words, they are necessary but not sufficient
aspects of readiness to engage in treatment.
In order to develop the MORM model, we simply addressed each of the impediments
identified by Howells and Day (2002) and asked the following questions: ‘‘What does this
impediment prevent from occurring?’’ and ‘‘What is it due to, what is causing it?’’ In other
words, if a given impediment was removed, what psychological, contextual, and therapeutic
conditions would be in place? Upon reflection, it appears that these obstacles to treatment
reside within the person, the context, or within the therapy or therapeutic environment. This
analysis in conjunction with the introduction of some new psychological constructs enabled
us to formulate the following definition, following Howells and Day: ‘‘The concept of
readiness can be broadly defined as the presence of characteristics (states or dispositions)
within either the client or the therapeutic situation, which are likely to promote engagement in
therapy and which, thereby, are likely to enhance therapeutic change.’’ According to this
definition, readiness to change persistent offending behavior requires the existence of certain
internal and external conditions within a particular context. It includes the constructs of
responsivity and motivation as traditionally understood but goes well beyond these in its
approach to enhancing treatment engagement and effectiveness. Thus, readiness is a complex
construct that incorporates a number of psychological and behavioral dispositions and states,
particular contextual features, and distinct therapeutic dimensions.
The major assumption underlying the MORM model is that treatment readiness of
offenders is a function of both internal (person) and external (context) factors (see Fig. 1).
Offenders who are ready to enter a specific treatment program are viewed as possessing a
number of core psychological features that enable them to (at least minimally) function in a
therapeutic environment and thereby benefit from the interventions provided. These person
factors are cognitive (beliefs, cognitive strategies), affective (emotions), volitional (goals,
wants, or desires), behavioral (skills and competencies), and identity (personal and social).
The contextual factors related to these properties are circumstances (mandated vs. voluntary,
offender type), location (prison, community), opportunities (availability of therapy and
programs), resources (quality of program, availability of trained and qualified therapists,
appropriate culture), interpersonal supports (availability of individuals who wish the offender
well and would like to see him or her succeed in overcoming their problems), and program
characteristics (e.g., program type and timing of treatment).
The MORM model suggests that an offender will be ready to change offending to the
extent that he or she possesses certain cognitive, emotional, volitional, and behavior
properties, and lives in an environment where such changes are possible and supported. It
Fig. 1. Model of treatment readiness.

is hypothesized that the subject and contextual factors combine to increase the likelihood a
person is ready to engage in treatment. The model incorporates whether or not a person is
ready to change his or her behavior (in the general sense), to eliminate a specific problem, to
eliminate a specific problem by virtue of a specific method (e.g., cognitive behavioral
therapy), and finally to eliminate a specific problem by virtue of a specific method at a
specific time. The idea is that readiness will increase to the degree a person moves from the
first treatment target to the final one. In our view, this aspect of the model maps rather well
onto the stages of change model to be described later (Prochaska, DiClemente, & Norcross,
1992). We will now systematically unpack the MORM model of readiness. It is important to
note that the focus will be on those factors that relate to offenders’ readiness to enter an
offender rehabilitation program. Internal readiness conditions, external readiness conditions,
and target factors will be considered.
2.2. Internal readiness conditions
Internal readiness consists of cognitive, affective, behavioral, volitional, and personal/

social identity factors.
2.2.1. Cognitive factors

According to the MORM model, many offenders exhibit a number of attitudes, beliefs,
and thinking styles that reduce their willingness to engage in therapy. Existence of hostile
attitudes and beliefs can result in a tendency to view the world and the actions of others in a
negative, cynical fashion (Buss & Perry, 1992). This may make it difficult to accept that
therapists will behave in a trustworthy manner and deliver the kind of interventions initially
promised to the offender. These implicit theories and attitudes may bias ongoing problem
solving and attributions and result in offending behaviors, resulting in further social
rejection.
Client resistance (sometimes referred to as reactance) is a term used in psychotherapy to
imply a refusal to cooperate or change, or a tendency to resist the therapist’s influence. In
their review of treatments for depression, Beutler, Clarkin, and Bongar (2000) conclude that
effective psychotherapy is correlated with relative absence of resistance. In other words,
resistance impedes the achievement of therapeutic goals, and resistant clients are more prone
to prematurely terminate from treatment than those who are cooperative. It seems likely that
those offenders with beliefs that they should not comply with the therapist’s requests are
unlikely to be those that successfully engage in rehabilitation.
Some discussion of the growing research literature in psychopathy is relevant in this
context, given that psychopaths are commonly labeled as either untreatable or treatment
resistant. While the construct of psychopathy may be defined in terms of affective (e.g., lack
of remorse or guilt), behavioral (e.g., impulsivity), and interpersonal (e.g., short-term
relationships) components, other variables such as failure to accept responsibility, patho-
logical lying, and conning may be regarded as more cognitive in nature. Hemphill and Hart
(2002), in their review of treatment for psychopathic offenders, have concluded that
psychopathic offenders are more likely to be disruptive in treatment and are more likely to
drop out of treatment, and struggle to form effective therapeutic alliances. Hemphill and Hart
go on to suggest that ‘‘psychopathic offenders might further resist help if they perceive a
power differential between the therapist and themselves and view therapy as an affront to
their attempt to seek and exert status and influence’’ (p. 23).
An important cognitive variable in treatment outcome research is client expectations. This
refers to the client’s expectations about what will happen in therapy and what the likely
outcomes will be (Garfield, 1994). Client outcome expectancies have been positively related
to treatment outcome in a number of clinical studies (Arnkoff, Gallis, & Shapiro, 2002) and
are commonly implicated in explanations of the findings of positive effects in placebo
treatments (Kirsch, 1990). Role expectations (the expected behavior of people in particular
roles) and preferences (the desired, rather than expected, treatment or therapist) have also
been proposed as possible moderators of treatment outcome. Expectancies can come from
previous experiences of treatment, the experience of the assessment process, or the reputation
that programs and program staff have in a particular institution. All of these factors are likely
to influence an individual’s expectations about treatment and his or her consequent readiness.
Related to client expectancies are the client’s perceptions of the therapist (Marshall et al.,
2003). When offenders meet program providers and case managers as part of a reception or
early assessment process, the impressions they form are likely to influence their expectancies
about treatment.
Self-efficacy is a cognitive factor that potentially may influence treatment readiness in
offenders. Self-efficacy is self-appraisal about how well one can perform actions to deal with
a situation (Bandura, 1997). Bandura and Locke (2003) have argued that perceived self-
efficacy is related to both enhanced motivation and performance. In this context, it is
plausible that low levels of self-efficacy in offenders will be associated with poorer treatment
performance, although existing research with offenders has tended to use self-efficacy as a
measure of change rather than as a pretreatment measure to predict subsequent performance
(Day, Maddicks, & McMahon, 1993; Hall, 1989).
More generally, it has been argued that the attitudes that offenders hold towards treatment
in the criminal justice system are important determinants of subsequent treatment perform-
ance (Baxter, Marion, & Goguen, 1995). This area has received surprisingly little attention in
the literature, although studies suggest that generally, offenders are likely to hold quite
negative views towards criminal justice agencies (Lyon, Dennison, & Wilson, 2000) and
would be unlikely to approach correctional staff for help, particularly for emotional support
(Dear et al., 2002; Hobbs & Dear, 2000). General beliefs about personal change may also
influence the likelihood of individual offenders identifying a need for treatment and engaging
with a rehabilitation program. The Health Belief Model (see Chew, Palmer, Slonska, &
Subbiah, 2002) has been applied to a range of health promotion behaviors. This model
proposes that for an individual to take steps to change, he or she must not only believe that
the benefits of the action outweigh the barriers, but also experience some trigger to take
action (usually in a medical context, this comes from advice from a doctor). The person must
also believe that he or she is susceptible to the condition and view the condition as serious
(Chew et al., 2002). Applying the Health Belief Model to offender rehabilitation would imply
that the offender needs to see his or her offending as likely to recur (i.e., that he or she is
susceptible), that offending is a serious problem, and that the costs of change do not outweigh
the benefits (e.g., not associating with friends who are likely to offend).
2.2.2. Affective factors

The presence of emotional dysregulation can lead to ongoing hostile feelings and high
levels of physiological arousal. There are a number of patterns of dysfunctional emotional
regulation (Baumeister, Heatherton, & Tice, 1994; Carver & Scheier, 2003). Individuals can
fail to control their behavior or emotions and behave in a disinhibited manner. This type of
self-regulatory failure can be associated with either positive or negative emotions. In addition,
the use of ineffective strategies to achieve goals can backfire and ultimately result in a loss of
control, a misregulation pattern. The experience of such difficulties may result in frequent
rule violations and an inability to benefit from therapy. In other words, a necessary condition
for entering a treatment program is a basic level of emotional control.
Generalized distress is one type of affective factor that is also likely to impact on readiness.
When psychological distress is experienced, an individual may contemplate behavior change
or become resistant to change. In our experience, level of distress that a client presents with
during the reception and screening assessments is often viewed as relevant in making
decisions about program referral, although we are not aware of any empirical research that
has directly addressed this question. This view would, however, be consistent with clinical
research suggesting that subjective distress is not only likely to be an indicator of problem
severity, but from both a clinical and theoretical perspective, is also likely to have motiva-
tional properties (Frank, 1974). Levels of pretreatment client distress are related directly to
treatment outcome in other types of psychosocial treatment. For example, in their review of
treatments for depression, Beutler et al. (2000) concluded that treatments achieve their
greatest effects among those with moderate to high initial levels of subjective distress.
High initial levels of distress upon entry to the criminal justice system in general, and
prison in particular, are seen by some as providing a window of opportunity to engage
offenders in treatment. In relation to the courts, Casey and Rottman (1998) have described the
‘‘teachable moment’’ where the opportunity to promote a more therapeutic outcome may
occur. Lipton (1994), for example, has argued that imprisonment presents an important
opportunity for substance use treatment, given that many drug users are unlikely to seek
treatment by themselves, and that drug use and criminality are likely to continue after release.
The corrections system can act to harness the teachable moment with a distressed offender
when it arises (Birgden, 2002).
Another important (and related) component of the affective state of an offender being
considered for treatment or rehabilitation will be the individual’s emotional reaction to their
offence or to their status as ‘‘offender.’’ For some, the immediate offense may be their first,
with the result that they have also newly acquired the social status of being an offender. Given
the focus of treatment and rehabilitation programs on medium to high risk offenders, and
given the high weighting of previous offences in most methods for assessing risk, the great
majority of offenders being assessed for programs will have established histories of
offending, and the conferral of the status offender will be longstanding. There will, however,
particularly in violence programs, be some individuals with one-off offenses, with no
significant previous offence histories, for example, domestic homicides. Intuitively, it might
be predicted that individuals in this latter group would have stronger negative, emotional
reactions to their offence and to their offender status. Among such offenders, reactions
emotions of guilt, shame, and remorse may be common. We know of no empirical studies
investigating differences in these emotions in one-off as opposed to repetitive offenders,
though the high incidence of subsequent suicide in domestic homicides would be consistent
with stronger guilt, shame, and remorse in this group (West, 1965).
In order to assess the potential influence of offence-related emotions such as guilt, shame,
and remorse on readiness for treatment, there are two requirements. First, these emotions need
to be defined and differentiated. Second, possible mediating mechanisms need to be
identified. Proeve (2002) has recently advanced our understanding of the different compo-
nents of guilt, shame, and remorse. Cognitions that characterize guilt and shame have a
different focus (Proeve, 2002; Proeve & Howells, 2002). In guilt, the individual’s focus is on
the act, while in shame, it is on the self (Tangney, 1999). Guilt also involves a focus on the
negative consequences of the act for others and an accompanying belief that the individual
has violated a personal, moral standard. A number of action tendencies have been described
for guilt, including apologising, undoing damage and attempts to repair the damage done
(Proeve, 2002).
It has been suggested in the literature (Lewis, 1995; Proeve, 2002; Proeve & Howells,
2002) that shame can be distinguished from guilt in terms of the self-evaluative components
of emotion. Although guilt may involve focusing on aspects of the self that lead to the
transgression, typically, the self is not negatively evaluated in a global way. Global negative
evaluations of the self do characterize shame. The self is seen as inferior, incompetent, or
otherwise bad. Shame also involves an awareness of judgement of the self by others, of the
defectiveness of the self in the gaze of the observing other (Taylor, 1985). The action
tendency associated with shame appears to be hiding oneself from others, whereas confession
and reparation are more salient for guilt (Proeve, 2002).
Thus, it appears that shame and guilt can be distinguished to some degree in terms of their
phenomenology and accompanying cognitive and behavioral processes. There are also
indications that shame is more associated with other psychological variables that might
impair readiness than does guilt. Shame proneness is associated with low empathy, anger,
irritability, externalization, blaming of others for negative events, resentment, suicidal
behavior, and psychopathology, whereas guilt tends to show an inverted or no relationship
to many of these variables (Bumby, 2000; Bumby, Marshall, & Langton, 1999; Proeve, 2002;
Proeve & Howells, 2002; Tangney, 1991). Bumby (2000) has suggested that guilt is
associated with critical analysis of the transgression, while shame leads to poor perspective
taking. Hudson, Ward, and Marshall’s (1992) formulation of shame and guilt in sex offenders
in attributional terms is also consistent with the above findings. These authors argued that
internal, controllable attributions of a lapse would result in experiences guilt and a desire to
commit to abstinence. Shame, according to this analysis, reflects an attribution to internal
uncontrollable causes and would be associated with failure to cope and subsequent relapse.
Proeve and Howells (2002) have proposed that therapy for child sex offenders involves a
movement from shame to guilt. From this perspective, the sex offender is ‘‘unready’’ to work
on his or her problems at the beginning of a program because he or she is preoccupied with
the bad self and with the negative evaluations by others. As shame is remediated, constructive
guilt slowly predominated and stimulates engagement in treatment and behavior change. A
highly responsive program would, ideally, be capable of varying the type of intervention
according to the shame and guilt status of the individual sex offender. Proeve and Howells
state, for example, that high shame offenders may be adversely affected, at least initially, by
group treatment—‘‘shame may perhaps be offset by the careful encouragement of support
within the group and a focus on the commonality of their inappropriate behavior rather than
on their identity as sex offenders’’ (p. 664).
The above discussion and studies have largely been in relation to sex offenders. For a
variety of reasons, issues of shame (and even guilt) are likely to be more salient for this group
than for acquisitive offenders or violent offenders. Cultural and subcultural supports are more
likely to exist for acquisitive and violent offending than for sex offending, particularly sexual
offending against children. Cultural supports (e.g., having peers who endorse or at least fail to
condemn the aberrant behavior and attitudes) are likely to diminish both shame and guilt.
The above analyses would seem to support the notion that affective reactions to the
offence, and particularly the emotions of shame and guilt, may be important determinants of
treatment readiness, although one of the difficulties in doing this may be the unavailability of
state and offence-specific measures of shame and guilt, as opposed to trait measures (Proeve
& Howells, 2002).
2.2.3. Behavioral factors

In the MORM model, we distinguish three types of behavioral factors that influence
readiness. These factors can be seen as occurring in a temporal sequence. First, the offender
must evaluate their current behavior as a problem. Second, the offenders must seek help for
the problematic behavior. Third, the offenders must have competencies to allow them to
participate in the therapeutic process.
Models of behavior change commonly suggest that a person may be willing (i.e.,
motivated) to alter some aspect of his or her functioning, but unclear (unwilling) about just
what should be changed. To be ready for treatment, the individual must recognise a need to
change (i.e., that their offending creates problems for themselves and others) and make some
commitment to change. In most models of behavior change (such as the Transtheoretical
Model), some level of problem awareness or problem recognition is seen as an important
readiness factors. The extent to which a behavior or a feeling is defined as a problem will, in
part, be determined by cultural rules and norms relating to what is acceptable or appropriate
(Cheung & Snowden, 1990). Thus, for example, in some environments where certain types of
offending are normative, it is unlikely that the individual will see his/her offending as
problematic. Other contextual factors, such as poverty, may also influence the decision to
recognise a particular behavior as a problem.
To be treatment ready, offenders must not only recognise that their offending is problem-
atic, but also make a decision to seek help from others. This implies a belief that they are
unable to desist from offending unaided. Once offenders makes a genuine commitment not to
reoffend, they may then be considered to be treatment ready and taught the relevant skills and
strategies in treatment to help them achieve this goal. The decision to seek help may also be
affected by factors such as which services are available, attitudes or beliefs about those
services, beliefs about the importance of privacy and autonomy, or that problems are likely to
diminish over time anyway (Cauce et al., 2002). Generally, it appears that women have more
positive attitudes towards help seeking than men (Boldero & Fallon, 1995), and that some
problems may be particularly associated with low levels of help seeking, such as suicidal
ideation (Saunders, Resnick, Hoberman, & Blum, 1994), family conflict (Boldero & Fallon,
1995), and mental health problems (Wilson, Deane, Ciarrochi, & Rickwood, 2000). Socially
marginalised groups are also more likely to drop out of helping services prematurely,
particularly when they experience suicidal feelings (Deane, 1991; Takeuichi, Bui, & Kim,
1993).
An offender may be ready to work on a particular problem, but not necessarily one that the
therapist views as relevant and central to his or her offending. An example would be the wish
to stop assaulting a partner rather than to simply be a ‘‘better person’’ (general change). An
implication of the Good Lives Model of offender rehabilitation (Ward & Stewart, 2003) is
that offenders will identify areas of need and be motivated to work on issues that are not
regarded by the service as criminogenic. Clearly, to be treatment ready, both the treatment
provider and client have to agree that addressing the specific issues that a program aims to
address will also help the offender meet broader personal goals.
Behavior factors also include possession of the basic communication and social skills
necessary to participate in therapy. These are assumed to be necessary conditions for entering
therapy and are not to be confused with the skills that are expected to be acquired during
treatment. In other words, if an individual is unable to initiate and maintain basic
conversations with others, he or she is not ‘‘ready’’ for treatment. The nature of the required
skills or competencies will depend on the methods of delivery and the content of the
particular treatment program. A program with a large educational component will require
different competencies (e.g., literacy) than will a program based primarily on role playing and
rehearsal of core behavioral skills (confidence in group setting) or a program with a
significant component of intellectual analysis of the antecedents for the person’s offences
(verbal ability, capacity to discuss thoughts, feelings, and behavior in front of other group
members).
In their research with incarcerated sexual offenders, Shaw, Herkov, and Greer (1995) found
that both reading ability and marital status impacted upon successful program completion.
They suggest that successful participation in cognitive–behavioral treatment programs
requires some literacy and comprehension skills and saw marital status as an indicator of
better interpersonal skills and treatment support. In some psychotherapeutic traditions, the
experience of at least one intimate adult relationship is also regarded as an important indicator
of a client’s ability to engage in a therapeutic relationship.
Given the prevalence of mental disorders (Hodgins & Muller-Isberner, 2000) and
intellectual disability in offender populations (Day, 2000), it is also important to note that
the existence of mental illness or intellectual disability may functionally disable these
important core skills and prevent the individual concerned from successfully functioning in
groups or having the necessary attention and concentration abilities to acquire new skills.
Mental disorder has consistently been identified as a factor that is associated with treatment
attrition (e.g., Aunins, 2003). The negative symptoms associated with conditions such as
schizophrenia and mood disorders, even when the disorder is in remission to some degree,
may mean that the individual is unable to arrive at program sessions on time, sit for an
extended period with concentration on group activities, engage and empathise with the
problems expressed by other group participants, or organise and carry out homework tasks.
These myriad readiness deficiencies in mentally disordered offenders has led some clinicians
to modify standard rehabilitation programs by including more extended pretreatment assess-
ment, skill development sessions, and additional therapeutic sessions (Novaco, Ramm, &
Black, 2001). Similarly, intellectual and educational disabilities are relevant to readiness
assessments and may require that mainstream rehabilitation programs are modified in style
and content.
2.2.4. Volitional factors

Volition refers to formation of an intention to pursue a certain goal and the development
and subsequent implementation of a plan to achieve the goal in question. In our view,
motivation to enter therapy involves development of intentions (i.e., the will) to seek a
number of goals, including the desire to behave pro-socially. However, other relevant aspects
of volition include the belief that one is capable of exercising choice and can directly control
important personal outcomes (i.e., an internal locus of control). In the criminal justice context,
exercise of volition requires the ability to consent to treatment programs, to make a decision
based on a cost-benefit analysis and to make a decision without coercion or constraint
(Birgden & Vincent, 2000). There is also therapeutic value in choice. Miller (1985) states that
individuals are more likely to be motivated if they can choose from alternatives.
Typically, in the offender rehabilitation literature, volitional factors have been operational-
ised in terms of motivation to change. Levels of motivation have been shown to be consistent
predictors of retention in substance use programs, and client motivation has also been related
to better treatment engagement in these programs. Joe, Simpson, and Broome (1998)
concluded that indicators of intrinsic motivation were more important predictors of engage-
ment and retention in treatment than other socio-demographic variables.
The Transtheoretical Stages of Change Model (Prochaska et al., 1992) is essentially a
model of internal motivation to change behavior. One of the most important ideas within this
model is that changing behavior is seldom a sudden event, but a process that typically
involves a chain of events that lead to a growing awareness of a problem, a decision to do
something differently, followed by a transitional phase that involves developing change
strategies and implementing them (Tucker, Donovan, & Marlatt, 1999). The model therefore
not only offers a structure for understanding how motivation might change over time, but also
conceptualises change as a process. There have been several attempts to apply the Trans-
theoretical Model to offender populations (e.g., McMurran, 2002; McMurran et al., 1998;
Williamson, Day, Howells, Bubner, & Jauncey, in press), but the emphasis in the model on
internal motivation (rather than contextual or externally motivating factors) means that it is
likely to be of only limited use in forensic contexts (Casey, Day, & Howells, submitted for
publication).
Client motivation is thus only one component of a broader range of responsivity variables
considered in offender rehabilitation and in psychological treatments. Nevertheless, motiva-
tion is a vital construct to consider. Human motivation has a long history as a topic of
theoretical debate within psychology. Ford (1992) has attempted to integrate a range of
findings and concepts from the field of motivation into a Motivational Systems Theory
framework. Motivation from this perspective is defined as the ‘‘organised patterning of an
individual’s personal goals, emotions and personal agency beliefs’’ (Ford, 1992, p. 78). Thus,
motivation involves directedness (towards the goal), emotional/affective energising, and
expectancies about being able to achieve the goal. The absence of motivation (e.g., for
treatment) could be due to any of these three components being deficient. A client might be
unmotivated for therapy because the therapeutic goal is not important for them, because there
are emotional or affective inhibitions to goal pursuit, or because there is a perceived low
capability of achieving the relevant goal.
Karoly (1993, 1999) has endeavored to apply goal system constructs to clinical phenomena
and to treatment. Hence, Karoly’s contribution, together with an earlier influential work by
Ford (1992), will receive particular attention in the present discussion. In 1993, Karoly
defined goals as ‘‘imagined or envisaged states towards which people intentionally aspire and
actively work to bring about (or to avoid, in the case of negative goals)’’ (p. 274). Previous
researchers have sometimes used different terms to describe goals of this sort (Austin &
Vancouver, 1996). Emmons, for example, investigated ‘‘personal strivings’’ while Little
(1983) described ‘‘personal projects’’. Ford (1992) distinguishes three types of goals, based
on their level of prioritisation by the cognitive regulatory system: wishes, current concerns,
and intentions. Personal goals are thus cognitive representations and potential self-regulatory
mechanisms by means of which behavior is activated and coordinated. Karoly (1993) argues
that the goal system approach constitutes ‘‘an analytic framework of immense consolidative
value and considerable pragmatic leverage’’ (p. 274).
Personal goals can be conceptualised at three different levels—the latent, the phenom-
enological, and the external observer (Austin & Vancouver, 1996). Latent goals may be
outside of phenomenal awareness while phenomenological goals are experienced directly and
are (presumably) capable of self-reporting. External observers may infer goals from features
of the individual’s behavior.
Personal goals need to be understood in terms of content; what does the individual want?
The emphasis in goal system theory tends to be on tangible, task-specific incentives rather
than on broad, higher order incentives, such as control or competence (Karoly, 1999). Other
dimensions of goals in Karoly’s framework include goal topography, structure, process
representation, dynamics, modality of representation, procedural predispositions, mind-set
effects, social context effects, and interface with emotion.
Austin and Vancouver’s (1996) review structures previous investigations of personal goals
in terms of goal organisation and goal dimensions. Goals are widely believed by researchers
and theorists to be hierarchically organised, cascading from higher order goals to goals at the
level of local and briefly experienced psychophysiological states.
Austin and Vancouver (1996) identified six dimensions of goals addressed in previous
theoretical and empirical studies: (1) importance/valence, (2) difficulty level, (3) specificity
representation, (4) temporal range, (5) level of consciousness, and (6) connectedness
complexity. Space does not permit detailed description of these dimensions here. In
simplified terms, using anger and aggression as an example, the goal of ‘‘controlling your
temper’’ might be (1) either important or unimportant, (2) perceived as difficult or easy to
achieve, (3) represented in highly specific terms (not punching men in bars on Saturday
nights) or in general terms, (4) a short-term or a long-term task, (5) conscious and intentional
as opposed to automatic and out of awareness, and (6) linked or not linked to other important
goals at the same level of the hierarchy (to superordinate goals and to subgoals, such as
keeping your job or being popular with others).
Ford (1992) has attempted to define the necessary conditions for achievement/competence
from a goal systems perspective. For the purposes of the present discussion, we can substitute
‘‘achieving rehabilitation goals’’ for achievement/competence, the latter terms having been
used because of the educational/developmental context of much goal system research. Ford’s
analysis, when extended to the field of readiness for treatment, would suggest the following
as necessary conditions for achieving therapeutic goals:
1. Personal goals are constituted by, supportive of, or consistent with the therapeutic goal.
2. Emotional states are congruent with therapeutic goal pursuit and achievement.
3. Capability beliefs are present (re-achievability of therapeutic goals).
4. Positive context beliefs are present (perceived supportiveness of the environment in
achieving therapeutic goals).
5. Actual capability/skill exists.
6. Actual environmental/contextual support exists.
From the goal system perspective, psychopathology is related to goal system dysfunctions
that produce ineffective regulation of behavior, cognition, and affect over time and across
different environments. Mental health, from this perspective, denotes ‘‘a process of goal-
directedness that is flexibly self-regulated, unconflicted, balanced as to content, socially
responsible and consistent with core values’’ (Karoly, 1999, p. 18). Karoly adds ‘‘mental
well-being has less to do with the successful attainment of socially sanctioned goals than with
the manner of their daily pursuit and the nature of their subjective construal’’ (p. 18).
Therapeutic change involves the therapist examining with the client what goals the client is
pursuing, how these goals are organised, and how they are being regulated or misregulated
(Karoly, 1999).
Issues of treatment motivation have been directly addressed by goal theorists, albeit briefly.
Karoly (1993), for example, stresses the need to examine treatment targets in the context of
broader client goals and the motivational salience of change. He suggests, also, that
‘‘therapeutic failures of various kinds (premature termination, resistance, relapse, etc.) can
result from the therapist-assessor’s failure to appreciate the structural relation between time-
limited treatment goals and life goals in general’’ (p. 279). Karoly makes the point:
Assuming that a ‘‘therapy goal’’ represents a to-be-achieved destination, it must be borne in mind
that the instantiation of any new trajectory or pathway is always accomplished in the context of
existing and projected pathways and hierarchically distant aspirations. Therapy goals that help
achieve, or are consistent with, meaningful higher order goals stand a better chance of long-term
success than do therapy goals that are at odds with higher order goals or values’’ (Karoly, 1999,
pp. 24– 25).
In summary, goal systems theory would suggest that the client having goals incompatible
with implicit or explicit rehabilitation goals would constitute low readiness. Additionally,
absence of effective self-regulative strategies and processes in relation to goal attainment
would also be a determinant of the occurrence of the presenting clinical problem (e.g., anger
difficulties) and would, in turn, form an impediment to effective change in therapy. The goal
system perspective would suggest that determining the client’s goal structure and associated
self-regulative skills is a key component of pretreatment readiness assessment. The goal
system assessment would need to be multidimensional, including, for example, the dimen-
sions suggested by Austin and Vancouver (1996, see above) and by Karoly (1993), and
Karoly and Ruehlman (1995).
We have found no published examples of applications of goal systems theory to offender
readiness for rehabilitation, although goal constructs are beginning to be applied to under-
standing the causation and maintenance of juvenile delinquency (Carroll, Durkin, Hattie, &
Houghton, 1997; Carroll, Hattie, Durkin, & Houghton, 2001).
2.2.5. Personal identity factors

The subject factor of personal identity is a critically important, albeit a neglected, one for
treatment readiness. Our day-to-day activities are ultimately directed at the achievement of
basic human goods (via goals), and in seeking to realize these goods in specific ways of
living, we construct personal identities (Emmons, 1999). The weightings or priority allocated
to specific primary goods is constitutive of an offender’s personal identity and spells out the
kind of life sought, and relatedly, the kind of person he or she would like to be. For example,
if an offender decides to pursue a life characterized by service to the community, a core aspect
of his or her identity will revolve around the primary goods of relatedness and social life. The
offender’s sense of mastery, self-esteem, perception of autonomy, and control (as outlined
under volitional factors) will all reflect this overarching good and its associated sub-clusters
of goods (e.g., intimacy, caring, honesty). An offender’s personal identity reflects his or her
basic values and way of realizing them in the specific contexts of his or her life. These
contexts necessarily involve ethnicity, gender, class, and age. The important issue for
readiness is that an individual’s personal identity must allow for the possibility of an
offence-free lifestyle (and includes the possibility of change) and is not based too strongly
on being an offender.
As a multicultural society, Australia needs to ‘‘. . . expand the focus of the ‘traditional’
offender—the white adult male—to other historically understudied populations. This includes
women offenders, young and old offenders, and ethnic and racial minorities’’ (Ogloff, 2002,
p. 247). Therefore, personal, cultural and social needs, and the impact on personal identity
should inform program development and delivery. But programs are often developed in ways
that do not cater well for the needs of particular groups such as culturally and linguistically
diverse clients, and those with lower incomes and less education. Such groups have all been
shown to be associated with higher attrition rates in out-patient mental health programs
(Wierzbicki & Pekarik, 1993). Bonta (1995) indicates that rehabilitation sensitive to gender
and cultural issues may enhance treatment effectiveness by providing a context for increasing
motivation and targeting criminogenic needs.
In relation to women offenders, most studies investigate male risk factors and needs and
then apply them to women rather than seeking factors genuinely related to women. While
research has identified criminogenic needs for men and women such as antisocial attitudes
and substance abuse, there has been debate as to which needs are specifically criminogenic
for women. Hannah-Moffatt (1997) lists women offenders’ criminogenic needs as low self-
esteem, dependency, suicide attempts, substance abuse, poor education and vocational
achievement, parental death at an early age, foster care placement, constant changes in foster
care, residential placement, living on the street, prostitution, and parental responsibilities.
Women have distinct gender-based needs for effective program delivery (Sorbello, Eccleston,
Ward, & Jones, 2002), although the relationship of variables such as low self-esteem and past
and present victimisation to recidivism is still uncertain (Blanchette, 1997).
In terms of motivation in treatment, Riehman, Hser, and Zeller (2000) report that partner-
related variables are more significantly associated among women. While the literature has not
focused on treatment readiness per se, there is recognition that programs need to be adapted to
meet the needs and learning styles of women offenders. Coping strategies and avoidance of
exploitative relationships (Howden-Windell & Clark, 1999), and anger control strategies
(Byrne & Howells, 2000) and women’s specific needs should be addressed. Educational
studies on learning styles have found that many women tend to approach learning in more
‘‘connected’’ ways, responding to styles that emphasise empathy, collaboration, and listening
(Belenky, Clinchy, Goldberger, & Tarule, 1986). For women, ‘‘providing programs which
offenders feel directly addresses their needs, which enhance self-esteem, and where staff/
client relationships are viewed as supportive are critical elements’’ (Blyth, 2001a, p. 8).
Women with high-level cooccurring disorders are more likely to drop out of programs, and
individual intervention to enhance retention may be required (Blyth, 2001b). In terms of
treatment readiness, an initial focus on self-esteem building and individual intervention to
prepare for group work and building trust as outlined by Bouffard and Taxman (2000) would
assist.
A paucity of research has been conducted on offenders from culturally and linguis-
tically diverse backgrounds. Particular issues such as English proficiency, unresolved
trauma, acculturation stress, intergenerational conflict, legal problems, and the wider
issues of minority and social exclusion status need to be considered. For example,
acculturation is the process of change in which individuals from one culture, after
continuous contact with that culture, take on the elements of another (Kim, 1977). When
a group is in a minority position however, the pressure to change produces acculturative
stress (Couture, 1995). This stress is likely to impact upon readiness to change. Very
little is known about whether there are culturally related criminogenic needs and whether
risk and need assessments are reliable and valid when applied to such offenders,
including aboriginal offenders. Providing motivation to participate in rehabilitation
programs is of particular importance to such offenders as otherwise such programs
may be perceived as irrelevant to cultural identity. In the United Kingdom, cognitive–

behavioral approaches and pro-social modelling are considered effective, although trans-
cultural specialists add a more sophisticated theoretical base (Vennard & Hedderman,
1998).
2.3. External readiness conditions
External readiness consists of circumstances, location, opportunities, resource, support,

and program/timing factors.
2.3.1. Circumstance factors

This factor relates to an offender’s personal circumstances and the extent to which they
facilitate engagement in treatment. There are at least two sets of issues to consider here. First,
it is important to ascertain whether or not treatment is mandated or voluntary and therefore a
matter of individual choice or social pressure. Clearly, the latter may result in resentment and
a lack of commitment to treatment. Second, it is important to establish what offender
subgroup an offender belongs to. For example, an over-controlled violent offender might only
behave aggressively after intense or repeated provocation, while an under-controlled subtype
might exhibit little self-control in potentially violent situations (Megargee, 1966). Different
sets of circumstance will interact with these predispositions to make it more or less likely that
an offender is ready for treatment.
The extent to which compulsory, coerced, or mandated treatment influences treatment
readiness and subsequent outcomes is difficult to determine, in part, because the definition of
what constitutes ‘‘voluntary’’ is problematic. Mandatory treatment usually refers to court-
directed treatment, although the sanction or threat attached with noncompliance may vary
considerably according to individual circumstances. While many studies use the terms
mandated and coerced interchangeably, the approach does not seem to be entirely accurate.
Definitions of coercion vary substantially across accounts, with the main distinction being
that of actual legal versus perceived coercion.
Most of the early work in the area of coercion has directly compared legally referred
and self-referred clients. However, this is likely to be an oversimplification, given that
legal status is unlikely to be an accurate indication of the level of coercion experienced
by the individual. Farabee, Shen, and Sanchez (2002) have proposed that coercion should
be understood in terms not only of legal status but also of legal pressure to attend a
particular program, and the offender’s perceptions of coercion. All three have been shown
to be powerful predictors of retention in offender drug treatment (Maxwell, 2000; Young,
2002).
An individual’s perceived level of coercion may be linked with their personal treatment
goals. For those clients who concur with the need to attend for treatment and perceive the
treatment as likely to be helpful in meeting their goals, legal pressure to attend will be a less
significant issue. It is only when clients believe that the treatment is not likely to fulfill
personal goals, and when they perceive external pressure to attend that mandated status
becomes an issue (and in some cases, an issue that can be used to avoid entering treatment).
That is, it is the individual’s perceived level of coercion rather than the actual legal pressure
that is important.
2.3.2. Location factors

Location of the offender is relevant to the issue of treatment readiness because of its impact
on meaningful choice and learning opportunities. One critical distinction here is whether or
not the offender is serving a community or prison sentence. This factor has implications for
viability of treatment and the extent to which certain skills can be meaningfully applied in an
ecologically valid way. Location will also directly influence the degree to which family can
visit regularly and therefore support (or discourage) the option of treatment.
2.3.3. Opportunity factors

These factors refer to the availability of therapy and programs within the agency or institution
in which the offender is located. Thus, the extent to which a person is ready for treatment
extends beyond his or her psychological characteristics and those of the treatment itself (i.e.,
whether or not it is a structured skills-based intervention, etc.). In assessing whether an offender
is ready for treatment, certain competencies and psychological states have to be present, and in
addition, the requisite programs have to be available. The key question is ‘‘Is the institution
(agency, etc.) ready to deliver effective treatment to a willing offender?’’
Environmental factors also play an important role in shaping behavior, and the prison
social environment is a central factor in determining the extent to which treatment gains are
sustained and generalized. If prisoners are placed in prison units characterized by guardedness
and suspicion, they are less likely to volunteer to participate in therapeutic groups in which
self-disclosure and openness are encouraged. Thus, the existence of an anti-therapeutic
environment might impact negatively upon readiness for treatment (see Birgden, 2002;
Howells & Day, 2002). While some such as Losel (1996) have argued that evaluations of
offender treatment have played insufficient attention to environmental variables such as these,
the offenders’ experience of the prison environment will also affect treatment readiness.
Stage of sentence will also play an important role in whether offenders see an opportunity for
treatment participation. Those who are approaching release from prison may not have sufficient
time to complete a program and consequently not be offered one, or conversely may be more
ready to participate as the possibility of early release on parole draws closer. Alternately, they
may prefer to wait so they can access community treatment programs on a voluntary basis.
Those beginning long sentences may feel that they will have multiple opportunities over the
course of their sentence and as such feel no immediate pressure to attend.
2.3.4. Resource factors

Despite considerable need for treatment, there is evidence to suggest that existing
offender rehabilitation programs tend to be overburdened, and most offenders receive either
very limited treatment or none at all. In the USA, National Institute of Justice statistics
show that although drug and alcohol counselling was available in nearly 90% of state and
federal facilities, only 10–20% of prison inmates participated in treatment during their
incarceration. Resourcing of programs has also been identified as an important issue in
maintaining program continuity. For example, Baldwin, Heather, Lawson, and Ward (1991)
argue that substance-abusing offenders have not traditionally been seen as a high priority in
service planning, with ‘‘service provision being characterized by poor quality and
intermittent delivery’’ (p. 13).
Ability to provide meaningful treatment programs also requires the presence of skilled and
trained staff, and the physical resources necessary to run the program in a given setting (e.g., a
suitable room). Required skills will involve relevant technical knowledge, experience with
the interventions and the population in question, the capacity to motivate offenders, and an
institutional or agency culture that supports rehabilitation. The key question is, ‘‘Does the
institution or agency have the psychological, social, cultural, and physical resources to deliver
effective treatment to offenders?’’
2.3.5. Support factors

Another external factor we have identified in the MORM model is support. The readiness
of an offender to enter and stay in treatment is likely to be a function of the degree of support
available to him or her. This support is derived from individuals who wish the offender well
and would like to see him or her succeed in overcoming their problems. While family
members and friends are likely to provide some of this support, this may not be enough or
even necessary for some individuals. In our view, what is critical is the presence of prison
officers, community corrections officers, and clinicians who encourage the offender to enter a
specific program and provide basic facts and guidance to this end. Some degree of social
support have been consistently found to be too necessary for psychosocial interventions to be
effective across a wide range of mental health areas (Beutler et al., 2000). In addition,
existence of rewards for completing treatment successfully (e.g., parole, leaves) should also
be construed as important supportive factors.
2.3.6. Program/timing factors

Once a decision has been made to seek help, the offender must agree that a program is the
appropriate way to receive help. Help with problems typically comes from three main
sources: informal supports (such as family, friends, and clergy), ‘‘collateral’’ services
(including health services), and formal correctional services (such as psychiatrists, psychol-
ogists, and social workers). An important determinant of this decision will be the attitudes
that offenders hold towards programs and services, given that more positive attitudes to help
seeking have been consistently associated with help seeking behavior (Deane & Todd, 1996).
A perceived lack of confidentiality about information in correctional settings has been put
forward as one factor influencing (female) offenders to not reveal problems to staff (Maden,
Swinton, & Gunn, 1994).
At this point, the intention is to work on a particular type of problem with a specific
intervention. For example, an individual might decide to stop assaulting his partner through
entering a cognitive–behavioral treatment program. The hope would be that the acquisition of
new cognitive and behavioral skills would enable him to control his aggressive tendencies
and to resolve conflict in a more adaptive and personally satisfying manner. Alternatively, an
offender might posses all the personal conditions to be ready for treatment, and be willing to
change his aggressive behavior, but be adamant that he wants to enter a psychodynamic or
gestalt type of program. He is ready for treatment—but not the treatment that is available or
considered appropriate.
The offender at this point is ready to work on a particular and clinically salient problem at a
time that suits the agency and the therapist concerned. This situation is to be contrasted with one
where he or she is willing to enter a rehabilitation program sometime in the future, not ready for
treatment at this point in time. Lack of readiness may also involve beliefs about self and other
psychological factors that collectively combine to postpone the date of treatment. For example,
a person may think he or she ‘‘needs more time’’ to talk to a partner or to work on their anxiety.
Tucker et al. (1999), in their work on substance use, argue that it is often critical events or
triggers that appear to precipitate the decision to seek help. This commonly involves some
actual or feared negative event or loss (or some actual or anticipated positive life change), and
they suggest that a cognitive reflection and appraisal process appears to be involved in
moderating the impact of such events. Clearly, contact with the criminal justice system
(conviction and sentencing) will be, for some (but by no means all) offenders, be a critical
event that will lead to loss (e.g., imprisonment). Early stages of imprisonment are often a
period of reflection and appraisal about the offence. This appraisal may provide a teachable
moment and is critical to the decision to seek help. If an offender sees the causes of his or her
offending as either unlikely to reoccur or within his or her control, he or she is unlikely to see
a need to seek professional help.
2.4. Target factors
The internal and external readiness factors identified within the MORM model are all
hypothesized to bear a direct relationship with subsequent treatment engagement and
performance. Those who are treatment ready will engage better in treatment, and this will
be observably evident from their rates of attendance, participation, and program completion.
Assuming that programs are appropriately designed and delivered and that they target
criminogenic needs, higher levels of engagement are likely to directly lead to reductions in
levels of criminogenic need and consequent reduction in risk levels.
3. Modification of low readiness
In this paper, we have defined the concept of readiness as presence of characteristics (states
or dispositions) within either the client or the therapeutic situation, which are likely to promote
engagement in therapy and which, thereby, are likely to enhance therapeutic change (following
Howells & Day, 2002). According to this definition, readiness to change persistent offending
behavior requires the existence of certain internal and external conditions within a particular
context. Thus, we would suggest that when working with those offenders that have previously
been regarded as ‘‘resistant,’’ ‘‘untreatable,’’ or ‘‘challenging,’’ a starting point will be to
identify those internal and external conditions that are required for engagement in treatment. As
such, we hope that the MORM model will serve as a heuristic model for clinical decision
making. Given that our definition of readiness incorporates client, program, and setting factors,
it follows that increasing readiness can occur by modifying any or all of these factors.
3.1. Modify the client
Those client characteristics most closely associated with readiness fall into three domains:
the cognitive, the affective, and the behavioral. We have argued that in the cognitive domain,
some degree of problem recognition and decision to seek help are likely to be important
readiness factors, along with confidence in the types of programs and services provided. In the
affective domain, some level of general distress (including anxiety and depression), guilt, or
remorse are identified as potentially important readiness factors, and in the behavior domain,
some access to social support and some ability to function in a group seem important.
Ability to increase readiness will depend on the extent to which these specific subject
factors form a major barrier to engagement in treatment. Low motivation may be addressed
using problem recognition and decision-making techniques often used in motivational
interviewing (Miller & Rollnick, 1991). Motivational interviewing has also been designed
to offer a client a relatively safe and nonthreatening introduction to therapy, such that any
anxieties about entering treatment are allayed. Hemphill and Hart (2002) have discussed ways
of working with psychopathic offenders to increase their motivation. They identify four
motivational strengths of psychopaths: associated with a need to feel superior to others, a
desire for and tolerance of novelty, good interpersonal skills, and a desire to be in control.
They suggest, among other things, that interventions suggesting the low status of a criminal
lifestyle help clients feel in control of their treatment, and emphasised self-sufficiency can all
help to motivate the psychopathic offender to engage in treatment. Assisting offenders in
decision making can also be further enhanced by applying a standardised assessment process
to ensure that a reasoned choice is made about whether and which programs to participate in
(Birgden, in press).
In working with offenders, motivation may also be increased by educating offenders about
the impact of their offences on victims of crime. Victim awareness programs (e.g., Thompson,
1999) may serve to increase levels of remorse and guilt, such that offenders are motivated to
seek help to address the causes of their offending behavior. Other offenders may need to learn
how to recognise and respond appropriately to their emotional states. For those that
experience too much negative affect, mental health interventions (including pharmacotherapy
and counselling) may help an offender contain high levels of arousal to a level that he or she
can still engage in treatment.
Peer education and mentoring schemes, or access to other services (such as the chaplaincy
or culturally based groups), may improve levels of social support to encourage a person to
engage in and sustain treatment over time. Some programs (such as sexual offender
programs) also engage partners and spouses as a means of increasing motivation.
Negative attitudes about programs and/or program providers may be able to be addressed
through giving offenders access to information about what programs actually involve
(through videos or even documentary film), or contact with other offenders who have
previously participated in the program.
In short, there are a number of ways in which individual low readiness factors can be
addressed. We are aware that many of these interventions are already available in correctional
services. However, in our experience, there are rarely clear pathways into such programs and
a general lack of coordination between different initiatives. The MORM model offers a
framework by which individual factors relating to readiness can be examined, and addressed
through a planned and coordinated response.
3.2. Modify the therapy
Another option, and that identified most explicitly in the responsivity principle, is to
modify the treatment or therapy offered. This could involve amending treatment methods so
they are better suited to the client population in terms of literacy level requirement to
participate, or the cultural or gender appropriateness of treatment materials as previously
outlined. It can also involve modifying structural components of the treatment, such as
program intensity—some may not be willing to commit to a program that lasts over a year (or
a therapeutic community), but will be willing to engage in a briefer program.
In terms of the types of treatment offered, there is a tension between offering programs that
are based solely on methods (such as cognitive–behavioral) that have been shown to be
effective with offender populations, and offering a range of treatment modalities that are more
likely to cater for the diverse needs of an offender client population. Although readiness for
treatment is likely to be a reasonably consistent construct across most treatment modalities,
there may be some occasions where readiness factors differ for different types of treatment. For
example, it has been suggested that clients who have low levels of distress may be better suited
to more prescriptive interventions (Beutler et al., 2000), while those clients who have high
levels of distress or specific needs may be better suited to individual methods of delivery rather
than group-based approaches.
3.3. Modify the setting
Setting factors include the social environment and climate within which therapy is offered.
Options available might be to use the sentence planning process to move offenders to more
desirable prison settings, or to promote a therapeutic culture within prisons through the active
involvement of correctional staff in program delivery. Developing prisons as more treatment
supportive through training staff in the value of programs is another obvious way in which
readiness might be improved. On a practical level, lower security prisoners or those nearing
completion of their sentences might be given the option of a leave scheme to attend
community-based treatment programs.
4. Conclusions
In outlining the MORM model of readiness, our intention has been to provide those
involved with assessment of offenders, with a conceptual framework by which they can also
identify those factors that are required to successfully engage in a treatment program. In our
view, it is likely that offenders with low readiness across multiple areas will be those that
either do not complete treatment or for whom treatment does not impact on their offending.
That is not to say, however, that high treatment readiness will necessarily be associated with
good treatment performance. The way in which the program is delivered and the extent to
which program facilitators are able to respond on a moment-by-moment basis to the changing
needs of offenders will be critical in both the successful formation and maintenance of a
strong therapeutic alliance. This is a skilled task, even in programs that are predominantly
psycho-educational in nature.
Finally, it should be noted that different types of rehabilitation program will have different
approaches to the management of therapeutic engagement. The treatment of sexual offenders
is relevant here, as it is relatively common for sexual offenders to enter treatment maintaining
either that their offending did not happen or that it was not problematic. Low levels of
problem recognition and motivation would, in some programs (such as some substance use
programs), exclude offenders from participation. In sexual offender treatment, however,
denial, unless extreme, is rarely grounds for exclusion. In our view, the early stages of these
programs should not be considered as treatment, but more as a preparatory stage of treatment
where the task is to increase readiness.
Research in the area of treatment readiness for offenders is poorly developed. Each of the
factors identified in this paper as related to readiness would benefit further from empirical
validation with offender populations. There appears to be a real need for development of a
brief assessment of treatment readiness that can be used in conjunction with risk and needs
assessments to determine future program placement. Such an assessment would also identify
areas where low readiness might be modified, so that a greater proportion of offenders are
able to benefit from rehabilitation programs.
Acknowledgements
This research was jointly funded by Corrections Victoria and the Australian Research
Council (ARC Linkage-Project).
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Aggression and Violent Behavior

9 (2004) 645 – 673

The multifactor offender readiness model

Received 16 July 2003; accepted 7 August 2003

Keywords: Offenders; Readiness; Recidivism

2. The multifactor offender readiness model

2.1. An offender readiness model

Fig. 1. Model of treatment readiness.

2.2. Internal readiness conditions

Internal readiness consists of cognitive, affective, behavioral, volitional, and personal/

2.2.1. Cognitive factors

2.2.2. Affective factors

2.2.3. Behavioral factors

2.2.4. Volitional factors

2.2.5. Personal identity factors

may be perceived as irrelevant to cultural identity. In the United Kingdom, cognitive–

2.3. External readiness conditions

External readiness consists of circumstances, location, opportunities, resource, support,

2.3.1. Circumstance factors

2.3.2. Location factors

2.3.3. Opportunity factors

2.3.4. Resource factors

2.3.5. Support factors

2.3.6. Program/timing factors

2.4. Target factors

3. Modification of low readiness

3.1. Modify the client

3.2. Modify the therapy

3.3. Modify the setting

West, D. J. (1965). Murder followed by suicide. London: Heinemann.

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