From denial to acceptance of sexually offending behaviour: a psychodynamic approach
| Date | 09 September 2013 |
| Pages | 293-299 |
| DOI | https://doi.org/10.1108/AMHID-06-2013-0041 |
| Published date | 09 September 2013 |
| Author | Nigel Beail |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
From denial to acceptance of sexually
offending behaviour: a psychodynamic
approach
Nigel Beail
Professor Nigel Beail is
a Consultant Clinical
Psychologist, based at South
West Yorkshire Partnership
NHS Foundation Trust,
Barnsley, UK and University
of Sheffield, Sheffield, UK.
Abstract
Purpose – Offenders who have intellectual disabilities like any one else may deny their offence. This paper
reports a case study of a man who admitted his offence and them accepted probation with a condition of
treatment. However,when he attended treatment he denied the offence. Thus do those providing treatment
send them back into the criminal justice system or work with them try and help them accept what they have
done and provide appropriate treatment to help them reduce future risk of offending.
Design/methodology/approach – In this case study the assimilation model was used to understand the
process of change and monitor change through exploratory psychotherapy. The psychotherapeutic model
was psychodymnamic.
Findings – The client demonstrated gains through the stages of the model toward acceptance of his
problematic behaviour and continued to work on this through further psychotherapy.
Originality/value – The assimilation model offers a useful approach to monitor change in psychotherapy;
but especially when the client does not accept the problem the rest of the world feels they have.
Keywords Offending, Psychotherapy, Assimilation model, Psychodynamic
Paper type Case study
Cognitive-behavioural therapy (CBT) has become the most widely available treatment for sex
offenders who have intellectual disabilities (ID). The adapted sex offender treatment programme
(SOTSEC) has been provided for a number of years now and reports on the interventions
effectiveness are now being published (SOTSEC-ID, 2010). This is a group-based treatment
which lasts for 13 months. It is manualised and follows a curriculum that covers human
relations and sex education, the cognitive model, victim empathy, sexual offending and relapse
prevention. The aim of treatment is to change participants cognitive distortions, improve
empathy and develop and understanding of their offending behaviour. Lindsay has also
published numerous papers on CBT interventions for sex offenders which are reviewed in
his treatment manual (Lindsay, 2009). Lindsay’s approach similarly addresses cognitive
distortions and the cycle of offending, pathways to offending and relapse prevention. His
manual provides guidance on how to develop group dynamics and practical ways to engage
participants in role plays and enhance motivation. Unfortunately not all sex offenders who have
ID can access these programmes due to their lack of suitability for CBT. Willner (2006) has
described the factors that influence people’s readiness to engage in CBT. One key factor is
motivation for change. In the “stages of change model” (Prochaska and DiClemente, 1982)
clients are assumed to move from a pre-contemplation stage to a contemplation stage. In the
pre-contemplation stage the client may not be aware that they have a problem or that they need
to change in any way. They have no understanding of the risks or consequences of their
behaviour. In the contemplation stage they start to think what needs to be done and start to
DOI 10.1108/AMHID-06-2013-0041 VOL. 7 NO. 5 2013, pp. 293-299, CEmeraldGroup Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
PAGE 293
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