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Models Of Intervention With Sex Offenders Psychology Essay

Models Of Intervention With Sex Offenders Psychology Essay

Morrison discussed how intervention in the field of sexual offenders cannot be value free, and continuing the work of Salter (1988) proposed that an acceptable value base for practitioners should reflect acknowledgement of a prosecutable criminal offence which is fundamentally unacceptable. Indeed, while the overarching aim of sex offender treatment must be protection of the public, the apparent success with treatment over that of purely punitive measures certainly suggests a need to adopt therapeutic means of dealing with the sex offender problem.

Naturally tensions arise when combining social work’s core values including warmth, value and respect with the confrontational and ethically questionable methods of treatment which have been permitted with sex offenders due to the media and political pressure. As a result risk, penal and correctional interventions have dominated. Sheath (1990) was amongst the first to recognise the short-comings of confrontatitive interventions and began to deconstruct the formulaic methods used in sex offender treatment, looking most specifically at CBT, and suggested alternatives approaches characterised by respect (for the offender, not the offence itself) and the need to understand the experiences of the offender contextually thus recognising potential developmental and environmental factors which may have been contributory. He argued for a balance between risk and need and his influence is reflected in some facets of work with sex offenders. Personal Construct Theory (PCT), for example requires practitioners so see the ‘client’ as an individual with their own unique and valid takes and interpretations and perspectives. Unlike in CBT where the sex offender is informed from the offset that their view is wrong and shameful (and so ultimately further damaging to self-esteem and professional/client relationship); PCT challenges us to observe the world from their position. By doing so we can hopefully begin to empathise, considering that perhaps their behaviour, though not justified, may be understandable given the circumstances which may have disaffected them.

The Thematic Inspection of Probation Service work with Sex Offenders (HM Inspectorate of Probation, 1998) supported these ideals, stating that treatment should apply “What Works” principles to work with sex offenders (McGuire, 1995) thus targeting those most at risk of re-offending by concentrating on areas related directly to offending and acknowledging risk and need. Such needs are important to consider, especially when considering the high amount of sex offenders who are themselves survivors of abuse. Dependent on studies, this number can be as high as 80% (Erroga, 2002). Indeed, while a small number of offenders are responsible for many offences, the victims are seldom children (Grubin, 1998). Beckett suggest that abuse survivors tend to have difficulties forming appropriate adult relationships experience other problems (which include cognitive distortions) which link to their childhood (1994). Given the high number of offenders who are themselves victims, Maletzky and McGovern (1990) recommend the use of the Sexual Assault Cycle  which plots the offender’s own pattern of abuse alongside a timeline of their changing patterns of sexual arousal including how the felt, what they were doing and feeling at the time in order to identify triggers.

Other practitioners have sought to plug the gap in interventions and amongst the most viable suggestions were raised by Brigden and Cucolo (2011) who discuss the intervention framework of Therapeutic Jurisprudence (TJ). TJ is the invention of Wexler and Winick (1996) and requires that we see the law as a therapeutic agent and use it to minimize anti-therapeutic consequences. TJ recognises that the criminal justice process which sexual offenders find themselves is anti-therapeutic and ultimately further damaging as it encourages the accused to ‘go innocent’, maintain their innocence and discourages responsibility.  TJ proposes a ‘treatment tracking model’ whereby the perpetrator is encouraged to enter guilty pleas, acknowledge responsibility and accept the support offered. As a result of this, there is greater lenience in sentencing and compliance can be rewarded with early revocation. While this may be considered that the offender is ‘getting away with it’, should they fail to comply the rest of their sentence will be carried out in full. The sex-offender thus becomes the agent of their own destiny and in effect responsible for their own outcomes, trust has been placed back with them, respect achieved for their honesty and hopefully some dignity gained. Many victims are known to blame themselves for being raped or assaulted and therefore by the offender acknowledging responsibility in an open and public court, the victim does get a legitimate form of closure.

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Restorative justice has also proved effective; with its origin in Canada, ‘Circles of support and accountability’ (CSA) was piloted in Britain in 2005 with positive results. CSA can be used as a license condition and targets offenders assessed as ‘high risk’ or who do not have extended networks of support or family. It is both understandable and accepted that convicted sex offenders, when released back in the community can become reclusive for fear of harassment. CSA creates a supportive network of professionals and volunteers around the offender as the ‘core member’  and works on the premise that successful reintegration must include participation from the subject but also the community. CSA challenges common cognitive distortions and feelings of apathy which can, in some cases help justify service users committing new offences. New relationships are forged and offenders receive regular interactions both in face to face contacts and phone calls which also serve as a means of monitoring the high risk client but through less oppressive methods than previously envisioned.

CSA has received some criticism for focusing on the offender, as opposed to providing resources to the victim (which are, like most victim support work completely inadequate) however, CSA does reflect a holistic approach which is proven to work time and time again. Still in relative infancy in the UK; Canadian reports indicate a 60% reduction in recidivism amongst their most dangerous and high risk clients. Such findings clearly indicate promise and, as Hudson writes challenge the oversimplified views held in the UK about what should be ‘done with, and to, sexual offenders’ (2005; 45).

Another theory presented is the ‘good lives model’ which is a psychological theory conceived by Tony Ward and his colleagues. This model works on the idea of the ‘strength perspective’ (Rapp, 1998) and focuses to enable those subject to its treatment to be equipped with the necessary skills to secure primary goods (or goals) which are meaningful and socially acceptable. The good lives model proposes supports a holistic and constructive approach of conceptualizing and engaging with offenders, focusing less on individual offender deficits and more on the personal, inter-personal and social contexts required to enable offenders to live and sustain ‘a good life’. Ward offers a list of primary life goals amalgamated from research in psychology, social science (Cummins, 1996), ethics (Murphy, 2001), philosophical anthropology (Nussbaum, 2000; Rescher, 1990) and evolutionary theory (Arnhart, 1998) which include: life, acceptance, friendship and community amongst others.

The model is very specific in relation to the values it is underpinned by and Ward and colleagues propose that ‘good lives’ model is not used as the sole treatment for sex offenders, but rather in conjunction with the risk-need model. This it is suggested, will help the practitioner understand the motivation for offending but also maximise the opportunity for therapeutic alliance thus hopefully improving the overall outcome. To this end it is an empowering model of intervention and does acknowledge the service user at the centre of the treatment, something which is much ignored when working with sexual offenders and a tailored approach meaning that individuals receive different packages of interventions, depending on their specific set of circumstances, related strengths, and aspirations as per the recommendation proposed in ‘What Works’ (1998). Indeed, while the idea may seem idealistic, transferring goals into tangible actions has a well-established evidence base and is commonly used in task-cantered practice (Doel and Marsh, 2005).

Taking a basis in the work of Preston-Shoot (1995), Hackett discusses how any practice which seeks to challenge oppression associated with sexual abusers frequently takes place within organisations and structures which may support but also may undermine the practice (2008). Indeed, this is a common problem which child protection social workers, mental health social workers and probation officers may face. Hackett therefore suggests a three level approach; focusing initially on ‘the self’. In this model we must acknowledge the existing relational power imbalance between client and practitioners and consider how this is both used and experienced. Furthermore, we must recognise our differences and value them. As discussed previously, when a client is a sexual offender, generally any other potentially oppressive factors (such as ethnicity, learning needs) tend to be overlooked, as such we must lastly constantly scrutinise our own personal values and behaviour.

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The second level refers to ‘self-organisation’ within organisations and asks that aims are clear and explicit. Research into failing with sexual offenders notes that interventions were often ad hoc and unplanned and without focus and therefore, at organisational levels goals and policies must be clear and transparent; especially in relation to multi-agency working and information sharing. The offenders’ rights must be defined and made clear to them; this will however be in addition to the required risk management policy which will exist alongside the intervention.

Stage three of the approach looks beyond the individual and organisations and discussed the ‘interpersonal’ nature of the work and builds upon the offender’s (and their families) experiences (good or bad) to consolidate and promote a strength based perspective and aligns with the undertaken by ‘circles of support’. As has been reiterated throughout this dissertation is importance of practitioners seeing the offender, rather than just the offence. This must be rooted in acknowledgment of the client’s own experiences of power, discrimination and, if relevant, their own abuse suffered. In doing so, we seek to understand the potential links between experiences, context cognition and abusive behaviour.

8.2 Conclusions

As social workers we must shift position from the solely reflective, inward practitioner into one which can offer insight and knowledge and a voice that challenges the stereotypes and offers and a means within which to integrate the most marginalized societal group. The above dialogue is contributory to a discourse concerned with literature surrounding ‘who works’. ‘Who work’s literature focuses attention of process issues within therapeutic intervention, but perhaps more crucially it addresses the importance of the style of the practitioner. The discourse has broadly been accepted in practice, but like the introduction of CBT has been less acknowledged than initially thought. ‘Who works’ focuses on the practitioner and the relationship attached with the service user. In terms of meeting the core values and principles of ADP (and indeed social work) ‘who works’ provides perhaps the most legitimate framework for intervention and, while this presents some difficulty for practitioners who struggle with this client group; if we are to remain client cantered and effective this ethos must be adapted and utilised.

These approaches support a more therapeutic or perhaps ‘social work’ based position on working with sex offenders, which while supported by academic and progressive research still creates tensions with policy makers and the public. Restrictive and exclusionary measures will always be justifiable with this client group on the grounds that it protects the public, and most importantly children. As such risk models have proven very popular with the above interventions still very much in embryonic stages of development in mainstream social work and probation practice. This said, the cost of prison and reduced spending in criminal justice requires, fundamentally, that custody is used less and we promote social inclusion and rehabilitation through community based orders (McNeill et al., 2005)

9.1 Implications for social work practitioners working with sex offenders

It is not unreasonable to argue that a basic and inherent requirement of effective social work is a grounding of empathy.  Achieving empathy is however  unlikely in the traditional sense given the nature of the offence, however here empathy must manifest as insight and understanding of the service users situation and what led to their offence, rather than trying to find common ground or a shared experience. What must be considered however is whether this level of empathy can, or indeed realistically should be achieved? In this chapter I aim to discuss the impact of working therapeutically with sex offenders and consider from the available literature how this impact can affect both social workers’ practice, but also their lives.

What is the likely impact of working with sex offenders for practitioners?

O’Connell and colleagues (1990) argue that the nature of work with sex offenders invariably leads to increased stress, and demands for practitioners, with Jackson (1997) further suggesting that workers may be reluctant to discuss resultant concerns and stresses due to the perceived limits of confidentiality, or a belief that others would simply not understand, leading to a sense of alienation and defensiveness (Jackson et al., 1997), or indeed a fear that sharing such concerns and issues may, in turn, ‘contaminate’ those they speak to (Clarke & Roger, 2002).

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Available research indicates that between 20 – 25% of practitioners working with sex offenders report deleterious psychological changes, (Edmunds, 1997; Farrenkopf, 1992; Myers, 1995; Turner, 1992). And whilst such figures are specific to the UK, it is reasonable to assume a similar pattern internationally; indeed Farrenkopf’s 1992 study in the USA and Hatcher and Noakes’ Australian study (2010) both reflect pictures of negative psychological impacts, characterised by burnout, compassion fatigue and trauma (Figley, 1995; Pearlman & Saakvitne 1995).

Taylor (date) found that, for practitioners working with sex offenders, a third reported that their intimate relationships had been negatively affected, and that over a third reported fears that relationships with their own children had altered (becoming over-protective etc.) with some (HOW MANY) finding they were no longer able to play with their children for fear that their behaviour(s) held hidden meaning to such an extent, that they were concerned this was abusive.

Hill (1995) suggests that in addition to emotional personal and direct difficulties faced by those working with sex offenders, there are additional stresses relating to the expectations of institutions (for example employers) and a more general societal expectation that practitioners  will ‘deal’ with a problem that others would sooner not think about, resulting in ‘triadic counter-transference’ of negativity towards offender as a compounded result of underlying personal feelings and such pressures. Using the Maslach Burnout Inventory (Maslach, Jackson, & Leiter, 1996), Ellerby (1998) for example, found practitioners working in custodial settings reported significantly higher levels of depersonalisation, compared to community providers, which the author suggests are linked to greater exposure to psychopathology, in an environment which is physically anti-therapeutic .

Farrenkopf (1992) discusses the inherent dangers of emotional distance and depersonalisation and describes four phases of adjustment which professionals face; shock, mission, anger, and alternatively, erosion or adaptation. The period of erosion, he claims, resembles professional burnout which can cause practitioners to become resentful, depressed and to reduce their expectations of service users. Farrenkopf suggests that, instead of eroding, we must learn to ‘adapt’. The implications of his findings were notable and marked the recognition of genuine and empathetic therapeutic relationships as a successful means of treatment with sex offenders (Polson & McCullom, 1995).

Farrenkopf’s (1992) study on the impact of therapists who work with sexual offenders included fear amongst common emotions felt by practitioners and found over half of his participants had their personality affected by working with this client group to their detriment, and were ultimately left feeling ‘pessimistic’ and ‘cynical’.

What ‘protective’ factors have been identified?

Age

The literature suggests that factors including: age, gender, educational level, job role, living status, time in the job, victim status, parental status and also length of time in the role, all contribute to the likely impact that working with sex offenders may have for practitioners. Of these, there are only two where the research evidence is fairly unequivocal, are age (Clarke, 2004; Ellerby, 1998;) and gender (Clarke, 2004; Ellerby et al., 1993; Farrenkopf, 1992). Generally speaking, younger therapists are found to report higher levels of distress, those aged under 25 years (Clarke, 2004; Ellerby, 1998). Way et al. (2004) also concluded younger practitioners reported increased levels of vicarious trauma and, that those most negatively affected prematurely left their profession. Conversely, Weekes et al.’s 1995 study found that, amongst prison officers, those with more years in service reported greater stress due in the main to professional stigmatisation from working with the client group.

Gender

Farrenkopf’s American based study (1992) suggests female practitioners felt particularly vulnerable to paranoia and threats of abuse, while others stated that they experienced ‘constant’ concern relating to their children. Farrenkopf discusses how work of this kind may ‘re-sensitize’ women to previous experience of abuse from men. While an interesting point is no doubt made, it must also be considered that the majority of sexual offenders are male by default and the overwhelimg male dominance and culture in prisons, both amongst inmates and staff which is characterised by ‘compulsive heterosexuality, homophobia and misogyny’ (Mac An Ghaill, 1994. P. 96).

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Men also experience distress; it is however thought to manifest differently, through anger as opposed to the anxiety and fear (Sheath, 1990; Clarke & Roger, 2007). Thus, while male workers may appear to hold increased resilience; this can only be considered in relation to how negative we as individuals interpret the different effects.

Screening

It is argued strongly that regularly screening individuals, using validated measures, is likely a identify those at highest risk of negative emotional reactivity when exposed to potentially traumatic events or material (Alexander & Wells, 1991; Paton, Ramsay, & Sinclair, 1992). This, in turn, may provide a valuable preventative device, in that it affords the opportunity to highlight well-being training needs and adapt support strategies to the needs of individuals or groups of individuals over time.

Training

Whilst research is limited, there is a general regard that professionals who have specialist training have improved attitudes and resilience (Lea et al, 1999). Hogue’s 1995 research into the effectiveness of the SOTP training programme found that, of the 81 multi-disciplinary participants which included teachers, prison officers, probation officers and medical staff; training improved attitudes towards sexual offenders significantly and particularly 6 months post training onwards suggesting reflection is an important skill. Training also serves to improve the confidence of practitioners in both delivering intervention and their belief that it could actually be effective. Weekes et al.’s (1995) study in yielded similar findings with regards attitude to sex offenders and found that 68% of their



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