Characteristics that predict firesetting in male and female mentally disordered offenders

Few studies have adequately explored the characteristics of male and female mentally disordered firesetters and compared these to those of non-firesetting mentally disordered offenders. Furthermore, there is a paucity of research examining the characteristics which can predict repeat firesetting within this population. The current study aimed to examine similarities and differences in the characteristics of (1) male and female mentally disordered firesetters, (2) male and female mentally disordered firesetters compared to non-firesetting offenders, and (3) one-time and repeat firesetters. Furthermore, the ability of these characteristics to predict offence status (i.e. firesetter or non-firesetter) and repeat firesetting was explored. Information was collected from patient hospital records for 77 (43 firesetters, 34 non-firesetters) mentally disordered offenders; including sociodemographic, family and personal background, psychiatric, and offence history factors. The findings suggest that mentally disordered firesetters are similar to their non-firesetting counterparts on key characteristics; however, firesetters are more likely to have an expressed interest in fire/explosives and a diagnosis of a schizophrenic disorder and female firesetters are more likely to have a higher number of firesetting incidents than males. Furthermore, findings suggest that fire interest is the largest predictor of repeat firesetting. Clinical implications in terms of treatment and risk assessment are discussed.     

New Zealand's special treatment units: the development and implementation of intensive treatment for high-risk male prisoners

In the late 1980s, New Zealand developed two highly innovative residential treatment programmes for serious offenders that blended together the strengths of structured cognitive behavioural group programmes and therapeutic community approaches. Since the mid-1990s this hybrid model – recently advocated as a fruitful direction for future offender programme development – was adopted and further refined for use in New Zealand's four high-risk special treatment units (HRSTUs). We outline the HRSTU model, noting the challenges and potential benefits of providing an intervention that integrates therapy, resocialisation and reintegration experiences for high-risk, high need, low responsivity clients: many with significant psychopathic features. On average, the majority of those referred to HRSTUs complete the programme and make small but significant amounts of change on important treatment goals. But most changes remain tentative, suggesting the importance of more supportive aftercare. Although an earlier evaluation of the first unit to open found the programme to be modestly effective in reducing recidivism, an outcome evaluation currently underway will help establish whether improvements since that time are associated with reductions in disciplinary infractions and recidivism.     

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.     

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.     

Components underlying sex offender treatment refusal: an exploratory analysis of the Treatment Refusal Scale—Sex Offender version

Abstract

Approximately half of sexual offenders in prison and community settings refuse to participate in sex offender treatment programmes; however, the reasons for this remain largely unexplored. This pilot study used the previously untested Treatment Refusal Scale—Sexual Offender Version in an English prison, with 72 adult males (63 treatment accepters and nine treatment refusers) imprisoned for sexual or sexually motivated offences. Principal factors analysis revealed three factors within the scale: “pressured to take part in programmes”; “fear of negative effects”; and “programme is not relevant to/appropriate for me”. Treatment refusers scored more highly than treatment accepters on the first and last components, while there was no statistically significant difference in the scores of the two groups on the “fear of negative effects” component. Suggestions for further development of the scale are discussed, along with the practice implications of these findings.     

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.     

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.