Lecture 8: Assessment and treatment of sexual offenders Flashcards
Types of sexual offending
- Exhibitionism = exposing yourself
- Frottage = rubbing against someone without consenting
- Voyeurism = secretly watching someone in sexual way
- Rape
- Child sexual abuse
- Sexual homicide = murder with sexual elements
Sub-types of rape
Broken down by motivation that drives offence:
- Angry
- Opportunistic
- Sexual (sadistic and non-sadistic)
Can be broken down into victim is:
- Stranger
- Acquittance
- Marital
- Gang rape/multiple perpetrator rape
Sub-types of child sexual abuse
Often broken down by relation of abuser to victim:
- Extrafamilial
- Intrafamilial
Can be broken down into:
- Approach (planned)
- Opportunistic = normally offending for emotional or antisocial reason
- Internet
- Females
Motivation-facilitation model
- Seto (2017)
- Starts with kind of motivation e.g. paraphiliac or high sex drive
- Motivates them to be prone to offending but doesn’t mean they will
- What decide whether the offend:
- -> State factors e.g. alcohol, negative emotion
- -> Trait factors e.g. antisocial
- -> Situational factors
Reoffending/recidivism
- Higher reoffending with extrafamilial because not confined to one victim
- Higher with boy victims because indicates sexual interest higher as not driven by non-sex related variable
Risk assessment
-Split into low, medium, high, very high risk
Static risk factors
Static factors:
- Largely historical factors
- Non-changeable aspects of individual
- Young when first offend
- Suggested that its what these factors indicate that show the risk
STATIC-99
- Hanson and Thornton (1999)
- Most used risk assessment for static factors
- Never married
- Young age (cut of 25)
- Prior sexual offence
- Non-contact sexual offences
- Stranger, unrelated, male victims
- As years increase risk levels increase, however unsure what actual things need treating = where dynamic factors come in
Dynamic risk factors
- Factors that can change/fluctuate
- E.g. employment instability, sexual preoccupation
- What is addressed in treatment
- Tend to be broken down into:
- -> Stable = enduring (but changeable) characteristics linked to the offending behaviour e.g. beliefs
- -> Acute = rapidly changing characteristics affected by situation. Indicate re-offence may occur within short period of time e.g. arousal due to alcohol
- Some factors can be stable and acute
Dynamic risk domains
- Mann, Hanson and Thornton (2010) characterised risk factors into most important
- Sexual deviance e.g. sexual interest in children
- Distorted attitudes e.g. hostility towards women
- Socio-affective issues e.g. lack of intimate adult relationships
- Self-management issues e.g. self-management issues
Dynamic risk assessment
- STABLE-2007 and ACUTE-2007 (Hanson et al, 2007)
- Most powerful acute factors:
- -> Hostility
- -> Sexual preoccupation
- -> Victim access
- -> Rejection of supervision = marker for being anti-social
- When assessment includes 1+ these tools judges have greater confidence in assessment
- According to DSM-5 if enduring, persistent and necessary for sexual enjoyment can be regarded as paraphilia - if causes sig distress/impaired function can be considered paraphilic disorder
Paraphilias
- Transvestism
- Frotteurism = paraphilic interest in rubbing
- Fetishes
- Paedophilia
Paraphilias: sexual arousal
- Psychological, physiological, behaviour responses to internal or external target of sexual interest
- Subjective sexual arousal = cognitive realising = assess through self report
- Objective sexual arousal = physiological = can measure phallometric assessment
- Act upon sexual arousal = behavioural = can assess using case file info
Self-report assessment for paraphilia
- Directly ask individual how much they are interested in various sexual categories
- Mostly use questionnaire
- Example = multiphase sex inventory:
- -> 300 yes/no times
- -> 20 scales related to sexual interest
- -> Good test-retest reliability and internal consistency
Benefits:
- -> Rich detail
- -> Easy to administer and analyse
Criticisms:
- -> Assumes info consciously accessible
- -> Sensitive topic = prone to social desirability responding
Phallometric assessment of paraphilia
- PPG
- Measure volumetric changes of penis in response to sexual stimuli
- Stimuli can be visual, auditory or fantasy
Benefits:
- -> Objective
- -> Research shown best measure for distinguishing child abusers from non-sex offenders and rapists
Criticisms:
- -> Invasive
- -> In some countries seen as unethical
- -> Assumes erection equates to sexual arousal = not the case, especially in older men
- -> Prone to faking and suppression
Indirect measures of paraphilia
- RT based computer tasks
- Based on idea that pressurised automatic response evokes genuine indications one interest
Types of indirect measures of paraphilia
Task relevant
- Viewing time
- IAT
- Go/No-Go Association task
Task irrelevant
- Emotional stroop
- Choice reaction time
- Rapid serial visual processing
Types of indirect measures of paraphilia: Viewing time
- Task relevant
- Oldest
- Records how long image viewed whilst being rates on sexual attractiveness scale
- Meta analysis:
- -> VT showed a moderate ability to discriminate child abusers from comparison group
Types of indirect measures of paraphilia: IAT
- Task relevant
- Assesses the strength of association between target categories and attribute categories
- If someone has interest to children they should be responding faster to children with sex words
- Meta-analysis:
- -> Child sex IAT can distinguish child abusers from comparison groups
- -> Correlates with other measures of sexual interest e.g. PPG
Problems:
- Only involves 2 target and 2 attribute categories so can only assess some relative association
- Not clear what the association is
Types of indirect measures of paraphilia: Go/No-Go Association Task
- Variant of IAT = addresses some issues of IAT
- Involves ppts responding to target stimuli and withholding responses to non-target stimuli
- Can measure associations towards single target
- Can measure absolute associations
Promising development in measuring paraphilia
- Eye tracking
- Pupil dilation = pupils of non-offending men dilate to images of women but not to men, children, neutral scenes
- Mouse tracking = can detect real-time biases for sexually preferred stimuli in non-offending males
- Virtual reality = can have situations with children more ethically
Evaluation of indirect measures of paraphilia
Strengths:
- Responses based on uncontrollable, automatic processes
- Less prone to faking
- Possible to access consciously inaccessible preferences
Limitations:
-Rich and detailed info not obtained
RNR principles
- Risk = match treatment intensity with risk level
- Need = target relevant criminogenic risk factors
- Responsivity = tailor treatment to ensure maximum benefit
Sex offender treatment
- Based on behavioural strategies including cognitive, social learning, modelling and skill building
- Goals of treatment:
- -> Address dynamic risk factors
- -> Understand progression to the offence
- -> Develop self-management plan
- -> Typically delivered as group therapy
Treatment of dynamic factors
- Deviant interest = aversive reconditioning and fantasy management = works out what’s triggering it
- Distorted attitudes and cognition = cognitive restructuring and schema therapy
- Intimacy/relationships = CBT, role-playing
- Anger and hostility = anger management therapy and CBT
- Self-regulation issues = identifying new coping strategies, mindfulness
Behavioural progression
- Series of events and situations, combined with cognitive and emotional states that lead to sexual offending
- = offence chain
- Can help device a case formulation = taking all different piece of information to understand how things led to other things in the offence
- Case formulation aims to describe a person’s presenting problems and use theory to make explanatory inferences about the causes and maintaining factors (which informs treatment)
Self-regulation plan
- Once they have gone through treatment and identifies what risk factors are
- Establish goals promoting offence-free life
- Develop coping strategies for internal and external risk factors
- Ensure cognitive and emotional aspects are present
- Include support network
- Be concrete but generalisable
Self-regulation model
- Ward and Hudson (1998)
- Everyone is goal driven and trying to regulate how they approach/attain goals
- Life experiences effects what we dont want to do
- In case of offending = might have motivation e.g. interest in children but dont want to offence so avoid triggering situations = have an avoidance goal
- But might regulate is passively = under-regulation or disinhibition pathway = lack internal skills
- May regulate is activity = mis-regulation pathway, uses bad strategies e.g. fantasy
- Others will have same motivation with the desire to offend
- -> May meet goal automatically = might circumstances, have scripts
- -> OR may meet goal explicitly = planning
- Once identify style can create better treatment plan
Good lives model
- Ward and Stewart (2003)
- Strengths based approach to treatment and highly influential
Theoretical assumptions:
- All humans are goal directed organisms that seek primary good
- Primary goods = actions, experiences and activities that are intrinsically beneficial e.g. life, knowledge
- Secondary goods = way people go about acquiring primary goods
The good lives model and sexual offending
- Sexual offending occurs when individuals try to obtain these goods but in antisocial way because lack internal/external resources to achieve primary goods
- Dynamic risk factors are internal obstacles that affect the prosocial acquisition of primary goods
4 problems in acquiring goods:
- Means used to secure goods = such as seeking ‘relatedness’ via child sexual abuse
- Lack of scope = focussing only on a few goods
- Presence of conflict among goods sought = relatedness via sex offending conflicts with inner peace
- Lack of capacity to secure goods = lacking social skills to establish and maintain a relationship
Does sex offender treatment work?
- Found it does work
- Treated = 9.7% risk of reoffending
- Untreated = 14.6% risk of reoffending
Self Regulation Model
-Ward and Hudson (1998)
-model proposes people behave in a way that is goal-directed = act to achieve a desired state or to avoid an undesired state
4 paths:
- Avoidant-passive pathway = individual has desire to commit sex crime = they try not to offend but are under regulated or disinhibited = can’t cease behavioural pattern that has developed
- avoidant-active pathway = have a goal of avoiding committing sex crime = will enagge in actions such as substance abuse in order to not commit a crime, but often leads to a sex crime as a result
- approach automatic pathway = goal of committing sex crime = cognitive and behavioural patterns well established –> sex crime
- approach-explicit pathway = individual has childhood history that led to sex crimes = engage in detailed grooming behaviours
