FRI, Oct 8 \ 9.00-11.00 \ Treatment Techniques, III

086
PRETHERAPY WITH SEX OFFENDERS

Kris Vanhoeck
I.T.E.R.-Centrum voor daderhulp, Brussels, Belgium
iter@pi.be
www.iter-daderhulp.org

Pretherapy is not a new concept. It was developed by Prouty who wanted to reach therapy resistant clients by first restoring their broken contact with reality, with themselves and with meaningful others. How to use this concept with sexual delinquents?

Two groups of potential clients can possibly benefit from this approach :
offenders still in prison and waiting for treatment to start after detention (in Belgium there is no therapy provided in prison)
• offenders out there in society who don't see any reason for going to therapy and who don't face prosecution (many victims prefer not to go to the police)
Pretherapy with sex offenders can have three objectives :
• increase the knowledge about the reality of therapy
- weaken false ideas about therapy (e.g. “it will rebuild your personality totally”)
- give a first impression of what it can be
• enhance motivation
- make curious
- there may be something in it you can benefit from, if you want
• improve basic skills that are needed for therapy
- questioning oneself
- opening up for other realities than one's own
It is important that pretherapy can be provided by non-specialized community and prison social workers. Therefore it should have a semi-standardized format. An excellent way of doing this is by helping the client working his way through a workbook and sending the home assignments to a specialized treatment facility. The workbook we use is available in Dutch, German and French.

087
THE USE OF MOTIVATIONAL INTERVIEWING WITH MENTALLY DISORDERED POPULATION: ENHANCING CLIENT MOTIVATION TO CHANGE OFFENDING BEHAVIOR

Dagmar Hartshorn, Gary Hughes
Kemple View Psychiatric Services, Blackburn, England
dagmarhartshorn@virgin.net

There is a substantial literature that focuses upon the perceived lack of motivation to change problematic behaviour in sex offenders. How motivation to change behaviour is now considered crucial in the treatment of sex offenders. The Motivational Enhanced Programme employs the transtheoretical model and utilizes motivational interviewing techniques in a group setting to help engage and motivate patients to make or recognize the changes necessary in order to address their offending behavior. It has been hypothesized that the use of motivational interviewing techniques would enable patients to move in a positive direction on the stages of change models and develop a more positive stance to change as a whole. In addition, it aims to encourage the treatment group to positively increase their readiness to change their offending behavior. Using self-report measures, the stage of change and readiness to change their behavior has been explored in a male psychiatric population all of whom are detained under the Mental Health Act (1983), under sections 3, 37, and 37/41
The programme has demonstrated that a significant positive difference has been found in the treatment group and the group's readiness to change their offending behavior. This programme has become a precursor to further group work interventions.

088
GROUP CLIMATE AND IT'S IMPACTS ON TAIWANESE SEX OFFENDERS

Roda Chen, Ph.D.; Sheng-Ang Shen, Ph.D., Hsin-pei Tang,M.D.
National Dong-Hwa University, National Central Police University & Jianan Mental Hospital, Taiwan
rodachen@mail.ndhu.edu.tw, shen@sun4.cpu.edu.tw, hsinpei@mail.cnpc.gov.tw

Although much has been said on the effectiveness of sex offender treatment programs, there is relatively little research on how much and what kinds of influence of the group therapy treatment are in sex offenders. The purpose of this study were to examine the changes on sex offenders' cognition, emotion, and impulse control etc dimensions after group intervention, and group climate and therapeutic factors in different phases of group therapy.
In this study, an six-months group therapy program, mainly focused on relapse prevention, was held by various therapists, for sex offenders in the prison system and community treatment program. Reseach sample was 80 sex offenders who were recruited from different prisons and community in different areas of Taiwan. In addition to demographic data, other data was collected from six measurements, i.e., Static-99, Attitude toward Sex(Chen, 2000), Group climate questionnaire, Yalom's therapeutic factors measurement, and Emotion Evaluation questionnaire(Chen, 2000) to evaluate the changes of sex offenders.
The results show that, first, there were significant changes in rape myth, rationalization, denial and impulsive control after the intervention of group treatment. Second, compared to low and high risk of sex offender, apparent improvement effect was seen in the middle risk group. Third, group climate and therapeutic factors, particularly in engagement and conflict, were also changed in different phases of group therapy.
In general, the study provides some support of present practices in group therapy and points to areas of improvement. With training and support, therapists can become more effective agents of change for the sex offender in prison and community treatment.

089
WHAT IS THE STATE-OF-THE-ART IN SEXUAL OFFENDER TREATMENT IN EUROPE?

Jos Frenken, Ph.D.
The Rutgers Nisso Group/Netherlands Institute of Social Sexological Research, Utrecht, the Netherlands
NISSO@POBOX.RUU.NL, RNG@rutgersnissogroep.nl, nisso@nisso.nl

This presentation is based on the results of a questionnaire study among 67 professionals from 22 European countries, working in the field of sexual offender management or mental healt care. The results show the differences between countries in the development of sexual offender treatment. In most northwestern European countries there has been significant progress in this field; however, much slower progress has been made in southwestern European countries, while in Central and Eastern Europe only incidental treatment facilities are available or none at all. When treatment does occur in Europe, treatment methods differ markedly between countries ranging from psychoanalytic therapy to cognitive behavioural treatment. More recent trends in some European countries are -besides the already existing treatment facilities- prison programs, the increasing use of risk assessment instruments, juvenile treatment programs and abuse prevention campaigns by media. Here again, the northwestern European countries are more advanced and active than the southwestern European countries. It is not easy to explain these differences, for this requires of the observer an in-depth knowledge of the sociocultural context (What is the public opinion about sexual crimes, punishment and prevention?), the judicial system variables (What are the opinions of the courts about court-ordered treatment as a prevention instrument?) and the attitudes of the helping professionals specific to each nation (Aversion toward these clients, prepairedness to work with these clients in a court-ordered context). The new member states of the European Union ask for support and help with the implementation of modern specific sexual offender assessment and treatment methods. This presentation offers some tentative explanations of the observed differences across countries.