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Relapse Prevention Plan: A Practical Therapist-Client Group Workbook

Introduction to the Group

The purpose of the Sexual Offender Group is for the offenders to develop and carry out their own relapse prevention plan. This group will create a safe environment where parolees who have sexually assaulted can share their experiences; challenge & support each other; acknowledge their offenses and cycle of offending; reduce denial; work toward taking full responsibility; recognizing impact on victims and victim empathy; recognizing impact of their own victimization; plan for regaining trust of family members and friends; identification of current maintenance behaviours; and work toward carrying out their own relapse prevention plan.

Other issues, such as healthy attitudes toward sexuality, substance abuse, anger management, effective social skills, work habits, personal adjustment, couple issues, children's protection agency, and the legal system is addressed depending on the group members' needs.

We focus the group treatment plan for all offenders on the identification of an individual offense cycle and development of a personalized relapse prevention plan. The idea of this plan is rooted in the belief that offenders could continue to experience the urge to offend sexually. The philosophy is that treatment helps offenders in managing their urges but not necessarily is a cure or removal of the urge to offend sexually.

We develop the personalized relapse prevention plan after extensive group disclosure and discussion of the offender's sexual offense cycle. This incorporates an examination of the progression from the initial urge through the steps that culminate in the sexual offense. We help the offender in understanding his own individualized offense cycle and identifying his specific pre-offense thoughts, feelings, and behaviours. We identify the progressive and self-reinforcing nature of the pre-offense components to help the offender in recognizing that the offense is not a spontaneous event, but the product of a generally predictable series of thoughts, feelings, and behaviours. As well, we identify their current maintenance behaviours that make them more vulnerable to re-offend.

The personalized relapse prevention plan takes each step of the offense cycle and generates options, diversions or alternate behaviours that interrupt the offense cycle. All activities carried out in the group treatment relate directly or indirectly to interrupting the offense cycle and strengthening the prevention plan.

We develop the personalized relapse prevention plan orally and in writing. We frequently modify it as we gain new insights. We develop it in the group setting where all group members participate in identifying the options and strengthening the plan. We also work the plan in consultation with the Parole Officer and between the associates; share between group and individual therapists working with the particular parolee; and may be shared, where appropriate, with volunteer workers, victim(s), parents, siblings, spouse, and other significant collateral. We stress the importance of the parolee sharing his relapse prevention plan with people who support his treatment and can help him carrying out his plan. We expect the parolee to identify these people.

We expect the parolees will remain in the group until their Warrant Expiry so as to develop group cohesiveness and accomplish group objectives and treatment. Groups are one and half hours durations and meet weekly through the year. At the end of each semester, we reassess the parolees to decide on their progress in the program.


In the beginning...

Making my victim(s)/survivor(s) come alive
  1. Victim #1's first name: Age:

    Relationship to you:

    What I did to him/her:

    How long the abuse went on?


  2. Victim #2's first name: Age:

    Relationship to you:

    What I did to him/her:

    How long the abuse went on?


  3. Victim #3's first name: Age:

    Relationship to you:

    What I did to him/her:

    How long the abuse went on?


Part One

This homework assignment (pgs. 4-18) should be completed before the first semester. You must disclose all of the sexually abusive behaviours that you have engaged in. You must include every victim and incident and not just those for which you have been charged. Start with your most recent offense and work backward. Discuss with the other group members and your therapists about your description(s) as you go along. Your work should be neat and legible.

Important: It is NOT acceptable to say that you do not remember what happened because you were so drunk when you committed the offense(s). In most cases this is simply an excuse to avoid talking about embarrassing things. In the unlikely event that you truly cannot remember what you did, then report what you believe is true based on the charges against you.

You may use the work that you accomplished in previous treatment programs to help you complete this assignment.

Now think about the sex offense(s) that brought you into treatment and answer as many of these questions about your thoughts, feelings and behaviours before, during, and after your offense(s) and now that you are here.


BEFORE YOUR OFFENSE(S)
  1. What were your thoughts before each offense?

  2. How did you "select" your victim(s)?

  3. What did you do to get your victim(s) to go along with you? (Promise food or candy? Threaten to hurt or tell someone? Use your power or authority?)

  4. How did you plan each offense?

  5. What did you do to keep from getting caught?

  6. How do you set yourself up for offending, e.g., drinking, fantasizing, falling in love, . . . ?

  7. How did you make things so that it was easier to offend?

  8. What are some excuses you used to allow you to go ahead with the offenses? e.g., nobody gets hurt.

DURING YOUR OFFENSES
  1. Describe your sexual offense(s) in detail, including what was said and done by both you and your victim(s).

    Where did the offense take place?

    What clothing did your victim wear?

    What clothing did you wear?

    Tell exactly what you did, in detail?

    What was your victim's usual response during the offense and after?

    What did the victim(s) do to fight back, both obvious and not so obvious?

    How did you control your victim(s), both during and after the offense(s)?

AFTER YOUR OFFENSES
  1. What you did to try to keep from getting caught (threaten, lie, etc.).

  2. What were your feelings after being caught?

  3. What were the reactions of your family, friends, and the victim after they caught you?

  4. How did you downplay your actions?

  5. How did you explain to yourself or others what you did?

  6. Whom did you blame for what happen?

  7. Did you deny what you did? (Please explain)

  8. Did you ignore your problem? (Please explain)

  9. After they caught you, who were you the most angry with?

  10. What were your feelings about your victim right after getting caught?

  11. How did you feel about yourself, during and after offending?

  12. Describe your thoughts, feelings and behaviours after the offense(s).

  13. Give a history of how they discovered your offense(s), includes all confrontations, accusations and investigations. How did you react to each?

  14. Write down the following:

    a) what was life like before getting caught?

    b) how did you get caught?


NOW THAT YOU ARE IN TREATMENT
  1. How do you feel about your victim now?

  2. Do you think your victim enjoyed what you did?

  3. Do you think your victim was hurt? How?

  4. Do you think you will reoffend? Why?

  5. Do you have a sexual problem? (Please explain)

  6. In what ways have you changed?

  7. In what ways did you try to stop offending?

  8. Which ways do not work?

  9. Which ways have worked?

  10. How long do they work?

  11. What thoughts and feelings do you have as you think of your sexual offenses?

  12. Who knows that you have this problem?

  13. List ten (10) things you lose by offending.

  14. How has sexual offending affected your life in the following areas?

    a) the way you feel about yourself:

    b) family:

    c) friends:

    d) marriage:

    (e) work:

  15. How can your sexual needs be met in non-harmful ways?

  16. What are your strengths and weaknesses?

  17. What is missing in your life right now?

  18. What are the major problem areas in your life now?

  19. What are the major strength areas in your life now?

  20. What are your biggest fears and how are you dealing with them?

  21. What are your non-sexual outlets for fun and excitement?

  22. List at least four (4) things about yourself that you need to change to not reoffend.

  23. What are the things you need in therapy, in other words, what can we do to help you help yourself?



IF YOU HAVE BEEN INVOLVED WITH THE LAW FOR OTHER REASONS, THIS NEXT SECTION IS THE PLACE TO MENTION IT.
OTHER BEHAVIOUR THAT BROUGHT YOU INTO TROUBLE WITH THE LAW


  1. When and how did you first get involved with the law?

  2. What other things have you been involved with police for? When? What happened?

  3. Time in custody? How long? Where? For what?

  4. What other similar crimes have you been involved with and for how long?

  5. Which drugs, drinks or chemicals have you used? For how long? Do you still use or plan on using?

Part Two

My Sexual Offense Cycle

The sexual offense cycle describes the sequence of behaviours that led you to carry out the sexual offense(s). In this exercise you are required to examine your thoughts, feelings and behaviours as you progressed through your offense cycle. Looking closely into your cycle may help you gain some insights of your maladaptive behaviours that led you to sexually offend.


My Current SUD's

In this exercise you are required to examine the decisions and behaviours that led you to sexually offend. They may be small decisions and behaviours, but if left unchecked they may lead you to offend again. We sometimes called them lapses. By looking closely at your lapses, and using them as a guide you can develop a list of risk situations that you will need to cope with successfully in order to avoid a total relapse - i.e. sexual re-offending.


My Thinking Errors & Their Alternates

When people commit sexual offenses they make it easier for themselves to do it by making excuses (which are sometimes called thinking errors, distortions, and rationalization). Use the thoughts from your sexual offense cycle as a guide to identify at least 10 thinking errors which you used in the past to "give yourself the permission" to engage in both your offense-related behaviours and the sexual offenses themselves. Then provide at least one appropriate alternate way of thinking to each of these thinking errors. You should regard this exercise as a rehearsal for a thinking strategy you may use in the future to lower your risk of re-offending.

  1. Thinking Error:
    Alternate Thinking(s):


  2. Thinking Error:
    Alternate Thinking(s):


  3. Thinking Error:
    Alternate Thinking(s):


  4. Thinking Error:
    Alternate Thinking(s):


  5. Thinking Error:
    Alternate Thinking(s):


  6. Thinking Error:
    Alternate Thinking(s):


  7. Thinking Error:
    Alternate Thinking(s):


  8. Thinking Error:
    Alternate Thinking(s):


  9. Thinking Error:
    Alternate Thinking(s):


  10. Thinking Error:
    Alternate Thinking(s):


  11. Thinking Error:
    Alternate Thinking(s):


Coping Strategy

In this exercise you are required for each risk situation or factor to prepare an avoidance strategy to prevent this from happening again. For example, if alcohol is a risk factor for you, then finding ways to abstain would clearly be a big help to you. In case you cannot avoid the risk situation you should have a clear idea of what to do. The escape plan would consist of two parts: (1) What you would say to yourself to get out of the situation, and (2) What you would actually do to get out. Do this for all risk situations that you can think of.


  1. Risk Situation:
    Avoidance Strategy:
    Coping Thought:
    Coping Behaviour:

  2. Risk Situation:
    Avoidance Strategy:
    Coping Thought:
    Coping Behaviour:

  3. Risk Situation:
    Avoidance Strategy:
    Coping Thought:
    Coping Behaviour:


Victim Empathy - Part I

Answer the following questions as if you were the child/person that you sexually offended. Write your name in the blank spaces.

1. How did you feel about ______ before the sexual abuse?

2. What things did ______ do when the abuse first started?

3. How did it feel? (physically & emotionally)

4. What prevented/stopped you from telling someone about ______and how did people finally finds out?

5. Do you still think about what ______ did? (Please explain)

6. Has it affected your feelings about yourself and relationships with others? (Please explain)

7. Do you feel safe? (Please explain)

8. How did your abuse end? (Please explain)

9. What would you like to say to ______ ?

10. What would you like ______ to say to you?

11. Do you think ______ understands why you do or do not want contact with him? (Please explain)

12. What kinds of promises would you want ______ to make to you or others he has hurt?

13. Should you forgive ______ ? (explain)

14. Do you ever want to see ______ again?


Part II - Apology Letter

1. Reason for writing
 - statements of your concern for your survivor's welfare after the abuse
- "I am writing to you because I am feeling . . . about . . . , and . . . about what I have put you through"
2. Statements of Apology
 - details of sexual abuse
- details of other abuse, harassment, etc.
- not facing up
3. Statements of responsibility
 - Who is responsible?
4. Statements of understanding of impact
 - about the abuse itself
- secrecy
- making threats
- betrayal
5. Statements of what you are doing about it
 - receiving help
- treatment plans
6. Relapses
 - Statements of consequences
- readiness to stand up and face the consequences
7. Statements of future intent
 - "I will never sexually offend you or anyone else again"
- restitution



Part Three

Individualized Relapse Prevention Plan

Relapse prevention is a way of thinking or looking ahead to prevent getting into trouble again. Look at it as your insurance policy. Basically, you look at the progression you went through to get into trouble and you put a stop at each point to escape and/or avoid getting any closer to the trouble again.
Abstinence - Now That I Am No More Offending:

  1. (a) What keeps you from sexually offending, again?
    (b) What are you thinking nowadays when you are not sexually offending?
    (c) How do you feel now that you are not sexually offending?
    (d) What are you doing that make you so sure that you are not sexually offending?

  2. (a) How have you set-up your life to stop you from sexually re-offending?
    (b) List healthy activities you participate in and healthy outlets when you are upset.
    (c) Who do you talk with now about positive and negative things in your life?
    (d) What high risk situations do you try to avoid?

  3. What are some of the areas of your sexual offense cycle you still have problems with?

  4. Write out rules for staying away from potential victims, review your RP plan, make leisure time plans, school and work plans.

  5. Who can you tell about your urges and deviant thoughts? (Get the Urge Contract form from your group leader).


    Motivation:

  6. (a) List the current situations that make you angry, depressed, stressed out, and want to take revenge.
    (b) What do you think is going on that is making you so angry and stressed out?

  7. Write down other ways of understanding your current situations.

    (a) Identify specific problem situations with your partner, parents, siblings, employer, and/or friends.
    (b) Write down specific coping skills to handle the situations.

    (a) Write down how you and your partner feel in conflict situations (perspective taking).
    (b) How can you take responsibility for further developing coping and problem-solving skills (e.g., counselling, any special programs, school work, and discussion with other people)?


    Internal Barriers:

  8. What thinking errors/lies, misinterpretations, etc. have you solved?

  9. Which thinking errors do you still have trouble with that might contribute to your SUD's.

  10. (a) Write down your current deviant sexual fantasies. Please give details and you must include the target of your fantasies.
    (b) What are the triggers and/or warning signs before you start to fantasize?
    (c) What did you do to allow the fantasies to go on?

  11. (a) What must you do the next time to stop the fantasies from becoming too strong?
    (b) How are you going to change your sexual fantasies to allow only consenting adult sexual relationships?

  12. Who can you tell about your current deviant sexual fantasy? (Get the Urge Contract from your group leader).

  13. (a) Write out your plans for consenting adult relationships and outlets.
    (b) List the people you can discuss your thoughts and feelings with so as to help you check your thinking errors. Please provide names and telephone numbers.

    External Barriers:

  14. Which events, feelings, and thoughts are still high-risk elements for you? Please list as many as you honestly can.

  15. Now, please give your interpretations as how you would understand those events, feelings, and thoughts to be high-risk. Please give your answers in great detail.

  16. Refer to your answers to question #18 in the previous page, give some other interpretations of how you would "escape" and/or "avoid" those high-risk elements. Please give your answers in great detail.

  17. (a) Give some examples of how you have managed to overcome some high-risk elements and/or situations.
    (b) As well, identify your planning towards these high-risk elements and/or situations which you subsequently conquered.
    (c) Finally, what have you learned from using the other interpretations to overcome those high-risk elements and/or situations?

  18. (a) Write a list of safeguards or preventions for those identified high-risk elements and/or situations.
    (b) Then make a list of people whom you think should receive the "safeguards" list you just prepared.
    (c) Why do you think these people should receive the "safeguards" list? Please give detail.

    Victim Resistance:

    Re-trace and write down the steps of how you groomed your victim. Include the method you used to carry out the offenses against him/her. [Please give in detail both the steps of victim grooming leading to the actual offenses, and how you have managed to overcome the victim's apprehension, "resistance" and "No!"].

  19. Identify what you think your survivor(s) felt during and after your first and then second and more offenses against him/her.

  20. What do you think are some of the long term effects your survivor will have? Please give detail.

  21. Do you really think survivor empathy in your case can prevent a relapse? Give reasons.

  22. Give your ideas in details of how you plan to provide restitution to your survivor(s) and other survivors of sexual abuse.

  23. How you would remind yourself to take other people's feelings into consideration on an ongoing basis. Give detail of your plan.

    Relapse:

  24. Relapse - where are you still vulnerable to victimizing or sexually offending another person?

  25. What thinking errors make you still vulnerable to victimizing or sexually offending another person?
  26. Write down alternate understanding, and your escape or avoidance plans.

  27. What would reoffending mean to you?

  28. List the consequences to your survivors, your family, your friends and yourself if you were to reoffend.

  29. Who do you talk to about your worries and potential problems?

[Consent Form] [Treatment Contract] [Urge Control Contract] [Relapse Prevention Model]