A Project of the Office of Justice Programs, U.S. Department of Justice

Long Version
Section 3: An Overview of Sex Offender Treatment for a Non–Clinical Audience
Elements of Sex Offender–Specific Treatment
4 hours, 30 minutes

Lecture Topic TOPIC: DISTORTED ATTITUDES—THE SECOND DOMAIN OF TREATMENT
(40 minutes)

Use SlideUse Slide #33: Distorted Attitudes—The Second Domain of Treatment

Use SlideUse Slide #34: Cognitive Restructuring

Now let’s turn our attention to the second domain that sex offender treatment should address, namely distorted attitudes. Our purpose here is to identify and alter offenders’ justifications for sex offending. One particular aspect of this is an intervention referred to as cognitive restructuring (or identifying and addressing thinking errors). As we discussed when addressing these issues with sex offenders who deny their offense histories, almost all sex offenders know that sex offenses are harmful to victims, and even if they aren’t clear about that, they typically well understand that committing sex offenses is against the law.

Cognitive Restructuring

Knowing that sex offending is harmful and illegal, in order for sex offenders to justify their behavior to themselves, they must create rationalizations, excuses, and minimizations to reduce the dissonance that they would otherwise feel.41 These become the “thinking errors” or “cognitive distortions” that are so common in the minds of sex offenders. Although lots of people develop idiosyncratic thoughts on various subjects, these thoughts typically are questioned or challenged by others when they are shared. However, since sex offenders rarely share their cognitive distortions with others, their dysfunctional thinking isn’t challenged by others. For example, the sex offender who is molesting his step–daughter, believing this is a trivial event in her life, doesn’t tell anyone he is doing this and, therefore, his analysis of his abusive behavior remains unchallenged.

The purpose of cognitive restructuring with sex offenders is to have them identify and examine their cognitive distortions and obtain information and feedback about the errors in their thinking.42 In so doing, we expect that they will become more aware of victim issues. The overall goal is to stop offenders from utilizing their rationalizations and excuses to justify future sex offending behavior. As we’ve noted before, since most offenders do not seek to harm victims per se, this is thought to make it more difficult for them to decide to commit sexual assaults in the future. In addition, attitudes supportive of abusive or criminal behaviors have been found to predict sexual recidivism (see, e.g, Hanson and Bussiere, 1998; Hanson and Morton-Bourgon, 2004; Hudson, Wales, Bakker, and Ward, 2002).

Use SlideUse Slide #35: Methods of Cognitive Restructuring

This intervention is done with sex offenders often by beginning with a discussion of why people use cognitive distortions to excuse or justify behaviors with which they are uncomfortable, such as overeating, smoking, or speeding. Through group discussion, offenders come to acknowledge that even though cognitive distortions commonly are used in a variety of contexts, no amount of excuse–making alters the underlying reality that the behavior is wrong, harmful to health, or whatever the case may be. Discussion usually includes offenders’ noting that excusing personal matters such as overeating results in relatively minor consequences, but excusing sex offending can lead to severe consequences.

As was described in the interventions with sex offenders who deny their offenses, group members next are asked to complete a sentence like “Even though I knew my sex offenses were wrong, or at least illegal, what I said to myself to make it seem okay was _____________.” Offenders are requested to write anonymously on paper a list of their cognitive distortions and turn them in to the group facilitator. These lists of thinking errors then become the content of group discussion, in which the facilitator reads them off one at a time and the group discusses the errors in the cognitions.

Another method for offenders learning the problems with these thinking errors involves a series of role–play exercises. One such role–play method involves group members playing the role of the father of the victim, a long–time friend of the perpetrator who promotes the offender taking appropriate responsibility, and a supervision officer. In this exercise, the group facilitator plays the role of a sex offender who professes to believe various cognitive distortions and he states and defends these distortions to the three offenders playing their respective roles. It becomes the task of the group member role–players to explain to the facilitator/offender what is faulty with his thinking. This is relatively easy for offenders to do, because although they might have trouble challenging their own cognitive distortions, they readily can see the distorted thinking that others engage in. This is especially true when different types of sex offenders, such as rapists and child molesters, are mixed in the same group.

This exercise can be especially useful because it causes offenders to go beyond the simple explanation of the illegality of the behaviors to explicate the underlying reasons (for example, why it is never beneficial for a child to have sexual contact with an adult). Not incidentally, this also provides some empathy–building, because having people play roles often results in the actors experiencing emotions of the person in that role. Therefore, a sex offender playing the role, for example, of the father of a victim, frequently feels some of what a victim’s father might feel. After each exercise, the content of the role–play is discussed by the entire group.

Refer to Handout Refer to Handout: Learning Activity 3–1: Dealing with Sex Offenders’ Cognitive Distortions.

Note: Review the Learning Activity aloud with participants, and seek two volunteers from the audience to assist with the role–play. Limit the role–play to no more than 5–10 minutes.

Learning Activity Learning Activity

Although we’ve been talking about role–playing as a treatment technique, today we will also use role–playing as a learning activity. Refer to Exercise 1, which outlines a role–play exercise that will help us to identify some of the common distortions that sex offenders use and to brainstorm some of the ways in which a collaborative management team may be able to respond to those distortions in positive ways.

Note: Process each of these questions for a few moments, summarizing or repeating the salient points. Take no more than 5–7 minutes to process this Learning Activity.

Processing of Learning Activity

To those of you who were observing this role–play:

  • What was the value of follow–up questions and statements from the probation/parole officer to the offender’s cognitive distortions?
  • What advantage does the brother offer as a participant in the management of this offender? Could the brother continue to reinforce the messages being sent by the probation officer?
  • Could the brother make it more difficult for the offender to continue his thinking errors during the time when he is at home, or spending time with his brother?
  • Should information about this exchange be shared with the offender’s treatment provider?

Use SlideUse Slide #36: Rationale for Victimization Awareness/Empathy Training

Victimization Awareness/Empathy Training

As we discussed when talking about treatment with sex offenders who deny their offenses, another aspect of addressing distorted attitudes with sex offenders is to increase their awareness of issues of victimization and, to the extent possible, increase empathy.43 As we have discussed, this material may not be relevant in the treatment of psychopaths or sexual sadists because studies have shown that efforts to increase victimization awareness in people who apparently have no capacity for empathy or real concern for others might make them more likely, rather than less likely, to commit subsequent offenses.44 In the case of sadists, since they are erotically aroused by pain, suffering, and humiliation in their victims, increasing their awareness of how victims suffer risks teaching them how to be more effective sadists. For these reasons, many programs exclude sadists and psychopaths from empathy training.

As we discussed previously, it appears that most sex offenders minimize the harmful effects of their offense behaviors. They don’t necessarily intend to cause harm to others, but they do so because their sex offending involves a selfish pursuit of gratification with extreme disregard for the welfare of their victims. For the majority of sex offenders who don’t derive pleasure from hurting other people, the rationale for providing this information is that by heightening offenders’ awareness of victim trauma, it will make it more difficult for them to commit further sexual assaults. In the area of empathy, it has been found that although sex offenders often experience empathy similarly to non–offenders in many realms, it is their sex offending behavior that does not provoke empathic responses.45

Use SlideUse Slide #37: Goals of Victimization Awareness/Empathy Training

Use SlideUse Slide #38 and Slide #39: Methods of Victimization Awareness/Empathy Training

Slide #38
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Slide #39
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Thus, the goals of this component of treatment are for offenders to:

  • Understand the pervasive negative effects of sexual assault on victims and others;
  • Know the likely consequences of their assaults on their victims and their families; and
  • Learn empathy skills, especially the ability to empathize with their victims.

We’ve already discussed two typical methods for increasing victimization awareness when we talked about working with sex offenders in denial, namely the use of videotaped materials and sexual assault survivors visiting treatment groups.

Other methods that often are utilized to enhance this component of treatment include having offenders complete written assignments describing the offenses they have committed. However, instead of writing from their own perspective, they are instructed to write the narrative from the perspectives of their victims. This is a direct attempt to build feelings of empathy. This kind of homework is read and critiqued by the group facilitators, often with instructions for offenders to rewrite sections where minimization is evident.

After each offender has had the opportunity to describe in writing his offenses from his victims’ perspective, a variation of this exercise often is done verbally in group treatment settings. Each offender is asked to describe to the group his worst offenses from his victim’s perspective, that is by playing the role of his victim so his description is in the first person of the victim. In role, the offender introduces herself/himself and indicates her or his age, and then describes how the offender accessed or groomed him or her, what specific behaviors the offender used in the assault, what the offender did to influence the victim not to report the offenses, how the victim is faring now, what the victim would like to say to the offender, and what the victim would like to ask the offender.

This is a very challenging assignment for most offenders, primarily because they lack empathy skills. They are very uncomfortable embracing the role of their victim because it puts them in touch with how their victims likely have suffered as a result of their assaults.

This treatment component is critically important because offenders tend to avoid thinking about the consequences of their actions in the lives of their victims.

Refer to Handout Refer to Handout: Learning Activity 3–2: Victimization Awareness/Empathy Training.

Learning Activity Learning Activity

In order to examine more clearly the consequences of cognitive distortions for victims of sexual assault, we will now pause and try to generate a list of the distorted attitudes that offenders often have about their victims. With the sexual assault described in the previous learning activity, and using Learning Activity 2 as an aid, consider the list of cognitive distortions that might be associated with a crime such as the one we’ve just discussed. Take a moment and jot down, in the spaces provided, the correct thinking on each matter and how correcting that thinking can be of benefit to the victim and also to the offender.

Note: Take about five minutes and ask several participants to read their responses to these questions. Following each individual’s report, you might ask how many others noted this same distortion, whether they would suggest the same correction, and whether they saw the same or different benefits to correcting the distortion.

Processing of Learning Activity

Let’s talk for a moment about some of the other distortions that surfaced during our role–play, or ones you might imagine would surface if you were working with this offender. Can someone share with us another distortion and correction and discuss the benefits to both victim and offender?

Wrap Up

This has been a good discussion and a helpful way to summarize our discussions about the second domain of treatment, distorted attitudes. Let’s now move on to talk about the third domain, interpersonal functioning.