Working with Sex Offenders

Therapeutic Interactions & Techniques

Purpose of Treatment

Reduce recidivism? Have a better life for the offender?

Purpose of Treatment
Reduce recidivism

Do you treat non-criminogenic factors? Depression Anxiety Self-esteem


Therapists represent world of authority Antisocial teens and adults – not accepted the social contract

Prosocial Allies

Teens Adults

Not entrenched Getting older

Teens View of Adults

  

Don’t understand Focus too much on responsibilities: not enough on fun Exaggerate risks Obsess on remote dangers Don’t understand the teen is immortal Just wants to berate them and make them feel bad

Delinquent Teens
 All

of the previous  Defiance, not alliance  Prone to power struggles  Do not identify  Share family’s view of therapists

Antisocial Adults
 Actively

reject the social contract  Defiance, not alliance  Engage in power struggles  Do not identify with larger society

Identification Outside Self
Planet Country College/Town

High School
Group/Gang Friends Kin Me

The Invisible Audience

Tightrope Walking

Represent norms of law-abiding world Build a working relationship

Therapists Cannot . . .

Fail to report infractions Collude in blaming the victim Wink at “technical” violations, e.g., alcohol and drugs Expect reciprocity

Basis of Therapeutic Relationship
 Trust?
 Warmth?  Empathy?  Self-Disclosure?

“I tell my clients that I do not operate on a trust basis. Trust is what’s abusable. . . Feeling confident about them can be dangerous.” (Knopp, 1984)

If trust them . . .
 No

polygraph  No GPS  No drug testing  No verifying info  No collateral supervision  No checking in with employer, family, individual therapist, etc.

Trust Undermines Abstinence
Removes external controls

Basis of Therapeutic Alliance

Fairness Goodwill

Three Rules of Sex Offender Treatment

Verify Verify


More important to teens Gross and elementary (One size fits all)

What to Do?

Teen A

Calms down when sent to a time-out for inappropriate behavior Escalates in time-out Calms down if left in group

Teen B

Different penalties seen as “unfair”

What If . . .

What’s good for individual

Is seen as “unfair” by group?

Adult Antisocial Offenders
 Unfair


 Entitlement

 Grievance,

paranoia, resentment

What is a Personality Disorder
No Assimilation No accommodation

What’s At Stake?
Therapists represent authority Anti-social teens & adults do not accept authority Group – towards or away to an acceptance of legitimate authority

Nobody accepts arbitrary authority No therapeutic alliance with “unfair” authority

For Teens
Acceptance of authority in form of therapists, teachers, parents, coaches,
 

Precedes Abstract Acceptance of Authority

For Adults

Acceptance of authority in the form of a therapist, teacher, supervisor, or boss Precedes acceptance of more abstract agents of the social contract such as police officers, probation and parole agents, and judges

What to Do Teens

Always consider group’s view of what’s fair Never dismiss it as “unimportant” Always monitor where you stand on fairness issue Try to come up with solutions accepted as fair

What to Do Adults

Assess who has grievance-based thinking Understand they project “unfairness” onto you Always point to, “same rules for everyone” Put program rules in writing



Have not accepted legitimate authority Have rejected it as a sham


Concept of Authority

Not personal – same rules for everyone For Antisocials – it is always personal

Grievance Thinking in Adults

“I started remembering everything. Everything. The death, the pain. I used to get mad. I still do. When I hear people laugh I get mad. Why is life so much fun for you and not for me?.”

Leroy’s Response

“All this was is battery. I got railroaded.”

Attacked Officers in Jail

“That incident in the county jail it wasn’t personal. It wasn’t one of those things that officer so and so is working today – whoever was working – it was going to happen. . . You go into that situation knowing . . . Just like if you go in a robbery with a gun, you don’t think you are going to kill someone. But you know you need to take the gun in the robbery because you might need to kill someone. Of course that’s wrong. But you don’t care. Why should I care? That’s why you need to get to the point where you care.”

Grievance Thinking

Much of the ruminating on past “injustices” Unable to see authority in any other light See ambiguous and even benign incidents as malevolent

Avoiding Power Struggles

Always give choices You can do this – this will happen You can do that – that will happen This is up to you I can’t make that choice for you

Principles of Therapeutic Alliance

Right Distance

Not too close; not too far Never changes

Risk of Empathy

Wants to please therapist to hold his/her regard Doesn’t want to disappoint therapist by admitting he’s been lying Wants to look good in front of therapist Disappoints therapist and therapist withdraws

Symmetrical and Asymmetrical Relationships

Most relationships are symmetrical Psychopaths form asymmetrical relationships

Too close

Client fakes good Client “disappoints” therapist

Too far

Therapist angry Withdraws

The Right Distance

Will help client, if client lets him/her Understand client’s behavior reflects on client, not on therapist Therapist wishes client well, but does not base self-esteem on client’s behavior Therapeutic narcissism under control

No Yo-Yo Therapists

Warm and disclosing in one session Distant and judgmental in the next

Impact of Empathy on Therapist
Risks Lost of objectivity Minimizing abuse Colluding with offender Projecting therapist world view on offender

Working with Lost Souls & Predators

Lost Souls


Lost Souls
 Emotional

identification with

 Lack

of social skills

 Low


 Planning

 Grooming

of Victims

 Callousness

 Predatory


Treatment of Lost Souls
 Anti-confrontation  Raise


 Emphasize
 Social

positive life style (New Me)

skills/Intimacy training goals

 Approach

Treatment of Predators
 Utilizes


 Focuses

on avoidance goals (Relapse prevention)

 Polygraph/plethysmograph

 Community


 Fairness

 The

right distance

 Good-will

 No

axe to grind stake in proving client a predator

 No

 Not

over-invested in believing he is low or high risk for the best; accepts possibility of the worse

 Hopes


Accepts need for external control Always working towards internal control

 Fairness

 The

right distance

 Good-will

 Up-front

Upfront & Honest

Will tell you first Discuss in advance what testimony/report will be If consulting/meeting on their case, tell them in advance

Client Dependent on Therapist? Whose Needs Are Met?
Praise and Blame Both make client look for external validation

Therapist as center of spokes on a wheel? Therapist praises? Therapist confronts? Therapist judges? Therapist engineers a setting, exercises and group culture which fosters change

  

Therapeutic Techniques
Praise Not too effusive More often than negative reinforcement Must up in offenders who are acting out to keep balance

Therapeutic Techniques
Modeling Prosocial Poor Little positive effect Massive negative effect

Prosocial Modeling

 

Treating group members & co-therapists respectfully Always talking about women and children respectfully Always talking about victims respectfully Admitting to a mistake Refraining from complaining or whining Keeping promises

Inappropriate Modeling

 

Dominating the group & not allowing cotherapist equal air time Looking bored when co-therapist speaking Ignoring co-therapist’s point and switching topics Sharing personal troubles Blaming administration for unpopular rules Allowing a likeable member to get away with things

Inappropriate Modeling

  

Breaking promises when convenient Allowing group members to refer to girls as “ho’s” Cancelling group frequently Showing up late for group Not prepared for group Constantly looking at watch during group

Challenge or Power Struggle?

Challenge or Confrontation With the therapist With the group With their future With the consequences

Relaxed body language when challenging Use of humor: “Riddle me this, batman” Giving choices

Side-stepping power struggles “I only know one thing; I’m not going to jail no matter what you decide.”

Teen believes sex with 7-year-old sister consensual or “she would have said no” What to do?

Less Useful

“Don’t she think she might have frozen because she was scared?” Gives him “right” answer “If it were me, I might have been thinking . . . “ Right answer plus therapist views At center of things

Therapeutic Techniques
  

Puts focus on therapist Blurs professional boundaries Allows manipulation and even blackmail by high risk offenders Causes lost souls to take care of therapist

Therapeutic Techniques
   

Borderline clients lose all boundaries Fosters client comparison with therapist Decreases projection Takes time from client issues

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