THUR, Oct 7 \ 11.30-13.30 \ Treatment Techniques, II

033
EMPATHY IN SEXUAL OFFENDERS: THE NATURE OF THESE DEFICITS AND THEIR TREATMENT

William Marshall, Ph.D., FRSC, Y.M. Fernandez, Ph.D., & Liam E. Marshall, MA
Rockwood Psychological Services, Kingston, Ontario, Canada
bill@rockwoodpsyc.com

A model of empathy will be outlined followed by a summary of research with sexual offenders relevant to the model. Essentially this research shows that sexual offenders do not accurately perceive problematic emotions in others, that they are unable to see things from the perspective of others, and that they selectively ignore the harm they cause to their victims. As a result of this review of the evidence, two approaches have emerged to the treatment of empathy deficits in sexual offenders: (1) a structured approach that attempts to correct deficits in each stage of the empathic process (i.e., an attempt to enhance empathy skills); and (2) an approach that simply construes these apparent empathy deficits as a particular category of cognitive distortions (i.e., an attempt to sensitize offenders to the harm they cause). While both of these approaches appear to be effective, in both cases certain offenders (i.e., psychopaths and sadists) appear to be unsuited to such treatment interventions. This issue will be discussed.

034
GROUP THERAPY WITH ADULT SEXUAL OFFENDERS

Steven Sawyer, MSSW
Project Pathfinder, Inc., St. Paul, MN, USA
ssawyer@projectpathfinder.org

“This group is like an organism, it can change and adapt but it is not the same when someone leaves.” (former group member)
This session will review concepts and issues in group therapy with adult sex offenders. Treatment of sex offenders has been documented for more than 100 years, but only in the past 20 years has group therapy become the most common method of treatment. Groups are used for education, support, therapeutic milieu, and psychotherapy. What makes group based treatment effective and the most common venue?
Group therapy evolved in the early 1900's in the United States when two authors, LeBon and McDougal, offered opposing appraisals of the group impact. In 1920, LeBon observed a negative effect of groups on individuals, concluding that the group contributed to “a diminishing of human functioning.” The result of this negative effect was a loss of self and the individuals' ability to act on their own will. In contrast, McDougal (1920), while also observing the potential negative effect observed an important additive when individuals were in groups. He observed that when groups are organized around a clearly defined common purpose the group had the potential to enhance individual behavior.
The early years of group therapy were dominated by psychoanalytic theory and more recently cognitive behavioral theory and techniques have become popular and have shown evidence of effectiveness. Unfortunately, traditional cognitive behavioral approaches do not foster group member interactions – one of the hallmarks of an effective group, as Yalom argued in his seminal work in 1995. Effective groups foster cohesion, challenge dysfunctional beliefs and behaviors and both tolerate differences as well as encourage adherence to group norms that further therapeutic goals.
There has been an increasing body of evidence that group based therapy offers a rich and effective environment that enhances and furthers the goals of therapy. Authors such as Beech and Fordham (1997), Sawyer (2002, 2003) and Levenson and Macgowan (2004) have begun to apply these group therapy principles to the special clinical population of sex offenders.
Group therapy enhances the goals of sex offender treatment in many ways. The supportive environment of the group promotes the emotional safety necessary to allow essential self-disclosure of shameful personal material. Only when a group milieu of support and cohesion is facilitated through interpersonal interaction can effective treatment and behavior change occur.

035
LEARNING RESILIENCE IN SEXUAL OFFENDERS FAMILY THERAPY

Isabel Boschi
Psychologist, Institute for Development Sexology, Argentina
sanssa@giga.com.ar

The presentation is divided in three parts: 1) Part 1 defines RESILIENCE as the human attitude of being aware that it is possible to change and to help people to change even the worst antisocial behaviours replacing them by better behavioural alternatives.
As therapist as well as citizen of this world we believe that resilience might be a social practice. 2) Part 2 will show some examples of how resilience is learnt in Sexual Offenders (S.O.) Family Therapy in ISDE, Institute for Development Sexology in Buenos Aires, Argentina. 3) Part 3 describes the different steps by which resilience can be learnt in S.O. Family Therapy sessions. This learning consists of: a) listening each other without interruption. b)talking to each other with a respectful predisposition. c)accepting our own mistakes that have produced others´ damage. d) deciding one´s behavioural change towards a safer one. e) asking somebody else for help when necessary. f) avoiding dangerous situation where one cannot be helped. g) receiving follow up for an appropriate time. CONCLUSIONS: The whole society might adopt a resilient attitude to ask ourselves what is wrong with our sexuality education, our idealized family concept and the rol of mass media to teach what sexual offenders are and how to help them. Family Therapy is a means to help S.O. to live happier, reinserting themselves into society with responsibility and self-esteem.

036
PROVIDING CLINICAL SERVICES TO SEXUAL OFFENDERS: THERAPIST IMPACT ISSUES

Lawrence Ellerby, Ph.D., C. Psych.
Forensic Psychological Services, Manitoba, Canada
ellerbyl@mts.net

It has long been recognized that a clinician's experiences impact his/her personal life (Green, 1968; Terkel, 1972). Given that psychotherapy routinely involves developing and maintaining a helping relationship with distressed or stress-engendering individuals, it is not surprising that there has been considerable interest in evaluating the impact of the therapeutic process on clinicians (Deutsch, 1985; Farber, 1985; Figley, 1982; Kottler, 1993; Norcross & Prochaska, 1986; Sussman, 1995).
The provision of treatment services to sexual offender clients is a challenging and demanding form of clinical practice. These clients are frequently unwilling consumers who present with a multitude of behavioral deficits and excesses which have the potential to pose a danger to society. In providing clinical services to this population clinicians are faced with both the stressors associated with general psychotherapy as well as a number of stressors unique to providing care to this particular client group.
This paper will explore the specific impact issues associated with the provision of clinical services to sexual offenders. Issues discussed will include theoretical frameworks for considering therapist distress, anecdotal and empirical data regarding the stressors associated with the provision of treatment services to sexual offenders, the experience of burnout and compassion fatigue amongst sexual offender treatment providers, and the variables that appear to moderate distress. Effective coping strategies for managing the identified stressors and the satisfactions associated with providing care to this population will also be discussed.