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A Sex Offenders’ Perspectives on Attending an Offence-focused Treatment Program

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Introduction

The internet has provided conditions of perceived anonymity and lower risk of detection for individuals to access what is commonly known as child pornography (Dervley et al., 2017; Jung, Ennis & Malesky, 2012; Merdian, Curtis, Thakker, Wilson & Boer, 2013). Child pornography has now been more appropriately termed child sexual exploitation material (CSEM), to reflect that accessing indecent images, videos and audios of children is child sexual abuse (CSA), and therefore differs from legal adult pornography (Merdian & Perkins, 2018). As access to the internet has increased, there has been a substantial growth in the production, possession and distribution of CSEM (Kloess, Beech & Harkins, 2014; Merdian & Perkins, 2018). This has become a global problem (Internet Watch Foundation, 2016; National Society for Prevention of Cruelty to Children, 2016), as there is now the opportunity for easier, faster and cheaper distribution of CSEM, both nationally and internationally (Kierkegaard, 2008). This has resulted in an increase in the number of CSEM convictions in recent years (Crown Prosecution Service, 2014), and as a consequence there are more CSEM offenders (CSEMOs) seeking or being referred for treatment (McManus & Almond, 2014; Radford et al., 2011).

A key question that has arisen is whether or not CSEMOs differ in criminogenic needs and risks from traditional contact child sexual offenders (CCSOs), or whether they have the same profile as CCSOs but are utilising a new resource to facilitate their offending (Seto & Hanson, 2011). Research comparing CSEMOs and CCSOs has provided evidence that there are differences in the characteristics of CSEMOs and in offence-related factors, suggesting they may be a distinct type of sexual offender (Babchishin, Hanson & Hermann, 2011; Babchishin, Hanson & VanZuylen, 2015; Elliot, Beech & Mandeville-Norden, 2013; Lee, Li, Lamade, Schuler & Prentky, 2012; McCarthy, 2010). This has important implications for conventional sex offender treatment programmes (SOTPs), as it questions whether the risks and treatment needs of CSEMOs are being appropriately targeted (Dervley et al., 2017; Henshaw, Ogloff & Clough, 2017). As such, there has recently begun to be a move toward providing specific internet SOTPs, although few programmes tailored to internet offenders exist and the literature exploring the effectiveness of such programmes is limited. This study aims to explore if CSEMOs perceive their criminogenic needs and risks to be met through a newly developed CSEM-specific treatment programme, and it aims to gain an insight in to the perceived mechanisms of effective change.

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Comparisons between CSEMOs and CCSOs

Socio-demographics

Research has consistently found that CSEMOs are almost always exclusively males of Caucasian ethnicity, which appears to be representative of CSEMOs generally (Bourke & Hernandez, 2009; Merdian, Wilson, & Boer, 2009; Motivans & Kyckelhahn, 2007; O’Brien & Webster, 2007; Seto, Reeves, & Jung, 2010; Wakeling, Howard, & Barnett, 2011). Compared to CCSOs, CSEMOs have often been found to have a higher level of education and occupational attainment (Aslan & Edelmann, 2014; Babchishin et al, 2011; Babchishin et al., 2015; Merdian et al., 2009). Furthermore, it has been suggested that CSEMOs are also often younger in age compared to CCSOs, with the average age ranging from late-30s to mid-40s, although this finding is less consistent in the literature (Babchishin et al., 2015; Seto et al., 2010; Wakeling et al., 2011).

Psychological characteristics

Sexual deviancy

Existing research has demonstrated that CSEMOs are more likely to have a sexual interest in children compared to CCSOs, with CSEMOs reporting a higher level of sexual deviancy (e.g. sexual fantasies involving children) (Babchishin et al., 2015). A higher sex drive and a higher level of sexual deviancy, have been established as characteristics that are predictive of CSEM offending behaviour compared to contact sexual offending (Elliott & Babchishin, 2012; Klein, Schmidt, Turner, & Briken, 2015; Merdian et al., 2016).

Offence-supportive beliefs

Research investigating offence-supportive beliefs has tended to focus on cognitive distortions and degrees of victim empathy (Henshaw et al., 2017). Compared to CCSOs, CSEMOs have been found to have greater degrees of victim empathy and fewer cognitive distortions in relation to sexual offending (Babchishin et al., 2015; Elliott, Beech, Mandeville-Norden & Hayes, 2009; Merdian, Curtis, Thakker, Wilson, & Boer, 2014; Seto & Eke, 2017). These psychological variables have been suggested to be internal barriers to committing a contact sexual offence (Babchishin et al., 2015; Seto & Eke, 2017). However, CSEMOs have been found to exhibit distinct cognition distortions associated with CSEM use that facilitate this type of sexual offending (Babchishin et al., 2015; Kettleborough & Merdian, 2017). CSEMOs often deny the harm or level of harm done by their actions, and therefore distance themselves from the label ‘sex offender’ (Elliot et al., 2013; Kettleborough & Merdian, 2017; Neutze, Seto, Schaefer, Mundt & Beier, 2011; Merdian et al., 2014; Winder & Gough, 2010; Winder, Gough & Seymour-Smith 2015).

Interpersonal functioning

Research has suggested that although there are deficits in interpersonal functioning globally amongst sexual offenders (Hanson & Morton-Bourgon, 2005; Stinson, Sales & Becker, 2008), CSEMOs are more likely to identify as single compared to CCSOs (Elliott et al., 2013; Seto, Wood, Babchishin, & Flynn, 2012; Webb, Craissati & Keen, 2007). Furthermore, there is a higher proportion of CSEMOs that live alone, as they are less likely to be in a co-habiting relationship compared to CCSOs (Elliott et al., 2013; Seto et al., 2012; Webb et al., 2007). This finding may reflect that CSEMOs have more deficits in interpersonal skills compared to CCSOs (Babchishin et al., 2015).

Theories of sexual offending

The research discussed has important implications for theories of sexual offending, as existing theories of CSA have largely been guided by research with CCSOs (Bale, 2017). Many theoretical models of CSA consider the offending behaviour as an interaction between motivational and facilitative factors (Finkelhor, 1984; Seto, 2008, 2017; Ward & Beech, 2006). The Motivation-Facilitation Model (MFM) (Seto, 2017) considers an individual’s underlying motivation for sexual offending, as well as facilitative factors related to the individual and situation that increase the likelihood that the motivational state will be translated into a behavioural event. For contact sexual offending, the MFM proposes that a high sex drive, efforts toward acquiring a new ‘mate’ and paraphilia, are a motivation for sexual offending, and self-regulation problems, misogynistic attitudes and beliefs, and state factors (e.g. negative affect), facilitate this motivation, along with situational factors (i.e. vulnerable victims, presence of guardians, and time and place) providing the opportunity to act (Seto, 2013, 2017).

Given the research demonstrating that CSEMOs display characteristics distinguishing them from CCSOs, there is on-going concern that there is limited applicability of existing theoretical models of CSA to CSEMOs (Babchishin et al., 2015). A meta-analysis focusing on identifying motivational and facilitative factors of CSEM offending compared CSEM-exclusive offenders and CCSOs (Babchishin et al., 2015). CCSOs and CSEM-exclusive offenders were found to differ on a number of motivational and facilitative factors, indicating differences in risk-relevant propensities (Babchishin, Merdian, Bartels & Perkins, 2018). CCSOs were less likely to have a sexual interest in children compared to CSEMOs, with the latter reporting a higher level of sexual deviancy (Babchishin et al., 2015). Furthermore, CSEMOs tend to report less offense-supportive cognitions than CCSOs, and instead exhibit distinct cognitive distortions which facilitate internet sexual offending (Kettleborough & Merdian, 2017). In addition, CSEMOs score significantly lower than CCSOs on measures of antisocial tendencies, criminal history, substance misuse, and unemployment, and higher on psychological variables that could be barriers to committing a contact sexual offense (e.g., greater victim empathy, fewer cognitive distortions) (Babchishin et al., 2015; Seto & Eke, 2017). In regards to situational facilitative factors, CSEMOs were less likely to have access to children and were more likely to have access to the internet compared to CCSOs (Babchishin et al., 2015).

This has important implications for the treatment of internet sex offenders, as current SOTPs are based on theories of contact sexual offending and therefore have an increased focus on factors such as antisociality, compared to sexual deviancy for example (Magaletta, Faust, Bickart, & McLearen, 2014). Subsequently, treatment programmes specifically designed to target the criminogenic needs and risks of CSEMOs may be more beneficial than traditional SOTPs (Magaletta et al., 2014; Merdian et al., 2016; Seto et al., 2010).

Treatment programmes

A recent review aimed to establish what treatment programmes exist for individuals who engage in online CSA and exploitation (OCSA/E), and the effectiveness of such programmes (Perkins, Merdian, Schumacher, Bradshaw & Stefanovic, 2018). The review found there were only eight UK-based services directly providing interventions specifically for perpetrators of OSCA/E (Perkins et al., 2018). Of these services, only two had interventions specifically for CSEMOs. This included the Internet Sex Offender Treatment Programme (i-SOTP; Middleton & Hayes, 2006), and the psycho-educational risk-reduction community-based programme called Inform Plus (Lucy Faithfull Foundation, 2014) (Derveley et al., 2017; Perkins et al., 2018).

An evaluation of i-SOTP using pre/post measures provided preliminary findings that there were significant changes on 10 of 12 psychological measures (Middleton, Mandeville-Norden & Hayes, 2009). These psychological measures corresponded to the treatment targets of general and sexual self-regulation problems, offence-supportive attitudes and beliefs, and interpersonal deficits (Middleton et al., 2009). Furthermore, a study examining the effectiveness of Inform Plus found improvement in treatment targets pre/post treatment completion and at longer-term follow-up (8-12 weeks) (Gillespie et al., 2016). Treatment targets included affective and interpersonal functioning and distorted attitudes (Gillepsie et al., 2016). A qualitative evaluation of Inform Plus found CSEMOs who had completed the programme self-reported having techniques to manage their thoughts and behaviours, and avoid or change situations that could be problematic (Dervley et al., 2017). Although these are preliminary findings, they provide support for the development of treatment programmes specifically designed for CSEMOs.

Overall, there is limited research on the effectiveness of internet-specific interventions in reducing CSEM offending risk (Middleton et al., 2009). This is concerning given that evaluation research is vital in further developing treatment programmes for the increasing numbers engaging in CSEM (Robertson, 2010). The majority of research to date evaluating the effectiveness of SOTPs has taken a quantitative approach, collecting pre- and post- psychometric measures to identify changes in offence-related behaviours (Bowden, Glorney & Daniels, 2018). Exploring the perspectives of individuals who have completed a SOTP could provide nuanced information regarding what specific aspects of the treatment programme resulted in change, and the mechanism by which these changes occurred (Drapeau, Korner, Brunet & Granger, 2004; Mann & Marshall, 2009; Wakeling, Webster & Mann, 2005; Walji, Simpson & Weatherhead, 2013). Although there is some qualitative research with CCSOs who have engaged in a SOTP, only one study has qualitatively explored the perspectives of CSEMOs who have engaged in an offence-focused treatment programme (Dervely et al., 2017).

The current study

The Counselling and Psychotherapy Center (CPC) in North America has begun to address the problem of a lack of sensitivity of SOTPs to the internet offender population, with a particular focus on CSEMOs. The CPC R.U.L.E. Programme is a group based therapy programme that has been specifically designed for internet sex offenders. It is based on the current literature on internet sexual offending, including the specific risk factors and treatment needs of CSEMOs, and drawing on the pathways to CSEM offending (Merdian & Perkins, 2018). Therefore, treatment targets are aligned with empirically-derived risk factors for CSEM offending, including CSEM-specific cognitive distortions and sexual arousal to children. Given the paucity of research in to the effectiveness of internet SOTPs and the value of using a qualitative approach as an evaluation method, this study aims to explore whether CSEM offenders perceive their criminogenic needs and risks to have been met through the R.U.L.E programme. Furthermore, as it is understood that the way group therapy is delivered (e.g. therapist characteristics and group process) impacts on the effectiveness of treatment (Beech & Fordham 1997), the study aims to identify what the perceived mechanisms of change are. Semi-structured interviews with CSEMOs who have completed the programme will be conducted and analysed using Thematic Analysis. The findings from this study will help develop an understanding of the most important treatment targets for CSEMOs, helping to review existing internet-specific treatment programmes in the UK.

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