Oct 19, 2017 in Psychology Category

Sexual Aggression

Introduction

Alcohol contributes to cases of sexual assault via numerous pathways, frequently aggravating the risk factors.  Beliefs regarding alcohol’s effect on aggressive and sexual behavior, stereotypes regarding drinking women, and the alcohol’s impacts on cognitive and motor skills all play a part in propelling cases of alcohol-related sexual assault (Brooks-Gordon & Bilby, 2006).  There is an adequate research that supports the association between perpetration of violent crimes and alcohol use; however, the connection between sexual offending and substance abuse is not completely established. Estimates related to the level of substance abuse differ broadly across the population of youth who sexually offend (McMurran, 2013).  Jeremy’s case mirrors violent crimes that involve alcohol consumption by the perpetrator where there is a connection between alcohol consumption and sexual assault. This does not prove that the alcohol utilization yield to sexual assault (Parker & McCaffree, 2013).

Psychological treatments of sex offenders can be widely categorized: 1) aiding the offender derive insight into Jeremy’s acquisition of offending behavior or personality; 2) aiding to control or obscure  those influences that sustain the offending pattern; and, 3) aiding to safeguard against relapse into re-offending when the subject is under stress or in high risk circumstances within the community. It is essential to safeguard against reoffending by paying close attention to several aspects: deviant sexual arousal or sexual pre-occupation; cognitive distortion that might reinforce offending; limited/unsuitable reactions to victim distress; antisocial/impulsive lifestyle; difficulty in spotlighting personal risk factors; difficulty in instituting coping strategies for personal risk factors; social support for sexual offending; poor emotional control; emotional loneliness; dysfunctional schemas connected to early attachment experiences; and, a history of drug and/or alcohol abuse (Marshall et al., 1991).

Offender Category that Concurs with the Scenario Client

Jeremy is a violent offender having been arrested, convicted, and incarcerated for a felony crime-rape. Jeremy does not hold a prior arrest record as this is his first conviction. Jeremy, who is 21 years old, is a first offender convicted of sexual assault (rape), which has yielded to his 7-year sentence.  The instant offence derives from a party he attended in which he took excessive amounts of alcohol and probably LSD, which occasioned his lack of recollection and fuelled his perpetration of the crime of raping his girlfriend at the party.  Since Jeremy is not a chronic offender, the approaches to treatment will encompass skill-based interventions and motivation- based interventions. Literature highlights the significance of incorporating diverse treatment methods across a broad collection of treatment targets so as to satisfy the individual treatment needs/risk factors manifested by offenders.

The Multicultural Factors Evident in the Scenario

An analysis of literature on sex offender treatments features work on sexual recidivism and comparisons between diverse therapeutic methods. Long-term follow-up studies on sex offenders have indicted conflicting “survival rates.”  Largely, the biggest risk sex offenders appear to be typified by a number of factors: early incidence of criminal history typified by sex and violence convictions; antisocial lifestyle, attitudes, and social influences; sexual deviant arousal, per-occupation, and fantasies; psychopathic personality, and high impulsivity. The bulk of incidents detailing sexual aggression encompass male perpetrators (McMurran, 2013). Although, socioeconomic and racial differences may be overrepresented within certain settings, young people referred for treatment within diverse environments mirror the same racial, socioeconomic, and religious distribution within the general population.

Several etiological factors (risk factors) can be highlighted to elaborate the developmental origin of sexual suffering. Prominent factors to this end entail possessing abusive experiences, substance abuse, and exposure to aggressive role models. Risk factors to violence cannot be regarded as static. Their predictive value usually changes based on when they manifest within the client’s development based on the social context and the circumstances (Marshall et al. 1991). Risk factors may manifest within the individual, the environment, or the client’s capability to respond to the demands of the environment.  Race and ethnicity have for extended periods been perceived as a risk factor for the manifestation of violence and incorporated as a risk factor within studies utilizing bivariate predictors of violence (Brocato & Wagner, 2008). 

Jeremy case reveals high levels of parental support and presence of role models and Jeremy enjoys affection from his family.  Jeremy sustains strong family relationship with his family and they manifest no history of addiction, difficulties with the law, or mental illnesses.  There is a suggestion of adequate supervision and monitoring, which safeguards against development or association with antisocial peers (Brocato & Wagner, 2008). Similarly, Jeremy does not come from low income family, and there is no reference of parental association with antisocial behavior inclusive of violence criminal activity, or substance abuse.  The outlined factors avail a buffer against the development of antisocial behavior.

Treatment Approaches and/or Programs to Use with the Offender

 The model selected highlights a collection of risk factors that might impact on future offending.  The core emphasis centers on individually tailored programs. There is minimal scientific evidence indicating a constructive effect on dynamic psychotherapy alone with sex offenders, and the approach has increasingly given way to behavioral and cognitive behavioral approaches to the problem. Recent research has exhibited support for social-learning theory and cognitive-behavioral-based intervention programs (Moster et. al., 2008). Although, the models detail numerous analogous elements as the non-violent and violent offender treatment programs characteristically encourage the establishment of offenders’ insight and pursue to instruct offenders substitute behavioral strategies that will enable them to steer conflict more successfully.  The approach adopted should be aligning with the theoretical approaches highlighting substance abuse and health education. The cognitive-behavioral treatment model adopted should de-emphasize empathy establishment while elevating the establishment of suitable attribution styles (Moster et. al., 2008). As such, the core emphasis lies in teaching Jeremy to embrace the sole responsibility for his action instead of blaming the victim of his actions.

Cognitive-behavioral therapy (CBT) details a short-term and characteristically time-limited collection of techniques incorporating strategies to adjust both behavioral habits and cognitive assumptions that may be connected to some form of sexual deviance. Cognitive-behavioral approaches mainly draw from empirical research centering on criminogenic factors linked to sex offending and multi-modal functional analyses of individual offenders dwelling on contemporary patterns of offending, which aids in treatments to the distinct patterns of offending. Overall, CBT represents an effective intervention for minimizing the recidivism associated with both juvenile and adult offenders.

The relapse prevention model, derived from substance abuse literature, pursues to aid sex offenders identify their offense patterns, towards the objective of highlighting cognitive, situational, and emotional factors that yield to offending. Nevertheless, this approach attracts criticism for lacking ecological validity given that sex offenders might be unable to utilize their skills and techniques learned within the therapy in real life. Other psychologists perceive some cognitive of sex offenders as unalterable and inborn.

One of the core foci in CBT/RP treatment of the sexual offender centers on investigating, in detail, all of Jeremy’s past offending behavior so as to derive map an ‘offense pathway/offense cycle,’ if any.  This draws from the assumption that a universal series of thoughts, feelings, and behaviors typifies all the offenses of the individual client, and it is only by doing this that Jeremy can be aided to structure strategies to avert future offending.   Plans to minimize the probability of re-offending subsequent to discharge from prison should be equally highlighted.  The plans derived from the CBT/RP program characteristically spotlight only situations, substances, or persons that Jeremy should avoid.

Building Skills for a Better Life

The focus during the treatment does not entirely hinge on eradicating pro-offending perceptions and desires as this is implausible to minimize the subsequent predisposition to re-offend. The focus of the treatment centers on helping Jeremy overcome loneliness and intimacy deficits by establishing a more secure attachment style; aiding Jeremy develop a powerful sense of self-worth, enhance his capacity for expressing empathy as well as enhance his coping skills, minimize shame; and, ultimately, infuse behavioral, emotional, and sexual self-regulatory skills (Brooks-Gordon & Bilby, 2006). 

Collectively, the outlined changes pursues to shift the focus away from Jeremy’s past and the corollary establishment of avoidance plans, towards improving skills, attitudes, and self-regulation to ensure that Jeremy live a more fulfilling life.  As such, the objective of the therapist lies in working collaboratively with Jeremy develops a limited collection of personalized goals that align with his interests and capabilities.  Consequent to the establishment of the goals, the main task lies in helping Jeremy highlight steps necessary to the attainment of the goals. It is essential for Jeremy to gain skills, knowledge, and self-confidence that allow him to continue striving towards the attainment of the goals even after discharge from treatment.

Legal and Ethical Issues that Might be Involved in the Treatment of the Offender

Some of the ethical and legal concerns connected to the treatment include confidentiality; the duty of care and  informed consent (Hunter & Lexier, 1998). Ethical concerns related to alcohol treatment and treatment of sexual offender are frequently complex, and multidimensional.  It is pertinent to maintain client confidentiality as demanded by the professional bodies’ code of ethics (Hunter & Lexier, 1998). As the therapist, it is essential to inquire about the client’s alcohol use while, simultaneously, respecting the individual privacy and autonomy.

Model Used to Measure Treatment Outcomes

One of the most popular models for formulating offender treatment is attributed to Andrews, Bonta and Hoge (1990) and spotlights three principles: risk, needs, and responsiveness (Andrews et. al.,1990).  The authors’ review demonstrated that reoffending rates are highly and successfully minimized when programs: 1) structures treatment approaches to align program intensity with offender risk level; 2) spotlight needs of offenders that may stimulate criminal behavior (in this case substance abuse (alcohol abuse); and, 3) align the style a presentation of treatment with the offender’s learning style and capabilities.

 The development and execution of any treatment program for offenders begins with a thorough appraisal of the individual offender. Given that the effectiveness of treatment within forensic settings is most frequently gauged by consequent reductions within offender recidivism rates, the appraisal of an offender’s predisposition to recidivism details a critical part of the establishment of any treatment plan (Harkins &Beech, 2007).   Several instruments have been established within the last two decades and can be classified into two: risk assessment instruments gauge static (invariant or historical) variables such as violence risk appraisal guide, and risk assessment instruments that encompass static and dynamic variables (incorporating variables connected to reoffending that shift overtime (pro-criminal attitudes) the violent risk scale, and the degree of service inventory (Harkins &Beech, 2007).  Dynamic risk assessment instruments are selected within the establishment of treatment plans since they accommodate the directing of certain variables that can be regarded theoretically agreeable to change.

It is essential to ensure that the psychological interventions for sex offenders employed are appraised through the employment of reasonable appraisal formula of outcome = mechanism + content, whereby the concepts aid one to investigate the dynamics of the intervention employed. This incorporates the ‘context’ and the ‘mechanism’ of the intervention.  A number of methods can be employed to examine the efficacy of the sex offender treatment such as risk band analysis, random assignment, and matched control groups each of the approaches manifests its own strengths, but also methodological downsides.  The effectiveness of the treatment could be gauged by examining the outcomes of interest (recidivism rates), as well as proximate outcomes (relating to whether or not the treatment heralds change).   Risk band designs mainly compare the reported recidivism rates of the treated groups to the reported rates of re-offense as predicted by published risk appraisal measures. This design can readily be implemented, given that it does not necessitate a comparison group, and enables examination of risk level by treatment interaction. 

Conclusion

Cognitive behavioral group therapy has overtime been a prominent choice for treating sex offenders. It incorporates treatment goals such as enhancing empathy for the victim, taking up the responsibility for the offense, adjusting cognitive distortions connected to sex and the offense, comprehending the offense cycle, and instituting alternative behaviors, coupled with a safety plan that safeguards against relapse. The aim on this case is in changing the means by which Jeremy perceives his circumstances. It is essential to investigate the attachment that Jeremy experienced given that sexual offenders typically experience sexual, physical, and emotional abuse or neglect during their childhood. It is equally important to explore Jeremy’s adult experiences within relationships as this is pertinent to establishing possible origins of the client’s poor attachment.

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