Assessment and case conceptualization in sex offender treatment

The assessment of sexual offenders consists of the systematic collection of clinically relevant information in order to detect clinical phenomena or problems and to provide clear treatment targets. The result of this process is a conceptual model, or case formulation, representing the client’s various problems, the hypothesized underlying mechanisms, and their interrelationships. The focus of this article is on the importance of psychological assessment and case formulation in the rehabilitation and management of individuals convicted of sexual offences. First, we make a number of general points about the importance of evidence based assessment and clinical reasoning in case formulation. Second, we review key elements of contemporary sexual offender theory that highlights the heterogeneity evident among sex offenders and the implications for case formulation and treatment planning. Third, we discuss the role of case formulation for risk assessment and management. Finally, we illustrate our major points with a brief case study and conclude with a brief consideration of the value of case formulations.

On a clear day you can see forever : integrating values and skills in sex offender treatment

The topic of sex offender rehabilitation frequently evokes fierce reactions, ranging from strident demands for harsher sentences contrasted with calls for more imaginative and compassionate sentencing options. There seems to be a polarization of positions centred on the question of offenders' moral standing: are they moral strangers or fellow travellers? This fundamental disagreement about offenders' moral status is at the core of a number of independent, although related current practice and research issues confronting the field, namely: (1) risk management versus strength-based treatment approaches; (2) the utility of utilizing individually tailored versus manual-based programmes for offenders; (3) focusing on the technical aspects or therapy as opposed to relationship and therapist factors (what has been called process issues); and (4) the conflict between protecting the community versus promoting the interests of offenders. In this paper I suggest that an approach to sex offender treatment based on a combination of human rights theory (an ethical resource) and strengths-based approaches can help us navigate our way through the above dilemmas in a way that addressees both the needs of offenders and those of the community.

Group Dynamics in Sex Offender Treatment Involving Individuals with Personality Disorders

This qualitative investigation primarily employing a phenomenological perspective and psychoanalytic interview approach intends to provide contextual understanding of group dynamics in sex offender treatment involving individuals with strong features of personality disorders or Axis II psychopathology according to the Diagnostic and Statistical Manual of Mental Disorder (4 ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000). Of note, this study particularly focuses on the cluster B type (Narcissistic, Borderline, Histrionic, and Antisocial Personality Disorders), based on the assumption that this type is more interpersonally operational in its nature. The present study is based on semi-structured interviews of three clinicians who arecurrently providing group treatment for sex offenders. The interview was designed to elicit the participants' clinical observations of group dynamics involving group members with features of the Axis II, Cluster B type. In this study, 11 therapeutic factors postulated by Yalom (2005) were utilized to qualitatively investigate group dynamics. Analyses of qualitative data highlighted how group members with features of the Axis II, Cluster B type may distinctively affect group dynamics. Based on the results, group members with Axis II diagnoses, as reported bythe therapists who responded to this study, were observed to present with altruistic behaviors in group. In addition, motivation appeared to be one of the most influential factors in promoting and maintaining therapeutic group behaviors. Group members with antisocial features appeared to present with low motivation for treatment, and individualswith a pervasive history of criminal institutionalization seemed more prone to disengagement in group. Individuals with borderline and histrionic traits seemed to be interpersonally oriented and affectively engaged in group process. Persons with a narcissistic tendency also appeared to be interpersonally invested and showed altruistic behaviors, yet the importance of confirming their superiority seemed to outweigh the need for acceptance or approval from other group members. As briefly discussed above, the qualitative analyses of the current data showed that individuals with Axis II disorders, Cluster B type uniquely affect group dynamics, which suggest clinical considerations foreffective treatment planning, maintenance, and outcomes.

'Grooming' and the Sexual Abuse of Children: Implications for Sex Offender Assessment, Treatment and Management

'Grooming' has been termed 'a ubiquitous feature of the sexual abuse of children' (Thornton, 2003: 144). Despite the prominence of the term in contemporary discourses on sexual offending against children, it is a term that is insufficiently understood in the psychological, sociological, criminological or legal literature. Most recently, the term has been used in two primary offending contexts - on-line grooming and abuse by strangers, and institutional grooming and abuse by those in positions of trust. This article argues, however, that grooming and its role in child sexual abuse is a multi-faceted phenomenon and much more complex than has been highlighted previously. While there are a number of typologies of grooming, this article concentrates on those which may be most relevant for treatment and management contexts - 'peer-to-peer grooming' and 'institutional grooming.' Drawing on extensive fieldwork with professionals who work in the fields of child protection or victim support, and sex offender assessment, treatment or management across the United Kingdom and the Republic of Ireland, the aim of this article is two-fold: (i) to deconstruct the term grooming and examine its actual role in the onset of sexual offending against children; and (ii) to draw out the implications of these complexities for policy and practice, chiefly in terms of treatment and prevention.

The ethics of care and treatment of sex offenders

The ethics of care acknowledges the importance of establishing and maintaining practices that help people to meet their needs, develop and protect basic capabilities for problem solving, emotional functioning, and social interaction, and avoid pain and suffering. In this article, we explore the contribution an ethics of care perspective can make to work with sex offenders. First, we briefly describe five classes of ethical problems evident in work with sex offenders. Second, the concept of care is defined and a justification for a version of care theory provided. Third, we apply the care ethical theory to ethical issues with sex offenders and demonstrate its value in responding to the five classes of problems outlined earlier.

Back to basics : empirical support for the importance of release planning in reducing sex offender recidivism

This article reports findings from a series of empirical studies investigating whether poor release planning might contribute to sex offender recidivism. A coding protocol was developed to measure the comprehensiveness of release planning which included items relating to accommodation, employment, pro-social support, community based treatment, and the Good Lives Model (T. Ward & C.A. Stewart, 2003) secondary goods. The protocol was retrospectively applied to groups of recidivist and non recidivist child molesters, matched on static risk level and time since release. As predicted, overall release planning was significantly poorer for recidivists compared to non recidivists. The accommodation, employment, and social support items combined to best predict recidivism, with predictive accuracy comparable to that obtained using static risk models. Results highlighted the importance of release planning in efforts to reduce sex offender recidivism. Implications for policy makers and community members are briefly discussed.

The treatment of sex offenders : evidence, ethics, and human rights

Public policy is necessarily a political process with the law and order issue high on the political agenda. Consequently, working with sex offenders is fraught with legal and ethical minefields, including the mandate that community protection automatically outweighs offender rights. In addressing community protection, contemporary sex offender treatment is based on management rather than rehabilitation. We argue that treatment-as-management violates offender rights because it is ineffective and unethical. The suggested alternative is to deliver treatment-as-rehabilitation underpinned by international human rights law and universal professional ethics. An effective and ethical community–offender balance is more likely when sex offenders are treated with respect and dignity that, as human beings, they have a right to claim.

Absence of malice: Constructing the female sex offender

It could be argued that all crimes have a general moral basis, condemned as ‘wrong’ or ‘bad’ in the society in which they are proscribed, however, there are a specific group of offences in modern democratic nations which bear the brunt of the label, crimes against morality. Included within this group are offences related to prostitution and pornography, homosexuality and incest, as well as child sexual abuse. While the places where sex and morality meet have shifted over time, these two concepts continue to form the basis of much criminal legislation and associated criminal justice responses. Offenders of sexual mores are positioned as the reviled corruptors of innocent children, the purveyors of disease, an indictment on the breakdown of the family and/or the secularisation of society, and a corruptive force (Davidson 2008, Kincaid 1998). Other types of offending may divide public and political opinion, but the consensus on sex crimes appears constant.

Sex Offender Registration: Some Observations on ‘Megan’s Law’ and the Sex Offenders Act 1997

“Megan’s Law” in the United States and Part 1 of the Sex Offenders Act 1997 in the United Kingdom, make provision for the creation of a register which will record the names and addresses of all persons convicted or cautioned for a sexual offence. Arguments expounded in favour of the legislation include the supposedly high recidivism among sex offenders, the inadequacy of supervision provisions, and the resulting need to ‘track’ the dangerous offender for public protection. In practice, however, there are a plethora of obstacles, such as cost and inadequate policing resources, which may impede its effectiveness in aiding law enforcement and reduce it to symbolic significance only. In addition, there are an array of ethical objections to the legislation, such as it breaches civil liberties and constitutes ‘double jeopardy’, which may prevent meaningful imposition.

Sex Offender Registration: Implications and Difficulties for Ireland

The aim of this paper is to explore the implications and difficulties of a system of sex offender registration for Northern Ireland and the Republic of Ireland. From the orthodox perspective, registration appears justified. Sexual offending has increased and this is used by the media to generate a ‘moral panic’. However, sexual offenders in the community have also been socially constructed in Ireland, as a problem requiring specific action, through Blumer’s (1971) developmental perspective. It is this perspective which most adequately explains the formulation of the legislation. Arguments expounded in favour of registration include the supposedly high recidivism among sex offenders, the inadequacy of supervision provisions and the resulting need to ‘track’ the offender for public protection. Yet, in practice there are a plethora of obstacles such as cost and inadequate policing resources, not considered at the time the legislation was being formulated, which may impede its effectiveness in aiding law enforcement and reduce it to symbolic significance only. Given these difficulties, it is argued that registration is not an appropriate response to the problem of released sexual offenders in Ireland. Rather, from the social constructionist perspective, it is suggested that it is better to ‘treat’ the sex offender through less formal and stringent means in the community away from the criminal justice process.

Does sexual offender treatment work? : A systematic review of outcome evaluations. '??Es efectivo el tratamiento de los delincuentes sexuales? : una revisi??n sistem??tica de los resultados evaluados'

Resumen tomado de la publicaci??n. Resumen tambi??n en ingl??s