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

Connecting

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

Dont understand Focus too much on responsibilities: not enough on fun Exaggerate risks Obsess on remote dangers Dont 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 familys 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 whats 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
Honesty

Three Rules of Sex Offender Treatment

Verify Verify
Verify

Fairness

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 . . .

Whats good for individual

Is seen as unfair by group?

Adult Antisocial Offenders

Unfair

World

Entitlement

Grievance,

paranoia, resentment

What is a Personality Disorder

No Assimilation No accommodation

Whats 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 groups view of whats 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

Differences

Teens

Have not accepted legitimate authority Have rejected it as a sham

Adults

Concept of Authority

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

Grievance Thinking in Adults

Resentment
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?.

Leroys Response

All this was is battery. I got railroaded.

Attacked Officers in Jail

That incident in the county jail it wasnt personal. It wasnt 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 dont 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 thats wrong. But you dont care. Why should I care? Thats 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 cant 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 Doesnt want to disappoint therapist by admitting hes 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 clients behavior reflects on client, not on therapist Therapist wishes client well, but does not base self-esteem on clients 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

Predators

Lost Souls
Emotional

identification with

children
Lack

of social skills

Low

self-esteem

Predators
Planning

Grooming

of Victims

Callousness

Predatory

Attitude

Treatment of Lost Souls

Anti-confrontation Raise

self-esteem

Emphasize
Social

positive life style (New Me)

skills/Intimacy training goals

Approach

Treatment of Predators
Utilizes

confrontation

Focuses

on avoidance goals (Relapse prevention)

Polygraph/plethysmograph

Community

supervision/management

 Fairness

The

right distance

Good-will

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

Good-Will

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-therapists 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 hos 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; Im 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

Dont 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
Self-disclosure

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
Self-disclosure

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