How do therapists contribute to therapeutic change in sex offender treatment: An integration of the literature

Abstract

Psychotherapy research suggests that therapists contribute to the process of therapeutic change. Research into sex offender treatment has tended to focus on the content rather than the process of therapeutic change. This paper reviews the evidence for the role of therapist characteristics in relation to therapeutic change in sex offender treatment. A literature search of a number of electronic databases and additional manual searches identified a total of 15 relevant articles. Studies were carried out in different treatment contexts and with a variety of methodological approaches. A number of therapist characteristics were identified in relation to the process of therapeutic change in sex offender treatment. Due to the methodological limitations of the studies, no conclusive evidence was found for the contribution of therapist characteristics to treatment efficacy. Nevertheless, the findings may have some clinical utility in relation to improving the therapeutic effectiveness of sex offender treatment.     

Experiences of engaging in psychotherapeutic interventions for sexual offending behaviours: A meta-synthesis

Abstract

This meta-synthesis explores individuals' experiences of engaging in psychotherapeutic interventions for sexual offending. The findings of ten qualitative studies were integrated and five over-arching concepts emerged: (1) incentives and inhibitions: to engage or not to engage?; (2) help or hindrance: the impact of others in therapy; (3) the abused and the abuser: perspectives for transformation; (4) struggling and striving: dealing with distress and difficulties and (5) what works: inside and outside. A line of argument derived from these concepts is proposed as a framework for understanding sex offenders' experiences of therapy and highlights aspects of treatment programmes that need further exploration or emphasis. Using qualitative accounts can improve the responsiveness of treatment programmes, but such research is currently limited. Future qualitative studies and reviews could help further improve the effectiveness of treatment programmes, and thereby reduce the rate of sexual reoffending.     

Exploring the role of locus of control in sex offender treatment

Abstract

This study aims to investigate the concept of Locus of Control (LoC) and its relationship to risk, personality disorder and treatment outcome in sexual offenders. The sample was taken from referrals to a community treatment service for sexual offenders in south-east London. One hundred and eighty-five men completed a measure of LoC at the time of assessment, of whom 74 entered the treatment programme and 39 completed a post-treatment LoC measure. At assessment, child molesters and non-contact offenders had a significantly more external LoC than rapists, and LoC was also significantly associated with cluster A and C personality disorder traits, as well as the presence of traits in two or more personality disorder clusters. LoC was not associated with risk measures or compliance with treatment. Once outliers were removed, a significant change was seen in post-treatment LoC scores, with most change occurring in an increasingly internal direction.     

Personal construct psychotherapy: Fixed-role therapy with forensic clients

Abstract

Fixed-role therapy, a dramaturgical approach to psychotherapy developed by Kelly in 1955, has been used in a variety of situations over the years with various client groups, including criminal offenders. Some of the benefits and limitations of fixed-role therapy with sexual abusers will be discussed. It is suggested that the strengths of some offenders, such as the social skills necessary to succeed at confidence games, be recognized and directed in fixed-role sessions. Illustrations of a number of issues will be drawn from two clinical case examples.     

Déjà vu: from Furby to Långström and the evaluation of sex offender treatment effectiveness

Abstract

The notion that sex offender treatment does not work fuels public outrage and demands for protective legislation. This paper will respond to a recent meta-analysis reporting major weaknesses in research designs that preclude drawing conclusions about the effectiveness of sex offender treatment. Methodological and ethical challenges exist in the investigation of counselling interventions in general and sex offender treatment specifically, and we argue that the medicalization of psychotherapy research may have inherent flaws. Alternatives to dichotomous recidivism outcomes are proposed, including harm reduction measures and reduction of maladaptive behaviours. Future clinical directions for sex offender treatment are explored, including application of risk-needs-responsivity models, a focus on process as well as content and incorporation of principles of trauma-informed care.     

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.     

Social problem-solving correlates of sexual deviancy and aggression among adult child molesters

Cognitive-behavioral treatment programs for adult sex offenders often include training geared to improve a perpetrator's social problem-solving skills. However, little empirical evidence exists to date that documents the relationship between problem-solving and deviant sexual interest or behavior among child molesters. As such, this study investigated the association between problem-solving and two aspects of sexual offending—self-reported sexual deviancy and clinician-rated sexual aggression among a recruited sample of incarcerated child molesters. To minimize the potential for biased self-reports, criterion scores on a lie scale were employed to exclude individuals who might be prone to misrepresent their responses. Results indicated this sample to be characterized by significant deficits on all measures of social problem-solving as compared to the general population. In addition, a series of correlational analyses indicated that an avoidant problem-solving style was significantly associated with past sexual aggression, whereas a negative problem orientation and an impulsive/careless problem-solving style were significantly related to a measure of current sexual deviancy. Of particular interest is the finding that a rational problem-solving style (i.e., the constructive style that involves the systematic application of specific problem-solving skills geared toward identifying an effective solution) was not significantly related to either sexual offending measure. The implications of these collective results are discussed.     

An examination of the role of neuropsychological deficits in mentally disordered sex offenders

Abstract

The present study examines the neuropsychological model of sexual offending proposed by Flor-Henry (1987) in relation to a group of mentally disordered sex offenders and a control group of mentally disordered non-sex offenders. The model predicts that the sex offender group would show specific left fronto-temporal dysfunction as compared with the control group. The results, while in the predicted direction, failed to reach statistical significance. Implications and limitations of the study are discussed.     

Attributions of blame in a hypothetical internet solicitation case: Roles of victim naivety,parental neglect and respondent gender

Abstract

This study investigates attributions towards the perpetrator, the victim and the victim's parents in a hypothetical internet solicitation case. A community sample of 187 respondents read a vignette outlining an internet chatroom conversation between a 10-year-old girl and a 25-year-old man, followed by a depicted sexual assault, before rating 26 attribution items. Principal components analysis extracted six reliable and interpretable factors which were then subjected to a two-respondent gender×two-victim age×two-victim internet naivety×two-parental neglect between-subjects multiple analyses of variance (MANOVA). While levels of victim naivety had no impact on any measure, parents who were neglectful of their child's online activities were deemed more culpable for their child's later abuse than were parents who took an active interest in their child's activities. In general, females deemed the victim more credible than males. Implications are discussed.