Group-based interventions are widely used as the preferred method for the treatment of sexual offenders. However, little attention has been given to the vital interpersonal processes within groups, which contribute to their therapeutic effect. This paper describes specific principles and techniques of group therapy that will help sex offender treatment practitioners take full advantage of this unique modality and thereby maximize the positive impact of treatment. In contrast to an individual-focused style that characterizes many sex offender treatment groups, group-focused interventions involve all group members and use the social/relational energy that is essential to the group modality.
The basic attitudes toward prostitution of 140 men who have used prostitutes were examined in relation to several descriptive characteristics, as well as to MMPI-2 results for a subgroup of these men. The attitudes were assessed by subscales of the Attitudes Toward Prostitution Scale (ATPS)-Inaccurate Beliefs about Prostitution, Social/Legal Acceptance of Prostitution, Personal Acceptance of the Prostitute, and Negative Beliefs about Prostitution. Older and more educated participants were less likely than younger and less educated men to believe inaccurate "myths" about prostitution and more likely to indicate support that prostitution should be decriminalized. Curiously, only one-third of the men who used a prostitute reported they enjoyed sex with her, and 57 percent reported they had tried to stop use. The use of alcohol or drugs may be an important risk factor, as 29 percent of the men reported they used alcohol proximate to prostitution use. MMPI-2 results for a subgroup of men suggested that significant psychopathology may exist in as much as one-third of men arrested for prostitution use. Our results suggest "johns" are a heterogeneous group and that further research is needed to guide intervention efforts and to differentiate subtypes of men who use prostitutes.
Ethical standards are core components of practice standards and codes of conduct for mental health practitioners. Practice standards and ethics related to boundaries are generally based on historical review, study of mental health services, and the impact of boundary crossing or boundary violations on clients receiving services. This article explores some common standards of ethical practice related to boundaries and dual or multiple relationships between mental health professionals and clients. The underlying conceptual basis for these standards and examples of questions encountered in clinical practice with sexual offenders are explored.
Sex offender treatment as a specialized procedure is maturing, and more comprehensive approaches that treat co-morbid patient problems (e.g., mood and anxiety disorders, relationship conflicts, social skills deficits) have emerged. However, little attention has been given to the role of sexual dysfunction in the assessment and treatment of sex offenders. We propose that: (a) sexual dysfunction is a prevalent co-occurring sexual disorder in sex offenders; (b) sexual dysfunction is, by definition, a lack of sexual health, which diminishes overall life satisfaction; and (c) sexual dysfunction can be a contributing factor for some in maintaining offense-related arousal patterns and therefore is a potential contributor to sex-offense risk. This article describes the importance of treating sex dysfunction in selected cases when it is present among men in sex offender treatment, in order to improve the men's quality of life and to deter sex offense recidivism. A brief case example illustrates this benefit.
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