A qualitative investigation of treatment components for families of youth who have sexually offended

ABSTRACT

Traditional treatment approaches for youth who commit sexual crimes are generally understudied and lack consideration for youths’ evolving context and development. A holistic model is important in service delivery, whereby multiple socio-ecological risk and protective factors are targeted in treatment. Family treatment, a key component of holistic practices, has not been well-defined for families of youth who have committed sexual crimes. Better understanding of the practical techniques used in service agencies can inform family services for youth. Using an inductive grounded theory approach, this qualitative study interviews service providers (N?=?19) to understand components of family treatment. Findings suggest components including problem solving, communication skills, and working through the pain meet certain goals of restructuring and uniting families. The therapeutic relationship was a component that meets all goals of family treatment and helps families and youth overcome stigma of sexual offending. Findings have implications for developing and testing models of family treatment for sexually abusive youth.     

Wise mind—risky mind: A reconceptualisation of dialectical behaviour therapy concepts and its application to sexual offender treatment

Abstract

This paper aims to introduce a reconceptualisation of dialectic behaviour therapy (DBT), “wise mind–risky mind”, and its application to sexual offender treatment. This reconceptualisation holds some promise in addressing issues around general, affective, cognitive and sexual dysregulation, and may provide an alternative way of thinking about sexual offender treatment. The wise mind–risky mind dialectical construct helps clients and therapists utilise a common language that captures and validates the experiential difficulties that clients go through in effectively managing their risk for sexual offending. The incorporation of DBT principles in standard sexual offender treatment programmes can assist clients in effectively managing problems with dysregulation in various domains. It can also afford a more integrated treatment framework when working with sexual offending dynamics. The authors discuss this new construct and its possible applications within the broader forensic mental health field.     

Marshall and barbaree's integrated theory of child sexual abuse: A Critique

Abstract

The aim of the current article is to critically examine an extremely influential multi-factorial theory of child molestation, Marshall and Barbaree's (1990) integrated theory. This powerful model was developed as a general theory of sexual offending and used to explain the onset of child sexual abuse in addition to other forms of sexual deviance. Despite its prominent status the adequacy of its basic ideas have never been systematically evaluated. First, I describe the integrated theory in detail and outline its core assumptions. Next, these ideas are subject to critical analysis and I highlight its strengths and weaknesses. Finally, I conclude with some brief comments about the model and the role of theory development in the sexual offending area.     

Decisions to offend in men who sexually abuse their daughters

Abstract

A group of nine intrafamilial child molesters of daughters and stepdaughters from Canada and the United Kingdom were interviewed about their analysis of opportunities to sexually offend. Questions focused on the evaluation of immediate and life circumstances surrounding the offence, including how the offender defined, created and responded to opportunities for offending. An equally important goal was identifying strengths in resisting opportunities and coping with spoiled attempts. The interviews were transcribed and subjected to grounded theory analysis. Consistent with the rational choice theory of criminal behaviour the majority of offenders identified information and decision-making processes used to evaluate opportunities for offending. Themes related to offender and victim characteristics, as well as situational factors, are identified and discussed with respect to risk and protective factors. Offenders described positive relationships, greater social/community connectedness and successful employment as present in their lives when not offending. These elements are consistent with positive approaches to sexual offender treatment and management.     

Arbitrary decision making in the absence of evidence: an examination of factors related to treatment selection and recidivism for female sexual offenders

ABSTRACT

As criminal justice professionals are asked to assign risk levels and treat females who sexually offend, identifying risk factors for recidivism prediction and treatment targets is important. Although the majority of risk and treatment studies have focused on males, general female offender research and developing research with female sex offenders both provide some evidence for possible factors related to sexual offending behaviour in women. The purpose of this study was to explore what possible factors were related to treatment selection in a sample of 506 females serving prison sentences for a sexual offense, and, in turn, to examine which factors predicted non-sexual and sexual recidivism. Results demonstrated that exploratory variables were significantly related to treatment selection, as opposed to variables previously supported in research. Furthermore, living with a significant other for more than two years, and prior sexual offending arrests predicted sexual recidivism, while decreased age and treatment participation predicted non-sexual recidivism. These findings indicate that while similarities between male and female sexual offenders exist, females still demonstrate gender-specific risk factors.     

Understanding men who access sexualised images of children: exploratory interviews with offenders

ABSTRACT

The number of online users of child sexual abuse imagery is increasing but factors associated with internet offending and effective treatment remain unclear. This qualitative study aimed to understand what leads individuals to access sexually abusive images of children and to assist with treatment development. In-depth interviews with 12 adult men from prison or community offender treatment programmes were conducted and thematically analysed. Findings were that the men's development was characterised by difficulties in early family life, negative school experiences, difficult sexual development, and difficult intimate relationships. Precipitants to offending included stress, progression from legal material, loneliness and isolation. Maintaining factors included trying to cope with negative emotions through accessing abusive images, seeing it as an “addiction”, and denial (a “victimless” offence). Useful treatment included understanding their offending, working in a group, a safe therapeutic environment, and knowledgeable, non-judgemental therapists. Continued psychological support post-treatment was requested, and deterrent software monitoring.     

What has worked and what has not with Minnesota sex offenders: a review of the evidence

Abstract

Since the early 1990s, many states in the USA have attempted to control sexual offending and, more narrowly, sexual recidivism by implementing longer prison sentences for sex crimes, sex offender registration and notification, residency restrictions, involuntary civil commitment and lifetime probation and parole. The early 1990s also marked the beginning of a decline in official rates of sexual offending, including sexual recidivism. This study reviews recent research conducted on Minnesota sex offenders in an effort to identify which policies, programmes and practices might have contributed to the drop in sexual recidivism rates that have been observed over the last few decades. By assessing what has, and has not, worked with Minnesota sex offenders, this study discusses how lessons learned from the Minnesota experience may apply to broader efforts within the USA and abroad to control sexual offending.     

Integrating risk,the Good Lives Model and recovery for mentally disordered sexual offenders

Abstract

Personality disordered and mentally disordered sexual offenders (MDSOs) with complex diagnoses such as schizophrenia, developmental disorders and mood disorders face challenges of restoring their mental health, living more safely with personality- and offence-related risks, while addressing concerns about their capacity to reintegrate into society; this has been termed “secure recovery”. This paper reviews the literature on recovery, demonstrating its commonality with the Good Lives Model (GLM) as applied to MDSOs' offending treatment. GLM appears to provide a better fit with the recovery needs of MDSOs than the Risk–Need–Responsivity model because it emphasises approach goals, enhanced responsivity and skills acquisition. Recovery needs to integrate coping with mental disorders with risk management and a healthy, future lifestyle. Both secure recovery and GLM support the need for client–clinician collaboration, promoting self-determination and a shared narrative about coping with enduring risk and the hope of sustained well-being.     

Victims of sexual assault perpetrated by female youth: an exploratory study of gender differences*

ABSTRACT

This study examines sexual offending behaviour of juvenile females and juvenile males who come to the attention of the police. Using victim age as an analytical tool and more than 20 years of incident-level crime data, perpetrator, victim, and offense characteristics are compared to assess if the offending behaviours of juvenile females and juvenile males differ when the victim is a child versus a peer. The multinomial logistic regression showed there were differences in offending between juvenile females and juvenile males dependent on type of victim. Perpetrator substance abuse, victim sex, victim-offender relationship, type of sexual assault, use of force, location of the sexual assault, the time of day of the sexual assault, and whether or not the incident resulted in an arrest all reliably predicted these differences. The results reinforce the field's call for a greater development of a gendered understanding of sexual offending behaviour.     

Clinical assessment of adult sexual offenders with learning disabilities

Abstract

Assessment and treatment of adults with learning disabilities who commit sexual offences presents a number of challenges. Much of the professional forensic and psychiatric literature on work with this group concentrates on the development of interventions based on theoretical models of sexual offending originating from the mainstream criminal justice system and have often been adapted and applied to people with learning disabilities. Currently, there is very little evidence to demonstrate the effectiveness or validity of the adaptation and application of mainstream models to this population. The efficacy of such adapted models used to describe sexual offending in people with learning disabilities clearly has an impact of any intervention informed by them. In particular, some researchers suggest that key factors such as cognitive distortions are evident in sexual offenders with learning disabilities; there is, however, no research relating to the prevalence of these or other key factors within the general population of people with learning disabilities. The present literature review highlights some of the clinical issues with a particular focus on the assessment of deviant sexual interest. Specifically, the literature is confused with inconsistencies relating to the definition of the group, the extent and nature of offending and a lack of standardized methodology for assessment and comparison. Consideration is given to the particular needs of this group and the implications for research and treatment.     

Responding to youth sexual offending: a field-based practice model that “closes the gap” on sexual recidivism among Indigenous and non-Indigenous males

Abstract

Most studies that have explored the impact of youth sexual offender treatment on recidivism have not assessed whether effectiveness varies for important subgroups. The present study evaluated the impact of treatment provided by the Griffith Youth Forensic Service (GYFS) on 104 adjudicated youth sexual offenders referred between 2006 and 2012. Sexual, violent and “other” offending outcomes were examined, based on Australian Indigenous cultural heritage and whether the youth resided in a remote community, over an average 2.5-year follow-up timeframe. The findings indicated that GYFS treatment was equally effective for Indigenous and non-Indigenous youth for preventing sexual recidivism and, for youth residing in remote and non-remote locations, for preventing sexual, violent and “other” recidivism. Treatment was less effective in preventing violent and “other” recidivism for Indigenous youth. The core components of the GYFS treatment programme therefore appear particularly well suited for reducing sexual recidivism by Indigenous offenders and those residing in remote communities.     

Is sexually abusive behaviour in personality disordered inpatients analogous to sexual offences committed prior to hospitalization?

Abstract

Sexually abusive behaviour by personality disordered patients presents a serious threat to the integrity of staff–patient relationships and the safety of other residents. The occurrence of such behaviour is also problematic for the offending patient, as it may impact on perceived treatment needs and their access to the community. This paper reports on a study of sexually abusive behaviour in a high security psychiatric hospital. It also examines the relationship between these behaviours and patients’ history of sexual offending. The results showed a high frequency of low-severity sexually abusive behaviour and no significant associations between sexually abusive behaviour during hospitalization and sexual offence history. These findings imply that low-severity sexually abusive behaviour within secure settings may be determined, partly, by environmental conditions. This sexual abuse may also be functionally dissimilar to severe sexual abuse perpetrated in the community. The meaning and determinants of sexual abuse within secure settings must be scrutinized carefully and comprehensively before they are considered analogous to previous sexual offences.     

Using immersive virtual reality and ecological psychology to probe into child molesters' phenomenology

Abstract

Child molesters (n=13) and sexually non-deviant subjects (n=29) were immersed with virtual characters depicting relevant sexual features while their sexual arousal and gaze behaviour were assessed to characterise their sexual preferences and intentional dynamics. Sexual arousal was measured using circumferential penile plethysmography (PPG). Gaze behaviour dynamics were derived from average gaze radial angular deviation (GRAD) and GRAD coefficient of variation (GRADCV). Results show distinct sexual arousal profiles according to sexual preferences and point towards the existence of specific gaze behaviour dynamics guided by sexual intentions. Theoretical interpretations are based on the ecological psychology of J. J. Gibson, the extended mind theory and the integrated theory of sexual offending. Theoretical underpinnings stemming from these approaches are advocated as being especially well suited to explain how virtual reality can help probing into child molesters' phenomenology as lived from the “first-person” stance.     

Child sexual abuse material in child-centred institutions: situational crime prevention approaches

ABSTRACT

This paper focuses on the potential for child-centred institutions to use situational crime prevention (SCP) strategies to prevent or reduce child sexual abuse material (CSAM) offending as a distinct form of child sexual abuse (CSA). We discuss the failure of the Royal Commission into Institutional Responses to Child Sexual Abuse in Australia to address the potential for CSAM offending to occur in child-centred institutions. Our premise is that CSAM offending is markedly shaped by the situation in which it occurs, rather than by any pre-existing preparedness to offend sexually against children. In this context, SCP for CSAM offending must be considered as part of overall strategies to combat CSA in institutional settings. However, we acknowledge that effective implementation of SCP in this area is not straightforward. We consider some of the challenges in implementing SCP at an institutional level.     

Sexual offenders’ parental and adult attachments and preferences for therapists’ interpersonal qualities

ABSTRACT

This study explored sex offenders' parental and adult attachment difficulties and assessed the extent to which these were associated with preferences for therapists' interpersonal qualities. One-hundred and twelve adult male child sexual offenders were invited to provide self-report data on their attachment histories, adult attachments and preferences for therapists' interpersonal qualities. A weak relationship between childhood and adulthood secure attachment was found, suggesting that attachment at the time of offending may be more relevant than childhood attachment to the aetiology of sexual offending. Participants valued a range of therapists' qualities previously identified as important for positive treatment change. Therapist trust and genuineness were perceived as particularly important by those with attachment difficulties, demonstrating the need for these qualities in offender programmes where attachment difficulties would be expected. There were some differences in the preferences for therapists' qualities between participants with different adult attachment types, highlighting the importance of responsivity factors in treatment.     

Sexual offenders with learning disabilities: risk,recidivism and treatment

Abstract

While the literature on the assessment, treatment and management of non-learning disabled sexual offenders is well established, it is only in recent years that researchers and clinicians have focused on sexual offenders with learning disabilities. In contrast to mainstream sex offender treatment programmes, there are few evaluated community-based treatment programmes for sexual offenders with learning disabilities, and of the small number of published studies that describe treatment programmes, most are based on small samples and few have been validated empirically. Sexual offenders with learning disabilities differ from their non-disabled counterparts in several important ways, having implications for management and treatment. Due to methodological differences between studies, the prevalence of sexual offending by men with learning disabilities is not clear. However, in some studies, the sexual recidivism rate of offenders with learning disabilities is 6.8 times and 3.5 times that of non-disabled sexual offenders at 2- and 4-years’ follow-up, respectively. Sexual offenders with learning disabilities are also at greater risk of re-offending in a shorter time period. There remains an urgent need for further research into the assessment of risk and whether components from mainstream treatment programmes can be adapted to meet the needs of learning disabled sexual offenders. Approaches to working with sexual offenders with learning disabilities and programme development are discussed.     

Measuring grievance thinking in sexual offenders: The revised Dissipation–Rumination Scale

Abstract

Rumination is an important part of “grievance thinking”, which has been linked to recidivism in sexual offenders. Grievance thinking is a dynamic risk factor that can be targeted in treatment, and is characterized by a perception of being wronged accompanied by angry, hostile rumination about revenge, and has similarities to the “dangerous world” implicit theory . A revised version of the Dissipation–Rumination Scale is used currently to measure grievance thinking in sexual offenders incarcerated in England and Wales. The study aimed to establish whether this revised measure is valid to use with this population. The scale demonstrated adequate reliability and good convergent validity. However, analyses revealed problems with both construct and predictive validity. Further, it is suggested that the scale may not be sufficient to measure the whole of the “grievance thinking” concept. The results do not provide overwhelming support for the use of this tool with sexual offenders; further research is required before firm conclusions can be drawn regarding the scale's utility. Directions for future research are discussed.     

A critique of hall and hirschman's quadripartite model of child sexual abuse

Abstract

The aim of the current article is to critically examine an extremely influential multi-factorial theory of child molestation. Hall and Hirschman's (1992) quadripartite model. This innovative model was originally presented as a theory of rape and later extended to explain the onset of child sexual abuse. Despite its prominent status the adequacy of its basic ideas have never been systematically evaluated. First, I describe the quadripartite model in detail and outline its core assumptions. Next, these ideas are subject to critical analysis and I highlight its strengths and weaknesses. Finally, I conclude with some brief comments about the model and the role of theory development in the sexual offending area.     

Speaking about sexual abuse in British South Asian communities: offenders,victims and the challenges of shame and reintegration

Abstract

Cultural dynamics have a significant impact on how sexual matters, including sexual abuse, are discussed in British South Asian communities. The ways in which these communities talk about sexual violence often reinforce patriarchal norms and values, especially those concerned with honour and shame. As a result, victims are either silenced or the blame for the sexual violence they have suffered is laid at their own feet. Addressing the fact that these problems are rooted in patriarchal norms and values is key to understanding how to tackle sexual offending effectively in such communities. Both retributive and restorative justice are necessary in responding to sex crimes; retributive approaches help to recognise victims’ suffering, while restorative approaches offer promising avenues for encouraging victims and offenders alike to speak about their experiences. Both approaches are essential components to reintegrating victims and offenders into their communities.