Treating individuals who have sexually offended
The aim of this thesis was to contribute to our understanding of the therapeutic relationship between clinicians and individuals who have committed sexual offences against children and adults. To do this a systematic review was carried out which explored the relationship between attachment styles and types of sexual offending to investigate whether there is an association between types of sexual offences and types of insecure attachment styles. 16 articles were identified and evaluated. The results of this review indicated that individuals who have sexually offended against children demonstrated more insecure childhood maternal and paternal attachments alongside higher rates of insecure adult attachment styles whereas individuals who have sexually offended against adults demonstrated a more variable pattern of maternal and paternal attachments. Types of sexual offending did appear to be related to different insecure attachment styles with child molesters predominantly identified as preoccupied and fearful and rapists classified as dismissing. A separate qualitative study using Interpretative Phenomenological Analysis was also completed which explored the experiences of therapists involved in the delivery of group treatment for sexual offenders. Some of the experiences reported were similar to those outlined in previous studies (the importance of collegial support, the experience of intrusive cognitions, managing challenging characteristics of sexual offenders and the perception of being involved in protecting the public) but some were not (the prestige felt from belonging to a niche profession, the pride of pushing professional boundaries and the perception of protecting the patient and managing professional challenges) offering further insight into the possible types of experiences encountered. An awareness and appreciation for the integral role attachment status plays in sexually deviant behaviour enables clinicians to anticipate the relational dynamics that may emerge during treatment and modify interventions appropriately to facilitate effectiveness and maintain the therapeutic alliance. In addition by exploring the experiences of sex offender therapists an understanding of the ways in which the therapeutic relationship and a therapist’s sense of self may be impacted can be garnered (Hernandez, Engstom & Gangsei, 2010; Lyn & Burton, 2004) assisting individuals and organisations in ensuring that the rewards are maximised and the challenges supported and reduced.