Changes in coping following treatment for child molesters.

Relapse prevention theory assumes that specific coping skills deficits contribute to sexual reoffending. Recent research suggests that the general coping style of sexual offenders is also ineffective. In this study changes were examined in specific and general coping deficits following a treatment program that incorporated specific skills training as well as modifying general styles. Treated incarcerated child molesters were compared to a group of incarcerated child molesters on a waiting list for treatment. Groups completed various measures aimed at identifying coping strategies used in specific high-risk situations and general coping styles. Compared to the waiting list group, treated child molesters identified more effective coping strategies in specific high-risk situations. Changes are noted in their general coping styles with an increase in the endorsement of task-focused strategies and social diversion strategies. No changes in their endorsement of ineffective strategies such as emotion-focused or distraction strategies occurred. Implications for treatment are discussed.

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.

Diagnosing sexual sadism in sexual offenders: reliability across diagnosticians.

On the basis of detailed accounts of offences committed by 12 dangerous sexual offenders and of descriptions of their life histories, their responses to various tests, self-reports of offenders' sexual interests and activities, and results of phallometric evaluations, 15 expert forensic psychiatrists diagnosed whether each offender met the criteria for sexual sadism. The psychiatrists also indicated their confidence in the diagnoses they made and rated the relevance to the diagnosis of sexual sadism for various features of the offence and the offender. Results revealed unsatisfactory levels of diagnostic agreement among the psychiatrists. On the other hand, they agreed quite well on the importance for the diagnosis of several of the offence features described. Suggestions are offered for clinical practice.