Stephen D. Webster

Approach Versus Avoidance Goals in Relapse Prevention With Sexual Offenders

Relapse prevention (RP) plays a major role in the vast number of treatment programs for sexual offenders. However, despite its widespread application, questions have been raised regarding the uncritical adoption of the approach (R. K. Hanson, 1996). More specifically, the way in which it is presented to sexual offenders has been criticized for being unhelpfully negative in focus (Mann, 2000) and it has been suggested that treatment should adopt a broader focus on improving quality of life (T. Ward and C. A. Stewart, 2003), with the expectation that recidivism would reduce as a side-effect. The current study evaluated two orientations to relapse prevention, comparing a deliberately positively-focused orientation, focusing on creating a “good life,” to the more traditional approach that focuses on avoiding and controlling risk factors. Twenty-four participants completed an approach-focused RP intervention and 23 completed an avoidance-focused RP intervention. Results indicated that participants who completed the approach-focused intervention had a greater engagement in treatment as measured by homework compliance and willingness to disclose lapses. Furthermore, participants within the approach-focused intervention were rated by therapist to be more genuinely motivated to live life without offending by the end of treatment. However, differences between the groups in terms of self-esteem change following treatment were not very marked. These results are discussed in terms of their implications for treatment delivery.

Pathways to Sexual Offense Recidivism Following Treatment An Examination of the Ward and Hudson Self-Regulation Model of Relapse

Ward and Hudson (1998, 2000) proposed a self-regulation model of relapse in sexual offenders, which classifies offenders into one of four pathways. This study examined the validity of the model, whether sexual recidivists are characterized by one predominant pathway and offense type, and whether participants would change pathway pre- to posttreatment intervention. Twenty-five sexual offenders who had participated in a comprehensive cognitive-behavioral treatment program during a prison sentence, but committed a further sexual offense on their release from custody, participated in the study. Results supported the content validity of the model. The predominant pathway pre- and posttreatment was approach explicit. The hypothesis that participants would change pathway posttreatment was not supported. These results may have implications for the efficacy of treatment of approach-explicit sexual offenders.

The measurement and influence of child sexual abuse supportive beliefs

Abstract The identification of offence-related cognition is a major target of most cognitive–behavioural treatment programmes for sexual offenders, and a number of measures are available for this purpose. This study assessed the psychometric properties of a brief measure of beliefs that support and justify child sexual abuse: the Sex With Children (SWCH) scale. Factor analysis revealed two distinct types of belief: that sex with children is harmless, and that children actively provoke adults into having sex with them. The SWCH was also found to have good internal consistency, test–retest reliability and concurrent validity. Child molesters scored significantly more highly on the SWCH than did rapists or non-offenders, and high-risk child molesters reported more entrenched offence-supportive beliefs than lower risk child molesters. A relationship was also observed between general offence-supportive beliefs as measured by SWCH and offence-specific cognitions ascribing responsibility or enjoyment to the offenders victim. The SWCH subscales appeared to closely match two of the implicit theories hypothesized by Ward and Keenan (1999) to be related to child molestation. Sex offender treatment providers need to be aware of the relationship between underlying implicit theories and offence-specific distorted cognitions about the victims experience.

Inter-rater reliability of dynamic risk assessment with sexual offenders

Abstract This paper describes the inter-rater reliability of the Structured Assessment of Risk and Need (SARN, formerly known as Structured Risk Assessment). The SARN is a structured framework for identifying sexual offenders’ dynamic risk factors. The SARN comprises 16 dynamic risk factors, categorized into four domains: Sexual Interests, Distorted Attitudes, Socio-Affective Functioning and Self-Management. Two studies, utilizing three samples, are reported. Study 1 examined the inter-rater reliability of four SARN cases with a sample of seven expert raters. Results indicated high inter-rater reliability amongst these participants. Study 2 examined the reliability of SARN with two samples who had received training before supplying inter-rater data (N=88). Results provided some support for the reliability of SARN. However, strength of reliability was dependent upon the method of analysis applied (percentage agreement, Cohens Kappa, intra-class correlation coefficients). These results are discussed in terms of their clinical and methodological implications.

Further validation of the short self-esteem scale with sexual offenders

Objective. This research was designed to validate a brief measure of self-esteem in sexual offenders: the Short Self-Esteem Scale (SSES). Method. The SSES was administered to 1,376 adult males serving a prison sentence for a sexual offence, and 40 non-offending males. Results. The internal consistency and test–retest reliability of the measure were excellent. The measure was able to discriminate between different types of sexual offender, and between sexual offenders with differing levels of static risk. The instruments sensitivity to sexual offender treatment intervention was also demonstrated. Conclusions. The SSES is a useful screening tool for self-esteem deficits in sexual offenders. However it cannot identify problematic high self-esteem and it does not differentiate between types or domains of self-esteem.

A psychometric study of six self-report measures for use with sexual offenders with cognitive and social functioning deficits

Abstract Despite the development of programmes to address sexual offending behaviour in offenders with cognitive and social functioning deficits, there is a lack of available psychometric tools specifically designed for this group (W. R. Lindsay, Journal of Intellectual Disability Research, 46, 74–85, 2002). This study firstly examines the psychometric properties of six assessment measures, which were specifically adapted for the lower functioning offender from existing sexual offender assessments. A group of 211 men who had undertaken HM Prison Services Adapted Sex Offender Treatment Programme (ASOTP) were used in this study. The assessments were found to have reasonable psychometric properties as determined by internal consistency and factor analyses. The second part of the study was an exploration of treatment change. Significant pre- to post-treatment change was found on five of the measures. However, the lack of a comparison group makes it difficult to draw firm conclusions about treatment change. Further evidence is also required to determine the link between self-report assessments and recidivism.

Sexual offenders’ treatment experience: a qualitative and quantitative investigation

Abstract HM Prison Service Sex Offender Treatment Programme (SOTP) has been running since 1992. Despite the collection of standardised psychometric data, no qualitative data to ascertain sexual offenders’ treatment experiences within HM Prison Service have been gathered to date. This study evaluates participants’ experiences of SOTP using qualitative and quantitative methods. A semi-structured interview was administered to 46 adult male sexual offenders. The interviews were transcribed and subject to grounded theory analysis. Treatment Summary Documents and psychometric measures were also interrogated to examine the relationship between subjective treatment experiences and other progress assessment. The results indicate that participants’ experiences of the Core Programme were multidimensional; they experienced both positive and negative affects during treatment, and learning points were drawn from every treatment ‘block’. Findings support the recommendation of using qualitative exploration, and triangulating methods of programme efficacy. The results are discussed in terms of implications for the improvement of future programmes for sexual offenders.

Developing empathy in sexual offenders: the value of offence re-enactments.

This paper describes an evaluation of different uses of roleplay to enhance victim-specific empathy in sexual offenders. Thirty-three men participated in a treatment program involving offence re-enactment as described by Pithers (1994) and Mann, Daniels, and Marshall (2002). A matched group of 33 men participated in a treatment program that was identical in all respects except that they did not complete offence re-enactments. Instead, they completed extra roleplays designed to enhance empathy for the short and long-term consequences for their victim(s). Results indicated that completing an offence re-enactment led to slightly better ability to identify some types of negative consequences for abuse victims, and identify cognitive distortions about their offending and women per se. Rapists in particular seemed more likely to benefit from offence re-enactment. The non-re-enactment group showed better understanding of lifestyle disruption effects for sexual abuse victims. The differences between the groups were not very marked, and the study only involved measures of cognitive empathy. Given the concerns about offence re-enactment expressed by Pithers (1997), this procedure should be used with caution and future investigations should test specifically for possible signs of damage caused by the procedure.

Assessing victim empathy in sexual offenders using the victim letter task.

In attempting to enhance victim empathy, it is common to have sexual offenders write an apology letter to their victim. This task is thought to reveal the level of empathy that the sexual offender has for his victim. However, until now there has been no reliable method for judging the quality of empathy revealed in the victim letter. This paper reports the development and evaluation of 2 templates to score letters written to child victims and adult victims, respectively. An acceptable level of interrater reliability was obtained for the templates. Deficits revealed by the templates did not correlate with scores on a generic empathy measure but did correlate with scales measuring minimization and denial. The measures were also sensitive to change following empathy training.

Why do sexual offenders refuse treatment

Abstract Theories of offender motivation for treatment have proposed that external factors may be as important as internal factors in creating a state of readiness for treatment. This paper reports an exploratory study of the barriers to treatment for incarcerated sexual offenders. Qualitative and quantitative analysis of interview and questionnaire data from treatment refusers and accepters suggested that refusers were less aware of the effectiveness of treatment, reported seeing negative side effects of treatment in others and felt they had a higher social status in prison which could be damaged by attending treatment. While this study does not demonstrate a causal link between these experiences and the decision to refuse treatment, it seems reasonable to suggest that take-up of treatment could be increased by more sustained efforts to build relationships with treatment refusers and by the provision of accessible information about treatment and its potential benefits.