Self-compassion in Treatment and with Ourselves.

PURPOSEOF REVIEW: This article explores the emerging role of compassion in the treatment of individuals who have caused sexual harm. It also brings focus to the importance of self-care and self-compassion for the practitioners who do this work. RECENT FINDINGS: Early studies into interventions designed to prevent offending behavior focused more on risk reduction than client resilience and well-being. The good lives model shifted focus to rehabilitation centered on clients' strengths. Recent critiques highlight the importance of compassion in treatment and self-compassion for practitioners working in this field. Compassion plays a fundamental role in therapy with clients who have caused sexual harm.

Seen and Not Heard: The Service User's Experience Through the Justice System of Individuals Convicted of Sexual Offenses.

User experience and client satisfaction is capturing more attention in the field of social services. The provision of treatment services to individuals convicted of sexual offenses, in particular, has expanded exponentially over the last 20 years. This growing population is now interviewed, interrogated, investigated, assessed, managed, treated, supervised, and surveilled, while their perspective as "service users" is almost entirely absent from research. To that end, this article introduces the service user voice within the context of society's responses to sexual offending. We conducted thematic analysis on secondary data from interviews with 93 individuals. These include 74 men from the United States and 19 men from the United Kingdom, all of whom had been convicted for sexual offenses. The original qualitative data from the two original studies were freshly analysed, inductively and deductively, using Thematic Analysis so that the themes, as well as resulting codes, were appropriate and fit for purpose. Specific themes emerged from each of three clear stages in their service user journey: (a) Interactions with the formal criminal justice system (police, courts, and custodial corrections), (b) Interactions with community corrections (probation and parole), and (c) Interactions with treatment providers (rehabilitation, therapists, and evaluators). We describe the service user experience at each stage and discuss how policy and practice can resolve areas of disconnection. We suggest several ways to promote and privilege the service user voice for those convicted of sexual crimes.

Motivational Interviewing: as Easy as It Looks?

PURPOSE OF REVIEW: This paper explores how motivational interviewing (MI) can be useful to practitioners working with people who have sexually abused. Research has found that the most effective practitioners working with these clients are warm, empathic, rewarding, and directive. Putting these characteristics into practice, however, can be challenging for professionals in treatment settings. Despite a wealth of information regarding MI practice generally, its use with people who have sexually abused has received little attention. RECENT FINDINGS: Motivational interviewing has been found to be effective in helping people change a wide range of problematic behaviors. Although it has been found to assist in treatment engagement with people who have engaged in intimate partner violence, it has not been subjected to rigorous examination in the treatment of sexual aggression. Nonetheless, it has received increasing attention within criminal-justice circles and can help clients of all backgrounds become involved in many of the treatment services available to them. The most effective practitioners working with these clients are warm, empathic, rewarding, and directive. The practice of motivational interviewing can benefit clients directly and can help professionals to develop the characteristics found to work with people who have sexually abused.

Adverse Childhood Experiences in the Lives of Male Sex Offenders: Implications for Trauma-Informed Care.

This study explored the prevalence of childhood trauma in a sample of male sexual offenders (N = 679) using the Adverse Childhood Experience (ACE) scale. Compared with males in the general population, sex offenders had more than 3 times the odds of child sexual abuse (CSA), nearly twice the odds of physical abuse, 13 times the odds of verbal abuse, and more than 4 times the odds of emotional neglect and coming from a broken home. Less than 16% endorsed zero ACEs and nearly half endorsed four or more. Multiple maltreatments often co-occurred with other types of household dysfunction, suggesting that many sex offenders were raised within a disordered social environment. Higher ACE scores were associated with higher risk scores. By enhancing our understanding of the frequency and correlates of early adverse experiences, we can better devise trauma-informed interventions that respond to the clinical needs of sex offender clients.

Adverse childhood experiences in the lives of female sex offenders.

This study explored the prevalence of early trauma in a sample of U.S. female sexual offenders (N = 47) using the Adverse Childhood Experiences (ACE) scale. Compared with females in the general population, sex offenders had more than three times the odds of child sexual abuse, four times the odds of verbal abuse, and more than three times the odds of emotional neglect and having an incarcerated family member. Half of the female sex offenders had been sexually abused as a child. Only 20% endorsed zero adverse childhood experiences (compared with 35% of the general female population) and 41% endorsed four or more (compared with 15% of the general female population). Higher ACE scores were associated with having younger victims. Multiple maltreatments often co-occurred in households with other types of dysfunction, suggesting that many female sex offenders were raised within a disordered social environment by adults with problems of their own who were ill-equipped to protect their daughters from harm. By enhancing our understanding of the frequency and correlates of early adverse experiences, we can better devise trauma-informed interventions that respond to the clinical needs of female sex offender clients.

A consumer satisfaction survey of civilly committed sex offenders in Illinois.

The purpose of this study was to obtain feedback from civilly committed sex offenders (N = 113) about the components of treatment that they believed to be most important and helpful in preventing reoffense. Participants were also asked to rate their satisfaction with the treatment process and therapists. Victim empathy and accountability were rated as the most important elements of treatment, along with skills for preventing relapse and methods for controlling sexual arousal. There was a fairly robust correlation between client perceptions of importance and satisfaction on most treatment components. Some clients expressed concerns about respect, confidentiality, and judgmental attitudes of some therapists. Because civilly committed sex offenders are considered to be among the most likely to reoffend, strategies are discussed for engagement of this population in a meaningful process of change.

Sex offender treatment: consumer satisfaction and engagement in therapy.

Convicted sex offenders attending an outpatient treatment program in Connecticut were surveyed about their experiences in therapy, their perceived importance of treatment content, their satisfaction with the help they receive, and their engagement in therapeutic services. There were strong correlations between perceived importance of content items and satisfaction with services. A robust correlation was also found between engagement and satisfaction. Clients rated accountability and victim empathy as the most important components of treatment. Other popular content areas were thinking errors, relapse prevention concepts, uncovering motivations to offend, and controlling deviant arousal. Most sex offenders valued the peer support and confrontation offered by group therapy. Though reduced recidivism is clearly the crucial measure of treatment success, clients who are engaged in the treatment process and develop healthy interpersonal skills by participating in therapy may be less likely to engage in abusive behavior. Implications for practitioners are discussed.

Treatment experiences of civilly committed sex offenders: a consumer satisfaction survey.

The purpose of the study was to elicit feedback from sex offenders about the components of treatment that they believed to be most helpful in preventing reoffense. A sample of civilly committed sex offenders from the Sand Ridge Civil Commitment Center in Wisconsin (n = 44) was surveyed about their perceptions of treatment, including content, process, therapists, rules, and completion requirements. Clients were asked to rate the importance of treatment components to their recovery and to rate their satisfaction with the treatment they received for each component. Participants expressed fairly positive sentiments about their treatment experiences, though specific concerns were noted. There was an overall positive correlation between importance of and satisfaction with treatment, but ratings of importance were consistently higher than ratings of satisfaction. Implications for practice and future research are discussed.

Emerging strategies for risk assessment of sexually abusive youth: theory, controversy and practice.

Clinicians and other professionals evaluating, managing, and treating sexually abusive youth are frequently called upon to offer judgments regarding risk for sexual reoffense. There are currently no empirically validated methods for accurately classifying risk among this population. Therefore, those faced with this task have an obligation to consider the research on the assessment of risk and recidivism. Five methods of risk assessment are reviewed, and four scales are discussed, with directions on how to obtain them. These include the Juvenile Sex Offender Assessment Protocol (JSOAP), the Protective Factors Scale (PFS), and Estimate of Risk of Adolescent Sex Offender Recidivism (ERASOR).