How Theory Can Support Me When The Internal World Is So Challenged By The Work

by Eileen Finnegan


Introduction

Firstly as I begin to write the second article in relation to my work with
 perpetrators I am truly grateful to my peers and colleagues and other
 individuals who contacted me after I had written the first article with many 
kind words and support for me in this work. The feeling of being on the 
outside from my colleagues quickly passed. I began working with a group
 of sex offenders as part of the Sex Offenders Treatment Programme in my
 place of work in November 2008. This was the first group treatment
 programme for the organisation which had developed from the one to one
 work with offenders. The programme which is on-going has three modules.
The first module focused on life histories, the second on the offending
 behaviour and the final module relapse prevention. I will first look at what 
research informs us regarding treatment models which underpinned the
 work and then my own personal experience of working with these models.

Research


Treatments for sex offending are informed by theories of the aetiology and 
maintenance of offending behaviour. The most comprehensive models view
 a broad range of developmental, psychological, environmental and
 physiological influences as function interdependent processes (Marshall 
and Barbaree, 1990). The models of treatment that were used were taken
 from the Trans-theoretical model, Mieichenbaum’s (1977) model of
 cognitive reconstructing, (Module 2, 2007) and Schlank and Shaw’s (1996) 
(Module 2, 2007) and applied under the principles of the Good Lives 
Model, Wards readiness to change model.

The Transtheoretical model (Prochaska and Di Clemente,1983; DI Clemente 
and Norcoss, 1992; Prochaska and Velicer, 1997, 12, 38-48) is a model that
 focuses on decision making and suggests a process called the ‘Stages of
 Change’ that offers strategies to support changing decisions one makes.
 There are five stages;

1) Pre-contemplation – the individual is not cognitively aware of any
 behaviour needing to be changed,

2) Contemplation – the individual will consider change in the future,

3) Preparation – the individuals is intending to change,

4) Action – the individual is actively making changes,

5) Maintenance – the individual is invested in mantaining the changes made.

Using the Good Lives Model, it is important to consider the internal 
conditions (competencies) and external conditions (opportunities)
 necessary for individuals to have a sense of their own autonomy and to
bring a focus about how they could make changes in their life style that
would bring about significant and long-term change to their criminogenic
 behaviour. The model links the individual’s offence specific issues as
explained by Marshall and Barbaree’s integrated theory (1990) regarding 
individual’s low self esteem, poor coping skills and difficulty with 
relationships and the individual’s learning how to change these factors and
 develop more supportive adult relationships without fear of being rejected.

The Self Regulation model Ward and Hudson’s (2000) focuses on four
 offence pathways as a strategy to prevent relapse: avoidant pathway,
 avoidant-active pathway, approach-automatic pathway and automatic-
explicit pathway. Applying this model supports individuals with strategies 
to manage known triggers as seen on their offence chain. It also supports a 
strategy for a response to managing offence related anger and violence, 
alcohol, impulse control, learning coping skills and not withdrawing from
 relationships and reverting back into sexually deviant behaviors.

Ward’s (2004b) Readiness to Change model, suggests ‘the presence of
 characteristics within the client or the therapeutic situation, which are 
likely to promote engagement in therapy….and likely to enhance
 therapeutic change’ (Ward et al. 2005:325). This is important in the work
 with individuals as their motivation to participate in treatment comes from
 within. Then they work through the stages of change making significant
 changes in managing the triggers in their life’s that stress them.

There are numerous theories that explain why an
 individual might sexually offend like Malamuth’s Confluence Model of Sexual offending,
 Evolutionary Theories, Schema Theories, Implicit Theories, Smallbone and Dadds Theories, Finkelhor’s Precondition Model (1984), Marshall and
 Barbaree’s Integrated theory (1990) and Ward and Siegert’s Pathways 
Model (2002b)

In the first module Life Histories, the group members were asked to identify 
positive and negative experiences of their lives by using Salter’s (1995) 
deviant cycle model. The cycle is initiated by three states which explain
 offence processes.

1)  negative effective state,
2)  deviant sexual arousal,
3)  anti-social beliefs’, (Ward, Devon, Polaschek and Beech,
2005:244)

Ward and Siegert’s Pathways Model (2002b) was developed by integrating
 the ‘common and unique features’ (Ward, et al. 2005:61) from Finkelhor’s
 Precondition Model (1984), Marshall and Barbaree’s Integrated theory 
(1990) and Hall and Hirschman’s quadripartite model (1992). The
 Pathways model attributes particular features to those who sexually abuse
 children. These are;

1)  difficulties in identifying and controlling emotional states,

2)  social isolation, loneliness and dissatisfaction,
3)  offence-supportive cognitions (cognitive distortions)
4)  deviant sexual fantasies and arousal (Ward et al. 2005:62).

The model also suggests that the ‘clinical phenomena evident among child 
molesters are generated by four distinct and interacting types of
 psychological mechanisms: emotional dysregulation, intimacy and social 
skills deficits, cognitive distortions, and distorted sexual scripts.’ (Ward, et
al. 2005:63). Each of the different pathways describe different causes that 
lead individuals to sexually offend. The pathway’s model is a theory that
 has ‘knitted the best elements’ (Ward, Polaschek, & Beech, 2005:61) of
 Finkelhor’s (1984) precondition model, Marshall and Barbaree’s (1990)
 integrated theory and Hall and Hirshman’s (1992) quadripartite model,
 developing a ‘comprehensive aetiology theory’, (Ward, et al. 2005:61)-Ward and Siegert’s pathway model (2002) suggests that there are different
 causes that motivate an individual to sexually offend and describes differed 
aetiologies for each of the five pathways.

Personal Experience

I worked in the addiction field for almost twenty years and have been
 aware of the levels of denial, distortions, manipulation, relapses and so forth
 that
 emerge in this work. I have always found the work rewarding as
 individuals find their way to break the cycle of addictive behaviour and no
 longer is their history their destiny. I have always wanted to support
 idividuals as they journey through the cycle of addiction through each of
 the stages. Most individuals I have met on this journey begin to take
 responsibility for their addictive behaviour as a result of the consequences 
either to themselves or those involved in their lives. Many had hit rock
bottom and they had the choice of going under or taking the long and
 painful journey back to some sort of reality. While there were many difficult
 times and lots of shameful stories resulting from their behaviour while 
actively addicted, I always managed to walk with them on their journey. 
However this was a very different challenge as I journeyed with individuals 
on the cycle of their offending behaviour. Never in my life have I ever been 
as challenged as when I worked with the different treatment models. Most 
of the individuals were on the programme because their offending
 behaviour had been discovered and not because they had come to realise the
 deviance of their behaviour. The impact the disclosure had on the
 individual’s families and friends was devastating, especially if the offences
 were carried out on a family member or an individual that was known to the
 family.

In the first module which looked at the individual’s life histories, I wanted 
to discover some understanding of what motivated them to sexually
 offend. I did not realise at the time that I wanted to discover something
 that caused them to act out in this horrendous way so I could make sense 
of it all. Alas this did not happen. While some had horrific occurances in
 their lives, none made sense to me as a motivation to offend. Yet as I did 
hear their life histories I began to feel some empathy for them. This was very difficult for me it felt like I was siding with the enemy: I felt I was
 being disloyal to the many individuals who had sat with me and shared 
their experiences of being sexually abused. However this began to change 
for me as the individuals began their life histories and were asked to 
identify positive and negative experiences of their lives. It was possible
 for me to begin to make some sense of how research had explained the 
causes of individuals to sexually offend and this grounded me more in the work.

In the second module the individuals began to describe their offending behaviour in detail. They each described how they groomed the individual, how they set about to carry out the sexual offence. While I say they each described the offending behaviour this was not an easy task to get them to 
do. It was also not easy to listen to the content of their offending behaviour.
 However as the group began to interact with each other and highlight the 
cognitive distortions they heard from each other, there was both a sense of
 relief and hope for me that they were beginning to make sense of their own 
distortions in relation to their motivation to offend. One of the big shifts for
 me was when the individuals began to experience victim empathy and really 
began to see how their offending behaviour had devastated so many lives 
including their own. The hope for me was that the individuals seemed to 
have a real motivation to change their offending behaviour. As we moved
 into the relapse prevention they were far more honest in the realization that 
if they offended before they could do it again. So having the tools to prevent 
this is imperative in order for them not to re-offend.

As I have said from the beginning of these articles the work is challenging
 and this is still the case. Recently I was recording the details of the context
of a victim’s sexual abuse and realized that thankfully the impact remains 
devastating to me. After completing this task I wondered with my co-
facilitator of the offenders treatment programme how we could sit with this
 group after reading the details of victims’ experiences of sexual abuse. This 
conversation had a profound impact on me and my colleague, yet it was a 
turning point for both of us, as we had reached the point of knowing this 
cycle of offending has to stop and that we are being informed about how it
 begins. In turn this understanding may inform others about how to protect 
our children and vulnerable adults in the future.

I know it is said to ‘err is human and to forgive divine’ but I struggle with
 this so much in this work. Yet I genuinely trust in the possibility of humans’
 ability to change their behaviour even in the most difficult circumstances.

Eileen Finnegan IAHIP is a psychotherapist and supervisor for One in Four.

References

Ennis, L and Home S. (2003) Predicting psychological distress in sex
 offender therapists sexual abuse: A Journal of Research and Treatment
 15,49-156 School of Psychology (2007). Module 3: Practice Assessment 
& Clinical Skills, Leicester: School of Psychology – Forensic Section,
 University of Leicester

School of Psychology (2007). Module 5 Research Methods Module,
 Leicester: School of Psychology – Forensic Section, University of Leicester

Marshall, W.L., Anderson D., Fernandez, Y. (2005), Cognitive Behavioural
 Treatment of Sexual offenders. Sussex: Wiley Press