Substance abuse among sexual offenders: review of research and clinical implications*

Substance abuse, and in particular alcohol abuse, has been linked to the aetiology and maintenance of violent offending generally and sexual offending specifically. The current paper reviews the literature pertaining to substance abuse among sexual offenders and highlights theoretical developments in the area. An emphasis on issues associated with the therapeutic alliance is stressed when working with high-risk clients who present with multiple needs, including alcohol abuse. The discussion concludes with some practical suggestions regarding assessment and treatment of groups of moderate- to high-risk offenders.     

Training multi-disciplinary teams to work with sex offenders: Effects on staff attitudes

Abstract

A recent British Prison Service initiative has focused on providing sex offender programmes facilitated by multi-disciplinary teams of staff. A three week long training programme was designed to provide staff with the necessary knowledge, skills and experience to facilitate these structured treatment groups. Following the training, staff indicated they were more confident in their ability to provide treatment and showed a greater belief that treatment could be successful. In addition, they showed significantly more positive attitudes towards sexual offenders and to offenders in general. However, participants did not indicate undue concern about working in a sensitive treatment area. This pattern continued at six month follow-up, indicating that the training changed attitudes as expected, and that the training was seen by participants as adequately preparing them to undertake provision of a structured sex offender treatment programme in a secure setting.     

Hope in the treatment of sexual offenders: the potential application of hope theory

Abstract

The present paper attempts to demonstrate how hope theory is conceptually consistent with current positive approaches to sexual offender treatment. Hope theory and its components of goals, pathways thinking, and agentic thinking is reviewed as defined by Snyder and his colleagues. A theoretical relationship exists between the role of hope and many aspects of sexual offending and treatment. Developmental course, attachment style, and the formation and maintenance of coping styles are reviewed as they relate to hope and sexual offending. A framework by which to apply hope theory to pre-treatment, treatment, and more specifically, self-management or relapse prevention for sexual offenders is proposed. Emphasis is placed on the use of techniques that target hope components, particularly in pre-treatment programs.     

Effect sizes in the treatment of sexual offenders

This article considers the benefits of sexual offender treatment in terms of the magnitude of the effect size produced by these interventions. Comparisons are made of the effect sizes with those generated by treatment of other offenders, by treatment for mental health problems, and by treatment for physical health problems. In all cases, effect sizes with sexual offenders are comparable to (and in some cases better than) effect sizes for the treatment of the other groups. As a final note, it is suggested that using a harm reduction index to estimate effect sizes for treatment with sexual offenders would produce more meaningful results.     

Ethnic origin of the victim as an aggravating factor in sentencing sexual offenders

This article examines R v Jamal Muhammed Raheem Ul Nasir, a Court of Appeal case where leave to appeal against a seven-year custodial sentence for sexual offences against children was refused. The appellant argued that his sentence length was excessive because the judge viewed the female victims’ ethnic and religious origin as an aggravating factor. In light of a number of charities’ condemning the judgment, this article evaluates whether the Court of Appeal made the correct decision, particularly in the wider context of sentencing principles. It also considers whether causing shame to a victim and her family can be regarded as an aggravating factor when sentencing sexual offences, and discusses the circumstances where the victim’s ethnic origin should be taken into account.     

Early maladaptive schemas in convicted sexual offenders: Preliminary findings

Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention.     

Review on female sexual offenders: findings about profile and personality

Introduction

Although in the past sexual abuse was perceived as an issue connected only with males the contemporary literature is placing increasing emphasis on the role of female sexual perpetrators. There is still disagreement about the definition of sexual abuse, the frequency that it occurs and the characteristics of the women that are sexual abusers.

Methods

Thorough research of the main databases (MEDLINE and PsycInfo), for case reviews and studies along with restriction on European and North American literature, is due to perceived culture differences. Further investigation for relevant studies through web search engines such as Google, locates agencies and organizations that are interested and connected to sexual abuse issues.

Results

Distinction between sexual offense and sexual abuse has as a result difference in the characteristics of female sexual perpetrators. They are mainly young (age up to 36 years old), friends or relatives of the victim, using more persuasion and psychological coercion and legally charged in a lesser extent compared with male abusers. However the psychological consequences for the victim can be more severe.

Conclusion

A unanimous view of what is female sexual abuse is difficult to reach. Often it is under reported, unrecognized or considered ethically more acceptable than male abuse. It is also connected with an increased self-report of history of sexual abuse of the perpetrators. A typology of female sexual abusers should be developed. Treatments focusing on different psychological interventions along with prevention and public awareness can be a powerful tool in reduction of sexual abuse perpetrated by females.     

Using clinical variables to evaluate treatment effectiveness in programmes for sexual offenders

Abstract

Typically, sex offender programmes are evaluated using recidivism, a distal outcome measure. This paper proposes that sex offender programmes also incorporate proximal variables to evaluate treatment effectiveness. Proximal variables assess within treatment changes immediately following the intervention. To demonstrate this approach, the effectiveness of a sex offender treatment programme is evaluated using proximal variables, specifically locus of control, empathy, cognitive distortions and acceptance of responsibility. We provide the findings of this evaluation and discuss the implications of this approach. In particular, we conclude with the importance of identifying relevant treatment targets and selecting suitable proximal measures of those targets in evaluating treatment effectiveness.     

In-prison treatment for sexual offenders in Taiwan

The present study was designed to investigate the current status of mandated treatment in prison for sexual offenders in Taiwan. The information-gathering methods were composed of two parts: questionnaires and interviews. The results showed the difficulties of mandated treatment in prison, including poor client adherence, the lack of consistent disciplines for the therapists, a standardized algorithm, and explicit laws and rules, the safety concerns of the therapists, and a shortage of staff. The development of mandated treatment in prison of sexual offenders in Taiwan is still in its early stage, and the treatment models have not yet been integrated. A cooperative and collaborative center for the mandated treatment in prison of sexual offenders and an integrated rule and treatment model should be set up in the future.     

Elderly sexual offenders: two unusual cases*

The aim of this case report is to describe two cases of sexual abuse by elderly subjects for which the Judge commissioned an expert psychiatric-forensic opinion. The elderly are generally believed to commit nonviolent crimes, whereas the two cases we observed feature forcible rape committed by elderly offenders, who showed no form of mental disease and had rationally planned their offense. They had never previously committed similar acts and had no history of homosexuality; both had been married for many years before the death of their wives and had adult children. Finally, no previous episodes of rape emerged in their personal histories during interrogations. The sociocultural context in which the crimes were committed was identical and arouses interest as regards both the method employed and how the crimes were discovered. The legal authorities then commissioned accurate investigations including medicolegal and psychiatric-forensic evaluations of the offenders and their victims.     

Using wilderness therapy in treating adolescent sexual offenders

Abstract

This article describes a follow-up study of 14 adolescent sexual offenders who had attended a community treatment programme. A core component of their treatment included outdoor wilderness group therapy. Interviews were conducted with adolescents and parents and tapped several areas including social skills and peer relationships, victim empathy, cognitive distortions, safety plans and coping with high risk situations, sexual offending cycle, perceived level of risk, intimacy and sexuality. The study also examined the child protection service records of the It adolescents. Data from child protection service computer records showed that none of the adolescents had reoffended. Interviews with adolescents and families focusing particularly on the wilderness component of the programme showed positive changes.     

Preliminary evaluation of the use of pharmacological treatment with convicted sexual offenders experiencing high levels of sexual preoccupation,hypersexuality and/or sexual compulsivity

The current study presents the preliminary evaluation of the impact of pharmacological treatment (Selective Serotonin Reuptake Inhibitors and anti-androgens) on hypersexuality, sexual preoccupation and sexual compulsivity. The participant pool comprised 64 convicted UK sexual offenders who had been voluntarily referred for pharmacological treatment to reduce their hypersexual arousal, 51 of whom agreed to take the medication (with a further five individuals on hold or under assessment at the time of data extraction). The preliminary findings were very encouraging; analysis on measures assessing sexual preoccupation, hypersexuality and sexual compulsivity indicated a significant reduction between pre- and post-medication, across both types of medication. Limitations of the current research are discussed.     

The personal impact of delivering a one-to-one treatment programme with high-risk sexual offenders: Therapists' experiences

Abstract

Previous research suggests that delivering treatment for sexual offenders can have both positive and negative effects on therapists. We know less about the specific impact of conducting such work in different ways; for example, individually rather than in groups. This study aimed to explore the experiences of sexual offender therapists delivering a one-to-one programme with clients. Eleven therapists delivering an individual intervention with high-risk sexual offenders in English prisons took part in interviews and focus groups about the impact this work has had upon them. One participant also completed a diary charting their experiences while delivering the intervention. Content analysis identified that participants felt they experienced changes in how they viewed themselves, others and the therapeutic relationship, in both positive and negative ways. They also described experiencing intrusive thinking and feeling overly responsible for the outcome of treatment. However, positive effects were also identified. Findings suggest that the provision of structured supervisory support was particularly key in mitigating the impact of treatment delivery.     

Attachment,anger and anxiety of male sexual offenders

Abstract

Common factors underlie sexual and non-sexual aggression, and they co-occur at high rates. This study reports on whether Dutton et al.'s model of partner abuse (1994) also predicts sexual offender status. Incarcerated sexual offenders (n?=?144) and non-sexual offenders (n?=?34) completed a voluntary, anonymous survey of attachment, anger and anxiety measures. Sexual offenders produced significantly higher insecure attachment (p?=?0.001), anger (p?<?0.05) and generalized anxiety (p?<?0.01) scores than non-sexual offenders. Intended multivariate analyses were prohibited by multicollinearity between predictors. Although insecure attachment, anxiety and anger distinguish sexual from non-sexual offenders, their predictive power in a multivariate model is yet to be determined. Awareness of the co-occurrence of sexual and non-sexual violence would improve assessment and treatment approaches for professionals in both arenas.     

Factors associated with contact child sexual abuse in a sample of indecent image offenders

Abstract

This study explored a sample of 244 UK adult male offenders convicted of offences involving indecent images of children (IIOC): 120 had a previous contact child sexual offence (defined as dual offenders) and 124 had no evidence of an offence against a child (defined as non-contact offenders). Offender groups were compared regarding their socio-demographic characteristics, previous convictions and IIOC possession. Key discriminatory factors that differentiated dual offenders were: access to children, previous offence history, sexual grooming and possession of IIOC that depicts similar-aged victims. In contrast, non-contact offenders could be identified from their greater amount and wider range of IIOC possession. The results suggest a homology between Internet behaviours, IIOC possession and victim selection. Implications for law enforcement agencies are discussed in terms of assisting investigative prioritisation by identifying those most at risk of committing sexual abuse against children.     

Effectiveness of sex offender treatment for psychopathic sexual offenders

Meta-analyses have suggested that sexual offender treatment (SOT) completion is associated with lowered sexual recidivism rates for convicted sexual offenders. The paucity of properly designed studies allows for the alternative explanation of less recidivism among treated samples as reflecting that lower risk offenders disproportionately self-select into treatment. A test of the "self-selection explanation" can occur by investigating treatment effect on known high-risk offenders. Psychopathy correlates with increased sexual recidivism risk, such that an exploration of the SOT effect on psychopathic offenders could clarify the accuracy of the self-selection hypothesis. Additionally, the debated degree to which psychopaths are treatable might obtain clarification by a research review. This article examines empirical findings concerning the effectiveness of SOT for psychopathic sexual offenders. Ten studies were found to meet the minimal quality standards used, stemming from only four data sources. Shortcomings of existing research precluded clear conclusions, though trends in the data are delineated.     

Working positively with sexual offenders: maximizing the effectiveness of treatment

In this article, the authors draw on literatures outside sexual offending and make suggestions for working more positively and constructively with these offenders. Although the management of risk is a necessary feature of treatment, it needs to occur in conjunction with a strength-based approach. An exclusive focus on risk can lead to overly confrontational therapeutic encounters, a lack of rapport between offenders and clinicians, and fragmented and mechanistic treatment delivery. The authors suggest that the goals of sexual offender treatment should be the attainment of good lives, which is achieved by enhancing hope, increasing self-esteem, developing approach goals, and working collaboratively with the offenders. Examples are provided of how these targets may be met. When this is done within a therapeutic context where the treatment providers display empathy and warmth and are rewarding and directive, the authors suggest that treatment effects will be maximized.     

Social networks of sexual offenders

Abstract

Despite the extensive research attention directed toward criminal peer groups, there has been little attention to the peer groups of sexual offenders. Sexual offenders are often considered to be loners who offend in isolation, but cases of sex crimes involving peer support are not difficult to find, e.g., child sex rings, gang rapes. To examine the role of peers in sexual offending, sexual offenders and nonsexual offenders were asked whether they knew other people who have committed sexual crimes. In comparison to the nonoffender community comparison group, the sexual offenders reported considerably more association and identification with sexual offenders. The associations also tended to be offence specific, such that child molesters knew other child molesters and rapists knew other rapists. These findings have important implications for the assessment and treatment of sexual offenders.