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presented in Prague in June 2006 at the Congress of the European Federation
of Sexologists, by The full text version is here: < http://www.helping-people.info/Treatment/sot/offender.htm > This is a short explorative study concerning the methodology of sex offender treatment (SOT), frequently used today as routine in the Netherlands and abroad. DataThe basis is
A short exploration of the literature is not much, but I read in the literature of 2006 nearly the same as in the literature of 1996. There seem to be only a few changes and developments, only in detail within the chosen model, but the model itself is the same. My impression is: Much of the same. Fifteen clients are not much, but data are extremely scarce and very difficult to get. This is because the clients are not allowed to talk about their own treatment. If they do, they break their contract, thus they hinder their treatment, thus they break the conditions of the court, and thus they can be sent back to prison. In several countries, this can be for many years in awful and dangerous circumstances. Nevertheless, fifteen narratives reached me. MethodThe methodology is described with ‘the seven elements of human acting,’ developed in my dissertation. SummarySee the scheme here below. The first column, "Element,"Gives the seven elements of - every - human action. To act is more than performing a deed.
The last row, Summary, gives a succinct description of the act as analyzed above. The second column, "Therapists,"Analyses the therapists' way of acting, as it is described in the literature. Here we see what the therapists see, want, do, the outcome of their acts, and so on. The summary is sharp and critical. The third column, "Clients,"Analyses the way the clients have experienced the acts of the therapist. The source is here what the clients have told me. The fourth column, "Critique,"Gives my critique of the way the therapists acted, including their interpretations, their goals, their methods, and so on. Scheme 'But sir, you are an
offender!'
|
Element |
Therapists |
Clients |
Critique |
(1) Interpretation |
As an offender. As strange and different, as distorted and dangerous, as a manipulator. As a behaving being. |
As a person with an inner, a personal biography, able to act, as a whole and as an individual. | Too reductionist. Two visions on the human, one for the clients, another for the therapists. |
(2) Goals |
Prevention of recidivism, thus changing the offence behavior; becoming responsible. | No data. Supposedly: only to survive. |
Too limited, too much concentrated on behavior, not therapeutic. |
(3) Ways of acting |
Narrative coercion and other forms of coercion and
control. Conditions beforehand, keeping distance, a group, an offence scenario, an offence chain, sexual script, avoiding the funnel, lots of orders, normalizing fantasies; sometimes medicines. |
Clients feel treated like toddlers and complain about
endless repetition.
|
Too much coercion, too concentrated on outward behavior; no attention to the inner mind or psyche and the underlying problems. |
(4) Outcome |
Recidivism? This is low. Behavior changed? Questionnaires, after-care group. Stimuli? Triggers or disinhibitors? Contacts? |
Clients learn to pretend. 'No stroke changed' Obsessions and depressions still alive. |
Not as intended: the outcome is far from
therapeutic.
|
(5) Feeling afterwards |
No data. Impression: Difficult!' 'but also pride on the own expertise. Negative feelings of the clients: This is part of the method, thus good. |
Extremely negative. Too awful for words. Depressed,
humiliated, traumatized, deprived of
self-confidence. This is a cruel method. |
Take the feelings of the clients afterward more seriously. |
(6) Insights |
One stays within the chosen model and believes in it. | I pretend to agree with them: the only way to be released. | This does not work, at least not therapeutically. |
(7) Way to improve |
None. No development, no self-critique. Ivory tower. Ideology. |
Let them listen to us and respect us. | Have a critical view of the model and the vision behind it. Start development of methodology. |
In summary |
A very one-sided model full of use of narrative and other kinds of coercion, which comes across as an ideology, is in itself a closed system. |
A disaster! |
Become self-critical; review the model. |
ResultsThe methodology shows a very one-sided view on the patients, narrow goals, and a very one-sided methodology in which narrative and coercion are at the core. The results show low recidivism, but also very negative feeling and judgment of the patients. The methodology is described as "psychotherapy," but there is no attention paid to the psyche of the patients, only to their behavior and thinking, not to their obsession, depression or such problems; it is not "therapy" at all, it is behavior modification – or ideology. ConclusionsThe cognitive behavioral model of treatment of sex offenders needs a critical view, review and change. Feelings of the therapists as well as of the patients have to be investigated in a process of developing this methodology into a less one-sided and narrow model. Start with the vision of the human being, thus on a philosophical level. Then, review the goals and methods, which might be done on the level of the psychology and psychiatry in a broad sense, thus not only on the level of the cognitive-behavioral psychology. QuotesA mother:"There are eight teenage boys and two therapists, and all the rest of us are parents and grandparents. We are bewildered, we are depressed and we are all consigned to this room for months. I am sick for hours beforehand and a day or more afterwards, unable to sleep in peace, to eat, to hold a casual conversation. These boys, including my son, are sex offenders. We, as their parents, are complicit in crimes hard to explain or define. Recently I asked my 14-year-old son what he's learned from the painful events of the last year, and he said, "I've learned sex is bad. I don't want to think about it anymore." I believe the cure has been
much worse than the disease. He's learning about
'ownership' and 'restitution' and 'errors of thought.' "The consequences afterwards? I have listed them:
Another client:"I could constantly hear welling up in my brain the words, 'Sex is wrong. Love is wrong.' |
