Specialist Rehabilitation Service for Sex Offending
December 2012
Dr Peter Chamberlain
Senior Clinical Psychologist

Owenia House: Effectively a behavioural clinic within the Forensic Mental health Service
Our core objective is to prevent sexual abuse of children by intervening with offenders and potential offenders
Provides:
 Community based assessment and treatment services for adults who have sexually offended against children, or fear they may do so .
 A treatment service for paraphilias e.g. exhibitionists, public masturbators

(As at 12 December 2012)
6
Director, 4 Clinicians, Administrative Officer
: 72*
(waiting list of 23)
All Male, average age 43 with ages ranging from 19 - 74
* We have a capacity for approximately 120
(Closed/Open)
Standard (2 phased) – normally functioning
Skills Based Treatment – intellectually impaired
Rural – rural clients, normal functioning, full day each month
NOS (other paraphilias & child sex offenders as required)

Offending
Trajectory
Therapeutic
Philosophy
> Finklelhor’s (1984) Precondition Theory motivation*, internal and external barriers and victim resistance
*3 components:
 emotional congruence: emotional need to relate to children
 sexual arousal: children are a potential source of sexual gratification
 blockage: adult sexual & emotional gratification unavailable
> Ward & Stewart’s (2003) ‘Good Lives’ Model
 constructive & holistic approach beyond a single focus on risk management
 enhancement drives rehabilitation
 realising an offending-free life that is beneficial and rewarding in ways that are socially acceptable & personally fulfilling

Principle Theoretical Models Continued:
Theoretical morphing:
Finklelhor's
Precondition Theory
Hall & Hirschman’s
Quadripartite Theory
(critical threshold)
Marshall & Barbaree’s
Integrated Theory
(negative early – life experiences

Pathways Model of Child Sexual Abuse
(Ward and Siegert 2002)
Intimacy Deficits

Normal sexual scripts

Offend at specific times; child is pseudo-adult
Deviant Sexual Scripts

Distorted (subtle) sexual scripts

Interact with dysfunctional relationship schemas
Multiple Dysfunctional
Mechanisms

Deviant sexual scripts

Deviant fantasies

Generally comorbid psychopathologies
Sexual
Offending
Emotional Dysregulation

Normal sexual scripts

Dysfunctional emotional regulation
Antisocial Cognitions

No distorted scripts

Offending reflects general pro-criminal beliefs/attitudes

 Preferential (fixated) versus Situational (regressed) offenders.
 Fixated : Primary sexual orientation is to children
interest generally begins in adolescence,
- pre-planned, premeditated persistence interest
- males primary target
 Regressed : Primary sexual orientation to age mates
interest in children emerges in adulthood
- pseudo adult substitute
- females primary target

Clinical Profile Considerations (DSM-IV-TR) :
 Axis 1 (Clinical Disorders)
 depression common (suicidal),
 psychosis 5-8%,
 Axis 2: (Personality & Intellectual Disorders)
 Personality disorder 5-7%
 Intellectual disability 15%
 Presentation variable
 Sexual abuse (estimates 40-50%); earlier and more severe abuse associated with earlier offending

 > 60 % of child sexual offenders have at least one previous conviction
 almost twice as likely to have been for non-sexual offences than for sexual offences.

 48% of non-familial offenders have arousal to children.
 28% of father-daughter incest offenders have arousal to children.
 15% of non-offender males have arousal to children.

 Referral Information
 Current Legal status
 Detailed personal history
(family of origin & current family situation, relationship history, education, occupation, medical & mental health history, medications, substance use/abuse)
 Sexual and non sexual offending history
 Detailed sexual history
 Psychometrics as indicated
 Recidivism risk
 Sexual attitudes and beliefs inventories
 Treatment Plan

WHY DID YOU SEXUALLY ASSAULT THE VICTIM?
NOTHING HAPPENED
‘I never laid a finger on her’
‘The boy’s lying’
‘The cops are out to get me’
AND
IT WAS WRONG
BUT
THERE WERE EXTENUATING
SITUATIONAL CIRCUMSTANCES
‘I was having money problems’
‘I was drinking too much’
‘My wife wouldn’t sleep with me’
SOMETHING HAPPENED
BUT AND
IT WASN’T MY IDEA
‘The kid came on to me’
‘She was all over me’
IT WAS MY IDEA
BUT
AND
IT WASN’T SEXUAL
IT WAS SEXUAL
BUT
IT WASN’T WRONG
‘There’s nothing wrong with it’
‘She liked it’
‘I was being affectionate’
‘I was angry at my wife’
‘I was teaching her to be careful’
BUT
THERE WERE EXTENUATING
PSYCHOLOGICAL FACTORS
‘I was sexually abused as a child’
‘I don’t know what got into me’
‘Women scare me’

 Closed (set programme, 2 stage)
 Open/Continuous (own pace, enter & at leave different times)
 Intensive (Country, short time)
 Skills-based (IQ compromised)
 SOIG (Information, support, supervising adult)
* NOS (Other paraphilias) – Individual Treatment

 cognitive, behavioural, situational antecedents, values
 pattern/offence cycle
 high risk moods and thinking
 concept irrelevant decisions
 lapses and strategies
 developing support network
 changes in lives – focus/orientation to children
 individual relapse prevention plan

Offending Behaviour
Along continuum of sexual aggression
4
Self - Centred Internal Conflict
Shame, self-pity, personality driven depression, self-defeating behaviour
5
6
Self - Directed Cognitive
Distortion
Denying, rationalising, minimising, sanitising, and avoiding detection
Offence - Directed Behaviour
Victim targeting, grooming, setting up the offence scenario
3
Conscious Intentions to
Offend
Acting in a manner that enhances the fantasies, imagery, arousal and/or impulses
2
1 Deviant Sexual Fantasies and Images
Experiencing feelings/arousal that reinforces the deviant imagery

 Understanding patterns of abusive behaviour
 Understanding consequences of abusive behaviour
 Victim empathy
 Take responsibility for actions
 Changing associated emotional, behavioural and lifestyle patterns
 Recognition of lapses
 Individualised risk management programme

 responsibility for abusive behaviour
 responsibility for future offence-free life
 disclosure of personal information
 recognition pro-offending attitudes
 avoidance of minimising/justifying effects
 insight into victim issues
 understanding impact lifestyle factors
 understanding and implementing relapse prevention strategies
 motivation to change as evidenced by value action plan

 Heterosexual: treated untreated
 Homosexual: treated untreated
 Familial/Incest treated untreated
18%
43%
13%
43%
(7.5%)
(18%)
(5.5%)
(19%)
8% (3%)
22% (7%)
NB Figures outside of brackets are unofficial police records and child protection services statistics. Those inside brackets are official police records.

Two pathways: Mandated or Voluntary
Criteria:
1.
Must have sufficient time if mandated
2.
Voluntary must self-refer and not be before the court
3.
Offences must have been against children (i.e. adult victim offences not accepted). NOS clients the exception
4.
Must accept some responsibility (deniers precluded)
5.
>17 years of age
6.
Male

> No child contact
> Likelihood for change
> Motivation for change
> Social supports