Week 10 Discussion

Historical developments in sex offender treatment

W. L. Marshall1* & Clive Hollin2 1Rockwood Psychological Services, Kingston, ON, Canada & 2Centre for Applied Psychology, University of Leicester, Leicester, UK

Abstract This paper describes our view of the important developments in the history of sex offender treatment with a particular emphasis on aspects of this growth in the UK. We begin where, in our view, treatment of sex offenders was first implemented; that is, at the Institute of Psychiatry in London. After the move across the Atlantic, we note the beginnings of more comprehensive programmes in North America which morphed into the Relapse Prevention model. The implementation of comprehensive programmes in Her Majesty’s Prisons led not only to further refinements but also offered the opportunity for researchers to explore all manner of possibilities. The more recent focus on strength-based approaches is examined, and we then spell out our hopes for the future in terms of treatment, assessment and theory.

Keywords Sex offender treatment; historical developments; treatment programs; assessments; Sex offenders

In the Departments of Psychology and Psychiatry at the University of London’s Institute of Psychiatry in the 1950s, the nascent behaviour therapy movement was beginning to emerge. Treatments for various disorders, including problematic sexual behaviours, were being developed at the institute. Clinicians/researchers like psychologist Stanley (Jack) Rachman and psychiatrists Malcolm Gelder, Isaac Marks and John Bancroft developed treatment approaches for various types of paraphilic behaviours. These early approaches, however, were mostly limited to reducing deviant sexual interests using a variety of aversive conditioning procedures (see Laws & Marshall, 2003, for a review of those early studies). These approaches were soon exported to North America (e.g., Abel, Levis, & Clancy, 1970; Bond & Evans, 1967; Marshall, 1971), where they were rapidly expanded into programmes that incorporated other targets and other strategies (e.g., Abel, Blanchard, & Becker, 1978; Marshall & Williams, 1975). These latter programmes described the first attempts in North America to assimilate the emerging cognitive behaviour therapy (CBT) movement into sex offender treatment. Subsequently, almost all treatment programmes in North America have been described by their authors as CBT with the later addition of relapse prevention (RP) components (see Pithers, Marquis, Gibat, & Marlatt, 1983). Ultimately, CBT/RP approaches

*Corresponding author. E-mail: [email protected] Like memory, history is a reconstruction and, again like memory, this reconstruction is always from a personal point of view. Therefore, we apologise for all those who have made significant contributions, but who we have omitted to mention. We have simply tried to identify major threads in the historical record.

Journal of Sexual Aggression, 2015 Vol. 21, No. 2, 125–135, http://dx.doi.org/10.1080/13552600.2014.980339

© 2014 National Organisation for the Treatment of Abusers

came to dominate North American programmes and influenced treatment in the UK and some European countries as well as in Australia and in New Zealand.

The results of three meta-analytic studies (Hanson, Bourgon, Helmus, & Hodgson, 2009; Hanson et al., 2002; Lösel & Schmucker, 2005) of treatment outcome encouraged optimism that the treatment of sex offenders could produce reductions in subsequent reoffending and that CBT appeared to be the most promising approach. These studies, along with the development of actuarial risk assessment instruments (see review by Craig, Browne, & Beech, 2008), and particularly the identification of criminogenic factors (see a recent appraisal by Mann, Hanson, & Thornton, 2010) markedly advanced the empirical basis of both assessment and treatment. While the adoption of the actuarial risk assessment approach has been widespread, the adaptation of treatment programmes to incorporate the findings on criminogenic factors has not been as universal. As surveys of North American programmes by the Safer Society (McGrath, Cumming, & Burchard, 2003; McGrath, Cumming, Burchard, Zeoli, & Ellerby, 2010) have revealed, many still address numerous non-criminogenic targets and at the same time fail to address all criminogenic factors. Apparently, evidence takes some time to persuade treatment providers to change what they view as their tried-and-true approaches. When Hanson et al. (2009) demonstrated that Andrews’ (Andrews & Bonta, 2006) Principles of Effective Offender Treatment applied equally to sex offender treatment, a basis was provided for the emergence of a rational, empirically sound treatment approach with sex offenders. Again, however, the field has been slow to adapt.

The negative emphasis of the RP model seemed to many treatment providers to fit well with Salter’s (1988) confrontational approach. In combination, these two models encouraged a negative view, not just of the criminal behaviours of sex offenders, which we all consider to be repulsive, but of the offenders as human beings, as if they had no saving graces and as if they were devoid of any strengths. Therapists following these models aggressively challenged clients at the outset and pressured them to agree with every detail provided in the victim’s statement and the police reports; not the usual way therapy is done with other Axis 1 or Axis 2 disorders. Good therapists work initially to establish confidence in their clients and to develop a positive and respectful relationship before moving on to more difficult issues. We might ask why did so many sex offender treatment providers decide that years of research in all other fields of therapy was irrelevant to dealing with sex offenders; fortunately some did not. For example, Tony Ward’s (2002) Good Lives Model (GLM) has spurred at least some treatment providers to think differently about their clients. What Ward’s GLM suggested was that the model advocated by Salter (1988), which had come to dominate programmes in the USA, was ill-founded and was more likely than not to reduce the effects of treatment.

What follows in this paper is our personal view of the important developments in the sex offender field. For convenience, we will break this into three parts: (1) developments in North America; (2) developments in Britain; and (3) speculations about the future.

Developments in North America

We will not provide a comprehensive history of sex offender treatment in North America as that has already been described in two papers by Laws and Marshall (Laws & Marshall, 2003; Marshall & Laws, 2003). We will do our best to summarise the most important features of this history.

While there were numerous attempts in the late 1960s and early 1970s in North America to treat sex offenders, the US psychiatrist, Gene Abel, was the pioneer in the USA for the application of CBT to these problematic offenders. After publications describing early programmes (Abel et al., 1970; Marshall, 1971, 1973), Abel put together a series of meetings.

126 W. L. Marshall & C. Hollin

These small conferences were aimed at expanding the scope of assessments and treatments. Early treatment descriptions (Abel et al., 1978; Marshall & Williams, 1975) outlined the first comprehensive CBT programmes in North America. It was a long time, however, before any programmes were evaluated for their long-term benefits. In fact, the debate about effective- ness, and how to properly determine effectiveness, continues to this day (see debates between Marshall & Marshall, 2007, 2008; and Seto et al., 2008).

Recently, RP has lost some of its appeal as a result of Marquis’ well-designed evaluation of California’s programme showing no overall effects (Marques, Weideranders, Day, Nelson & van Ommeren, 2005). These results led Yates (2007) to call for the abandonment of RP, although this appears not to have happened in most programmes. Yates took the view that RP should be replaced by either the self-regulation model outlined by Ward and Hudson (2000) or Ward’s (2002) GLM, and there is recently emerging evidence supporting the efficacy of these two approaches (Bickley & Beech, 2002; Harkins, Flak, Beech, & Woodhams, 2012; Kingston, Yates, & Olver, 2013).

While it is always bad science to generalise from one study to all programmes employing the same title, there may be good reasons to fault an excessive adherence to the early RP model. It is, for example, a decidedly negative approach to treating people, and there is now substantial evidence (see Linley & Joseph, 2004; Snyder & Lopez, 2005 for various reports) showing that with all human problematic behaviours a more positive orientation, particularly one that incorporates features facilitating a therapeutic alliance and group cohesion (see Marshall & Burton, 2010; Marshall, Marshall, & Burton, 2013), is likely to be far more effective. In any event, there appears to be a move away from thinking of sex offenders as simply characterised by a series of deficits. Strength-based approaches to both assessment (Craig et al., 2008) and treatment (Marshall, Marshall, Serran, & O’Brien, 2011) are emerging and appear to offer a more hopeful agenda.

Developments in the UK

Other than work at the Institution of Psychiatry, much of the early psychologically informed treatment of sex offenders in the UK took place in prisons rather than in the community. The undoubted reason for this situation was that by far the majority of psychologists within the criminal justice system were employed by the Prison Service. Laycock (1979) noted that at the time there were 93 psychologists employed in the Prison Service for England and Wales, with most being based in penal institutions. Laycock suggested that most of them were likely to be involved in the delivery of some type of treatment with prisoners. While not all of the treatment was behavioural in orientation, or aimed at sex offenders, there was a small amount of treatment specifically targeting sex offenders. Laycock noted that in the 1970s, the treatment of sexual deviance was centred at Wormwood Scrubs and Birmingham Prisons.

Laycock’s description of the Wormwood Scrubs’ treatment programme indicates that it was aimed primarily at child molesters and employed traditional behaviour modification methods, including aversive conditioning. With a group of 10 sex offenders, the short-term effects of the intervention were monitored using penile plethysmography (PPG). Laycock notes that a follow-up of these 10 men, two years after their release from Wormwood Scrubs, showed that none of them had been re-convicted. The work of Derek Perkins at Birmingham Prison was somewhat more multifaceted in approach than that at Wormwood Scrubs in that it involved the modification of sexual interests, improving social skills and reducing anxiety. Treatment methods included “shaping” of masturbatory fantasies, systematic desensitisation, relaxation training and social skills training (Laycock, 1979). Perkins (1982, 1987) later described the evolution of the Birmingham Treatment programme in detail.

Sex offender treatment 127

The subsequent development of treatment in the UK for child abusers was informed by Howells (see Cook & Howells, 1981). In addition, several innovative developments in the literature addressing child sexual abuse, such as the use of anatomical dolls in interviewing children (Westcott, Davies, & Clifford, 1989), began to attract attention leading to a greater sophistication in the assessment of children suspected of being sexually abused (Vizard, 1991). Since the sexual abuse of children often takes place within a family, there was, accordingly, a focus on working with children and families (Bentovim, 1991; Bentovim, Elton, Hildebrand, Tranter, & Vizard, 1988).

The development of clinical work with sex offenders was accompanied by a growth of psychological research and theory that targeted sexual diversity (Howells, 1984a). This work touched on a wide range of topics including coercive sexual behaviour (Howells, 1984b). It is interesting to observe with the benefit of hindsight how this emerging understanding of coercive sexual behaviour touched on several of the issues that have become evident in contemporary clinical forensic practice. Howells (1984b), for example, noted the importance of aggressive as well as sexual motivations in rape, as well as the role of the offenders’ attitudes and cognitive functioning in accounting for their behaviour. The inclusion of aspects of cognitive functioning in the understanding of sex offending was reflected in Perkins’ (1991) account of clinical work with sex offenders in secure settings showing that it had expanded to include addressing the offender’s denial and minimisations.

The work of researchers and clinicians such as Kevin Howells and Derek Perkins anticipated several mainstream developments which would unfold in later years. First, there was a move away from “single shot” treatment to multimodal approaches as later seen in the development of comprehensive programmes in both the prisons and the community (Mann & Fernandez, 2006). Second, it was recognised that there was a need to engage with the wider criminal justice system to enhance the quality of the implementation and integrity at the point of treatment delivery (Cooke & Philip, 2001). Third, the case for continued funding to develop sex offender treatment required a reliance on rigorous outcome research, using a range of research methods (Sheldon, Davies, & Howells, 2011), on the effectiveness of treatment with sex offenders. Finally, alongside treatment of sex offenders aimed at reducing reoffending, psychological treatment was also applied to the victims of sex offenders (Jehu, 1988; Jehu, Gazan, & Klassen, 1985).

The first application of a comprehensive CBT programme to the treatment of sex offenders in the UK occurred in the early 1990s in several institutions within Her Majesty’s Prison Service (HMPS). This initial programme was designed by David Thornton. It was a daunting task as Thornton had to not only design the programme but also train staff, organise the application of treatment across more than 20 prisons, produce a treatment manual, develop a comprehensive assessment package and design a monitoring system to ensure the programme was properly applied. Despite these challenges, Thornton managed to achieve these goals. HMPS’s programme, as designed by Thornton (see Mann & Thornton, 1998), integrated what was known at that time, along with what was thought to be essential. A CBT approach was accepted as the optimal model with the framework of RP as a significant component.

This endeavour was remarkable for the care of its design and implementation, and for the fact that it was applied in so many different prisons. Not only did this mean that a huge number of offenders would receive state-of-the-art treatment, it provided a gold mine for research. Almost overnight there were outstanding researchers (in the early days, e.g., Richard Beckett, Tony Beech, and Dawn Fisher) tapping into the vast body of data generated by HMPS programmes. The role Thornton played in the development of treatment programmes for sex offenders, and the research that subsequently proliferated in the UK, cannot be

128 W. L. Marshall & C. Hollin

overestimated. Although the UK eventually lost him to the apparently seductive appeal of the USA, Thornton was fortunately replaced by the similarly astute Ruth Mann who has led the continual development of HMPS programmes and research. The work at HMPS continues to be extended into new domains, such as Adam Carter’s work on sexual murder (Carter & Hollin, 2010, in press).

Nowadays, the UK is a leader in the sex offender field and across the country, there are innovative treatment providers and researchers whose names are too many to mention. Similarly, the several editors of The Journal of Sexual Aggression (JSA) over the past 20 years have provided leadership, and the National Organization for the Treatment of Abusers (NOTA) has offered an excellent avenue for clinicians, researchers and theorists to present and discuss their views and findings. The future of sex offender work in the UK is assured as brilliant young people bring new perspectives to the field and challenge established assumptions. When JSA began life, the field of sex offender treatment and research was at the front edge of what was to become a rapidly expanding knowledge base, to which the journal can proudly declare it played an important role. This early role of JSA was not only just in disseminating research findings but also very importantly, in conjunction with the formation of NOTA and its conferences, in encouraging clinical work and providing an outlet for treatment ideas and innovations.

There have been so many excellent articles over the years in JSA that it is impossible to list them all, except to say that the standards that have been set have increasingly raised the international prestige of the journal. In addition to the numerous excellent articles, it has been particularly pleasing to see the inclusion of specially edited topics, and the debates, both sets of which have served to challenge established views and take the field forward. The issues addressed in these topics and debates have been consistently important, and the various contributors have offered evidence and sound reasoning in support of their differing perspectives. JSA has been the epitome of the ideal journal in always balancing research and theory with good clinical practice, and the various editors over the years have managed to maintain this exemplary balance. JSA will no doubt continue to be one of the foremost venues for the spread of ideas, research findings and clinical innovations in the assessment and treatment of sex offenders.

The future possibilities

As the New York Yankees Hall-of-Fame catcher, and wise comic, Yogi Berra once observed, “The problem with prediction is it’s about the future”. We could not agree more. What does the future of sex offender treatment, research and theorising hold? We can only guess but here is what we hope.

Treatment

In treatment, we need to emphasise our clients’ strengths not only in order to overcome the deficits that led to their offending but also to give them confidence that they can change and build a prosocial future. British authors have been among those who have led the way (Beech & Print, 2008; O’Callaghan, 2002) in this emphasis, but others have also attended to strengths in the treatment of sex offenders (Bremer, 2006; Gilgun, 2006). The treatment programme outlined by Marshall, Marshall, Serran, and O’Brien (2011) is a strength-based approach which derives from both the general field of “positive psychology” and the Good Lives Model that Tony Ward (2002) developed.

Sex offender treatment 129

Currently, too many CBT programmes fail to fully attend to Andrews’ Risk/Need/ Responsivity principles. Most importantly, some sex offender programmes fail to implement Andrews and Bonta’s (2006) Core Correctional Practices (CCP). Among other things, the CCPs require therapists to be warm and empathic and to model and reward prosocial attitudes and behaviours. Research has demonstrated that treatment benefits are maximally achieved with sex offenders when therapists are warm, empathic and rewarding and when they create a cohesive and expressive group climate (Marshall & Burton, 2010). In other words, we need to be more psychotherapeutic in our approach rather than procedure-focused.

Not only does Andrews’ CCP require these features of therapy delivery for treatment to be effective, sex offender-specific research has revealed more expansive evidence on the importance of treatment delivery. For example, Drapeau (2005) found that sex offenders indicated they believed the therapist was the crucial element in treatment, although they also allowed that procedures used to modify aspects of their behaviour were also valuable. In particular, these clients said that they did not respond to a confrontational approach but did want to be challenged. They indicated that it was only a warm, empathic, supportive and respectful therapist whose challenges they responded to in a positive way. Consistent with the comments of Drapeau’s clients, Marshall and his colleagues (Marshall et al., 2003; Marshall et al., 2002) found that positive therapist features (warmth, empathy and encouragement) facilitated the desired changes in sex offenders on a comprehensive battery of tests. Therapists in these studies, who were confrontational, failed to produce benefits. In his examination of the group climate of sex offender programmes, Beech (Beech & Fordham, 1997; Beech & Hamilton-Giachritsis, 2005) demonstrated that it was only when the therapist created cohesive and expressive groups, that the desired changes became apparent. Again, it was shown that confrontation was counter-therapeutic.

From these studies, and an examination of the various elements of treatment (targets, procedures, delivery and theoretical orientation), Marshall and Marshall (2012) concluded that once the first three elements had been accounted for there was little, if anything, left for theoretical orientation to explain. Thus adopting a CBT approach will not in itself guarantee beneficial results, but rather it is the critical aspects associated with targeting criminogenic issues, employing sound procedures and, most importantly, delivering treatment according to empirically based principles that will ensure a positive outcome. Our hope is that treatment providers, who have not yet adapted their programme to these findings, will begin the processes of change necessary to increase the chances their programmes will successfully achieve the goal of reducing reoffending.

Given these observations of the important role of treatment delivery, we would also like to see programmes move away from the use of excessively detailed manuals. We realise, and do not deny, the value of manuals particularly for large-scale operations like the programmes in HMPS or those in Canada’s federal prisons. Our problem is more to do with the penchant of manual authors to be obsessive about procedural details while essentially ignoring, or giving only token acknowledgement to, the critical role of the therapist’s way of addressing clients, adapting to their individual uniqueness and in creating an effective group climate. As discussed elsewhere (Marshall, 2009), the effects of using treatment manuals influence a number of relevant dimensions of treatment with excessive manualisation producing problems while, on the other hand, not having any manual is likely to cause numerous other problems. A “guide” rather than a manual seems more likely to achieve the balance needed to allow the treatment provider to be an effective therapist.

A related point concerns the observation that most CBT programmes are primarily “cognitive” in their actual implementation with few behavioural elements (see Fernandez, Shingler, & Marshall, 2006, for detailed observations). Perhaps, more importantly, most CBT

130 W. L. Marshall & C. Hollin

programme providers seem to avoid, or curtail, emotional expression in their groups despite extensive evidence from the treatment of other disorders (Greenberg, Rice, & Elliott, 1993; Kennedy-Moore & Watson, 1999) that this is a crucial element. Even in sex offender treatment, there is evidence for the facilitating effects of emotional expressiveness (Beech & Hamilton-Giachritsis, 2005; Pfäfflin, Böhmer, Cornehl, & Mergenthaler, 2005). However, our main concern is the apparent comfort zone provided to therapists by a reliance on a strictly cognitive (some version of the so-called “Socratic” method) approach. As we have seen, clients want to be challenged, and it is clearly necessary to engage in discourse with them, but utilising behavioural methods such as modelling, being overtly rewarding, employing role-plays, and particularly insisting on between-sessions practice of what clients have learned, will not only enhance treatment effects it will also maximise the likelihood of the generalisation of treatment-induced changes to the clients’ real world. Encouraging emotional expression helps clients to fully integrate what they have learned. Acquired knowledge devoid of emotional attachment will rapidly fade. Cognitions, behaviour and emotions are integrated in the retention of ways of thinking and behaving, so ensuring that this happens in treatment is essential.

Assessment

We have some concerns about the data entering the meta-analyses that form the basis for generating criminogenic factors. For example, these studies have consistently shown that empathy problems are not criminogenic. An examination of the literature reveals that measures used to assess empathy differ across studies of sex offenders. Many studies employ either Hogan’s (1969) scale or the measure developed by Mehrabian and Epstein (1972). These two scales have both been shown to be multifactorial and unreliable (see Serran, 2002, for a review), so it is not clear what they are measuring. While Davis’ (1983) multi-component measure has greater face validity than these other two, its construct validity relied on examining its relationship with social competence, self-esteem, emotionality and intelligence, all of which are themselves multifactorial and not clearly concepts that reflect empathy. The point is that if studies use differing measures of a construct whose reliability, validity and factorial purity are in question, then we cannot simply dismiss this construct as a potential criminogenic factor just because the meta-analysis in question failed to reveal a relationship with subsequent reoffending. The same can be said of other constructs (e.g., denial and self- esteem) that meta-analyses have failed to show and predict reoffending (see Lund’s, 2000, astute challenge of Hanson et al.’s, 2002, conclusions regarding denial). In fact, both empathy and a sense of self-worth are critical components of effective relationship skills and yet intimacy deficits and emotional loneliness are established criminogenic features. Of course, in fairness, the initial meta-analyses should be seen as just that; they represent the first step. However, simply repeating them without due concern for how the various constructs are measured in the studies entering the analyses, will not advance knowledge. While there is no simple solution to this problem, efforts must be made to overcome these obstacles.

Finally, and consistent with the move towards strength-based approaches, we encourage researchers who are attempting to identify dynamic factors, to also examine protective factors that might serve to reduce future reoffending. We are pleased to note that some of the UK researchers are taking the lead in this endeavour (Gilgun, 1999; Griffin, Beech, Print, Bradshaw, & Quayle, 2008; Print, Morrison, & Henniker, 2001).

Sex offender treatment 131

Theory

Tony Beech and Tony Ward (in press) are presently editing a book on current etiological theorising. Theories about the origins of any human behaviour will always be short on comprehensive data, but at their best, they should have clear implications for treatment, research and long-term prognosis. Marshall and Barbaree’s (1990) early theory failed in many ways to do this, mostly by being overly ambitious in attempting to explain all sex offenders and by being remote from treatment considerations. Hopefully, Ward and Beech’s forthcoming book will address these limits and no one is better equipped to achieve this than these two eminent scholars.

Conclusions

We hope this view of the early, current and possible future developments in the sex offender field, will prompt readers to reflect on these trends and encourage them to generate ways in which we can build for the future. It is always as well to know where you come from: as George Santayana, the Spanish-born philosopher and poet, observed, those who ignore history are doomed to repeat it, and those who cannot forget history are condemned to relive it.

The many treatment providers, researchers and theorists we have had the pleasure of meeting over many years have inspired and encouraged us in our work. We have learned that those who devote themselves to the tasks required in this field are quite remarkable, concerned and compassionate people, and we have been privileged to know so many of them. For those of you who will continue this socially important work, we wish you well and encourage you to be aware of what a valuable contribution you make to the health of society. Many women, children and men may not be aware that your work has saved them from suffering at the hands of a sex offender, but it has!

References

Abel, G. G., Blanchard, E. B., & Becker, J. V. (1978). And integrated treatment program for rapists. In R. Rada (Ed.), Clinical aspects of the rapist (pp. 161–214). New York, NY: Grune & Stratton.

Abel, G. G., Levis, D., & Clancy, J. (1970). Aversion therapy applied to taped sequences of deviant behavior in exhibitionism and other sexual deviations: A preliminary report. Journal of Behavior Therapy and Experimental Psychiatry, 1, 58–66. doi:10.1016/0005-7916(70)90022-4

Andrews, D. A., & Bonta, J. (2006). The psychology of criminal conduct (4th ed.). Cincinnati, OH: Anderson. Beech, A. R., & Fordham, A. S. (1997). Therapeutic climate of sexual offender treatment programs. Sexual Abuse:

A Journal of Research and Treatment, 9, 219–237. Beech, A. R., & Hamilton-Giachritsis, C. E. (2005). Relationship between therapeutic climate and treatment outcome

in group-based sexual offender treatment programs. Sexual Abuse: A Journal of Research and Treatment, 17, 127–140. Beech, A. R., & Print, B. (2008, September 12). Strength-based approaches to working with those who sexually abuse: A

new paradigm. Paper presented at the 18th Annual Conference of the Organization for the Treatment of Sexual Abusers. Cardiff.

Beech, A. R., & Ward, T. (in press). Theories volume: Wiley-Blackwell handbook on the assessment, treatment, and theories of sexual offending. Chichester: John Wiley & Sons.

Bentovim, A. (1991). Clinical work with families in which sexual abuse has occurred. In C. Hollin & K. Howells (Eds.), Clinical approaches to sex offenders and their victims (pp. 179–208). Chichester: John Wiley & Sons.

Bentovim, A., Elton, A., Hildebrand, J., Tranter, M., & Vizard, E. (1988). Sexual abuse in the family. Bristol: John Wright.

Bickley, J. A., & Beech, A. R. (2002). An empirical investigation of the Ward and Hudson self-regulation model of the sexual offense process with child abusers. Journal of Interpersonal Violence, 17, 371–389. doi:10.1177/088626 0502017004002

Bond, I. K., & Evans, D. R. (1967). Avoidance therapy: Its use in two cases of underwear fetishism. Canadian Medical Association Journal, 96, 1160–1162.

132 W. L. Marshall & C. Hollin

Bremer, J. (2006). Building resilience: An ally in assessment and treatment. In D.S. Prescott (Ed.), Risk assessment of youth who have sexually abused: Theory, controversy, and emerging issues (pp. 222–238). Oklahoma City, OK: Wood ‘N’ Barnes.

Carter, A. J., & Hollin, C. R. (2010). Characteristics of non-serial sexual homicide offenders: A review. Psychology, Crime & Law, 16, 25–45. doi:10.1080/10683160802621933

Carter, A. J., & Hollin, C. R. (in press). When sex is attached to killing. In D. Wilcox, T. Garrett, & L. Harkins (Eds.), Sex offender treatment: Case studies (pp. 286–304). Chichester: John Wiley & Sons.

Cook, M., & Howells, K. (Eds.). (1981). Adult sexual interest in children. London Academic Press. Cooke, D. J., & Philip, L. (2001). To treat or not to treat? An empirical perspective. In C.R. Hollin (Ed.), Handbook of

offender assessment and treatment (pp. 17–34). Chichester: John Wiley & Sons. Craig, L. A., Browne, K. D., & Beech, A. R. (2008). Assessing risk in sex offenders: A practitioner’s guide. Chichester: John

Wiley & Sons. Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal

of Personality and Social Psychology, 44, 113–126. doi:10.1037/0022-3514.44.1.113 Drapeau, M. (2005). Research on the processes involved in treating sexual offenders. Sexual Abuse: A Journal of

Research and Treatment, 17, 117–125. Fernandez, Y. M., Shingler, J., & Marshall, W. L. (2006). Putting “behavior” back into the cognitive-behavioral

treatment of sexual offenders. In W. L. Marshall, Y. M. Fernandez, L. E. Marshall, & G. A. Serran (Eds.), Sexual offender treatment: Controversial issues (pp. 211–224). Chichester: John Wiley & Sons.

Gilgun, J. F. (1999). CASPARS: Clinical assessment instruments that measure strengths and risks in children and families. In M. C. Calder (Ed.), Working with young people who sexually abuse: New pieces of the jigsaw puzzle (pp. 45– 58). Lyme Regis: Russell House.

Gilgun, J. (2006). Children and adolescents with problematic sexual behaviors: Lessons from research on resilience. In R. Longo & D. Prescott (Eds.), Current perspectives: Working with sexually aggressive youth and youth with sexual behavior problems (pp. 382–394). Holyoake, MA: Neari Press.

Greenburg, L. S., Rice, L. N., & Elliott, R. (1993). Facilitating emotional change: The moment-by-moment process. New York, NY: Guilford press.

Griffin, H. L., Beech, A., Print, B., Bradshaw, H., & Quayle, J. (2008). The development and initial testing of the AIM2 framework to assess risk and strengths in young people who sexually offend. Journal of Sexual Aggression, 14, 211–225. doi:10.1080/13552600802366593

Hanson, R. K., Bourgon, G., Helmus, L., & Hodgson, S. (2009). The principles of effective correctional treatment also apply to sexual offenders: A meta-analysis. Criminal Justice and Behavior, 36, 865–891. doi:10.1177/ 0093854809338545

Hanson, R. K., Gordon, A., Harris, A. J. R., Marques, J. K., Murphy, W. D., Quinsey, V. L., & Seto, M. C. (2002). First report of the Collaborative Outcome Data Project on the effectiveness of psychological treatment of sex offenders. Sexual Abuse: A Journal of Research and Treatment, 14,169–194.

Harkins, L., Flak, V., Beech, A. R., & Woodhams, J. (2012). Evaluation of a community-based sex offender treatment program using a Good Lives Model approach. Sexual Abuse: A Journal of Research and Treatment, 26, 519–543. doi:10.1177/1079063211429469

Hogan, R. (1969). Development of an empathy scale. Journal of Consulting and Clinical Psychology, 33, 307–316. doi:10.1037/h0027580

Howells, K. (Ed.). (1984a). The psychology of sexual diversity. Oxford: Blackwell. Howells, K. (1984b). Coercive sexual behaviour. In K. Howells (Ed.), The psychology of sexual diversity (pp. 111–134).

Oxford: Blackwell. Jehu, D. (1988). Beyond sexual abuse: Therapy with women who were childhood victims. Chichester: John Wiley & Sons. Jehu, D., Gazan, M., & Classen, C. (1985). Common therapeutic targets among women who were sexually abused in

childhood. Journal of Social Work & Human Sexuality, 3, 25–45. Kennedy-Moore, E., & Watson, J. C. (1999). Expressing emotion: Myths, realities, and therapeutic strategies. New York,

NY: Guilford Press. Kingston, D. A., Yates, P. M., & Olver, M. E. (2013). The self-regulation model of sexual offending: Intermediate

outcomes and post-treatment recidivism. The online version of this article can be found at: http://sax.sagepub.com/ content/early/2013/08/02/1079063213495896

Laws, D. R., & Marshall, W. L. (2003). A brief history of behavioral and cognitive behavioral approaches to sexual offenders: Part 1. Early developments. Sexual Abuse: A Journal of Research and Treatment, 15, 75–92.

Laycock, G. (1979). Behaviour modification in prisions. British Journal of Criminology, 19, 400–415. Linley, P. A., & Joseph, S. (Eds.). (2004). Positive psychology in practice. Hoboken, NJ: John Wiley & Sons. Lösel, F., & Schmucker, M. (2005). The effectiveness of treatment for sexual offenders: A comprehensive meta-

analysis. Journal of Experimental Criminology, 1, 117–146.

Sex offender treatment 133

Lund, C. A. (2000). Predictors of sexual recidivism: Did meta-analysis clarify the role and relevance of denial? Sexual Abuse: A Journal of Research and Treatment, 12, 275–288.

Mann, R. E., & Fernandez, Y. M. (2006). Sex offender programmes: Concept, theory, and practice. In C. Hollin & E. J. Palmer (Eds.), Offending behaviour progammes: Development, application, and controversies (pp. 155–177). Chichester: John Wiley & Sons.

Mann, R. E., Hanson, R. K., & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse: A Journal of Research and Treatment, 22, 191–217.

Mann, R. E., & Thornton, D. (1998). The evolution of a multisite sexual offender treatment program. In W. L. Marshall, Y. M. Fernandez, S. M. Hudson, & T. Ward (Eds.), Sourcebook of treatment programs for sexual offenders (pp. 47–57). New York, NY: Plenum Press.

Marshall, W. L. (1971). A combined treatment method for certain sexual deviations. Behaviour Research and Treatment, 9, 292–294.

Marshall, W. L. (1973). The modification of sexual fantasies: A combined treatment approach to the reduction of deviant sexual behaviour. Behaviour Research and Therapy, 11, 557–564.

Marshall, W. L. (2009). Manualization: A blessing or a curse? Journal of Sexual Aggression, 15, 109–120. Marshall, W. L., & Barbaree, H. E. (1990). An integrated theory of sexual offending. In W. L. Marshall, D. R. Laws,

& H. E. Barbaree (Eds.), Handbook of sexual assault: Issues, theories, and treatment of the offender (pp. 257–275). New York: Plenum Press.

Marshall, W. L., & Burton, D. L. (2010). The importance of therapeutic processes in offender treatment. Aggression and Violent Behavior: A Review Journal, 15, 141–149.

Marshall, W. L., & Laws, D. R. (2003). A brief history of behavioral and cognitive behavioral approaches to sexual offender treatment: Part 2. The modern era. Sexual Abuse: A Journal of Research and Treatment, 15, 93–129.

Marshall, W. L., & Marshall, L. E. (2007). The utility of the Random Controlled Trial for evaluating sexual offender treatment: The gold standard or an inappropriate strategy? Sexual Abuse: A Journal of Research and Treatment, 19, 175–191.

Marshall, W. L., & Marshall, L. E. (2008). Good clinical practice and the evaluation of treatment: A response to Seto et al. Sexual Abuse: A Journal of Research and Treatment, 20, 256–260.

Marshall, W. L., & Marshall, L. E. (2012). Treatment of sexual offenders: Effective elements and appropriate outcome evaluations. In E. Bowen & S. Brown (Eds.), Perspectives on evaluating criminal justice and corrections (pp. 71–94). London: Emerald Publishing.

Marshall, W. L., Marshall, L. E., & Burton, D. L. (2013). Features of treatment delivery and group processes that maximize the effects of offender programs. In J. L. Wood & T. A. Gannon (Eds.), Crime and crime reduction: The importance of group processes (pp. 159–176). New York, NY: Routledge.

Marshall, W. L., Marshall, L. E., Serran, G. A., & O’Brien, M. D. (2011). Sexual offenders: A strength-based approach. Washington, DC: American Psychological Association.

Marshall, W. L., Serran, G. A., Fernandez, W. M., Mulloy, R., Mann, R. E., & Thornton, D. (2003). Therapist characteristics in the treatment of sexual offenders: Tentative data on their relationship with indices of behaviour change. Journal of Sexual Aggression, 9, 25–30. doi:10.1080/355260031000137940

Marshall, W. L., Serran, G. A., Moulden, H., Mulloy, R., Fernandez, Y. M., Mann, R. E., & Thornton, D. (2002). Therapist features in sexual offender treatment: Their reliable identification and influence on behavior change. Clinical Psychology & Psychotherapy, 9, 395–405. doi:10.1002/cpp.335

Marshall, W. L., & Williams, S. (1975). A behavioral approach to the modification of rape. Quarterly Bulletin of the British Association for Behavioural Psychotherapy, 4, 78.

Marques, J. K., Weideranders, M., Day, D. M., Nelson, C., & van Ommeren, A. (2005). Effects of a relapse prevention program on sexual recidivism: Final results from California’s Sex Offender Treatment and Evaluation Project (SOTEP). Sexual Abuse: A Journal of Research and Treatment, 17, 79–107.

McGrath, R. J., Cumming, G. S., & Burchard, B. L. (2003). Current practices and trends in sexual abuser management: Safer society 2002 nationwide survey. Brandon, VT: Safer Society Press.

McGrath, R. J., Cumming, G. R., Burchard, B. L., Zeoli, S., & Ellerby, L. (2010). Current practices and emerging trends in sexual abuser management. Brandon, VT: Safer Society Press.

Mehrabian, A., & Epstein, N. (1972). A measure of emotional empathy. Journal of Personality, 40, 525–543. doi:10.1111/j.1467-6494.1972.tb00078.x

O’Callaghan, D. (2002). Providing a research informed service for young people who sexually abuse. In M. C. Calder (Ed.), Young people who sexually abuse: Building the evidence base for your practice (pp.5–25). Lyme Regis: Russell House.

Perkins, D. (1982). The treatment of sex offenders. In M. P. Feldman (Ed.), Developments in the study in the criminal behaviour Vol. 1: The prevention of control and offending (pp. 191–214). Chichester: John Wiley & Sons.

134 W. L. Marshall & C. Hollin

Perkins, D. (1987). A psychological treatment programme for sex offenders. In B. J. McGurk, D. Thornton, & M. Williams (Eds.), Applying psychology to imprisonment: Theory and practice (pp. 192–217). London: Her Majesty’s Stationary Office.

Perkins, D. (1991). Work with sex offenders in secure settings. In C. Hollin & K. Howells (Eds.), Clinical approaches to sex offenders and their victims (pp. 151–177). Chichester: John Wiley & Sons.

Pfäfflin, F., Böhmer, M., Cornehl, S., & Mergenthaler, F. (2005). What happens in therapy with sexual offenders? A model of process research. Sexual Abuse: A Journal of Research and Treatment, 17, 141–151.

Pithers, W. D., Marques, J. K., Gibat, C. C., & Marlatt, G. A. (1983). Relapse prevention with sexual aggressors: A self-control model of treatment and maintenance of change. In J. G. Greer & I. R. Stuart (Eds.), The sexual aggressor: Current perspectives on treatment (pp. 214–239). New York, NY: Van Nostrand Reinhold.

Print, B., Morrison, T., & Henniker, J. (2001). An inter-agency assessment framework for young people who sexually abuse: Principles, processes and practicalities. In M. C. Calder (Ed.), Juvenile and children who sexually abuse: Frameworks for assessment (2nd ed., pp. 271–281). Lyme Regis: Russell House.

Salter, A. C. (1988). Treating child sex offenders and victims? Assessment and treatment of child sex offenders: A practical guide. Beverly Hills, CA: Sage.

Serran, G. A. (2002). The measurement of empathy. In Y. M. Fernandez (Ed.), Examining the issues of empathy and its place in the treatment of offenders: In their shoes (pp. 16–35). Oklahoma City, OK: Wood ‘N’ Barnes.

Seto, M. C., Marques, J. K., Harris, G. T., Chaffin, M., Lalumière, M. L., Miner, M. H., … Quinsey, V. L. (2008). Good science and progress in sex offender treatment are intertwined: A response to Marshall & Marshall (2009). Sexual Abuse: A Journal of Research and Treatment, 20, 247–255.

Sheldon, K., Davies, J., & Howells, K. (Eds.). (2011). Research in practice for forensic professionals. London: Routledge. Snyder, C. R., & Lopez, S. J. (Eds.). (2005). Handbook of positive psychology. New York, NY: Oxford University Press. Vizard, E. (1991). Interviewing children suspected of being sexually abused: A review of theory and practice. In

C. Hollin & K. Howells (Eds.), Clinical approaches to sex offenders and their victims (pp. 117–148). Chichester: John Wiley & Sons.

Ward, T. (2002). Good lives in the rehabilitation of offenders: Promise and problems. Aggression and Violent Behavior: A Review Journal, 7, 513–528. doi:10.1016/S1359-1789(01)00076-3

Ward, T., & Hudson, S. M. (2000). A self-regulation model of relapse prevention. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp. 79–101). Thousand Oaks, CA: Sage.

Westcott, H., Davies, G., & Clifford, B. (1989). The use of anatomical dolls in child witness interviews. Adoption and Fostering, 13, 6–14.

Yates, P. M. (2007). Taking the leap: Abandoning relapse prevention and applying of the self-regulation model to the treatment of sexual offenders. In D. Prescott (Ed.), Applying knowledge to practice: The treatment and supervision of sexual abusers (pp. 143–174). Oklahoma City, OK: Wood ‘N’ Barnes.

Sex offender treatment 135

Copyright of Journal of Sexual Aggression is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.