TREATMENT OF PAEDOPHILES

An essential aspect of dealing with paedophiles, for the government and the public as well, is risk assessment. This means calculating the probability of the occurrence of a harmful behavior and its impact on the target and all that will be affected (Kemshall, 2001). The assessment is based in observing and evaluating the factors that are indicators of the likeliness of offending or re – offending as well as those propensities that endure in known or probable offenders. There are two approaches to risk assessment: the actuarial, a statistical calculation of probabilities, and the clinical, based on the observation of factors that proved to have resulted in sex offences.

Actuarial methods

The most well – established scales of actuarial tools are:

The Rapid Risk Assessment for Sex Offence Recidivism (RRASOR)

Static – 99

The Risk Matrix 2000 (RM – 2000) and

The Sex Offence Risk Appraisal Guide (SORAG).

The RRASOR (Grubin, 1998) comprises of the evaluation of

  • prior sexual arrests
  • age
  • targeting male victims
  • relation of the victims to the offender.

RRASOR succeeds in identifying large groups of low risk offenders with low probability of recidivism and small groups of high risk offenders with high probability of recidivism.

Static – 99 is a combination of RRASOR and SACJ and considers static risk factors. It has a strong validity for male sex offenders who have been already served in prison. The items of Static – 99 are:

  • male victims
  • never married
  • offences that didn’t involve contact
  • victims that are unrelated
  • victims that are strangers
  • other sex offences
  • other than sexual current types of violence
  • more than 4 sentencing dates
  • age that vary between 18 and 24.9 years.

The Prison, Probation and Police Services in England and Wales use the Risk Matrix 2000. Its uniqueness compared to the other tools is that it can be used for whichever type of violence, sexual or non – sexual. The RM 2000 has two stages.

Stage 1

  • age at the commencement of risk
  • number of appearances in court for sex offence related issues
  • number of appearances in court for other offences than sexual
  • Evaluation of these factors leads in placement in four groups: low, medium, high or very high risk.

Stage 2

  • history of offences against male victims
  • history of stranger sexual offence victim
  • history of non – contact sexual offences
  • lack of long term intimate relationship

If any subject has one of these factors, moves up one group on the previous ranking. If all four factors are present, the subject moves two groups upwards.

The Sex Offence Risk Appraisal Guide (SORAG) was developed in Canada by a sample of inmates of a high secure psychiatric hospital. It is used widely to predict violence committed by sexual offenders but it is also quite popular on non – psychiatric offenders. It comprises of 14 items:

  • living with biological parents until the age of 16
  • maladjustment in elementary school
  • history of alcohol related problems
  • evidence of sustained intimate relationship
  • criminal activity with absence of violence
  • criminal activity with violence
  • prior convictions regarding sexual offences
  • convicted sexual offences against girls under 14 years
  • failure in achieving conditional release
  • age at index offence
  • personality disorder criteria from DSM-III are met
  • schizophrenia criteria from DSM – III are met
  • evident deviant sexual preferences
  • evident psychopathy.

Clinical methods

Clinical methods are conducted in psychiatric hospitals by interviewing and evaluating the responses of known sex offenders. They are not considered as reliable as the actuarial methods, yet they can provide structured behavioural rating scales as aid to the actuarial tools (Kemshall, 2001). Clinical methods can estimate successfully the impact of environmental factors on harmful behavior.

Clinical methods can be categorized in unstructured and structured methods (Shaw, 2011). The psychoanalytic approach proposed by the unstructured model relies heavily on the human factor and so, it is considered to be outdated and highly subjective. On the other hand, the structured models are well respected and, subsequently, used as they combine psychoanalysis with statistical tools. The structured clinical methods that are most frequently used are:

  • Psychopathy Checklist – Revised (RCL-R)
  • Historical, Clinical, Risk – 20 (HCR – 20)
  • Sexual Violence Risk – 20 (SVR – 20)
  • Structured Assessment of Violence Risk in Youth (SAVRY).

Managing risk

In order to manage the risk posed to society by sex offenders there have been established agencies all over the United Kingdom. For risk management to e effective there has to be a solid information base and strong coordination between all the participants involved in the task of control and prevention of sex offences. It is an ongoing procedure that must be kept up to speed with the developments, apply new strategies and measure the efficacy of the actions taken.

In Scotland the Multi – Agency Public Protection Arrangements (MAPPA) has been established since the Management of Offenders Act 2005. The aim of MAPPA is to aid the work of criminal justice organizations in association with social services, so as they can reduce the acts of sex offenders and prevent recidivism of know offenders (MAPPA Annual Report 2009/2010).

In England and Wales the Probation Service uses the Offender Assessment System to estimate the likelihood of re – offending and re – conviction. The Offender Assessment System uses the gathered information to alert the Multi – Agency Public Protection Arrangements (MAPPA). MAPPA was established under the umbrella of the Criminal Justice Act 2003

Treatment of paedophiles

Since the causes of paedophilia are yet unknown, it is a difficult task to determine the right course of treatment. At the moment, as there is no cohesive approach for the definition of paedophilia or its causes, there is a lack of the necessary consistency to the corresponding actions in regard of treating paedophiles as well. It is open to debate whether paedophiles exhibit mental disorder and if they are in need of treatment or their actions are of a sane person and are in need of punishment (Gordon & Grubin, 2004). However, the main common goal for all the approaches of treatment is to reduce the danger of recidivism (Perkins et al, 1998).

Treatment of paedophiles has changed its course many times over the years. The surgical castration(Perkins et al, 1998) that was used as a means of treating paedophiles and other convicted sex offenders, was abandoned by the ’70s (Gordon & Grubin, 2004), as hormonal therapy was gaining ground. Hormonal treatment included giving oestrogens but had high rates of side – effects, such as thrombosis of carcinogenesis. Oestrogens gave their place to cyproterone acetate and medroxy – progesterone acetate (Gordon & Grubin, 2004). The drug treatment managed to reduce recidivism as only 15% of the users relapsed as opposed to the 68% of the non – users (Perkins et al, 1998).Currently, dynamic psychotherapy is widely used for sex offenders (Gordon & Grubin, 2004).

The first step towards treatment is for the sex offenders to admit to their guilt. This is important as the treatment will try to persuade the offender to understand and empathize with the victim, while the psychological and physiological characteristics of paedophilia will be quelled. However, those who do not admit guilt can still be included in the treatment, although it will be an even more demanding task. At the same time, monitoring high risk factors and using a support system can avert re – offending behavior (Hanson & Harris, 2000).

Most of the attempts in treating paedophiles involve the restoration of the cognitive process. The distortion of cognition is considered to be a coping mechanism, that the offenders tend to develop before or after they offend (Sheldon & Howitt, 2007). The cognitive – behavioural therapy is used to help paedophiles find a way to avoid sexual arousal from abnormal situations (Perkins et al, 1998). What is necessary for those who provide the treatment is to understand that each individual sex offender has different treatment needs and that a combined methods approach is more likely to be successful.

The Sex Offender Treatment Programme (SOTP) is a well – established programmed of treatment for sex offenders and is widely used around the world. It is being managed by the Prison Offending Behaviour Programmes Unit and has been developed by the British Prison Service. The most significant criteria, SOTP is based upon, are application of treatment methods that have proved to be effective, an empirically – based model and treatment in accordance to the severity of each case (Perkins et al, 1998).

Reintegration of Paedophiles

Although still in a small scale, there have been schemes towards reintegrating released paedophiles. Starting by forming and application in Canada and the United States, schemes, such as the “Stop It Now Program”, started to be applied also in the United Kingdom and Ireland (McAlinden, 2006). The “Stop It Now Program” offers a professional assistance to those who have offended, those who are close to offending and those who suspect that there has been foul play in their environment.

The most widely used program in reintegration of sex offenders is the Circles of Support and Accountability that has been running in England for a few years. In this program the offender is the core of a circle of volunteers. These volunteers help the offender in solving practical job and boarding related issues. At the same time they hold the offender accountable for his actions and behavior in general, while at the time they are obligated to report any suspicion of re – offending to the authorities. Although the pilots are ready to be executed, they are not yet active. In some areas the difficulties lay in funding the project and in other cases it is extremely difficult to find volunteers (Armstrong et al, 2008).

Due to the obstacles these schemes keep finding suggestions are made that the particular programs or other initiatives could work under the umbrella of inter – agency risk assessment and management procedures (McAlinden, 2006). In addition to the pre – existing policies, this kind of schemes can help the goal of making re – integration more effective.

Public disclosure

High profile cases, such as the Sarah Payne abduction and murder by a known paedophile, resulted in the “name and shame” campaign from the media and especially the News of the World. The campaign started with the initiative of the newspaper (Moyes, 2000), promoting the naming of all convicted paedophiles, and received much attention from the public and the authorities as well.

The public’s wishes, accentuated by the media pressure, for disclosure for all sex offenders were met by the government to a pilot scheme where anyone could report someone else with access without supervision to their child. The scheme was implemented by Home Office in 2009 in four police areas in England and one area in Scotland and by 2010 it was set to run nationally. However, as other schemes, it didn’t find the anticipated participation (Kemshall et al, 2010), pointing out in a divergence between what the government provided and what the public actually demanded for (Kemsall & Weaver, 2012).

The reasons for this were multiple. Primarily, the public perceives these kinds of schemes, run through the police, as an increase in policing the everyday life, when they should be assumed by other agencies. Moreover, they are thought as a way to push the responsibility onto the public instead of the proper authorities (McCartan, 2010). It has also been established (McCartan, 2010) that the public views sex offenders as a complex issue, with child sex offenders being the most dangerous, so there is the need of differentiation in disclosure schemes.

Publicizing the schemes is an important tool for the successful implementation of them. They are to be explicitly explained to the public so as to be efficient (Kemshall & Weaver, 2012). In addition to this, public needs evidence that the schemes are actually beneficiary and result in child protection (Kemshall et al, 2010).