The influence of risk and psychopathy on the therapeutic climate in sex offender treatment

Older Individuals Convicted of Sexual Offenses: A Literature Review

The population of older individuals convicted of sexual offenses (OSOs) is rapidly increasing. However, we have little understanding of their characteristics (e.g., demographic, psychological, individual, offense, and risk) and needs. To identify any similarities or differences that are unique to older individuals convicted of sexual offending, it is important to compare such characteristics across the adult lifespan. Therefore, the aim of this systematic review was to specify and synthesize the current knowledge of characteristics across the adult lifespan of the population of individuals convicted of sexual offenses. Five databases were searched and 10,680 results were screened, resulting in 100 studies included in the final review. The findings were grouped into four emergent themes: age of onset and prevalence; offender and offense characteristics; age and the risk of reoffending; and treatment. Implications of the findings from this review are discussed in relation to future research and clinical practice.

Referral for group or individual treatment? Factors for consideration in the case of self-referred individuals with a sexual interest in minors

In Germany, several treatment programs offer psychotherapy for individuals with a sexual interest in minors (SIM) who are currently not in contact with the criminal justice system. The patients present anonymously in relation to the health insurance and judicial system. Group therapy plays an important role in these programs. However, to date there is poor empirical evidence on indication criteria for group vs. individual treatment for this specific group of individuals. This study examined individuals with SIM who voluntarily participated in a treatment program in Hamburg. We investigated via post-hoc analysis whether there were significant differences regarding readiness to participate in group therapy, dynamic risk factors, psychopathic characteristics, impulsivity and empathy between individuals indicated for group therapy (n = 26) and individuals referred for individual therapy (n = 47). Results show that individuals referred for individual therapy were significantly more impulsive than individuals referred for group therapy, but comparable in respect to readiness to participate in group therapy, dynamic risk, psychopathy, and empathy. These findings suggest that assignment to group vs. individual therapy is mainly based on other criteria than these characteristics. Implications for clinical practice and future research are discussed.

Review of the Empirical and Clinical Support for Group Therapy Specific to Sexual Abusers

This review compiles 48 empirical studies and 55 clinical/practice articles specific to group therapy with sex offenders. Historically, group therapy has always been the predominant modality in sex offender-specific treatment. In the first decades of the field, treatment applied a psychoanalytic methodology that, although not empirically supported, fully appreciated the primary therapeutic importance of the group modality. Conversely, since the early 1980s, treatment has applied a cognitive behavioral method, but the field has largely neglected the therapeutic value of interpersonal group dynamics. The past decade has seen a growing re-appreciation of general therapeutic processes and more holistic approaches in sex offender treatment, and there is an emerging body of empirical research which, although often indirectly concerned with group, has yielded three definitive conclusions. First, the therapeutic qualities of the group therapist-specifically warmth, empathy, encouragement, and guidance-can strongly affect outcomes. Second, the quality of group cohesion can profoundly affect the effectiveness of treatment. Third, confrontational approaches in group therapy are ineffective, if not counter-therapeutic, and overwhelmingly rated as not helpful by sex offenders themselves. Additional conclusions are less strongly supported, but include compelling evidence that sex offenders generally prefer group therapy over individual therapy, that group therapy appears equally effective to individual therapy, and that mixing or separating groups by offense type is not important to therapeutic climate. Other group techniques and approaches specific to sexual abuse treatment are also summarized.

A consumer satisfaction survey of civilly committed sex offenders in Illinois

The purpose of this study was to obtain feedback from civilly committed sex offenders (N = 113) about the components of treatment that they believed to be most important and helpful in preventing reoffense. Participants were also asked to rate their satisfaction with the treatment process and therapists. Victim empathy and accountability were rated as the most important elements of treatment, along with skills for preventing relapse and methods for controlling sexual arousal. There was a fairly robust correlation between client perceptions of importance and satisfaction on most treatment components. Some clients expressed concerns about respect, confidentiality, and judgmental attitudes of some therapists. Because civilly committed sex offenders are considered to be among the most likely to reoffend, strategies are discussed for engagement of this population in a meaningful process of change.