Sex Offender Specific Treatment. Howard Levine Ph.D., LCP Coles County Mental Health Center Mattoon, IL firstname.lastname@example.org. Grateful Acknowledgements. Center for Sex Offender Management ( www.csom.org ) For their expertise and excellent training curricula used here.
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Howard Levine Ph.D., LCP
Coles County Mental Health Center Mattoon, IL
The purpose of all this is to
Feed his imagination, strengthen justifications
Co-opt other adults, and victim(s)
Create reliable source for ongoing victimization
Decrease chances of being caught or stopped
Without external intervention most offenders behavior escalates and continues
If sex offenders come to understand the harm they cause, they will be more reluctant to commit future sex offenses because they will find it more difficult to disregard the consequences of their actions to their victims and others
Gene Abel et. al, (1983) landmark study on the frequency and variety of sexual offending behavior offenders commit. The 411 offenders in the study on average over a 12 year period had attempted 581 crimes, completed 533 crimes, had 366 victims and completed an average of 44 crimes a year. These crimes included ‘hands off’ offenses. 73%+ had two or more types of deviant sexual interest.
5090 incidents of sex offending
319 child molestations
30 ‘child molesters’
5891 assaults on children
213 rapes on women
Colorado DOC, 1998
36 sex offenders on average
2 victims by official records
165 victims after first polygraph
185 victims after second polygraph
Ahlmeyer et. al., (2000)
Incarcerated sex offenders (average)
2 victims 5 offenses
After second polygraph
110 victims 318 offenses
Tanner (1998) 128 ASO in first year of community based treatment and supervision
31% had sexual contact with child
25% had unauthorized contact with a child
12% had forced someone to have sex
86% was participating in new high risk behavior and/or new crimes
If such arousal can be decreased, the likelihood of future sex offending will be decreased
Treatment goals include:
Who is this best suited for?
Is this technique essential?
Can this technique be used exclusive of others?
Yes—but they’re only hurting themselves
Offenders with significant deviant sexual arousal
No—but some intervention must address deviant sexual arousal
NoCommon Questions about Behavioral Interventions
There are two primary types of medications used in the treatment of sex offenders:
Assists offenders to:
Offenders, in order to sexually abuse another person, have changed their way of thinking so that molesting another is not the same as others believe. Offenders think in ways that have made their sexual assault harmless, ‘OK’ or deserved. SOBS is also used to justify the behavior after the fact and support the offenders self-centered approach to meeting his needs. Offenders fight hard to justify and maintain their SOBS.
To increase social skills in:
Focus on ‘bad self’
Self as unchangeable
Self-focus reduces empathy
Feel exposed and scrutinized
Hostility, low esteem, hopelessness
Cripples coping response
Leads to entitlement
Focus on ‘bad behavior”
Views behavior as changeable
Promotes sense of responsibility
Discomfort from impact of behavior on others
Optimism and self efficacy increases
Motivates commitment to make amends and personal changeShame vs. Guilt (Kurt Bumby, 2003)
Sex offending is a choice made by the offender. Relapse prevention is also a choice. Both require commitment, consistently reaffirmed, to the goal. Effective treatment and supervision can assist and encourage the offender to behave in responsible and non-victimizing ways.
The sex offender must learn:
The sex offender must learn the typical sequence of events that lead to relapse:
The sex offender must learn that:
At a minimum, sex offenders entering treatment should have spelled out to them—preferably in writing:
Studies have examined how therapist styles affect the success of treatment:
Some treatment targets seem to be better achieved with the use of treatment delivered with a motivational approach based on empathic understanding, mutual trust and acceptance.
Account for 10-20% of sexual abuse of children
History of PTSD, addiction and MI
Victimized 2X male ASO
Much more likely victimized sexually
Emotional abuse and neglect victims
Physical and domestic abuse
Use less force or coercion
Abuse in care-giving contextFemale Sex Offenders
All include pre and post exam interviews
All PGE are limited to only a few (3-5) specific questions, chosen in consultation between provider and examiner. Offenders are informed of these questions prior to the exam.