"It's Not Something I Chose You Know": Making Sense of Pedophiles' Sexual Interest in Children and the Impact on Their Psychosexual Identity.

Sexual interest in children is one of the most strongly predictive of the known risk factors for sexual reconviction. It is an important aspect of risk assessment to identify the presence of such interest, and an important task for treatment providers to address such a sexual interest where it is present. It has been argued that understanding pedophiles' deviant sexual interest in children can enhance risk assessment, management, and treatment planning. This research study aims to explore the phenomenology of deviant sexual interest in children, the impact it has on pedophilic offenders' identities, and their views on the treatability of that interest. The study used semistructured interviews and repertory grids to make sense of participants' experiences. The results revealed three superordinate themes: "'living' with a deviant sexual interest," "relational sexual self," and "possible and feared sexual self." The analysis unpacks these themes and repertory grid analysis is used to explore a subset of participants' identities in more detail. The results reveal that there needs to be an acceptance from both client and therapist that their sexual interest in children may never go away. Through this acceptance, clients could work on enhancing sexual self-regulation, recognizing their triggers, and so managing their sexual thoughts, feelings, and behavior. Implications for treatment are also discussed.

An exploration of protective factors supporting desistance from sexual offending.

This article considers factors that support or assist desistance from sexual offending in those who have previously offended. Current risk assessment tools for sexual offending focus almost exclusively on assessing factors that raise the risk for offending. The aim of this study was to review the available literature on protective factors supporting desistance from sexual offending. This article discusses the potential value of incorporating protective factors into the assessment process, and examines the literature on this topic to propose a list of eight potential protective domains for sexual offending. The inclusion of notions of desistance and strengths may provide additional guidance to the assessment and treatment of those who sexually offend. Further research investigations are recommended to consolidate the preliminary conclusions from this study regarding the nature and influence of protective factors in enabling individuals to desist from further offending.

Specialization in and within sexual offending in England and Wales.

Existing evidence suggests that offenders tend not to specialize in sexual offending in general but that there is some specialization in particular types of sexual offending. This study examined the sexual histories and reoffending of a large, national data set of offenders convicted of a sexual offense and managed in England and Wales by the National Offender Management Service (N = 14,804). The study found that specialization in sexual offending compared to nonsexual offending was most evident for offenders with convictions for accessing indecent images. We also found considerable evidence of specialization within sexual offending, most notably for noncontact offenders, especially again indecent images offenders. Crossover between sexual offense types was very rare for those with contact adult offenses and for noncontact offenders although those with child contact offenses sometimes crossed over to indecent images reoffending. If specialization within sexual offending exists, the use of single risk assessment instruments to predict all types of sexual recidivism may be less effective than previously assumed. A comparison of different prediction models indicated that some items presently used in one-size-fits-all risk tools to predict any sexual reoffending only effectively predict certain subtypes of sexual offending. Statistically there appear to be some potential benefits to creating specialist risk predictors for different subtypes of offending, but further work is needed to justify the implementation demands that would be caused by abandoning one-size-fits-all tools.

Direct and indirect measures of sexual maturity preferences differentiate subtypes of child sexual abusers.

To aid risk assessment, management, and treatment planning it is essential to assess child sexual abusers' deviant sexual interests (DSI) and preferences (DSP) for sex with children. However, measurement of DSI/DSP is fraught with psychometric problems. In consequence, research interest has shifted to latency-based indirect measures as a measurement approach to complement self-report and physiological assessment. Utilizing the Explicit and Implicit Sexual Interest Profile (EISIP)-a multimethod approach consisting of self-report, viewing time, and Implicit Association Test (IAT) DSI/DSP measures-we replicated phallometric DSI/DSP differences between child sexual abuser subgroups in a sample of intrafamilial, extrafamilial, and child pornography offenders. DSI/DSP was associated with recidivism risk, offense-behavioral measures of pedophilic interest, and sexual fantasizing. It also negatively correlated with antisociality. Distinguishing between child sexual abuser subtypes and being related to recidivism risk, the EISIP is a useful tool for sexual offender assessments.

Victim empathy intervention with sexual offenders: rehabilitation, punishment, or correctional quackery?

A sexual offender is thought to have victim empathy when he has a cognitive and emotional understanding of the experience of the victim of his sexual offense. Most sex offender treatment programs devote significant time to developing victim empathy. The authors examine three meta-analytic studies and some individual studies that suggest victim empathy work is unnecessary, or even harmful. Service user studies, however, report positive reactions to victim empathy work. The authors conclude that the enthusiasm for victim empathy work as a rehabilitative endeavor is disproportionate given the weak evidence base and the lack of a coherent theoretical model of change. However, because the research is inconclusive, it is not possible to conclude that victim empathy work is "correctional quackery." We suggest a research program to clarify whether or not victim empathy intervention for sexual offenders has value.

Attitudes supportive of sexual offending predict recidivism: a meta-analysis.

Attitudes supportive of sexual offending figure prominently in theories of sexual offending, as well as in contemporary assessment and treatment practices with sex offenders. Based on 46 samples (n = 13,782), this meta-analysis found that attitudes supportive of sexual offending had a small, yet reasonably consistent, relationship with sexual recidivism (Cohen's d = .22). To the extent that differences were observed, attitudes predicted recidivism better for child molesters than for rapists. There was no difference in the predictive accuracy of attitudes assessed at pretreatment or at posttreatment. The current study indicates that attitudes supportive of sexual offending is a psychologically meaningful risk factor for sex offenders. However, given that many different constructs have been designated as sex offender attitudes, further research and theory is needed to understand how these various constructs contribute to recidivism.

Cognition, empathy, and sexual offending.

Most empathy research in the forensic context has assumed that empathy has two components. In this two-component model, the cognitive component involves perspective taking, and the affective component involves experiencing appropriate emotion. In this review, we identify how this assumption has both dominated and limited empathy research with offenders, nearly all of which has been conducted with sexual offenders. We propose instead that five components are involved in the experience of empathy: perspective taking, the ability to experience emotion, a belief that others are worthy of compassion and respect, situational factors, and an ability to manage personal distress. We suggest that the non-situational factors that blocked empathy for the victim at the time of a sexual offense are probably other dispositions known to be related to sexual offending, such as sexual preoccupation, generalized hostility to others, implicit theories about children and sex, and/or poor coping with negative emotions. We conclude with directions for practice and research, and urge greater caution in correctional policies on victim empathy programs.

Interrater reliability of Risk Matrix 2000/s.

Actuarial risk assessment instruments for sexual offenders are often used in high-stakes decision making and therefore should be subject to stringent reliability and validity testing. Furthermore, those involved in the risk assessment of sexual offenders should be aware of the factors that may affect the reliability of these instruments. The present study examined the interrater reliability of the Risk Matrix 2000/s between one field rater and one independent rater with a sample of more than 100 sexual offenders. The results indicated good interrater reliability of the tool, although reliability varies from item to item. A number of factors were identified that seem to reduce the reliability of scoring. The present findings are strengthened by examining interrater reliability of the tool in the usual practitioner context and by calculating a range of reliability statistics. Strategies are suggested to increase reliability in the use of actuarial tools in routine practice.

Interrater Reliability of Risk Matrix 2000/s.

Actuarial risk assessment instruments for sexual offenders are often used in high-stakes decision making and therefore should be subject to stringent reliability and validity testing. Furthermore, those involved in the risk assessment of sexual offenders should be aware of the factors that may affect the reliability of these instruments. The present study examined the interrater reliability of the Risk Matrix 2000/s between one field rater and one independent rater with a sample of more than 100 sexual offenders. The results indicated good interrater reliability of the tool, although reliability varies from item to item. A number of factors were identified that seem to reduce the reliability of scoring. The present findings are strengthened by examining interrater reliability of the tool in the usual practitioner context and by calculating a range of reliability statistics. Strategies are suggested to increase reliability in the use of actuarial tools in routine practice.

Assessing risk for sexual recidivism: some proposals on the nature of psychologically meaningful risk factors.

Risk assessment and treatment for sexual offenders should focus on individual characteristics associated with recidivism risk. Although it is possible to conduct risk assessments based purely on empirical correlates, the most useful evaluations also explain the source of the risk. In this review, the authors propose that the basic requirements for a psychologically meaningful risk factor are (a) a plausible rationale that the factor is a cause of sexual offending and (b) strong evidence that it predicts sexual recidivism. Based on the second of these criteria, the authors categorize potential risk factors according to the strength of the evidence for their relationship with offending. The most strongly supported variables should be emphasized in both assessment and treatment of sexual offenders. Further research is required, however, to establish causal connections between these variables and recidivism and to examine the extent to which changes in these factors leads to reductions in recidivism potential.

Working positively with sexual offenders: maximizing the effectiveness of treatment.

In this article, the authors draw on literatures outside sexual offending and make suggestions for working more positively and constructively with these offenders. Although the management of risk is a necessary feature of treatment, it needs to occur in conjunction with a strength-based approach. An exclusive focus on risk can lead to overly confrontational therapeutic encounters, a lack of rapport between offenders and clinicians, and fragmented and mechanistic treatment delivery. The authors suggest that the goals of sexual offender treatment should be the attainment of good lives, which is achieved by enhancing hope, increasing self-esteem, developing approach goals, and working collaboratively with the offenders. Examples are provided of how these targets may be met. When this is done within a therapeutic context where the treatment providers display empathy and warmth and are rewarding and directive, the authors suggest that treatment effects will be maximized.

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

This paper describes an evaluation of different uses of role-play 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 role-plays 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-reenactment 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.

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.

Evaluation of a national prison-based treatment program for sexual offenders in England and Wales.

Treatment efficacy is described for a sample of sexual offenders who had undertaken treatment in United Kingdom prisons (N = 647) and for a retrospectively selected comparison group (N = 1,910). The outcomes under observation in this study were sexual, sexual and/or violent, and general reconviction. Treatment impact was also examined in relation to offenders' risk of reconviction. The treatment group had slightly lower 2-year sexual reconviction rates than the comparison group, but these differences were not statistically significant. Significant differences were found between the treatment and comparison group for sexual and/or violent reconviction. Further analysis suggested that treatment produced a reduction in the probability of sexual and/or violent reconviction (p <.05) when other relevant variables were controlled for. General reconviction rates were consistently lower in the treatment group, but these differences were not significant.

Distinguishing and combining risks for sexual and violent recidivism.

A two-dimensional risk assessment system for sexual offenders was created that can classify them for risk of sexual recidivism, risk of nonsexual violent recidivism, and the composite risk of reconviction for sexual or nonsexual assaults. Receiver operating characteristic (ROC) analyses of separate follow-up samples were used for cross-validation. The system is easier to score than Static-99, and substantially easier to score than the VRAG or SORAG, while yielding comparable predictive accuracy in cross-validation samples with follow-ups from 2 years to 19 years. ROC AUC coefficients between.74 and.81 were found for the different scales and samples.