Transcript Sexual Offending

Owenia House
Specialist Rehabilitation Service
for Sex Offending
December 2012
Dr Peter Chamberlain
Senior Clinical Psychologist
Owenia House: Effectively a behavioural clinic
within the Forensic Mental health Service
Our core objective is to prevent sexual abuse of children
by intervening with offenders and potential offenders
Provides:
 Community based assessment and treatment
services for adults who have sexually offended
against children, or fear they may do so.
 A treatment service for paraphilias e.g. exhibitionists,
public masturbators
Owenia House
(As at 12 December 2012)
Staff: 6
Director, 4 Clinicians, Administrative Officer
Clients: 72* (waiting list of 23)
All Male, average age 43 with ages ranging from 19 - 74
* We have a capacity for approximately 120
Groups: (Closed/Open)
Standard (2 phased) – normally functioning
Skills Based Treatment – intellectually impaired
Rural – rural clients, normal functioning, full day each month
Individual Sessions: NOS (other paraphilias &
child sex offenders as required)
Principle Theoretical Models
> Finklelhor’s (1984) Precondition Theory
motivation*, internal and external barriers and victim
resistance
Offending
Trajectory
*3 components:
 emotional congruence: emotional need to relate to children
 sexual arousal: children are a potential source of sexual
gratification
 blockage: adult sexual & emotional gratification unavailable
> Ward & Stewart’s (2003) ‘Good Lives’ Model
Therapeutic
Philosophy
 constructive & holistic approach beyond a single focus
on risk management
 enhancement drives rehabilitation
 realising an offending-free life that is beneficial and
rewarding in ways that are socially acceptable &
personally fulfilling
Principle Theoretical Models Continued:
 Pathways Model of Child Sexual Abuse
(Ward and Siegert 2002)
Theoretical
morphing:
Intimacy Deficits
Deviant Sexual Scripts
 Normal sexual scripts
 Offend at specific times;
child is pseudo-adult
 Distorted (subtle) sexual
scripts
 Interact with
dysfunctional
relationship schemas
Finklelhor's
Precondition Theory
Hall & Hirschman’s
Quadripartite Theory
(critical threshold)
Marshall & Barbaree’s
Integrated Theory
(negative early – life
experiences
Sexual
Offending
Multiple Dysfunctional
Mechanisms
Emotional Dysregulation
 Normal sexual scripts
 Dysfunctional emotional
regulation
 Deviant sexual scripts
 Deviant fantasies
 Generally comorbid
psychopathologies
Antisocial Cognitions
 No distorted scripts
 Offending reflects
general pro-criminal
beliefs/attitudes
Typologies of Child Sex Offenders
 Preferential (fixated) versus Situational (regressed) offenders.
 Fixated:
Primary sexual orientation is to children
- interest generally begins in adolescence,
- pre-planned, premeditated persistence interest
- males primary target
 Regressed: Primary sexual orientation to age mates
- interest in children emerges in adulthood
- pseudo adult substitute
- females primary target
General Characteristics
Clinical Profile Considerations (DSM-IV-TR):
 Axis 1 (Clinical Disorders)
 depression common (suicidal),
 psychosis 5-8%,
 Axis 2: (Personality & Intellectual Disorders)
 Personality disorder 5-7%
 Intellectual disability 15%
 Presentation variable
 Sexual abuse (estimates 40-50%); earlier and more
severe abuse associated with earlier offending
Criminality
 > 60 % of child sexual offenders have at
least one previous conviction
 almost twice as likely to have been for
non-sexual offences than for sexual
offences.
Sexual Preference
 48% of non-familial offenders have
arousal to children.
 28% of father-daughter incest offenders
have arousal to children.
 15% of non-offender males have arousal
to children.
Assessment
 Referral Information
 Current Legal status
 Detailed personal history
(family of origin & current
family situation, relationship history, education, occupation, medical &
mental health history, medications, substance use/abuse)
 Sexual and non sexual offending history
 Detailed sexual history
 Psychometrics as indicated
 Recidivism risk
 Sexual attitudes and beliefs inventories
 Treatment Plan
Degrees of Denial
WHY DID YOU SEXUALLY ASSAULT THE VICTIM?
NOTHING HAPPENED
‘I never laid a finger on her’
‘The boy’s lying’
‘The cops are out to get me’
SOMETHING HAPPENED
BUT
AND
IT WASN’T MY IDEA
‘The kid came on to me’
‘She was all over me’
IT WAS MY IDEA
BUT
AND
IT WAS SEXUAL
AND
IT WAS WRONG
BUT
THERE WERE EXTENUATING
SITUATIONAL CIRCUMSTANCES
‘I was having money problems’
‘I was drinking too much’
‘My wife wouldn’t sleep with me’
BUT
IT WASN’T SEXUAL
‘I was being affectionate’
‘I was angry at my wife’
‘I was teaching her to be
careful’
IT WASN’T WRONG
‘There’s nothing wrong with it’
‘She liked it’
BUT
THERE WERE EXTENUATING
PSYCHOLOGICAL FACTORS
‘I was sexually abused as a child’
‘I don’t know what got into me’
‘Women scare me’
Group Treatment Programmes
 Closed (set programme, 2 stage)
 Open/Continuous (own pace, enter & at
leave different times)
 Intensive (Country, short time)
 Skills-based (IQ compromised)
 SOIG (Information, support, supervising
adult)
* NOS (Other paraphilias) – Individual Treatment
Group Content
 cognitive, behavioural, situational
antecedents, values
 pattern/offence cycle
 high risk moods and thinking
 concept irrelevant decisions
 lapses and strategies
 developing support network
 changes in lives – focus/orientation to
children
 individual relapse prevention plan
Offending Cycle
Self - Centred Internal Conflict
Shame, self-pity, personality driven
depression, self-defeating behaviour
5
Self - Directed Cognitive
Distortion
Offending Behaviour
Along continuum of sexual aggression
Offence - Directed Behaviour
Victim targeting, grooming, setting up the
offence scenario
4
6
Denying, rationalising, minimising,
sanitising, and avoiding detection
3
Conscious Intentions to
Offend
Acting in a manner that enhances the
fantasies, imagery, arousal and/or impulses
2
1
Deviant Sexual Fantasies
and Images
Experiencing feelings/arousal that
reinforces the deviant imagery
Treatment Goals
 Understanding patterns of abusive
behaviour
 Understanding consequences of abusive
behaviour
 Victim empathy
 Take responsibility for actions
 Changing associated emotional,
behavioural and lifestyle patterns
 Recognition of lapses
 Individualised risk management
programme
End of Treatment Expectations
 responsibility for abusive behaviour
 responsibility for future offence-free life
 disclosure of personal information
 recognition pro-offending attitudes
 avoidance of minimising/justifying effects
 insight into victim issues
 understanding impact lifestyle factors
 understanding and implementing relapse
prevention strategies
 motivation to change as evidenced by value
action plan
Treatment Success
 Heterosexual:
treated
untreated
18%
43%
(7.5%)
(18%)
 Homosexual:
treated
untreated
13%
43%
(5.5%)
(19%)
 Familial/Incest
treated
untreated
8%
22%
(3%)
(7%)
NB Figures outside of brackets are unofficial police records and
child protection services statistics. Those inside brackets are
official police records.
Referral Criteria
Two pathways: Mandated or Voluntary
Criteria:
1. Must have sufficient time if mandated
2. Voluntary must self-refer and not be before the
court
3. Offences must have been against children (i.e.
adult victim offences not accepted). NOS clients
the exception
4. Must accept some responsibility (deniers
precluded)
5. >17 years of age
6. Male
Referral/Discharge
considerations
>
>
>
>
No child contact
Likelihood for change
Motivation for change
Social supports