Using context and difference in sex offender treatment: An integrated systemic approach

Summary

The primary objective of this paper is to promote a re-examination of the current use of cognitive-behavioural programmes in work with men who have sexually offended against children or adults and to encourage the application of ideas from the systemic field. In order to support this objective, the paper puts forward and develops the following arguments:

1. That the current content of manualised programmes in this field has been distilled too far and left behind some of the most important principles of the cognitive approach. Returning to the work of Marshall et al (1999), the need for a thorough and broad-based assessment of each individual prior to deciding treatment goals is clearly recommended. Further, there is a need to pay much more attention to differences between, as well as similarities of those who sexually offend.

2. That ideas from within the systemic therapeutic field be integrated within existing approaches to attempt to address some of the limitations of cognitive-behaviour therapy as currently employed. Evidence for the potential benefits of this comes from a broad personal experience of working directly with offenders and consulting to group facilitators.

It is concluded that all therapeutic approaches reach a ‘moment of integration’ (Pinsof, 1994), when their failures are recognised and other approaches are drawn on. It is suggested that this moment may be upon us in this area.     

Sex offender treatment is not punishment

Abstract

The treatment of sexual offenders can be fraught with ethical dilemmas. Practitioners must balance the therapeutic needs of sex offender clients alongside the risks they might pose to others. These ethical challenges include balancing community safety with the rights of the offender, the privileged therapeutic relationship and the potential for coerced treatment. In this paper, we respond to Glaser's argument that treatment is punishment and that sex offender treatment providers breach ethical codes by violating confidentiality, engaging in coercion, and ultimately causing harm to clients. We first consider whether sex offender treatment is indeed punishment. We argue that it is not, and that mandated treatment can and should be conducted in a fashion consistent with professional codes of ethics familiar to mental health providers. We then discuss the human rights model, which we agree is an essential lens through which to view the psychological treatment of sexual offenders. We attempt, as have other scholars, to illustrate the ways in which human rights principles intersect with traditional mental health codes of ethics particularly in the case of sex offender treatment. We conclude that sex offender treatment can be conducted ethically, that treatment differs from punishment in clear and distinct ways, and that ethical treatment conforms to a human rights perspective.     

Social anxiety and sexual offending against children: A cumulative meta-analysis

Abstract

We examined the extent to which sexual offenders against children (SOC) differ from men who do not offend against children (non-SOC) on social anxiety. In study 1, 30 SOC and 31 non-sex offenders (NSO) were compared on a self-report measure of social anxiety (Social Avoidance and Distress Scale; SADS). SOC and NSO had virtually identical levels of social anxiety. In study 2, we conducted a meta-analysis of existing comparisons of SOC with various non-SOC groups on the SADS. SOC were generally more socially anxious than non-SOC. These findings suggest that the average SOC is more socially anxious than the average male who does not sexually offend against children. It remains unclear, however, whether social anxiety plays a causal role in the initiation of child sexual abuse.     

A review of the role of radical feminist theories in the understanding of rape myth acceptance

Abstract

Research into rape myth acceptance (RMA) first emerged in the 1970s, when authors such as Brownmiller (1975) and Burt (1980) proposed that rape was a mechanism that allowed men to exert power over women and that the endorsement of rape myths justified this sexual dominance. These influential theories have meant that subsequent definitions of rape myths have failed to acknowledge male victims of serious sexual assault, despite an increase in prevalence rates. More recent research has attempted to explore RMA in relation to male victims, with results suggesting that men are more likely than women to endorse rape myths regarding male victims when the victim is assumed to be homosexual, or when the victim is heterosexual and the perpetrator is female. Brownmiller's theory is challenged and a more holistic view of the importance of sex-role traditionality is explored, while acknowledging the contribution of individual factors relating to the development of RMA.     

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.     

Reflections on the development of the nota policy ‘working with adults and adolescents who exhibit sexually abusive behaviours: The use of sexually salient and pornographic materials’

Abstract

In 1994 the Policy and Ethics Sub-Committee of The National Association for the Development of Work with Sex Offenders developed and published a policy on the use of ‘sexually salient and pornographic’ materials in working with adults and adolescents who exhibited sexually abusive behaviours. Here, Alix Brown, one of the originators of this policy, reflects on the reasons it was brought into being and its relevance to sex offender treatment now. The policy document follows this article.     

Opening a debate on personal boundaries and work with sex offenders: A personal view of a clinical supervisor

Abstract

As a clinical supervisor of employees working in prisons conducting rehabilitation programmes with offenders, I frequently encounter situations where personal boundaries are breached. This paper discusses the types of boundary breaches that may occur in work with sex offenders and why, and suggests ways in which individuals and teams can guard against breaches. Accepting that the possibility of boundary breaches exists for everyone, and providing awareness education of how they occur can assist in reducing them. Once they occur, the consequences can be devastating, ranging from embarrassment and unwanted publicity to loss of career and criminal convictions.     

Developing a therapeutic environment for boys in secure settings who have sexually offended

Abstract

The role of secure units in helping sexually abusive adolescent boys to change their behaviour and attitudes is examined. The problems presented by 23 adolescent sex offenders at Glenthorne Youth Treatment Centre were used to identify issues for management and treatment. These boys had committed a variety of non-sexual offences, and were responsible for 691 recorded crimes. Many had committed violent offences and had emotional, educational, relationship and substance-abuse problems. In contrast to the situation in community settings, the use of offence-focused groupwork and individual psychological therapy is limited in secure units. Many of these boys are not suited to this kind of work, or are not yet ready to benefit from it. Secure units also have difficulty resourcing these types of intervention. Nevertheless, the secure unit environment can be organised and structured to effect changes in behaviours and attitudes associated with sexual offending. Attention should be given to particular aspects of residential practice, including anti-discriminatory practice, organisational values, establishing behavioural boundaries, challenging unacceptable behaviour and language, reinforcing appropriate behaviour, encouraging interpersonal problem-solving, providing effective supervision based on an evaluation of risk, and education to raise victim awareness and respect for others. Liaison with community programmes for sexually abusive adolescents should be encouraged.     

A case study of a male sex offender with zoosexual interests and behaviours

Abstract

This paper reviews assessment, treatment and supervision issues in relation to a high-risk, borderline functioning, male sex offender with zoosexual interests and behaviours. Mr Z was convicted of multiple sexual offences including rape, indecent assault and indecent exposure as well as actual and threatened bodily harm. He was convicted for two counts of attempted buggery of horses and he received a Probation Order to engage in group and individual work, as deemed appropriate. Significant treatment challenges emerged due to his cognitive/intellectual difficulties, coping problems (including anger management issues) and dissimulation. Further, continuing evidence of high-risk behaviours associated with his index offence as well as previously identified patterns of offending were reported. Ongoing concerns prompted a referral for a polygraph examination to gain additional information about Mr Z's offence history and to achieve a better understanding of his treatment needs. These findings are discussed and specific attention is focused on Mr Z's zoosexual behaviours.