Reasoning and Rehabilitation

Domain II · Behavioural & cognitive · Robert Ross, Elizabeth Fabiano, Ewles · 1985 · Canada

What it is

R&R is a manualised, closed-group cognitive skills programme for people whose antisocial behaviour has brought them under criminal-justice (or, for R&R2, social-service or mental-health) supervision. Robert Ross and Elizabeth Fabiano developed it in Canada in the mid-1980s for high-risk offenders,…

Format

• R&R is a programme rather than an individual therapy. It has no phases in the psychotherapy sense. Instead it runs a fixed sequence of modules, delivered in a fixed order by trained "coaches" to a closed group.
• Stages of a course (as a delivering clinician experiences it):

Who practises it, and how they are trained or regulated

• Versions and dose (sources differ; name the one you are licensed for):
• Coach preparation. Coaches complete a one-week training run by a certified R&R trainer (theory, modules, practice delivery with feedback). They write a separate lesson plan for each session, at roughly two hours of preparation per session and about 70 hours before the first group. They should deliver their first group within 30–60 days of training.
• Transfer. Each skill is practised in real-life situations (the "transfer of training" step). R&R2MHP also uses workbook homework and a staff mentor between sessions.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Plans that skip obstacles. It's working when real-life attempts are reported and reviewed.
• Problems defined as other people's faults. It's working when definitions become specific and solvable.
• Treating it as a game only. It's working when participants use tool names to structure their own decisions.
• Critical thinking used only against authorities. It's working when participants turn it on their own excuses.
• Answers about events rather than thinking. It's working when participants spontaneously label their own thinking steps.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.