Case study A

Predisposing
DSM criteria would comfortably categorise Andrew as a paedophile, his search for affection and
sexual contact has distressed him, causing him to commit high risk crimes with little reward. Growing
up as a socially awkward man with few friends, Andrew found it difficult to maintain any meaningful
relationships, this has impacted his confidence and lead to him seeing himself, as lacking the
attractive qualities that would make him desirable to women of his age. Facing constant rejection
and finding difficulty in maintaining conversations during dates has caused him to look elsewhere for
his sexual needs, he desires control; feeling embarrassed or tongue tied is uncomfortable for him,
causing him to try and avoid social contact. Seeing his peers grow up and enter relationships, whilst
he was experiencing social isolation, caused him constant cognitive conflict, his stress induced
loneliness and jealousy were likely the reasons for his disinhibited decision making, which was on
display when he waited outside schools to give children presents. Other children were out
progressing their social skills whilst his low self-esteem and awkwardness caused him to be
psychologically underdeveloped, unlike his peers, his lack of self-belief would’ve inhibited him from
joining sports clubs and engaging in other social activities. Social isolation and loneliness in
adolescence has been shown to lead to changes in individuation and cause peculiar behaviour
(Laursen, 2013). His lack of job and any goals is likely due to his lack of communication skills and
inability to advertise himself as a useful employee, it could also be down to his laziness, but his youth
job coupled with his habit to wait outside schools, display him as a relatively active man who is more
capable than he perceives himself. Denying any misconduct after his arrest could indicate
shamefulness meaning he feels guilt and remorse for his actions, however his use of the word
“friendly” may be a sign he thinks his actions were justified, a trait common in paedophiles. His
attachment avoidant personality, which has been enhanced through social isolation has made him
wary of girls his age, concluding that children are a more realistic option for an emotionally and
sexually satisfying relationship. He fails to consider the psychological impact of his action and
considers his relationships to be mutually beneficial for both parties. Despite this he’s labelled as a
situational offender, his crimes appear to be stimulated by his hypersexual drive and attachment
issues, activating a latent paedophilic tendency, rather than an exclusive interest in children. In
comparison to adults, he views children as more accepting of him, he engages with them constantly
in an attempt to rid his loneliness and find friends. In spite of this he still refuses to take
responsibility for his actions, a trend clear in his life, instead of looking to improve himself he blames
mature women for his predicament and changes his preference to kids, this could suggest he
possess narcistic attributes. Many of the traits Andrew possess are common in children who
experienced sexual abuse, 50 percent of imprisoned paedophiles were sexually abused in youth
(Marshall, 2000). As he currently lives alone and hasn’t mentioned any family, this could be an
indication that he doesn’t feel attachment to his parents, the reason for this is unknown but could
be due to him enduring a negligent childhood which could’ve included sexual abuse. This means
there could be a genetic component to his issues, however current evidence is insufficient.

Perpetuating
As shown by Figure 1.0, Ward believes that intimacy deficits and emotional dysregulation can help
explain why child sex offences take place (Ward, 2002). Coupling this with the precondition’s theory
will help provide an understanding of paedophilia, failure to develop intimate relationships with
adults pushes towards child attraction as a way of filling hole left due to inadequate development of
attachment style (Finkelhor, 2017). In Andrews case, limited friends and lack of girlfriend has caused
him to feel inferior to his peers, his emotional dysregulation enhances this effect making him feel
outcasted. At 45, he may be used to it but refusal to try and improve his social standing will
 Case study A

exaggerate this feeling and increase his chances of reoffending. Suffering perceived societal
abandonment (Could be true or could be due to lack of trying) will only encourage him to continue
with his passive approach to human contact, if his lack of self-esteem continues social development
will stay difficult. Interacting with girls his age group causes him distress, feeling embarrassed and
tongue tied when speaking to them makes him feel out of control of the situation, his desire for
control is clear in his sexual preferences. Children being physically weaker, and more open to
psychological manipulation than adults, make them an ideal target for a socially awkward man like
Andrew. lack of development and attachment in youth will continue to make him feel incapable of
approaching men and women his age, The intimacy deficits and hypersexual drive haunting him, will
lead him to reoffend unless a successful intervention plan is put in place. Feelings of rejection will
continue, to avoid this he must find someone to confide In or find something he enjoys doing
enough to distract him from his urges. Being unemployed without any hobbies means he has too
much time and opportunity to reoffend. Hiding away from society is his coping mechanism, this is
unsuccessful. Staying socially awkward with no goal in life will cause him to stay stuck in his spot,
unemployment means he’ll struggle meeting friends and continue to suffer from social isolation. It
would be recommended that Andrew not be allowed near children till his intervention is successful,
till then a physical job doing manual labour could reduce his loneliness and improve his social skills.

Figure 1.0 showing pathway to performing Pathway 1 and 3

sex offence on child. both apply
Andrew.
Toward a comprehensive theory of child Pathway 4 also
sexual abuse: a theory knitting perspective applies (doesn’t
see paedophilia
Psychology crime and law
as wrong).
Tony Ward, Richard j. siegert
Only 1 of 4
2002 factors needed
to explain
319-351 offences

Intervention
From the formulation Andrew’s issues are clear, his loneliness and low self-esteem are the roots of
his mental problems, causing him to commit deviant acts. Common treatment strategies include
drug use (no info is provided about his testosterone levels but they are likely to be low, reducing
drug effectiveness). however, Andrew is a better fit for behavioural cognitive techniques.
commitments such as group therapy sessions, will provide Andrew with an opportunity to make new
friends and reduce his speech impediment, in the process raising his confidence as well as his
awareness on the issues surrounding paedophilia. Andrew will have the opportunity to relate to
individuals who suffer from similar mental problems, making him feel he is no longer alone in this
world, relating with others will reduce his loneliness and help him to refrain from social isolation,
this indirectly lowers his chance of reoffence by decreasing emotional dysregulation. To help Andrew
feel comfortable, the group sessions will start of with only 1 participant, slowly as his confidence
develops, he will be moved on to bigger groups before finally being considered ready for his SOTP
 Case study A

(Sex offender treatment program) intervention. During these sessions fellow group members will
challenge his mindset, over time his denial should morph into him taking responsibility, him
recognising what he is doing as wrong will decrease his chance of reoffending (Marshall W. , 1994). If
he refuses to take responsibility, he will be moved straight onto the SOTP intervention, the later
blocks should undermine his paedophilic views, outlining the harm caused by his actions. During
SOTP Andrew will only work with selected professionals who are trained to deal with his condition,
Multiple studies have shown SOTP to be very effective for preventing reoffences, Hanson et al
showed in a meta-analysis that, partaking in the course lowered chance of sexual reoffending by
eight percent, Figure 2.0 shows that offenders who undertook SOTP were less likely to reoffend
(Schweitzer, 2003), and if they did, it was after a longer period of time. To limit reoffending, Andrew
will be asked to come in for an annual check-up after course completion.

Sex crime recidivism

Journal of interpersonal violence

Schweitzer,R Dwyer,J

2003

1292-1310

Figure 2.0 showing rates of recidivism for sexual conviction in 1990-1992

Firstly, Andrew will meet his group and develop relationships, he should be used to this by now due
to the previous group therapy sessions, his social awkwardness levels should drop during the 84-
session course, he will start getting used to the feeling of embarrassment, increasing his chance of
securing a mate after the course is over. This intervention is very time consuming (210 hours); this
will keep Andrew busy, distracting him from his deviancies. This course consists of 20 blocks, after
completion the clients should have clear life goals and developed social and behavioural skills
Practical problems such as his unemployment should also be addressed, his social awkwardness has
meant that his daily routine is severely lacking in activities and social contact, this is an issue as he
could reoffend after he completes the SOTP sessions, if his environment remains lonely and
unstimulating. To prevent this, he will be recommended local job schemes which hire previous
offenders, giving him a second chance and helping him set monetary or promotional goals (target
setting is something he has struggled with). Earning money should give him confidence and make
him more desirable to the opposite sex, spending money he earned on increasing attractiveness and
style will make him more wanted by adult women. Availability of adult mates will help stall his
paedophilic urges, working a daily 9 to 5 job will also make it impossible for him to wait for children
outside schools (due to timing restraints). Even though being employed or at least distracted seems
necessary for Andrew’s intervention. His tendency to avoid social contact and low confidence will
make convincing him difficult, for this reason, he will only be asked to work once he’s completed his
5-week SOTP course, when he understands that his actions were not acceptable and realises that he
is at risk of reoffending and spending the rest of his life in prison, it will become clear to him that this
is for the benefit of him and others making him more inclined to follow advice. It is recommended to
keep a friendly yet professional client – therapist relationship, opening up will be difficult for him
due to his lack of friends in childhood and adolescence and therefore he will appreciate patience and
perseverance.
 Case study A

References
Finkelhor, D. C. (2017). The four preconditions model: An assessment. APA Psychnet, 25-51.

Laursen, B. (2013). Understanding loneliness during adolescence: Developmental changes that

increase the risk of perceived social isolation. Journal of adoolesence, 1-8.

Marshall, W. (1994). A Reconsideration of Treatment Outcome with Sex Offenders. Criminal justice
and behaviour, 10-27.

Marshall, W. S. (2000). Childhood Attachments, Sexual Abuse, and Their Relationship to Adult Coping
in Child Molesters. sexual abuse: a journal of research and treatment, 17-26.

Schweitzer, R. D. (2003). Sex crime recidivism. Journal of interpersonal violence, 1292-1310.

Ward, T. S. (2002). Toward a comprehensive theory of child sexual abuse: a theory knitting
perspective. Psychology crime and law, 319-351.