Sex Offender Treatment Research Articles

Status, privilege and gender inequality: Cultures of male impunity and entitlement in the sexual abuse of children: Perspectives from a Caribbean study

This article reports from a Caribbean study on the sexual victimization of children. The authors proposes a synergistic approach to analysing the ways in which the multi-layered facets of abuse interact to reinforce each other and argues that these understandings can generate multi-level activities (conceptual, material, structural) that together might produce effects that are greater than their individual components. For example, a sex offender treatment programme that is developed alongside a public health oriented education and prevention programme, and in which both address the status of children and gender socialization, may be more effective in combination than as separate interventions.

The differences between sex offenders who victimise older women and sex offenders who offend against children

ABSTRACTObjectives: Within the literature on sex offending, much attention is paid to the distinction between those sex offenders who offend against adults and those who offend against children. In contrast, there is a paucity of research into sex offenders who offend specifically against elderly or older victims.Method: A detailed interview and psychometric tests were conducted with a sample of 28 sex offenders who had been convicted of a sexually motivated offence against an older female. These data were compared to a sample of 23 child sex offenders.Results: Results indicate that amongst other significant differences between these sub-groups, men who offend against older women are generally younger, are more violent, and are more likely to use a weapon and cause injury and death compared to child sex offenders. The men who offended against children were more likely to think about and plan their offending, spend more time with the victim pre and post offence, admit sexual arousal during the offence, and admit to a sexual motivation for the offence.Conclusions: This study suggests that men who sexually offend against older women and men who sexually offend against children are distinct groups. Treatment and risk management strategies should take this into account. Further exploration of this sub-group of offenders is recommended to help inform treatment and risk management strategies for sex offenders who offend against older people.

성 범죄자의 다중감각 치료에 대한 뇌파 활성도 변화

Sexual addiction is accompanied with anxiety, psychological and physical dependence. Also, sexual addict want to make their presence through sexual adventures and seem sexually obsessed. In this study, we examined the changes of brain activity related to sexual addiction by utilizing the developed multi-sensory therapy after 4-weeks sex offender treatment program. We analyzed the electroencephalogram (EEG) activity changes in the subjects and regions of brain. As a result, the theta wave significantly increased after treatment than before (p < 0.001). The absolute alpha wave was increased whereas the relative alpha waves were decrease significantly (p < 0.001). The results could conclude that multi-sensory therapy on sex offender shows more stable status against sexual stimulations. Moreover, the reduction of the relative alpha waves in parietal lobe of sex offender is correlated to the less attention on sexual stimulations. The multi-sensory therapy not only provides a neurobiological explanation, but also can be used for clinical implications, i.e. prevention and treatments, for sex addiction.

The support needs of learning disability nurse facilitators of sex offender treatment programmes: a discussion

Purpose – The role of the learning disability (LD) nurse has developed and expanded significantly within recent years, especially their responsibility for delivering a variety of specialist treatment programmes. The purpose of this paper is to discuss the facilitation of Sex Offender Treatment Programmes (SOTP) and the issues this raises in providing support for LD nurses. Design/methodology/approach – This is an opinion paper and the views and opinions expressed are solely those of the author and do not necessarily reflect the views of any organisation or group with which the author is affiliated. The aims of this paper are: first, to explore the support needs of the LD nurse facilitators of SOTPs; second, to consider the practical implications of providing clinical supervision and support for LD nurse facilitators of SOTPs; and third, to highlight the need for further research in this area. Findings – This paper does not contain original research findings but offers a discussion of the support needs of the LD nurse who facilitate SOTP, concentrating on the specific themes of training, clinical supervision and support. Practical implications – Implications for clinical practice are identified and recommendations for further research are made. Originality/value – Whilst this is not the first consideration of the support needs of facilitators of SOTPs, it offers a contribution to the discussion of how best to support the LD nurse to continue to deliver the high quality, specialist care for people with learning disabilities.

The efficacy, safety and ethics of the use of testosterone-suppressing agents in the management of sex offending.

The use of endocrine medications to reduce sexual offending recidivism is established and may involve clinicians from diverse specialities. The present review aims to outline relevant background information and note a Medical Ethics framework upon which to facilitate decision-making. There have been several systematic reviews in recent years. A number of problems with research in the area of the medical treatment of sex offenders have been highlighted. There remains scope for improvement in the research to answer a number of relevant clinical issues. Nonetheless, some very useful indicators of relevance to clinical practice have emerged. The use of medication to manage the risk of sex offending in males is appropriate under the right circumstances. These include, for example, hypersexuality with sexual deviance and psychological-treatment interfering sexual preoccupation.

화학적 거세의 의료윤리적 관점

Although the topic of sexual offense has received increased public attention in recent years, there has been relatively little research on the ethical issues related to the medical treatment of sexual offenders. Treatment options for sexual offenders include surgical castration and chemical castration through the use of sexual impulse control drugs. Opinions vary on the most effective and appropriate methods for treating sexual offenders. In this article we examine the side-effects of the drugs used in chemical castration and discuss the main ethical issues involved in chemical castration.

Treatment During Civil Commitment for Sexual Offending Behaviors.

The first sex offender civil commitment legislation passed in Washington State in 1990. Since that time, 21 additional jurisdictions in the USA have passed similar statutes. Although considered controversial by some, the statutes have withstood legal scrutiny at the state and federal levels. These statutes have been found constitutional in large part because they offer treatment to those individuals detained under them. In the 25years since sex offender civil commitment became a reality, significant advances in sex offender assessment and treatment have shaped the landscape of the associated treatment programs. This article reviews current practice in programs that treat individuals detained under these laws and provides a framework in which these programs are delivered.

Predictive Accuracy of Violence Risk Scale-Sexual Offender Version Risk and Change Scores in Treated Canadian Aboriginal and Non-Aboriginal Sexual Offenders.

The present study examined the predictive properties of Violence Risk Scale-Sexual Offender version (VRS-SO) risk and change scores among Aboriginal and non-Aboriginal sexual offenders in a combined sample of 1,063 Canadian federally incarcerated men. All men participated in sexual offender treatment programming through the Correctional Service of Canada (CSC) at sites across its five regions. The Static-99R was also examined for comparison purposes. In total, 393 of the men were identified as Aboriginal (i.e., First Nations, Métis, Circumpolar) while 670 were non-Aboriginal and primarily White. Aboriginal men scored significantly higher on the Static-99R and VRS-SO and had higher rates of sexual and violent recidivism; however, there were no significant differences between Aboriginal and non-Aboriginal groups on treatment change with both groups demonstrating close to a half-standard deviation of change pre and post treatment. VRS-SO risk and change scores significantly predicted sexual and violent recidivism over fixed 5- and 10-year follow-ups for both racial/ancestral groups. Cox regression survival analyses also demonstrated positive treatment changes to be significantly associated with reductions in sexual and violent recidivism among Aboriginal and non-Aboriginal men after controlling baseline risk. A series of follow-up Cox regression analyses demonstrated that risk and change score information accounted for much of the observed differences between Aboriginal and non-Aboriginal men in rates of sexual recidivism; however, marked group differences persisted in rates of general violent recidivism even after controlling for these covariates. The results support the predictive properties of VRS-SO risk and change scores with treated Canadian Aboriginal sexual offenders.

On the Lived Experience of Sex Offenders' Therapists: Their Perceptions of Intrapersonal and Interpersonal Consequences and Patterns of Coping.

In the last two decades, there has been a growing understanding that the therapeutic encounter with sex offenders takes a cost and has consequences on therapists. Despite the increasing research on the consequences of treating sex offenders, these studies in fact, have merely described the consequences, without providing an outlook for how therapists cope with them. The study presented in this article was part of a larger qualitative research project conducted among social workers, using in-depth semi-structured interviews. Emphasis is placed on therapists' perceptions of the intrapersonal and interpersonal consequences they experience from treating sex offenders, as well as the strategies they use to cope with these consequences. The study's central findings concern the therapists' perception of the intrapersonal consequences, which included two levels: primary responses and cumulative responses, and their perception of the interpersonal consequences that included their parenting relationships, intimate relationships, their attitude toward others (strangers and acquaintances), loss of their quality of life, and further positive consequences. The findings indicated a sequence and integrated use of the strategies to cope with the consequences. The results are discussed in light of the theoretical framework of Lazarus and Folkman's stress and coping theory. The limitations of the study as well as its implications for future research are discussed.

Fantasy-Driven Versus Contact-Driven Users of Child Sexual Exploitation Material: Offender Classification and Implications for Their Risk Assessment.

Since the advent of the Internet, convictions for the possession, display, trading, and distribution of child sexual exploitation material (CSEM) have risen steadily, but little is known about their appropriate assessment and treatment, especially concerning their risk of reoffending. It has been suggested that a conceptual distinction of fantasy- versus contact-driven CSEM users might be of merit. Sixty-eight offenders recruited from sex offender treatment providers were assessed via an anonymous computer survey including a variety of clinical and risk-related variables; the findings showed differences in the psychological profiles between CSEM users and contact child sex offenders. Numerical and spatial methods of data analysis were used to identify subgroups of CSEM users; these confirmed the twofold distinction of fantasy- versus contact-driven offending. The spatial representation of participants identified three dimensions as crucial in the classification of these subgroups: direct sexual contact with a minor, possession of fantasy-generating material, and social contact with other users with a sexual interest in minors; potentially differentiating distinct offender subgroups with different risks and needs. The current study informed the development of an empirical model of CSEM users that could aid in the assessment of risk of reoffending and cross-over to contact sex offending.

ICU Approach by Health Care Providers Towards Sexual Offenders

SESSION TITLE: Ethics SESSION TYPE: Original Investigation Slide PRESENTED ON: Saturday, April 16, 2016 at 04:00 PM - 05:00 PM PURPOSE: Patient autonomy and social justice are conspicuously absent from the Hippocratic oath. Pellegrino's Precepts, which uphold the principle of beneficence as central to medical ethics, have been suggested as a replacement for the Hippocratic oath. We studied the approach of health care providers towards sexual offenders in the ICU. METHODS: A 30-question survey was applied to staff members of 24 healthcare institutions in 8 countries. The confidential and anonymous questionnaire addressed personal opinions regarding diverse ethical issues that they encounter in their professional field, including treatment of sexual offenders. RESULTS: 1450 surveys were completed. Respondents were mostly young (age 31.0±11.4 years), single (59.7%, n=865) females (59.2%, n=859). There were 268 (18.5%) physicians, 392 (27.0%) nurses, 497 (34.3%) medical students, and 275 (19.0%) other healthcare practitioners. 1397 responded to the question regarding whether or not they would change their approach towards a patient in the ICU upon discovery of a background of incarceration for a sex offense would change their approach towards these patients. One in five medical students (20.9%, n=101) and nurses (19.7%, n=75) and one in six doctors (15.1%, n=39) reported they would change their approach towards the patient. Women seemed slightly more likely to change their approach towards sex offenders than men (20.2% vs 16.3%), but this difference was not statistically significant (p= 0.069). CONCLUSIONS: More than a fifth of healthcare practitioners declare they may not be fully guided by patient beneficence when treating sex offenders. Despite expectations that women would be more biased against such patients, we found no significant difference between genders. CLINICAL IMPLICATIONS: Pellegrino's Precepts should constitute part of the curriculum in medical schools worldwide. Medical practitioners that feel uncomfortable or unable to provide unbiased health care should be allowed to refer that patient to a colleague. DISCLOSURE: The following authors have nothing to disclose: Yamely Mendez, Shislandia Romero, Sharon Einav, Salim Surani, Joseph Varon No Product/Research Disclosure Information

The Role of Psychopathic Traits in the Development of the Therapeutic Alliance Among Sexual Offenders.

There is a growing body of research demonstrating that the therapeutic alliance (TA) affects outcomes among specialized forensic populations, including sexual offenders. Despite this consensus, researchers continue to question whether higher levels of psychopathic traits are conducive to the formation of a therapeutic relationship for high-risk sexual offenders. Thus, the current study adds to the literature by examining the relationship between the TA and levels of psychopathy among a sample of incarcerated sexual offenders participating in sexual offender treatment. Overall, we found no significant relationships between Psychopathy Checklist-Revised (PCL-R) scores and the Working Alliance Inventory (WAI) for either client or therapist ratings. However, when we excluded those offenders who were participating in aftercare, a significant negative relationship was found between client ratings of the Bonds subscale and PCL-R total scores. Next, after controlling for risk and group status (aftercare/non-aftercare), we found no significant differences between either client or therapist total WAI scores when compared by level of psychopathy as measured by the PCL-R (low, >20; moderate, 20-30; and high, >30). Furthermore, when Factor 1 and Factor 2 scores of the PCL-R were examined individually, neither factor significantly predicted either client or therapist total WAI score after controlling for risk and group status. Findings are discussed as they pertain to the treatment of sexual offenders with elevated levels of psychopathic traits.

Community support for sex offender rehabilitation in Europe

It is assumed that the public holds negative attitudes towards sex offenders, yet an increasing number of European volunteers are involved in sex offender rehabilitation programmes through Circles of Support and Accountability (CoSA). Public attitudes and their correlates have been mainly studied in Anglo-Saxon countries; research in European countries other than the UK is scarce. To fill this gap, a web-based survey was held among web-panels in nine European countries ( n = 200 per country). Measures included awareness and knowledge about sex offenders, community attitudes towards sex offenders in the community (CATSO), attitudes towards the treatment of sex offenders (ATTSO), public attitudes towards sex offender rehabilitation (PATSOR), support for CoSA, and attitudes towards volunteers working with sex offenders. Results indicated that clear misperceptions were held by a minority. Attitudes tended to be negative, but not extremely, and differences between countries were significant. The amount of support for CoSA was considerable and mean attitudes towards volunteers working with sex offenders were positive. The lower educated held more negative attitudes. Since web-panels were probably not representative on key demographic markers, the results are only indicative. Professionals should especially address the lower educated, correct key misperceptions about recidivism of sex offenders, and provide information about processes of change in convicted sex offenders.

Pharmacological treatment of sex offenders

Most people recognize that incarceration alone will not solve sexual violence. Indeed, treating the offenders is critical in an approach to preventing sexual violence and reducing victimization. In most cases, a diagnosis of paraphilia is associated with sexual violence. This review is intended to present and summarize the first recently published international guidelines about pharmacological treatment of paraphilias. Pharmacological interventions should be part of a more comprehensive treatment plan including psychotherapy and, in most cases, behavior therapy. Antiandrogens, and mostly GnRH analogues, significantly reduce the intensity and frequency of deviant sexual arousal and behavior. GnRH analogue treatment constitutes the most promising treatment for sex offenders at high risk of sexual violence, such as pedophiles or serial rapists, however informed consent is necessary. SSRIs remain an interesting option in adolescents, in patients with depressive or OCD disorders, or in mild paraphilias such as exhibitionism.Disclosure of interestThe author has not supplied his declaration of competing interest.

Preliminary Results of the Louisiana Sex Offender Treatment Program

The purpose of this study was to offer preliminary support for the Louisiana Sex Offender Treatment Program (LSOTP) in addressing the needs of juvenile sex offenders. Research objectives were (1) to offer statistical evidence for reductions in anxiety, depression, cognitive distortion and negative attitudes towards women comparing a group of 21 adolescents, 12 of whom received services as usual and nine of whom participated in the LSOTP. A controlled experimental evaluation design was utilized. The juvenile sex offenders were randomly assigned to the experimental group for 12 weeks receiving treatment services and a control group receiving care “as usual” in a residential group care program. Participants in the experimental group experienced statistically significant decreases in cognitive distortions related specifically to rape and molestation.The results of this study offer preliminary support of the LSOTP as a best practices alternative to other treatment modalities.

Review of the Empirical and Clinical Support for Group Therapy Specific to Sexual Abusers.

This review compiles 48 empirical studies and 55 clinical/practice articles specific to group therapy with sex offenders. Historically, group therapy has always been the predominant modality in sex offender-specific treatment. In the first decades of the field, treatment applied a psychoanalytic methodology that, although not empirically supported, fully appreciated the primary therapeutic importance of the group modality. Conversely, since the early 1980s, treatment has applied a cognitive behavioral method, but the field has largely neglected the therapeutic value of interpersonal group dynamics. The past decade has seen a growing re-appreciation of general therapeutic processes and more holistic approaches in sex offender treatment, and there is an emerging body of empirical research which, although often indirectly concerned with group, has yielded three definitive conclusions. First, the therapeutic qualities of the group therapist-specifically warmth, empathy, encouragement, and guidance-can strongly affect outcomes. Second, the quality of group cohesion can profoundly affect the effectiveness of treatment. Third, confrontational approaches in group therapy are ineffective, if not counter-therapeutic, and overwhelmingly rated as not helpful by sex offenders themselves. Additional conclusions are less strongly supported, but include compelling evidence that sex offenders generally prefer group therapy over individual therapy, that group therapy appears equally effective to individual therapy, and that mixing or separating groups by offense type is not important to therapeutic climate. Other group techniques and approaches specific to sexual abuse treatment are also summarized.

When yes, for how long? – Duration of antiandrogenic treatment of sexual offenders with paraphilic disorders

Hintergrund Insgesamt wurden seit 2010 in der Forensisch-Therapeutischen Ambulanz (FTA) Berlin 15 jeweils individuell begrundete, therapeutisch begleitete Auslassversuche einer antiandrogenen Behandlung (ADT) durchgefuhrt.

The Impact of Interpersonal Style on Ruptures and Repairs in the Therapeutic Alliance Between Offenders and Therapists in Sex Offender Treatment

The therapeutic relationship is a critical component of psychological treatment. Strain can occur in the relationship, particularly when working with offenders, and more specifically, those offenders with interpersonal difficulties; strain can lead to a rupture, which may affect treatment participation and performance. This study examined ruptures in the therapeutic relationship in sexual offenders participating in offense-focused group treatment. Fifty-four sex offenders rated the therapeutic alliance at the commencement and completion of treatment; at the completion of treatment, they also reported on the occurrence of ruptures and whether they believed these ruptures were repaired. Ruptures were separated by type, according to severity-Each relationship was therefore characterized as experiencing no rupture, a minor rupture, or a major rupture. Offender characteristics including interpersonal style (IPS) and psychopathy were assessed at the commencement of treatment; their relationship with ruptures was examined. Results revealed that more than half of the offenders (approximately 55%) experienced a rupture in the therapeutic alliance, with one in four of these ruptures remaining unresolved. Offenders who did not report a rupture rated the therapeutic alliance significantly higher at the end of treatment compared with those offenders who reported a rupture that was not repaired. Offenders who reported a major rupture in the therapeutic relationship were higher in interpersonal hostility and hostile-dominance. No interpersonal or offense-specific factors affected the likelihood of a rupture repair.

Understanding desistance from sexual offending

Although there is a substantial body of work on desistance from crime in general, comparatively little is known about desistance from sexual crime. The broad aim of this paper is to provide an overview of the research methodology and preliminary findings from a recent empirical study on desistance from sexual offending conducted by the authors.1 Such findings have potentially important implications for policy and practice concerning sex offender risk assessment, treatment and management.

Evidence-based treatments for juvenile sexual offenders: review and recommendations

Purpose – Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical literature on treatments for this clinical population. Design/methodology/approach – The authors searched PsycInfo and MEDLINE (via PubMed) for studies that evaluated outcomes of treatments with juvenile sexual offenders. Findings – There are a small but growing number of treatment studies (n=10) with juvenile sexual offenders, and all of these studies evaluated cognitive-behavioral therapy or multisystemic therapy for problem sexual behaviors. The results of these studies are promising, although conclusions about treatment effectiveness have been frequently limited by methodological problems. Originality/value – The authors provide recommendations for treatment providers and policymakers to consider in their decisions about interventions for juvenile sexual offenders. Furthermore, the authors offer suggestions for researchers who seek...