Treating Sex Offenders

An Introduction to sex offender treatment programmes

Sarah Brown

• Publisher: Willan
• Year: 2013
• Print ISBN: 9781843921226
• eBook ISBN: 9781134029495
• Edition: 1
• Topic: Social Sciences
• Subtopic: Criminology
• Index: Social Sciences

This book aims to provide an introduction and overview of sex offender treatment programmes, designed for students and practitioners coming to this field. It seeks to describe the development, theoretical underpinnings, treatment goals and operation of cognitive-behavioural and other programmes to an audience unfamiliar with this form of rehabilitation. In addition, it aims to examine the effectiveness of these programmes and the difficulties associated with assessing this, the public response to treatment and also the effects on staff responsible for implementing them. The book is concerned particularly to assess the operation of sex offender treatment programmes in the UK context, considering also the issues associated with implementing programmes developed in other contexts, especially the USA and Canada. It will be of interest to practitioners, particularly those who are beginning work on sex offender treatment programmes, or others (such as health workers, social workers, probation officers) who come into contact with these programmes indirectly.

Chapter 1

Introduction

Over the last two decades, the problem of sexual offending has received widespread public, media and political attention. In fact, Sampson (1994: xi) argued that ‘public concern about sexual crime has become panic’. Media reporting has created the image that there has been a dramatic increase in sexual crime and that women and children face a constant and continued threat of attack. Sexual offenders are despised perhaps more than any other type of offender; so much so, that:

The equation of sexual offender and monster is now firmly part of the public psyche. ‘Monster’ and ‘beast’ are common euphemisms for sex offenders in the prison system.

(Sampson 1994: 43)

This has been supported by politicians who were keen to play the law and order card, and calls for tougher sentences for sex offenders have largely gone unopposed (Sampson 1994). The result has been a more punitive criminal justice response, enforced by a recent flurry of rushed legislative changes; for example, in England and Wales at least ten statutes affecting sex offenders have been introduced since 1991. Such an approach is not isolated to England and Wales, for example:

Sexual abuse in North America is epidemic and the criminal justice system response to it is, for the most part, more reflexive, fear-driven, and irrational than it is practical.

(Freeman-Longo and Blanchard 1998, cited in Laws 2000b: 30)

During the 1980s, sexual offending emerged as a major social problem, although it was not a new phenomenon (see Calder (1999) for a brief history of child sexual abuse, and Silverman and Wilson (2002) for a short history of sexual offending). A persistent feminist campaign coupled with high levels of media attention was largely responsible for increasing public awareness and concern. The picture the media continues to portray is one of widespread sexual offending where women and children (although male victims are increasingly being recognized) are at a constant risk, despite the fact that sex offences comprise only a small proportion of all recorded crimes. Approximately 4.7 per cent of those convicted in the US are convicted of sex-related offences (Greenfield 1997, cited in Burdon and Gallagher 2002), which at the end of 1999 was approximately 296,100 offenders (Bureau of Justice Statistics 2001, cited in Burdon and Gallagher 2002). However, these figures do not include sex offenders who are most recently convicted of non-sex related offences. In England and Wales, sexual offences comprise less than one per cent of all recorded crimes. However, there has been an increase in the number of recorded sex crimes from 21,000 in 1980–1; 29,000 in 1990–1; 37,300 in 2000–1 to 52,000 in 2003–4¹ (Home Office 1991; 1995; 2001a; 2004). From 1986 to 1996, the increase in recorded sexual offences averaged around 10 per cent per year (Home Office 2004). In 2003–4, the half a million recorded sexual offences comprised 26,709 indecent assaults on a female, 1,942 incidents of gross indecency with a child, 13,247 rapes (93 per cent of which were rapes of a female), and 4,070 indecent assaults on a male. Recorded sexual offences in 2003–4 increased by 7 per cent from the previous year to account for 5 per cent of all recorded violent crimes and 0.9 per cent of all recorded crime (Home Office 2004). A combination of the growth in recorded sexual offences and an increase in media attention to these crimes has led to the impression that sexual offences are becoming more common. However, some of the increase in recorded offences is likely to be attributable to an increasing number of offences being reported to and recorded by the police, rather than an increase in the actual number of offences (Home Office 1995).

The extent of the problem

A wide range of behaviours are officially classified as sexual offences but treatment work (and hence this book) generally focuses on those who offend against either those who did not, or those who could not, give their consent (e.g. offences of child sexual abuse, rape and exhibitionism). It is important to note that sex offending is a legal definition; strictly speaking a sex offender is someone who has been sanctioned by law for a sexual offence, although more widely the term is used (and will be employed in tyhis book) to define those who engage in sexual behaviours that are illegal, whether or not they have been officially sanctioned for these offences. Paedophile on the other hand, a term that is often used interchangeably with sex offender (and child molester), is a clinical definition of a specific group of people who may engage in adult–child sexual behaviour. The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association 1994) classifies paedophilia within a broader category of paraphilias (sexual disorders in which there are strong, recurring sexually stimulating urges, fantasies or behaviours usually involving (a) objects other than humans; (b) humiliation or pain for the partner or self; (c) children or other non-consenting partners). Specifically paedophilia is diagnosed if: (a) for six months or more, a person has had such fantasies or behaviours involving children below the age of puberty; (b) these fantasies/behaviours result in clinically meaningful difficulties or distress at work, in social contexts, or in other major areas of functioning; (c) the person is 16 years or older, and is at least five years older than the child or children. There are many problems with this definition (and the DSM-IV classifications of paraphilias in general, for example, see McConaghy (1999b)) and in using it to clinically diagnose paedophiles. Perhaps most important is the need for clinically meaningful difficulties or distress, which may not be exhibited in many of those who have fantasies, and/or engage in sexual behaviour with children and the need for these fantasies (which clearly cannot be observed) to be reported to the clinician. Crucially in terms of this discussion, it can be seen that not all sex offences (even all those committed against children) are likely to be committed by clinically diagnosed paedophiles (or even those without such formal diagnosis, but who would meet these criteria), even though many refer to all those who sexually offend against children as paedophiles. Although many argue that all clinically diagnosed paedophiles are sex offenders, this does not necessarily follow, as it is possible that someone could experience fantasies and urges that they do not act upon. In this book, to avoid confusion, the term paedophile will only be used if it was used to classify offenders by the authors of the original publication being cited.

It is difficult to accurately assess the scale of the problem of sexual offending for a number of reasons: societal denial, the secrecy of the offence, the consequences of disclosure for the victim, and the lack of a standard definition and methodology (see Calder 1999; for a more detailed discussions see Goldman and Padayachi (2000); Hulme (2004); Sampson (1994)). Thus, estimates of the incidence (estimates of the number of new cases in a given period of time) and prevalence (estimates of the proportion of a population that has been affected by the phenomenon) are unreliable and provide a confused picture. For example, Safafino (1981, cited in Goldman and Padayachi 2000) estimated that 336,200 sex offences were committed against children each year in the USA, which varied considerably from the estimate of 44,700 by the National Centre on Child Sexual Abuse and Neglect (NCCAN 1981, cited in Goldman and Padayachi 2000). Rind, Tromovitch and Bauserman (1998, cited in Goldman and Padayachi 2000) reported that estimates of the prevalence of abuse ranged for males from 3 to 37 per cent, with a mean estimate of 17 per cent; and for females ranged from 8 to 71 per cent with a mean of 28 per cent.

Despite this confusion, numerous studies (there are fewer prevalence than incidence studies of child sexual abuse (Goldman and Padayachi 2000)) suggest the problem is significant and larger than we would like to believe.

Depending on the definitions used, surveys have yielded widely differing statistics of adults’ recollections of sexual abuse as children [prevalence], but even the lowest estimates suggest that at least ten per cent of the population has been involved in some childhood encounter.

(West 1996: 53)

For example, Finkelhor (1994) summarized the data from 19 surveys of American adults investigating their experiences of sexual abuse as children. He reported that considerable evidence existed that at least 20 per cent of women and 5 to 10 per cent of men experienced some form of child sexual abuse, although the rates were lower for people born before World War II. There was no evidence that the rates of abuse had increased dramatically in generations born after the war, nor that race or socioeconomic circumstances influenced the likelihood of abuse. However, the studies did show that children who experienced parental inadequacy, unavailability, conflict, harsh punishment, and emotional deprivation had an increased risk of abuse. Davies (1998) estimated that current prevalence studies of child sexual abuse would include 1,500,000 girls and 520,000 boys in the UK (where there were approximately 11.9 million children aged 0–15 (Census 2001; 2003)). Similarly, the lowest estimates suggest that 10 per cent of women have been adult victims of sexual offences (Sampson 1994). For example, Koss (1993) reported that approximately 10 to 25 per cent of all American women are raped or sexually assaulted as adults. As some of these individuals may have been victimized as both children and adults, and no reliable figures are available for sexual assaults against adult males, it is not possible to accurately estimate a lifetime prevalence rate. Yet, it is clear that a considerable proportion of the population will be the victim of at least one sexual offence during their lifetime.

It is difficult to use these data to estimate the number of sexual offenders, as some of these victims may suffer abuse from a number of different offenders and some offenders may be responsible for the victimization of many individuals. However, the problem is not confined, as the media image of sex offenders often depicts, to a handful of ‘sick monsters’. Indeed, Davies (1998) extrapolated that there are 1.1 million sex offenders who have victimized children in the UK (which has a total population of approximately 58.8 million (Census 2001; 2003)). Furthermore, Marshall (1997) revealed that by the time they were 40, 1 in 90 men born in 1953 in England and Wales (at least 165,000 men) had been convicted of a serious sexual offence (e.g. rape, incest, gross indecency) against a child; 1 in 60 had been convicted of a sexual offence, which included less serious offences. When this is considered with Abel et al.’s (1987) finding that their sample of sex offenders committed an average of 380 crimes during their lifetimes (although bear in mind that this sample is unlikely to be representative of all sex offenders), or that offenders report an average of six years of undetected offending prior to arrest (Elliott et al. 1995), it is clear that the scale of the problem is considerable.

Dealing effectively with this issue, though, is problematic as Percy and Mayhew (1997) reported that there are 15 times more unreported sex offenders than reported ones. For example, only 18 per cent of the rapes that were reported to the British Crime Survey had been reported to the police (Myhill and Allen 2002) and only 8 per cent of reported rapes led to a conviction (Cowling 1998). As well as making intervention difficult, the large number of unidentified offenders means that evidence about sex offenders is essentially biased, as it is based on identified/convicted offenders.

Sex offenders: who are they?

The image of sex offenders portrayed by the media is of lonely, isolated men who offend in this way because they are ‘evil’, ‘sick’ or ‘mad’ and ultimately different in some way from the ‘normal’ members of society. This impression is encapsulated by the following Daily Mail headline ‘Sex Monster Free Soon’ (Rose and Wright 1999) and is not confined to tabloid newspapers. In 1997, the Guardian contained a lengthy, supposedly well-researched and well-informed article entitled ‘Monsters with Human Faces’ (Birkett 1997). This image is mirrored by popular culture in best-selling novels and hit movies, such as The Silence of the Lambs, Se7en and Patricia Cornwell’s Kay Scarpetta novels. These works of fiction imply links to real life cases and portray serial killers (often with sexual motives) as ‘evil’ loners who were born ‘bad’ and thus were driven to commit the most heinous crimes, and who, ultimately, have no hope of rehabilitation.

The pervasive and enduring nature of this image perhaps lies in the impression that as a society, we find it easier to believe crimes with motives we find hard to comprehend are carried out by ‘abnormal’ individuals living at the fringes of our communities. A corollary of this is that we find it easy to believe, and gain comfort from the idea, that these offenders can be readily identified by some ‘abnormal’ characteristic(s) that sets them apart from the ‘normal’ population. Indeed, for many years a large number of research studies attempted to identify such characteristics. However, these studies have shown that:

There is no personality profile that differentiates sexual abusers from nonabusers, nor is there any battery of psychological tests that will identify if an individual is or is not a sexual offender.

(Groth and Oliveri 1989: 316)

Furthermore, research suggests that sex offenders are a highly heterogeneous population distributed throughout socioeconomic groups (Howard League 1985; West 1996), although more sex offenders from lower socioeconomic groups are processed by the Criminal Justice System (Howard League 1985). The majority is not mentally ill in the sense that they suffer from psychiatrically diagnosable conditions (Barker and Morgan 1993; Simon 2000), and many of those who are apprehended have no previous convictions for sexual or non-sexual offences (Quinsey et al. 1995; West 1996). In truth, ‘the available research suggests greater similarities than differences between sexual offenders and other people’ (Marshall 1996b: 322).

It could be argued that Marshall’s ‘other people’ should more accurately be described as ‘other men’, given that most research studies and criminal statistics suggest that the vast majority of sex offenders are male. More recent work (for example Elliott 1993; 1998), however, highlights the hidden nature of women’s sexual offending, and suggests the problem is more widespread than was previously believed (for reviews of the limited literature on female perpetrators of child abuse, see Atkinson (1996); Grayston and De Luca (1999)). Yet, estimates of the extent of sexual abuse conducted by female offenders vary widely. For example, Duncan and Williams (1998) contrasted the 1 per cent estimate of Groth (1979) to the 24 per cent estimate of Finkelhor and Russell (1984). In Finkelhor’s (1994) review of studies, 90 per cent of the perpetrators were male. Until recently (for example, see Lewis and Stanley (2000); Nathan and Ward (2002)), there have been few studies investigating the characteristics of female sex offenders; thus, there is limited knowledge about this group of offenders.

‘Other men’ implies, as does the media image, that all sex offenders are adults; however, a significant proportion of sexual offences are committed by juveniles or adolescents. For example, arrest statistics and victim surveys indicate that approximately 30 to 50 per cent of incidents of child sexual abuse and 20 per cent of all rapes are carried out by adolescents (Brown et al. 1984 and Deisher et al. 1982, cited in Davis and Leitenberg 1987). Furthermore, approximately half of adult sex offenders report an onset of sexual offending during adolescence (Gebhard et al. 1965; Groth et al. 1982; Smith 1984; Abel et al. 1985; Becker and Abel 1985, all cited in Davis and Leitenberg 1987). Davis and Leitenberg (1987) reviewed the research on characteristics of adolescent sex offenders, their offences and victims and found that in the majority of cases (nearly two-thirds), the victims were children younger than the perpetrators and were acquaintances or relatives. Furthermore, Shaw et al. (2000) found that there were no differences in the type of abuse committed by adults or juveniles on children. Abuse conducted by juveniles, like that conducted by adults, was characterized by ‘themes of secrecy, dominance, coercion, threat and force’ (p. 1598). Moreover, the sexual acts of the juvenile offenders were ‘advanced beyond those expected for the age’ and ‘often included oral and vaginal intercourse and forcible penetration of the anus or vagina with fingers or other objects’ (ibid). Victims of both adult and juvenile abusers experienced the same level of difficulties, and emotional and behavioural problems.

One consequence of the media image of sex offenders is that when thinking about sexual offences, we tend to imagine the most violent predatory crimes. However, sexual offending encompasses a wide range of behaviours from exposure to penetration, enacted using force that varies from subtle coercion through to overt physical violence. As West (1996: 51–2) highlighted, ‘only a small minority of sexual attacks involve homicidal violence, significant injury, sexual mutilation or even gross brutality’. Furthermore, as Cowburn and Dominelli (2001: 403) point out, there are

two images – the dangerous beast and the harmless, largely incompetent and misunderstood dirty old man … In this context, there is no stereotype that relates to the abuser who offends against children for whom he has a responsibility of care.

Yet, most offences are carried out by someone known to and/or trusted by the victim in private locations (Smith 1989; Kelly et al. 1991; Elliott et al. 1995; Simon 2000; Fieldman and Crespi 2002; Myhill and Allen 2002). Research and published statistics consistently show that children and adults are much more likely to be abused by people they know, despite the focus on ‘stranger-danger’ in the media and the fears of the public. For example, Finkelhor’s (1994) review of 19 studies (referred to previously) found that 70 to 90 per cent of abuse was conducted by someone known to the child, with family members...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• 1 Introduction
• 2 Development/history of sex offender treatment programmes
• 3 Current use of cognitive-behavioural sex offender treatment
• 4 Theoretical underpinnings of programmes
• 5 Treatment ethos and effects on staff
• 6 Cognitive-behavioural sex offender treatment goals
• 7 Are programmes effective? Part 1: Difficulties in evaluating programmes
• 8 Are programmes effective? Part 2: Research evidence
• 9 Are programmes effective? Part 3: What works?
• 10 Conclusion / the future of sex offender treatment
• References
• Index