Putting the ‘B ’ back into CBT: The use of behavioural

This paper aimed to highlight the neglect of the behavioural aspect of cognitive behavioural treatment with sexual offenders. Recent groundbreaking ideas have focused on the role of cognition in sexual offending (e.g. Ward & Keenan, 1999), and most treatment programmes emphasise the role of cognitive restructuring as a treatment method (e.g. Mann & Shingler, 2000; Accreditation guidelines). Whilst we do not aim to dismiss the importance or relevance of this work, we do point out that the ‘C’ is only 50 % of CBT. Whilst some programmes include the use of specific positive reinforcement as a treatment strategy (Mann & Shingler, 2000; Fernandez et al 2001), there is a wealth of opportunities to use other behavioural strategies that at best are being overlooked, and at worst misused due to a lack of awareness (Kohlenberg & Tsai 1994, 1995). Behaviourism is associated with B. F. Skinner and developed from his experiments in animal learning. He developed the notion of ‘operant conditioning’, which describes how learning occurs via associating a behaviour (e.g. with pigeons, pecking a red key) and the outcome (getting food or not). Those behaviours that are followed by outcomes viewed as favourable by the subject (e.g. getting food if you are hungry) will increase in frequency and intensity, whereas those behaviours associated with outcomes viewed as unfavourable by the subject (e.g. not getting food, or getting an electric shock) wil