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Article Excerpt
Juvenile sex offenders (JSOs) often appear unmotivated to change, which thus necessitates a therapeutic approach that matches "resistant" client characteristics. In this article, the authors review common traits of JSOs, introduce motivational counseling as an effective treatment modality, and offer a case illustration.
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Recently, increased attention has focused on crimes involving sexual offenses and on the treatment of perpetrators (Duller, 2006). Whereas the research on treatment modalities for sex offenders has focused primarily on adult offenders (Miner, 2002), 50% of adult offenders indicate that their paraphilias and sex crimes began when they were adolescents (Andrade, Vincent, & Saleh, 2006). Additionally, Miner noted that adolescents perpetrate at least 15% of all reported sexual offenses in the United States. Given these statistics, it is surprising to learn that many of the current treatment modalities used with this client population fail to acknowledge the interaction between adolescent developmental patterns and sexual offending behaviors (Calley, 2007). Clearly, an approach that recognizes this relationship is warranted. Following a brief review of the literature that provides a framework for the proposed treatment approach (motivational counseling), we explore this theory and present a detailed case example that demonstrates the successful implementation of this approach.
For the purpose of this article, the term sex offender is defined as one who committed any sexual act with a person of any age without that individual's consent (Gerardin & Thibaut, 2004), and the term juvenile is used to define an individual who is under 18 years of age. Therefore, a JSO is defined as a person who committed a sexual offense and who by law is considered to be old enough to be held criminally responsible for his or her actions but not old enough to be subjected to the fullest extent of adult law (Barbaree & Marshall, 2006). Additionally, because the majority of sex offenders are male (Rich, 2003), this article focuses exclusively on male offenders.
According to Lemmond and Verhaagen (2002), therapeutic counseling approaches with JSOs have varied throughout the years. Regardless of the approach, the prevention of recidivism is the overall goal (Gerardin & Thibaut, 2004). Three approaches are identified as the most frequently used models for treating JSOs: (a) psychosocial (Bourke & Donohue, 1996; Fanniff & Becker, 2006), (b) cognitive-behavioral (Calley, 2007; Rich, 2003; Serran, Fernandez, Marshall, & Mann, 2003), and (c) multisystemic (Fanniff & Becker, 2006; Saleh & Vincent, 2004). Each warrants a brief mention to help frame the model proposed in this article.
The psychosocial model is a common approach that aims to promote sex education. Within this model, the counselor attempts to identify and treat maladaptive sexuality by teaching "normal" sexual development, or, in other words, sex education (Bourke & Donohue, 1996). Although this may prove useful for the purposes of teaching normative behaviors, Fanniff and Becker (2006) concluded that data identifying a connection between the psychosocial model and decreased recidivism were insufficient.
The cognitive--behavioral (CB) model is primarily used to clarify thinking errors that a JSO might possess regarding his offense (Calley, 2007). Furthermore, the CB model allows counselors to help their clients identify the relationship between their thoughts, behaviors, and arousal patterns (Fanniff & Becker, 2006). Because of the emphasis placed on the implementation of specific therapeutic interventions within the CB model, Serran et al. (2003) noted that the role of the counselor--client relationship is minimized. Given the therapeutic efficacy of this relationship, the CB model may limit the overall successful resolution of sexually offending behaviors.
The multisystemic treatment approach assumes that problematic behaviors are multidimensional and require interventions that alter the JSO's systemic context (Bourke & Donohue, 1996). More specifically, the multisystemic treatment approach engages therapeutic support from the JSO's environment (e.g., family, school and community) in an effort to assist with treatment (Fanniff & Becker, 2006). However, Gerardin and Thibaut (2004) suggested that this therapeutic approach might prove difficult because members of these multiple systems (e.g., family members) may be resistant to engaging in the treatment process, be it due to the pain that they might have experienced or to their belief that treatment should focus solely on the JSO.
Although the aforementioned approaches do contribute helpful techniques and interventions for treating JSOs (e.g., the sexual offending cycle as offered by the CB model and the relapse prevention plan suggested by the multisystemic treatment approach), these counseling approaches do not thoroughly discuss the importance of the client's perception of his problematic behavior within treatment. Given the importance placed on the client's perceptions as they relate to treatment success (e.g., readiness to change, increased self-efficacy, ownership of blame, reduced denial and/or minimization), a few counseling modalities have been found to be very effective in addressing these perceptions, most notably motivational counseling (MC; Ginsburg, Mann, Rotgers, & Weeks, 2002; Ingersoll, Wagner, & Gharib, 2006; Miller & Rollnick, 2002; Miller, Zweben, DiClemente, & Rychtarik, 1995). This counseling approach matches the JSO's readiness to change and has the potential to be an effective treatment approach for this traditionally difficult client population.
MC is an integration of motivational interviewing (Miller & Rollnick, 2002) and motivational enhancement therapy (Miller et al., 1995). It is a therapeutic approach for effectively enhancing a client's intrinsic motivation to change, which has been well supported in research as leading to successful client outcomes (Britt, Blampied, & Hudson, 2003; Ingersoll et al., 2006). Furthermore, MC has been found to be an effective therapeutic treatment approach with traditionally difficult and resistant clients (e.g., adult alcoholics; Miller et al., 1995; nicotine addicted clients; Rubak, Sandbrek, Lauritzen, & Christensen, 2005; and adolescents who abuse substances; Stern, Meredith, Gholson, Gore, & D'Amico, 2007). Additionally, Rubak et al. concluded that MC is "particularly useful for clients who are reluctant to change" (p. 305). JSOs often appear resistant to change and necessitate a counseling approach that allows them to feel accepted and to have a level of safety for expressing their thoughts, feelings, and behaviors (Rich, 2003). MC allows this to occur by encouraging JSOs to explore and process their readiness for change and to set their own pace for treatment, rather than having the counselor set the treatment agenda, as found in other approaches (Ginsburg et al., 2002).
On the basis of JSOs' generalized resistance toward the counseling process (Rich, 2003) and given the research supporting the effectiveness of MC with challenging client populations, it is our contention that MC would be an effective counseling approach to support change with JSOs. From this point forward, we (a) present potential challenges concerning the treatment of JSOs, (b) introduce the theoretical constructs of MC and illustrate how they apply to working with JSOs, and (c) offer a detailed case example illustrating the application of MC with a JSO client.
Potential Challenges Concerning the Treatment of JSOs
Counselors often encounter a multitude of treatment challenges when working with JSOs. Aside from the sexual offending behaviors, JSOs bring a variety of obstacles with them into...
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