TREATING CHILD SEX OFFENDERS Pro's and Con's
TREATING CHILD SEX OFFENDERS What Is Child Sexual Abuse? Offenders-Who Are They? Warning Signs- Before You Offend Why Do I Need To Know About Sexual Abuse And Offenders? Why Should Sex Offenders Be Treated? What Is The Recidivism Rate? Recidivism Rates Of Sex Offenders Treatment Vs. No Treatment What Should Society Do With Sex Offenders? What Kinds Of Treatments? Elements Of Effective Treatment Programs Components Of Cognitive Behavioral Treatment Denial Mental Health Issues The Polygraph and the Sex Offender Substance Abuse And Sexual Offending: The Link FLP Offender Treatment Sample Letters From Offenders Victim Assistance Program CHILD SEXUAL Offender BIBLIOGRAPHY RESOURCES REGARDING OFFENDERS WHAT IS CHILD SEXUAL ABUSE? by Brook Arke, M.A. Child sexual abuse is when an adult, adolescent, or older child partakes in any sexual activity with a child, either through the use of force and coercion or charm and persuasion. However, some kinds of sexual behavior among children might be natural explorations rather than abuse. Child sexual abuse is NOT only penile penetration (intercourse). Although child sexual abuse definitely includes vaginal and anal penetration, it also includes, touching a child’s genitals or breast areas (private parts), masturbating in front of a child, asking a child to masturbate or do any sexual act, asking a child to touch his/her own or an adult’s genitals, simulating sexual intercourse, oral-genital contact, digital (fingers) or object penetration, exposing a child to pornography in any form (magazines, internet, video, live), an adult exposing him/her self to a child, and voyeurism (watching a child/teen undress or bathe). Child sexual abuse is illegal in all 50 states of the United States. For more information on this topic go to: http://www.apa.org/releases/sexabuse/homepage.html http://www.stopitnow.com/comquest.htm#Q1 OFFENDERS-Who are they? Offenders are usually people the victim knows, and even cares about (father, mother, stepparent, sibling, close relatives, friends, caretaker, and anyone else who has close contact with the child). In 90% of sex abuse cases, the victims know their abuser (Finklehor, 1994). Sexual abuse by strangers is much more uncommon. Men tend to offend more than women, but women can be offenders also. Contrary to popular belief, homosexual men are NOT more likely to sexually abuse children. WARNING SIGNS-What to look for in adults & children For checklists about the interactions that may give you a sense of whether you have a reason for concern go to: http://www.stopitnow.com/warnings.htm BEFORE YOU OFFEND --- If you are thinking about touching a child in a sexual way… Call STOP IT NOW! It’s a free* helpline for confidential information: 1-888-PREVENT (773-8368) Monday - Friday (except federal holidays) 1:00 PM - 5:00 PM -- Eastern Standard Time *Calls are toll-free within the United States Or visit their website at http://www.stopitnow.com/help.htm Why Do I Need to Know About Sexual Abuse and Offenders? 1. Because it occurs all around you on a daily basis (5-10% of boys, 10-25% of girls by age 18 are likely to be abused; Fergusson & Mullen, 1999)- It may be that a child in your own child’s classroom suffers at the hands of a sex offender, but is too scared to tell. Maybe your neighbor has been sexually abused, your niece or nephew, or your own child. Most of us think, ”not us”…”I don’t know people like that”. However, from reading above, you can see that child sex offenders are not dirty, alcoholic men in long trench coats who lurk in the shadows. It is most often someone close to your child who will be the offender. Child sexual abuse is a serious problem in the United States. While almost 85% of sexual abuse cases are never reported, it is estimated that 500,000 children are sexually abused every year 2. To protect your child-Teach your children about the red flags of sexual abuse. Teach your child to talk to you. Educating yourself about the signs to look for in offenders can also help you to protect your child or a child you love. For some sign to look for in a potential offender go to: http://www.stopitnow.com/warnings.htm#alertsignals http://www.stopitnow.com/warnings.htm#watchout 3. To know if you need to seek help-If you know what signs to look for you will be better prepared to seek professional help (for an offender or for a victim). 4. Community Notification Laws in Florida: We do have a concern about hurting victims of these offenders and their families by this public policy of notification. Notification also reveals who the victim is if it is a family member abuser. The victim can be shamed and shunned by other children and families. Many child molesters never molest a child again after they have been caught and have had effective and specialized sexual offender treatment. Many want to, do, and can give back to society and again be a productive member of society. They need society’s support and understanding to do so, not ostracism and discrimination, or worse, hate crimes against them. While offenders in treatment are taught to take responsibility for their actions and to eliminate any triggers to relapse, it is helpful for those around them to know, understand, and recognize common triggers. Find ways to be supportive of offenders who are trying to never do this crime again which they know is harmful to children and teens. References Finkelhor, (1994). Fergusson, D.M. & Mullen, P.E. (1999). Childhood Sexual abuse, An Evidence based perspective. Thousand Oaks, CA: Sage Publications. Brook Arke, M.A. Why Should Sex Offenders Be Treated? 1. Public Safety - The majority of sex offenders are eventually released back into the community. It is imperative that community corrections programs use treatment as an adjunct to supervision and thereby increase safeguards for the community. 2.Victims - Treated offenders are more likely to make restitution efforts and be available to contribute to the victim's treatment process. 3. Cost Effective -Sex offender treatment is cost effective. A 1% reduction in recidivism pays for the treatment of all treated sex offenders by reducing costs related to investigation, trials, incarceration, victims, and supervision. Any further reduction in recidivism results in cost savings to the state. 4. Offenders benefit. Many gain in personal growth and stability and learn new ways of relating to others, developing sensitivity and empathy towards others. What is the recidivism rate? sexual offenders recidivate much less than those who commit other crimes: 10% for incest perpetrators 20% for extrafamilial child molesters. both rapists and child molesters remain at risk 15-20 yrs after discharge facts not prejudice or caprice, should guide court, child-access, and treatment decisions. Cooper, A. J. (1999) See Recidivism of Sex Offenders: http://www.csom.org/pubs/recidsexof.pdf Recidivism Rates of sex offenders Institutionally based: studies: range Treated: 13%-25% Untreated: 22%-40% Community based (treating less violent clients): studies: range Treated: 3%-14.9% Untreated: 14.7-25.7% Type of Offender Number of % of new sex OFFENDERS offenses Pedophiles 195 7% Incest Offenders 190 3% Rapists 53 19% Untreated 38% Pithers, 1992 1-8 yrs follow-up (re-arrested or if parole officer or therapist believed they had reoffended) Treatment vs. No treatment Sexual offenders recidivated by violating probation: 1 of 17 who completed treatment vs. 7 of 13 who did not complete treatment Hall, 1995. What should society do with convicted sex offenders? by Jeremy Harrison, M.A. Many people would like to see sexual offenders locked up for life or even executed. While this may be a popular view in society, convicted sex offenders are frequently released from prison after serving only a portion of their sentence (McGrath, 1998). As a result, society must grapple with the question of how to treat sexual offenders and must also determine the effectiveness of these sex offender treatment programs. What kinds of treatments work in reducing sexual offending among offenders? Several studies have shown that treating sex offenders can reduce recidivism rates. One recent study by Polizzi, Mackenzie, and Hickman (1999) examined 21 psychotherapeutic sexual offender treatment programs. Polizzi et al. did a major review of scientific outcome studies on different treatment programs for sexual offenders. Ploizzi et al. found that those treatment programs that were cognitive behavioral in orientation were the most effective in reducing offender recidivism rates. However, they urge clinicians to exercise caution when applying these research findings to different types of sexual offenders. Their review included studies that focused mainly on child molesters and exhibitionists and did not include enough studies that focused on adult rapists or other types of sexual offenders. Therefore, they urge others to research the effectiveness of cognitive behavioral therapy with other types of sexual offenders. In the meantime, however, there is promising evidence that shows that treating sexual offenders with cognitive behavioral therapy is beneficial in reducing recidivism. References McGrath, R. J., Hoke, S. E., & Vojtisek, J. E. (1998). Cognitive-Behavioral Treatment of Sex Offenders: A Treatment Comparison and Long-Term Follow-Up Study. Criminal Justice and Behavior, 25, 2, 203-225. Polizzi, D. M., MacKenzie, D. L., Hickman, L.J. (1999). What works in adult sex offender treatment? A review of prison- and non-prison-based treatment programs. International Journal of Offender Therapy and Comparative Criminology, 43, 3, 357-374. Effective treatment programs and the Elements they contain: identified by Don Andrews & Paula Sandrow 1. An empirically based model of change. Research behind it identified. 2. Use trained staff 3. Use cognitive-behavioral approaches. 4. Focus on skill building behavior, practice, role playing, exercises, feedback. 5. Target criminogenic needs.-what are problems that are directly related to sexual offending? (e.g. intimacy needs, aroused to children vs. adults, alcoholism). 6. Matching service intensity to client risk and needs. 7. Are responsive to client learning style 8. Provide community aftercare services-when people leave the program. 9. Evaluate their program. From Texas website: http://www.tdh.state.tx.us/HCQS/PLC/csot.htm#treat Training from the State Department of Justice, National Institute of Corrections videos on Sex Offender Treatment Skills Components of Cognitive Behavioral Treatment specific, measurable objectives Progress in treatment, Offenders must show: * understanding of their deviant behavior * empathy for their victim, * make measurable behavior changes, * demonstrate they’ve learned techniques and skills in their daily life * seek help and support when needed. Steps in Treatment Dealing with denial and minimization Gaining Emotional Control Learning about sexual abuse & abuse patterns Relapse Prevention Training Changing Cognitive Distortions-attitudes towards sexuality, children, women, men Skill Training…Empathy Training…Coping skills Restitution Reunification Offenders must show they can make sure the abuse will not happen again state new rules handle behavioral problems encountered with sexually abused youth use dynamics of family interaction have positive sexual and intimate relationship with appropriate adult partner The Relapse Prevention Model is taught so that the offender can identify the sequence or chain of events which comes before a typical offense 1. having a deviant sexual thought or urge, 2. choosing to engage in deviant fantasizing, 3. masturbating while further fantasizing, 4. planning an offense, 5. engaging in rationalizing and justifying the deviant behavior, 6. choosing to put oneself in high risk situation, 7. re-offending. High Risk Situations By Brianne Lance Ongoing Risk Factors for Sexual Offenders (continuing problems that often help maintain the cycle or relapse process) Anger, getting into an argument with others Abusive sexual fantasies Boredom Denial of problems Alcohol/Drug abuse which reduces inhibitions Depressed, lonely Dysfunctional intimate relationships Frequenting places that are high risk situations (bars, taverns, adult entertainment, etc.) High-risk employment, job stress Living near or visiting places where children congregate (parks, schools, etc.), being around children in close physical contact Marital problems Masturbating to abusive, non-consenting persons, or about inappropriately aged persons-(teens and children) fantasies, deliberately fantasizing about children needing excitement Planning an offense Pornography use, exposure to child pornography STAGES OF CHANGE by Alli McHenry, M.A., PHASE ONE: Pre-contemplation - This is when the offender is not even considering change. He/she may be in denial that there is a problem. 2. Contemplation - This is when the offender is confused and unsure about change. He/she is no longer in denial and may even feel guilty for his/her actions...and sees some reasons for the need to change. PHASE TWO: Determination - This is when the offender decides to take the necessary steps for change. Change goals are identified. Therapy is imperative! The work is started to learn how to change. Action - This is when the offender starts to actually do things to change his/her behavior. Abuse cycles and high risk situations are identified. Coping Skills are learned and tried out. For example, he may avoid being alone with children. Maintenance - This is when the offender is able to change on a permanent basis. He/she may want to continue with some kind of treatment on a less frequent basis in order to maintain the gains made in therapy. DEALING WITH DENIAL By Kelly Bloomfield, M.S. Denial is one of the most common challenges in sexual offender treatment. As long as offenders deny having sexually offended, treatment is very difficult and offenders will not gain as much from treatment. Most offenders deny to some extent in the beginning as it is embarrassing and shameful for them to admit what they have done. It is generally agreed that clients are unlikely to benefit from treatment unless they acknowledge having a problem, as well as a desire to change. When sexual offenders admit their offense, there is a considerable threat of disapproval from others. It is very important that the client recognize that the positive consequences for changing outweigh the benefits of remaining in denial. Denial can take three forms: Total Denial. Clients in complete denial totally deny any offensive behaviors. Partial denial or minimization usually refers to the frequency of the offense, the duration of the offense, the seriousness of the impact, or the level of intrusiveness. (“I did it just once,” “I really love her and wouldn’t hurt her.” “I was just being affectionate.” “I just fondled her” (not saying that he also had his penis touching her buttocks)) Denial of intent (i.e. “I did touch him, but it was an accident.” “I was just medicating her” “I thought she was my wife.” “I was dreaming and woke up touching her thinking it was my wife” “I was drunk and don’t remember doing anything.” “I was just providing sex education for her.”) In order to address a client’s denial: It is important to empathize with the offender by recognizing the shame which may accompany acknowledging a sexual offense. In addition, it is important to normalize the denial process, as this is a common pattern among many offenders. It is important to explain the negative consequences of remaining in denial, as well as discussing benefits that other group members have encountered as a result of taking responsibility. Offenders who have made progress along these lines can be very helpful to group members just starting in treatment by sharing their experiences and how much progress they have made since being more open and honest. Mental Health Issues: By Stacey Nitschelm, M.S. Not every sexual offender has an underlying mental illness, but if one does, treatment is vital. It is important to screen for other psychological disorders, such as depression or bipolar disorder, that may be impacting the sexual offender, and affecting his behavior. Treatment for sexual offenders is likely to be more difficult if there is an underlying mental illness that is not discovered and treated. Although a professional should diagnose mental illness, it may be beneficial to view some symptoms of the more common illnesses. Treatment for an existing mental illness may increase motivation, self-efficacy, self-esteem and decrease anger and anxiety. In fact, a common type of anti-depressant (SSRI) may be helpful in helping the offender to modulate impulsive disorders, aggressive behavior, and aid in the reduction of intrusive deviant fantasies and obsessive sexual thoughts. Common conditions to identify and treat: Depression Bipolar Disorder Obsessive Compulsive Disorder Adult Attention Deficit Disorder (ADD and ADHD) Anxiety Anger and Impulsivity Substance Abuse The Polygraph and the Sex Offender By Joe Bonvie, M.S. The polygraph instrument is a relatively simple device that measures heart rate, blood pressure, respiration and electro dermal changes. These physiological changes are measures without any discomfort to the subject. The polygraph is used as a tool to determine compliance with counseling objectives and conditions of probation. Polygraph tests are done as deemed necessary by the court, probation, or the therapist. In regard to sex offenders, the purpose of the polygraph examination is to verify the perpetrator’s completeness regarding offense history and compliance with therapeutic directives and terms of supervision (Edson, 1991, Emerick and Dutton, 1993). Thus, when the polygraph is used as a treatment tool it increases the accountability of an offender living in the community (ATSA, 1993). In a 1990 research study, Philip E. Humbert found that when a polygraph was utilized during the latter part of sex offender treatment, there was a 600% increase in the number of sexual perpetrations reported originally. Taking this information into consideration, the usefulness of the polygraph in sex offender therapy cannot be underestimated when considering that pedophilia “is a disorder maintained largely by the offender’s ability to deny, justify, and rationalize the behavior” (Hagler, 1995, p.104). The polygraph is used more often with adult offenders than with juveniles. To date, there is little research on the polygraph’s reliability and validity in the evaluation of sexually abusive youth. However, Abrams (1989) found validity rates of 57% with 10-year olds were found, although improved rates were found with 11-year olds, at 83%, 12-year olds, at 96%, and 13-year olds, at 94%. Generally, the accuracy claims of polygraph testing range from 80 and 90% (Hagler, 1995). Abrams (1995) even stated that, “polygraph testing has much greater validity and reliability than any other clinical measure including the MMPI and Clarke Sexual History Questionnaire.” Despite the validity and reliability claims, research suggests that results potentially can be affected by a number of influences, including the client’s physical and emotional status, the client’s age and intelligence, and the examiner’s level of training and competency (Blasingame, 1998). Most practitioners using the polygraph indicate that the age threshold for use with juveniles is approximately 14 years old (csom.org, December 1999). On a final note, Hagler (1995) states that “the most effective polygraph programs require the offenders to pay for all, or part, of the examination expense. The financial commitment provides increased impetus for client honesty. Offenders learn quickly that a “failed test” represents additional cash outlay for retesting, if warranted, added expense due to regression within the treatment program” (p.108). Abrams, S. (1989). The Complete Polygraph Handbook. Lexington, MA: Lexington Books Abrams, S. (1995, January 7). Polygraph and the Pedophile. Lecture, Dallas. Blasingame, G. (1994). Sexual offender rehabilitative treatment: Program manual. Redding, CA: SORT Program. CSOM.org (December 1999). Understanding Juvenile Sexual Offending Behavior: Emerging Research, Treatment Approaches and Management Practices. Available at: http://www.csom.org/pubs/juvbrf10.html Cross, T.P.. & Saxe, L.. (2001). Application of the clinical polygraph examination to the assessment, treatment and monitoring of sex offenders. Child Maltreatment: Journal of the American Professional Society on the Abuse of Children. 2001 Aug Vol 6(3) 195-206. Edson, C. (1991). Sex OffenderTreatment. Medford, OR: Department of Corrections Emerick, R. & Dutton, W. (1993). The effect of polygraph on the self report of adolescent sex offenders: Implications for risk assessment. Annals of Sex Research, 6, 83-103. Hagler, H. (1995). Polygraph as a measure of progress in the assessment, treatment, and surveillance of sex offenders. Sexual Addiction & Compulsivity, Volume 2, No. Humbert, G. (1995, January 21). Polygraph usage in the State of Oregon. Report to the Oregon Polygraph Licensing Advisory Committee CVSA vs polygraph The United States Department Of Defense, after extensive research, reported that the voice stress analyzer " is not suitable for lie detection ". The majority of professional, experienced polygraph examiners seem to agree. The positions of the American Polygraph Association and the American Association Of Police Polygraphists can be found on their web sites. Substance Abuse and Sexual Offending: The Link by Josselyn Rivera • Substance abuse does NOT cause sexual offending HOWEVER SUBSTANCE ABUSE DOES: • Decrease Inhibitions- Potentially provides courage to behave in otherwise inhibited ways. • Excuse Behavior- Intoxication can be used as an excuse or blamed for actions. • Avoid Accountability- Through “memory loss” of event. • Manipulate Victims- Drugs or alcohol can be used to lure victims or obtain submission. • Exploit Vulnerable Victims- Offenders can take advantage of drug or drink-laden victims. *** It is important to note that while substance abuse refers to any DRUG, ALCOHOL USAGE is: • implicated in more incidents of sexual assault than any other single drug • associated with increased violence during an offense • is more common in sex offenders than in normal populations • more common in rapists than other offender types • implicated in up to 75% of college women date rapes And overall, substance abusers have an estimated 40% higher recidivism rate than those offenders who do not exhibit substance abuse problems. CHILD SEXUAL Offender BIBLIOGRAPHY Due to the serious nature of the offenses committed and the high potential for re-abuse, it is extremely important that professionals engage in specialized training for this population. These books give a good overall introduction to the topic of Child Sexual Offender Treatment. Those * indicate we find particularly comprehensive, sound basis in research, proper attitudes toward offenders, or effective in designing treatment for offenders. *Association for the Treatment of Sexual Abusers, Hensen, S.H. (Ed.). (1993). The ATSA Practitioner's Handbook. The Association for the Treatment of Sexual Abusers, P.O. Box 866, Lake Oswego, OR, 97034-0140, (503) 238-0210. Bays, L. & Freeman-Longo, R. (1989). Why did I do it again? Understanding my cycle of problem behaviors. S.O.S. Series Number Two. Orwell, VT: The Safer Society Press. Book 2. Bays, L., Freeman-Longo, R., & Hildebran, D.D. (1990). How Can I stop? Breaking my deviant cycle. S.O.S. Series Number Three. Orwell, VT: The Safer Society Press. Book 3. Bolton, F. G., Morris, L.A., and MacEachron, A.E. (19 ). Males at risk, The other side of child sexual abuse. Newbury Park, CA: Sage Publications. Carich, M.S. & Mussack, S.E. (2001). Handbook for Sexual Abuser Assessment and Treatment. Brandon, VT: The Safer Society Press. Coleman, E., Dwyer, S.M., & Pallone, N.J. (1996). Sex Offender Treatment, Biological dysfunction, intrapsychic conflict, interpersonal violence. NY: Haworth Press, Inc. Freeman-Longo, R. & Bays, L. (1988). Who am I and why am I in treatment? S.O.S. Series Number One. Orwell, VT: The Safer Society Press. Book 1 Freeman-Longo, R., Bays, L. & Bear, Euan. (1996). Empathy & Compassionate Action. Issues & Exercises: A Guided Workbook for Clients in Treatment. S.O.S. Series Number Four. Orwell, VT: The Safer Society Press. Book 4. Gonsioreck, J.C., Bera, W.H., & LeTourneau, D. (1994). Male Sexual Abuse, A Trilogy of Intervention Strategies. Thousand Oaks: Sage Publications. *Greer, J.G. & Stuart, I.R. (Eds.). (1983). The sexual aggressor: Current perspectives on treatment. NY: Van Nostrand Reinhold. Groth, A. N. (1979). Men who rape: the psychology of the offender. NY: Plenum Press. Hotaling, G.T., Finkelhor, D., Kirkpatrick, J.T. & Straus, (1988). Family Abuse and Its Consequences, New Directions in Research. Sage Publications. Horton, A.L., Johnson, B.L., Roundy, L.M., & Williams, D. (Eds). (1990). The Incest Perpetrator, A family member no one wants to treat. Newbury Park, CA: Sage Publications. Ingersoll, S.L. & Patton, S.O.(1990). Treating Perpetrators of sexual abuse. Lexington, MA: Lexington Books. Knopp, F.H. (1984). Retraining Adult Sex Offenders; Methods and Models. Orwell, VT: Safer Society Press. Laws, D.R. (Ed). (1989). Relapse Prevention with Sex Offenders. NY: The Guilford Press. **Laws, D.R., Hudson, S.M., and Ward, T. (Eds.) (2000). Remaking Relapse Prevention with Sex Offender, A Source Books. Thousand Oaks, CA: Sage Publications, Inc. Lew, Mike. (1988). Victims No Longer: Men Recovering from Incest and Other Sexual Child Abuse. NY: Harper & Row. **Maletzky, B. M. (1991). Treating the Sexual Offender. Newbury Park, CA: Sage Publications. Marshall, D.R., Laws, D.R., & Barbaree, H.E. (1990). Handbook of Sexual assault: Issues, theories, and treatment of the offender. NY: Plenum Press. Mayer, A. (1990). Child Sexual Abuse and The Courts, A Manual for Therapists. Holmes Beach, FL: Learning Publications, Inc. *Salter, A.C. (1988). Treating Child Sex Offenders and Victims, A Practical Guide. Newbury Park, CA: Sage Publications. Sgroi, S. M. (1982). A Handbook of Clinical Intervention in Child Sexual Abuse. Lexington, Mass: Lexington Books. *Schwartz, B.K. & Celini, H.R. (Eds.) (1995). The Sex Offender: Corrections, Treatment, and Legal Practice. Volume I. Kingston, NJ: Civic Research Institute, Inc. *Schwartz, B.K. & Cellini, H.R. (1997). The Sex Offender. New Insights, Treatment Innovations and Legal Developments. Volume II. Kingston, NJ: Civic Research Institute, Inc. Schwartz, B.K. (1999). ). The Sex Offender: Theoretical Advances, Treating Special Populations and Legal Developments. Volume III. Kingston, NJ: Civic Research Institute, Inc. Sgroi, S. M. (1982). A Handbook of Clinical Intervention in Child Sexual Abuse. Lexington, Mass: Lexington Books. **Steen, Charlene. (2001). The Adult Relapse Prevention Workbook. Brandon, VT: The Safer Society Press. This is a document not a website: www.fit.edu/flp/offender.doc