Sex Offender Treatment: Accomplishments, Challenges, and Future Directions
Craig, Melody A
Sex Offender Treatment: Accomplishments, Challenges, and Future Directions (Binghamton, New York: The Haworth Press, Inc., 2001) M.H. Miner and E. Coleman, Editors
This collection of concise articles regarding the advancements and issues within the field of sex offender treatment over the past 10 years will serve as a quick update for the busy practitioner. The articles include issues involving juvenile and adult sex offenders, new applications for existing treatment modalities, and community involvement in the recovery system.
“Advances in Sex Offender Treatment and Challenges for the Future” by Michael H. Miner and Eli Coleman explores the use of the relapse prevention model with sex offenders and the use of pharmacological therapies to reduce sexual interest in sex offenders, as well as to treat co-morbid psychiatric disorders. Advances in actuarial prediction tools for sex offender recidivism and the use of controversial tools, such as the Abel Screen and phallometric assessments are also discussed. In particular, the reliability of these tests utilizing fully clothed stimulus sets is discussed and questioned. A short section is devoted to juvenile sex offenders, as well as a conclusions section that indicates the need for further investigation into what works with special populations of sex offenders (i.e., developmentally disabled, women, and sexually reactive youth).
The following two articles focus on treatment modalities in use with juvenile sex offenders. “Multisystemic Treatment of Juvenile Sexual Offenders: A Progress Report” (Borduin, C.M & Schaeffer, C.M.) and “Collaborative Treatment for Sexual Behavior Problems in an Adolescent Residential Center (Prescott, D.S.) explore approaches to the treatment of juvenile sex offenders that have not traditionally been pursued. The multisystemic approach involves total familial absorption in change and confronts the many factors involved when juveniles offend. The collaborative approach discussed in this article demonstrates the efforts made within a residential treatment facility for juvenile sex offenders in Vermont.
Another innovative approach for high-risk adult sex offenders is reviewed in “Circles of Support: A Restorative Justice Initiative” (Wilson, R.J. & Prinzo, M.). This article includes a concise, but thorough, history of the philosophy of the Canadian correctional system as an introduction to the use of restorative justice measures to assist in the supervision and accountability of sex offenders in the community. The Circle of Support utilizes community volunteers to support, hold accountable, and manage high-risk sex offenders. While still in need of further study and a measure of statistical significance, the authors argue that this tool is a good first step towards increased public safety.
“Treatment of Pedophilia with Leuprolide Acetate: A Case Study” (Raymond, N., Robinson, B., Kraft, C., Rittberg, B., & Coleman, E.) illustrates one pharmacological approach to the reduction of inappropriate sexual thoughts and behaviors in an individual with comorbid psychiatric conditions. While serotonin reuptake inhibitors are more usually used, this study used a different antiandrogen, leuprolide acetate to control an individual’s pedophilic desires. The discussion portion of the article clearly indicates the need for further study of this approach and the need for psychotherapeutic interventions to occur concurrently with the pharmacotherapy.
A study that found differences between victim gender choice and social competence levels also found that individuals who choose to offend males exclusively also had more contact with children, in either sexual or non-sexual context. “A Comparison Between Exclusively Male Target and Female/Both Sexes Target Child Molesters on Psychometric Variables, DSM-IV Diagnoses and MTC:CM3 Typology” (Eher, R., Gruenhut, C., Fruehwald, S., Frottier, P., Bobl, B., & Aigner, M.) also reported no significant psychiatric comorbidity differences between the groups. Although the sample size for this study was small, significant results were found, especially in the particularly small sample of male only target child molesters. It revealed the importance of social competence training for this population.
The final article of this book, “Somatic and Mental Symptoms of Male Sex Offenders: A Comparison among Offenders, Victims, and Their Families” (MiccioFonseca, L.C.) attempted to determine if male sex offenders reported more somatic and mental symptoms than other individuals. The weaknesses of this study include the lack of neuropsychological testing, total reliance on self-report, and a lengthy list of possibilities for findings with very few definitive answers. The author calls for further development of treatment and assessment paradigms based on this study, however, the study found no significant findings among the participants. A reworking of this study is suggested.
The last section of this highly useful text regarding new, upcoming, and potential directions for sex offender treatment is the documenting of “Standards of Care for the Treatment of Aduit Sex Offenders” initially developed in 1990. The authors encourage readers to submit feedback regarding these standards.
Overall, this short, concise text is a good source of information for the beginner to sex offender treatment, the busy practitioner, and the peripheral professional who has contact with treatment providers but does not do direct care. The articles are easy to read and most are very nicely organized. The editors have organized the articles in a natural progression from one topic to another.
Melody A. Craig is a sex offender specialist for the Adult Parole Authority, the Ohio Department of Rehabilitation and Corrections. She holds a masters degree in sociology from Cleveland State University, specializing in deviance and social control.
Copyright Correctional Education Association Dec 2003
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