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Contemporary Sex Offender Treatment

Drs. Gene Abel, M.D., and Judith Becker, Ph.D. are considered to be leading authorities in the area of sexual deviancy.  In the 1980's, when both practiced in New York City, they conducted a study on child molesters that were referred to them by the probation department.  As a result, they devised one of the early treatment protocols for sexual offenders.

 

According to Abel and Becker sex offenders were deficient in six areas and these areas needed to be addressed in treatment. The six areas were: Assertiveness Training, Social Skills, Deviant Fantasy, Empathy Training, Cognitive Distortions and Relapse Prevention. The modality of treatment was the group, the thinking being that these areas were best addressed in a group setting as some of the treatment modules required role playing.  (Groups have an additional advantage - stigmatized populations, such as sex offenders,  are best treated in a group where their shame can be effectively dealt with.)

The Abel and Becker model was a cognitive-behavioral approach. That is, the offender was required to examine his thinking and thus change his behavior.  The cognitive-behavioral model of sex offender treatment has been endorsed as the preferred treatment for offenders by the Association for the Treatment of Sexual Abusers (ATSA). 

While ATSA still insists on promulgating the cognitive-behavioral approach, sex offender treatment has evolved beyond this particular approach although, according to a 2009 national survey, 86% of programs for adults and adolescents continue to use this approach. (It should be noted that while the cognitive-behavioral approach is allegedly empirically supported, there is no evidence that relapse prevention is of any value and the value of teaching sex offenders empathy is, at best, questionable.)

While groups remain the modality of treatment, how that treatment is delivered has evolved beyond the cognitive-behavioral approach.  Among the contemporary theories are the following:

• Good Lives
• Risk-Need-Responsivity
• Psychodynamic

THE GOOD LIVES MODEL

The goal of the Good Lives model is to aid the offender in achieving a good life in socially acceptable ways.  Risk management and avoidance strategies are deemphasized.

THE RISK-NEED-RESPONSIVITY MODEL

This model of treatment focuses on the moderate and high risk offender. It attempts to address the offender's risks that are linked to reoffending and targets them for change, being responsive to the offenders learning style. Social learning and cognitive-behavioral approaches are emphasized.

THE PSYCHODYNAMIC MODEL

This model first seeks to create a safe environment where group members are free to engage in interpersonal exchanges.  It is through such exchanges that individuals begin to understand and alter their inner responses and previously unexamined hypotheses about life and interpersonal relationships.

A critique of the cognitive-behavioral model is that 1) it is psycho-educational. The group leader(s) has the knowledge and deposits it into the offender (The Brazilian educator, Paulo Friere, referred to this as "the banking concept" of learning) and 2) it does not help the offender relate better to others.

Several years ago we converted our program from the cognitive-behavioral model to the psychodynamic model.  We noticed the following: some offenders, once their probationary period had ended, chose to remain in group voluntarily.  This was virtually unheard of when we used the CB model. People began to relate better and self-reported having more satisfied relationships outside of group. (See my video below on some of the benefits of (psychodynamic) group psychotherapy.)

 

                                                 

                                          Photo: Tojosan

Religious Services, Pastors and Sex Offenders

The minister (priest, rabbi,iman) was facing a dilemma.  A sex offender, recently released from jail, had approached him about participating in church (temple, mosque) services. The offender was not unknown - his case had been highly publicized when disclosure occurred. Should he be allowed to participate in services or should he be excluded? 

These are questions that are increasingly being asked by pastors and their congregations. There are no easy answers.

Sex offenders, particularly child molesters, are generally not welcome at church services. If they are, they are generally assigned people who meet them at the door, sit on either side of them during the services and are then escorted out, not being allowed to participate in any social activity that may take place after the services.

A church in Wisconsin chose to do it differently.  They are offering biweekly worship services in the evening specifically for sex offenders who have been released from incarceration. No children are permitted to be at the service. (To read more http://t.co/RMuya3A0)

What do you think?  Are convicted sex offenders welcome in your church?  If so, how are they handled?

 

Photo: calinuus

 

Debunking Sex Offender Myths

                                               SEX OFFENDER MYTHS

MYTH #1

             "A boy who is sexually abused will grew up to become a sex offender"

There is no support for this.  If this were true the vast majority of sex offenders would be female, not male, as one in four females and one in seven males are sexually assaulted before the age of 18. (Approximately 95% of offenders are male)

 

MYTH #2

                             Most sex offenses are committed by strangers

Although public education about childhood sexual abuse has lessened the spread of this myth it is still out there.  Most sex offenses are committed by someone the victim knows - family member, friend, intimate partner or acquaintaine.  About 27% are committed by strangers.

 

 

MYTH #3

                                         Sex Offenders can be profiled

No I"profile" of sex offenders exists.   Although mental health professionals who treat sex offenders describe them as "manipulative," "deceptive," and "secretive" there is no set of characteristics, be they physical, emotional, mental or psychological that are common to all sex offenders.

It is important to keep in mind that sex offenders can be:

• Male of female
• Be young or old
• Have various levels of education
• Be married or single
• Have strong ties to their families and communities, or have weak ties; and/or
• Have no record of prior criminal involvement or have a record for sexual or non-sexual offenses

 

MYTH #4

              When a sex offender recidivates he commits another sex offense

The reality is that sex offenders are more apt to be rearrested for non-sexual, non-violent crmes as opposed to sexual offenses.

 

MYTH #5

                Using the polygraph on offenders reduces their risk to re-offend

There is no evidence that the polygraph has been effective in preventing sex crimes.

 

MYTH #6

            Sex offender treatment doesn't work - sexual offender recidivism rates are high

The media is mainly to blame for propagating this myth.  A 2002 study by the US Department of Justice indicated that recidivism rates among sex offenders was 5.3%; that is 1 in 19 released sex offenders were later arrested for another sex crime.  In comparison, the same study found that 68% of released non-sex offenders wre rearrrested for any crime (both sex and non-sex offenses, while 43% of the released sex offenders were rearrested for any crime.

In 1994 approximately 4,300 child molesters were released from prisons in 15 states.  An estimated 3.3% of these 4,300 were rearrested for another sex crime against a child within 3 years of release from prison.

                                                         RESOURCES

                        www.atsa.com - The Association for the Treatment of Sex Abusers

                        www.csom.org - The Center for Sex Offender Management

                        www. sexoffenderissues.com

                        www.safersociety.org

Photo Credit: katinthecupboard

 

 

 

 

 

 

 

 

Sex Offender Disclosures

One method used by homicide detectives to get a murder suspect "to give it up" is to tell them that they will feel better when they admit their crime. There seems to be a positive power in a guilty party acknowledging their wrong doing.  As the saying goes, "confession is good for the soul."

I believe the same is true for sex offenders as I have seen it occur numerous times, all with a beneficial effect - they feel better and it helps them get down to the work of understanding why they committed their offense and what they have to do to see that they do not reoffend.

Sex offender disclosure, for the reasons above, is an important part of healing. But how does it take place?  One method I am familiar with has the group leader telling the offender that, because of their denial, they are only being given a trial of treatment, say 6 - 10 weeks, and if they cannot acknowledge their offense during that time they will be terminated as a treatment failure and returned to the court. Such a method tends to be heavy handed and, while it has worked, I would not be inclined to depend on it.

Another approach is to have the group members tell the resistant client.  Such an approach is much more effective as it comes from peers, and they will be listened to more than a group leader. Another advantage is that the group member who voices it is usually speaking for others in the group and the resistant client feels the group pressure on him.  Thirdly, the non-judgmental nature of the group is mentioned - "we won't think any less of you, we've all been through it" - coupled with the fact that the case is over, nothing the individual can say will put him in any danger, is helpful.

  Photo: aabomb

 

 

 

Guidelines for Selecting a Sex Offender Therapist

Sex offenders require sex offender specific therapy that not all mental health professionals are capable of providing. This being the case some guidelines are offered below to help in the search for a knowledgable professional.

Just because someone has an advanced degree as a mental health professional does not mean they can be engaged to provide sex offender treatment.  In choosing a therapist it should be someone who has the following:

• Professional Membership in an organization such as The Association for the Treatment of Sexual Abusers
• Demonstrated experience in providing sex offender specific therapy. Since most sex offender specific therapy is group therapy it helps if they are also as a Certified Group Psychotherapist (CGP)
• An individual who has conducted psychosexual evaluations
• Someone who is knowledgeable about risk instruments such as the STATIC - 2002, the VRAG, the STABLE 2007, to name a few
• An individual who is currently being supervised, or has been supervised, by a mental health professional who has expertise in the field of sexual offender evaluation and treatment
• If the treatment provider has 3 years or less of experience he/she should be currently supervised by a mental health professional with expertise in the field

As for anyone seeking mental health counseling, no matter what the focus of it may be, it is important to keep in mind that the individual seeking the counseling is a consumer and it is within their rights to ask the provider about their background.  Having more knowledge is better than having little or none at all.

 

 

 

 

 

 

 

 

 

 

 

 

 

The Sexual Interest of the Sex Offender

Many people are under the impression that the motivation behind a sex crime has to be sexual in nature.  This is understandable but not true.  For instance, it has long been known that rape is a crime of violence, not of sex. The lack of a sexual motive can also be found in other sexual offenses as well.

 

Two examples:

Jim, an unmarried man of 68, lived had lived alone much of his life, except for a period of four years when he was in the military.  He was quiet, unassuming and kept to himself. A young couple he had met through his only cousin called him one day.  They had lost their house after the husband became unemployed and were now homeless with a 5 year old son.  Jim decided to allow them to live in his house until they became financial sound.

He regretted his decision.  They were soon taking advantage of him, borrowing money for food, using his truck - with him buying the gas - yet not doing their share of the household chores. Being the quiet, passive, unassertive man that he was Jim didn't complain.  Yet his anger and irritation began to fester.  One day the couple's 5 year old son reported to them that Jim had fondled him in what was an apparent attempt to teach the boy how to masturbate.

Testing indicated that Jim had no sexual interest in children.  His score on a risk assessment instrument placed him in a low risk category of estimated risk to recividate. He had no prior criminal record.  The examiner concluded that Jim's inability to properly assert himself when he was aware of how he was being taken advantage of needed to be the focus of his sex offender treatment.  Unable to do this he had displaced his anger toward the parents onto their innocent child.

Another example:

Rodney was a 55 year old widower.  An adult neighbor called the police when she saw him on his front lawn exposing himself to her.  When the police arrived and told Rodney of the allegation he readily acknowledged his inappropriate behavior.  He was arrested and charged.  In court he denied he had acknowledged his offense to the police, stated they were lying and took his case to a jury trial where he was found guilty.

Referred for a psychosexual evaluation the examiner noticed that Rodney had made statements to him only to later deny he had said them.  His short term memory was impaired.  The psychologist recommended that Rodney undergo a neuropsychological evaluation, the results of which showed he was in the early stages of dementia.  The condition of his probation that he be in sex offender treatment was dropped and he was treated for his dementia.

 

 

 

 

 

 

The Benefits of Group Therapy

Research has shown that there is no appreciable difference between the benefits of individual vs group therapy.  However, I'm sold on group therapy, especially for the population I work with - sex offenders.

It used to be said - maybe it still is - that the benefits of group therapy for a person adjudicated for a sex offense are the following:

• It helps them overcome their denial
• It helps them work through their shame
• It helps them learn social skills

There may be more benefits that are mentioned but these are the ones I remember.

But groups offer many more than the commonly mentioned benefts listed above.  Perhaps an example will help.

Kyle entered a sex offender group at the insistence of his probation officer.  He had spent almost half of his 55 years incacerated for a variety of crimes, many of them violent.  Approximately 20 years ago he had committed and been found guilty of two rapes, the reason he was referred.

A heavy drug user Kyle attempted to turn the group into an NA meeting.  He was extremely vocal about the need of other group members with drug problems to get into NA or "you'll pick up and be back in prison." He refused to talk about the rapes he had committed. His angry tone and bullying tactics were off putting for the group. But the group pushed back and when it did he would fold his arms and state he wasn't going to talk anymore.  The group called him on this - "you want to pick up your ball and go home" - which he denied was the case.

He made an attempt to leave the group, fabricating a filmsy excuse.  Both the group leader and his probation officer refused to allow this.

One of the things the group confronted him with was his language.  He strenously objected, saying that he grew up speaking this way and, besides, people didn't mind it.  Who did the group think it was, telling him to change!  The group responded by saying they were not out to change him but rather would appreciate his considering that his language might offend others.

Slowly Kyle began to "settle in" the group.  It was noticed that his offensive language was being used less and less.  He identified with a group member who was from the same neighborhood he grew up in and, like him, had been in prison.  This group member was direct with him and he appeared to hear what he said, which was quite different from his interactions with other group members.  It was also noticed that Kyle was beginnning to make a series of self-disclosures - "anger is a problem for me," "I have to stop judging people like I do."

He even acknowledged that he hid behind his angry front.

The acknowledged leader in understanding how groups function is Irving Yalom, M.D., who has written extensively on the subject.  (He also wrote one of the first, if not the first, article on group therapy with sex offenders in 1966.) Yalom mentions several "therapeutic factors" that groups offer and Kyle has benefited from them. Specifically Kyle has seen group members grow and change, which offers him hope that he can too; he has learned from observing other group members - imitative behavior and interpersonal learning; he has come to see that he is basically no different from others - the principle of universality and his behavior is slowly being modified - the development of socializing techniques.

As I noted at the beginning - individual and group therapy benefits are pretty equal.  But from where I sit as a group facilitator it's exciting to see people grow and change and how a group makes this happen.  I'll take group therapy every time.

 

Photo Credit: yony_ro

 

 

 

 

The Sex Offender and The Legal System

The legal system can be intimidating, especially if you have never before been arrested. One's anxiety is probably heightened if you are being charged with a sex crime. This blog is a brief primer on what you can expect, with suggestions about what you might do.

 

 

Usually a criminal complaint has be to issued when an allegation of an offense, in this case, a sex offense, has been alleged.  This either comes in the mail or is delivered by the police.  If you are the recipient of a criminal complaint and the police tell you they want you to come to the police station to talk to them it is within your rights to refuse. Criminal defense attorneys almost always tell their clients not to speak to the police without their being present. This is excellient advice and should be followed.

You will need an attorney.  Most men that I know that have been charged with a sex offense such as Rape, Indecent Assault and Battery, Frotteurism or Exhibitionism, rely on their family and/or friends to assist them in coming up with a name.  Unless your family members and friends are knowledgable about the law I would advise against this approach.  You need an attorney that has defended individuals, such as yourself, that have been so accused.  Take the time to find an experienced attorney that has handled cases such as yours.  It probably will be expensive but keep in mind this is your future that is at stake here.

The case may drag on for longer than you thought. There may be many pre-trial conferences. You may show up at the courthouse only to be told that the conference was rescheduled for another day.  This will upset you as you have taken time off from work.  Try not to let this get to you.  Hard as it may be, be patient.  I have seen men lose patience and press their attorneys to settle the case - "get it over with" - such individuals usually wind up wishing, after the fact, that they had been more patient. They could have gotten a better deal.

Be pro-active. Don't hesitate to ask questions of your attorney.  You're paying him, he' working for you. Utilize the Internet for information.  Ask your attorney about hiring a forensic psychologist, with experience conducting psychosexual evaluations, about evaluating you. If the results are positive you may use it in your defense in court.

If a deal is proposed get the details.  Unfortunately, I have spoken to many men who have said they accepted a deal that involved probation only to find out later that conditions of that probation included a psychosexual evaluation and counseling.  According to them their attorneys knew of this but never informed them.

For most people the legal system is foreign territory. It's frightening and intimidating for the unexperienced.  But this is your future that is at stake here. You want the best possible defense.  Do what it takes to make that happen.

 Photo: lawyer86001

 

The Shame of the Sex Offender

                           "I've disappointed God and I've disappointed myself."

Not many people would expect to hear these words from a man who committed a sexual offense, but many offenders I've treated have uttered them in one form or another.  The notion of shame comes up in many contexts, one of them being the shame of having to register as a sex offender. Presenting oneself to an officer at the local police station and telling them why they are there is not an easy task.

Contrary to the popular perception of sex offenders as being out of control predators, most that I have met over the course of the last 30 years know that they have committed an egregious offense and feel guilty about it. Along with that guilt comes an abiding sense of shame. Some comments that reflect this are the following:

• "I'm disgusted with myself"
• "I humiliated myself and my family"
• "I hate myself"
• "I feel I resent myself"

Society, in the way it treats sex offenders, enforces the sense of shame.  But I am convinced that offenders would experience a personal sense of shame regardless. (I have real concerns about those that don't.)

In sex offender treatment the focus is generally on the offender's cognitive distortions, deviant sexual arousal, impulse control, knowing their "danger signs," developing strategies to employ when they find themselves in a high risk situation.  These areas have to be addessed.  But so does the deep, abiding shame many offenders carry with them.

Learning self-compassion is part of our treatment program.

 

Photo: Aurellan

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Photo: Aurellen

Criminal Defense of Sex Offenders - What an Attorney Should Know

You have been retained to defend a man accused of a sexual offense. He denies the allegation. How should you proceed?

You have reviewed the police report(s) and victim(s) statements.   Next have your client undergo a psychosexual evaluation.  This will provide you with information regarding your client's:

• Personality Functioning
• Sexual Interests
• Mood Disorders (Bipolar illness, Major Depression, etc.)
• Substance Abuse Problems
• Trauma
• Cognitive Functioning
• Level of Risk

How will such an evaluation help your client?

• If his IQ falls between 50-70 he is mildly retarded.  This will raise the question of competency
• If he has normal sexual interests that's a plus
• If he has substance abuse problems you will want him in treatment
• If his level of estimated risk is low that's a plus
• If he has a mood disorder you will want to refer him to a psychiatrist for a medication evaluation

If your client admits his guilt and says he wants to plead to the charge(s) then you should appraise him of the following:

• Doing so will probably mean that he has to register as a sex offender
• If he does have to register it will probably mean he has to register for the next 20 years
• Information about him and his arrest will be posted on the Internet
• His housing may be restricted
• He may lose his job and/or his job prospects will be limited
• Conditions of his probation - if he receives probation - will most likely be that he undergo an evaluation and treatment
• He will suffer some form of ostracism
• Neither you, nor he, will know what risk level he will be assigned by the registry board
• He may have to wear a GPS

If a plea deal is offered it is your duty to your client to appraise him of the consequences so that he can make an informed decision. Information you have obtained about your client from his psychosexual evaluation may assist you when negotiating with the prosecuting attorney.

 

Photo: G. Self