Book review of: International perspectives on the assessment and treatment of sexual offenders, by Boer, D. (Senior Ed.), Eher, R., Craig, L.A., Miner, M.H., & Pfäfflin, F. (Eds.) (2011)

Geraldine Akerman
HMP Grendon

[Sexual Offender Treatment, Volume 8 (2013), Issue 1]

This book will be a Must Have for all psychology and treatment programme libraries, as it is a cornucopia of information taking the reader through the vast literature in the field of sexual offending, summarising progress, and sign-posting future pathways. The Editors and Contributors are the most experienced practitioners and academics in the field of research and practice in the world, thus giving it a real air of authority. The Preface by Bill Marshall provides a whistle-stop tour of where we are in the treatment of those who have committed sexual offences and as the then President of the International Association for the Treatment of Sexual Offenders, (IATSO), explains the role it has in international policy making and many of their leading lights have written chapters. 

Given the length of the tome it would not be possible to review each chapter (of which there are 36) but in brief the book is divided into five parts, beginning as you would with an introduction to the international field of sex offender treatment and assessment, it moves through issues and applications in sex offender assessment, and treatment, looking in-depth at all aspects of this field. Human rights and ethics are then brought to the fore, finishing with future directions for policy, research and treatment.

The first part begins with Reinhard Eher and Friedemann Pfäfflin, who write in a clear and accessible style about the most recent findings about how effective treatment is with adult offenders and finish on an encouraging note that it can work if programmes are planned and ran carefully. Carol Ireland and Leam Craig then discuss the array of risk assessment tools available for use with adult male offenders. Their step-by-step guide help guide the reader through the maze in a very straightforward manner. They finish with a case study illustrating the process. Franca Cortoni and Theresa Gannon then discuss the paucity of literature available to those assessing the risk of women who commit sexual offences. In such an under researched area it is really helpful to have some foundations for future researchers and practitioners to build on. They tease out similarities and differences involved in assessing males and females.

Part 2 looks at the assessment tools and discusses some of the current debates again from an international perspective. Leslie Helmus, Karl Hanson and Kelly Morton-Bourgon describe the range of risk assessment tools available and provide a concise discussion on the intricacies of each. Martin Rettenberger and Stephen Hucker develop the theme by describing the use of structured professional guidelines, and how the generations of risk assessments have evolved, discussing their strengths and limitations. Researchers from Australia (Chris Lennings, Annalese Bolton and Emma Collins) then take the focus to the family courts, describing tools for assessing children, again explaining the somewhat complicated processes involved in assessing children within the structure of their family. Remaining Down Under Hannah Merdian and David Jones review the literature on the use of phallometric assessment of sexual arousal summarising the current research and describing alternative modes of assessment. They conclude that phallometric assessment, although complex provides invaluable information about the arousal of offenders. Wineke Smid, Daan Van Beek and Jelle Troelstra provide the view from Amsterdam of proxy measures of sexual deviance. As a PhD student I found this particularly helpful as it starts by defining the illusive term sexual deviance. They discuss the DSM-1V-TR diagnoses, the vast array of unusual sexual interests and how they relate to risk. They too discuss some of the measures available to assess sexual interest and the problems inherent with each. They go on the highlight the need for focus on those who have a preference for coerced sex. The next chapter (by Lea Studer, A. Scott Aylwin, Christine Sribney and John Reddon from Canada) reviews tools used to assess risk of violent and sexual offending while evaluating the misuses of instruments and then need to be aware of the imperfections of the measures.

Part 3 discusses treatment in various settings, starting with William Lindsay and his work with intellectual disabilities, followed by evaluation of a program for those convicted of rape in South Africa, (by Lorinda Bergh) which describes and evaluates the transformation management program, an action model for managing change, looking at the offender in a holistic manner. Ellids Kristensen and others describe the Danish treatment and research program and how treatment is either a supplement or alternative to imprisonment. They present their findings that treated offenders committed further offences leading to further convictions at a rate of 14% compared to 24% for the untreated group, indicating a good treatment effect. Next Canadian researchers (Charles Borduin, Richard Munschy, David Wagner and Erin Taylor) describe their Multisystemic therapy with juveniles. They provide detailed information on the principles of multisystemic therapy and evaluate the work with juveniles and their support network. We then return to Australian researchers, firstly Sarah Reid, Nick Wilson and Douglas Boer looking at the typologies of rape and how their Australian SOTP applies the risk-need-responsivity principles concluding with an example of how their treatment targets cognitive distortions with anger-motivated offenders as opposed to sexually motivated offenders. Such discussions provide food for thought for all treatment providers and encourage revisiting theory as we consider practice throughout the world. Staying in Australia Jayson Ware highlights the importance of the context in which treatment takes place, alongside intensity and dosage. Jayson presents the findings on groups and individual therapy and whether treatment is improved in closed or rolling groups. He touched on the importance of the role of the therapist and how efficacy can improve by using preparatory and maintenance groups. Moving across to New Zealand the role of culture is discussed when Douglas Boer again shares his substantial knowledge this time along with Armon Tamatea and Mate Webb. They too emphasise the importance of the treatment alliance and preparing offenders to get the most out of each intervention. The next chapter is collaboration with Ruth Mann, (from NOMS in the UK), Jayson Ware and Yolanda Fernandez (from Canada) explaining the importance of how programmes are managed, ensuring that therapists are qualified, competent and trained and that they should receive on-going support and supervision. The presented the research indicating the need to de-select staff should their well being be affected. They reminded the reader of the need to continually work with others in the environment in which the program is run and constantly evaluate the treatment integrity. Remaining chapters in this section look at the impact of denial, (Kris Vanhoeck and Els Van Daele) how it affects risk of further offending and how best to work with those who do not take responsibility without affecting the treatment alliance and risk. David Prescott and Joel Porter emphasise the importance of motivational interviewing explaining basic techniques to overcome the frustration that may occur in the therapist. They instil motivation with their encouraging style and it is plain to see how this would impact on those they are working with. Moving now to Israel Yal Idisis and Sheri Oz shift the focus and talk about the difficulties associated with getting victims to speak about the sexual abuse they have suffered. They too use the case study method to explore instances of disclosing abuse and how individuals can be supported through the process.

Chapter twenty-one, (co-authored by Peer Briken, Andreas Hill and Wolfgang Berner) examines the use of pharmacotherapy (pharmacological and therapeutic) interventions. They explain how medication can be used to manage deviant sexual behaviour and the ethics that need considering before embarking on this course of action. Andrew Frost then applies the Good Lives Model to working with sexual offending and how the Social Therapy model allows new skills to be developed and practised on a day-today basis, thus the title "bringing "Good Lives" to life!

The following chapters concentrate on those who have committed sexual offences and are being treated in the psychiatric domain, highlighting the relevance of mental illness in risk assessment (Bruce Watt and Tania Withington) and the treatment of psychosis (Leam Craig and Oretis Giotakos), including the treatment for Internet (Marc Graf and Volker Dittmann) and incest offenders (Lea Studer, Christine Sribney, A.Scott Aylwin and John Reddon followed by Cynthia Calkins Mercado, Hannah Merdian and Rudolph Egg) and going on to present findings from research into sexual abuse within the Catholic church, co-authored by Cynthia Calkins Mercado, Karen Terry and Anthony Perillo. The final chapter in this section again looks at chemical treatment of sexual interest written by Elena del Busto and Michael Harlow.

As we move into the human rights and ethical issues Douglas Boer (the current President of IATSO) co-authors a chapter with researchers from Brazil (Danilo Baltieri and Arthur Guerra De Anrade) using case studies to describe some of the dilemmas involved in the treatment of sexual offenders, such as is paedophilia an illness, does treatment work, and is the chemical treatment of sexual interest ethical, presenting the issues involved. These themes continue through subsequent chapters where the need to protect the public (Jill Levenson) is balanced with the requirement to consider treatment from a moral and legal perspective. James Vess highlights the fact that risk assessment may threaten human rights legislation and Karen Harrison and Bernadette Rainey delve into the minefield of gaining consent and the use of medication to control deviant behaviour. The book winds down with Friedemann Pfäfflin and Reinhard Eher explaining the role of IATSO and how important they are in informing International Public Policy and Practice. Having attended their conference last year in Berlin I can attest to how well this organisation draws together researchers and practitioners from all over the globe, all working together with a common aim of reducing offending and protecting others from harm. Steven Feelgood and Gerard Schaefer describe how to manage the difficulties associated with missing data.

The book ends poignantly with Bill Marshall co-authoring the chapter with his son Liam as they look to the future. Bill has been an excellent President for IATSO and I cannot imagine that he is planning to slow down too much, but maybe put his feet up a little more often! Liam is taking up the reins and they discuss the future for treatment and evaluation of research.

The only criticism of this book is that its' price (now reduced to £118 on a well-known Internet-based book seller) makes it too pricey for most students, who would undoubtedly refer to it regularly. However, I would suggest you put it on the wish list at your library or request that your Treatment Manager include it on your unit bookshelf.

Reference

1. International Perspectives on the assessment and treatment of sexual offenders: Theory, practice and Research. Chichester UK: Wiley-Blackwell. doi:10.1002/9781119990420

Author address

Geraldine Akerman
Grendon Underwood, Aylesbury
Bucks, HP18OTL
England
Geraldine.akerman01@hmps.gsi.gov.uk