Plenum Press This 483-page book assembles 31 descriptions of ongoing sexual offender treatment programs from around the world. This includes programs in prisons, community settings, and psychiatric institutions and programs that deal with differing populations, i.e., female, clergy, and ethnic populations. It is clear that there is much worldwide effort and attention being devoted to treating sexual offenders. Canada and the United States appear to be leading the way while many other countries are actively developing treatment programs in their own environments. Much of this activity can be traced to the influence and work of William Marshall, one of the editors, whose example and students have been seminal and guided the progress of sexual offender treatment. Each chapter includes descriptions of administrative concerns, institutional relationships and problems, funding problems, assessment procedures, treatment content, staffing questions, and as much evaluative and outcome information as is available. Any professional establishing a sexual offender treatment program or working to improve one already in place has much to learn from these chapters. While there is not enough outcome information yet available to demonstrate convincingly what works and what does not work for discriminable populations or types of sexual offenders, there are several concepts that appear to have consensual validation across the various reports. There is also modest empirical support for these concepts in the outcome evidence reported. Cognitive behavioral procedures are universally understood to be the most desired and most likely efficacious approaches to sexual offender treatment. Almost all programs also include a relapse prevention element that attends to the process of the individual in committing crimes and reoffenses. Confrontational, hostile, and controlling behaviors are understood to be counterproductive, lead to early terminations, and have little positive effect. Every program description in one way or another asserts that sexual offenders ought be treated with respect and consideration while therapists remain firm and aware of conning and manipulation. Treating sexual offenders as if they were monsters is likely to confirm their own cognitive errors and may increase the likelihood of recidivism. Allowing for development of trust, a realistic basis for improving self-esteem, and modeling a rational and nondestructive use of power and control is presented as essential to a treatment program. There is universal acknowledgment of the importance of therapist factors and hence staffing becomes a crucial issue. Therapist style and therapist actions toward the offenders must be observed and managed. Not everybody can be a good sexual offender therapist. There are also a number of warnings about negative effects on the therapists. In the present climate of budget cuts and greater accountability for funds and effectiveness, staffing decisions become even more significant. There must be ongoing and continuous training and updating of staff skills, consciousness, and awareness. Sexual offenders must take responsibility for their actions and behaviors. All programs seek to insure as an initial step that the offenders accept their individual responsibility for their criminal acts. Then they go beyond this to support and enhance personal responsibility throughout the life of the individual. Many also include training in social skills, intimate relationships, and development of empathy. Denial is recognized as a major issue, however, only one program description, that for clergy, even mentions the possibility of false accusations and false or wrongful convictions. The demonization of sexual offenders and their rejection by society is understood to be problematical. This may well result in increasing numbers of old sexual offenders filling up prison spaces at high costs and little discernible increment in public safety. This book represents the best thinking and practice currently being done in the treatment of sexual offenders. The net result is cautious optimism that there can be effective treatment programs that will reduce the likelihood of recidivism. Whether the costs may be too high remains to be determined. It is also necessary to continue to produce scientifically sound research to identify the factors that lead to success and with which groups and/or individuals. Every professional who has an interest in sexual offender treatments can profit from reading this book carefully and referring to it often as a resource for responding to basic issues about sexual offenders. Reviewed by Ralph Underwager, Institute for Psychological Therapies.
|
