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.     

Predictors of sex offender treatment dropout: psychopathy,sex offender risk,and responsivity implications

Abstract

We examined sex offender treatment dropout predictors, in particular, the relationship of psychopathy and sex offender risk to treatment dropout in a sample of 154 federally incarcerated sex offenders treated in a high intensity sex offender treatment program. Demographic, criminal history, mental health and treatment-related data as well as data on risk assessment measures including the Static 99, Violence Risk Scale – Sexual Offender version (VRS-SO), and Psychopathy Checklist – Revised (PCL-R) were collected. Logistic regression and discriminant function analyses were used to identify predictors that made significant and unique contributions to dropout among all the variables under study. The Emotional facet of Factor 1 of the PCL-R and never being married were found to be the most salient predictors of treatment dropout and correctly identified about 70% of the cases. The implications of the findings for managing treatment dropout and for the treatment of psychopathic offenders are discussed.     

Delivering effective therapeutic interventions for men with severe personality disorder within a high secure prison

Abstract

The Fens Unit is a government-initiated facility for male prisoners reaching criteria for Dangerous and Severe Personality Disorder (DSPD). Prisoners are assessed using a standardised process; those meeting criteria engage in a five-year treatment programme using a cognitive interpersonal model. Personality disorder is seen as a combination of coping strategies, developed in response to experience, which results in dysfunctions of thinking, feeling, behaviour and interpersonal relationships. These dysfunctions are linked to offending. Therefore, in order to reduce risk, multiphasic interventions – individual and group therapies – specifically target each dysfunction area, focusing on the developmental experiences that generated them. Each man's individual risk factors become treatment targets that are addressed in every aspect of the programme. All staff on the unit, clinical and operational, attempt to improve the quality of interpersonal relationships the prisoner has access to in order to create remedial experiences that are necessary to attain the capacity to develop socially adaptive cognitive, emotional and behavioural responses. This paper describes the treatment provided to these prisoners and the outcomes for the first cohort to have completed treatment (n=18). Results indicate that there is a reduction in violent behaviour, a higher than expected attendance at therapy, a decrease in actuarial risk measures and the majority of men are successfully managed in lower security after programme completion.     

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.     

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.     

Issues in the treatment of asian sexual offenders

Abstract

This aper considers the scant literature in the field of child sexual abuse in Asian families, and reports the authors' involvement with four male Asian sexual offenders. The therapeutic approach used with the offenders is described, and clinical themes arising from their treatment are identified. Issues and difficulties in therapy are discussed, in particular personal issues arising for the therapists. It is concluded that Asian sexual offenders are a group who have been neglected in the literature and in treatment, partly, perhaps, because they are infrequently referred to treatment services in comparison with non-Asian sexual offenders. Particular therapeutic issues relating to the treatment of immigrant Asians who do not speak English are raised and further research needs are identified in relation to this patient group.     

Intimate sexual violence in the United States: Social work and family therapy interventions

Abstract

This article defines what is meant by intimate sexual violence and provides a brief historical context to this phenomenon. The incidence and impact of intimate sexual violence are clarified and discussed, as are the various factors contributing to this abusive behaviour. Current literature on intimate sexual violence in the United States is reviewed and differing approaches to responding to incidents of intimate sexual violence are identified as they might inform assessment and treatment options.

Taking intimate sexual violence seriously has implications for contraceptive counselling, abortion counselling, mental health counselling and family therapy. The article aims to inform practitioners of the essential issues surrounding intimate sexual violence, so that whenever intimate sexual violence is suspected, the social worker or family therapist can assess and intervene in a responsive and effective manner.     

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.