Exploring the psychology of child sexual abuse perpetrators

Sexual Child Abuse: Exploring the Mind of the Perpetrator

Sex crimes are a very complicated and challenging issue in society, particularly so where children are involved. Child sex abuse is a particularly difficult problem, as the stigma attached to both being an offender and a victim of this crime often leads to silence and a concomitant lack of treatment for all parties involved. While the preferred reaction to sex offenses has been incarceration until recently, research has suggested that some treatments may be effective in at least curbing the problem, if not eliminating it. Many treatment solutions have been suggested within the two main categories of somatic and cognitive behavioral therapies. Various options will be discussed, with a general conclusion relating the issue to current research and possible directions for the future.

Although the general public opinion is that no therapy is effective for child sex offenders, Mahoney (2006) cites research statistics to suggest that some effect is possible. While considering the sex offense issue in general, she cites a study indicating that a group of child molesters taking part in a tested rehabilitation program had a 14% arrest rate, as opposed to a 26% rearrest rate for untreated offenders.

Although the effect of the treatment proved to diminish over time, the reoffense rate was nonetheless lower than that of non-treatment. Mahoney also notes that Specialized, community-based programs tended to be slightly more effective than non-specialized treatment programs. The author however also emphasizes that sexual deviation can be considered in a similar light as alcoholism; the offender's deviation is never cured, but the offender can choose to abide by the treatment directives and programs put in place to curb the problem.

Roseman et al. (2008) substantiate Mahoney's point that the retributive model is not necessarily always the best approach to handle sexual offenses involving children. According to the authors, incarceration has the single-dimensional effect of removal from a society that no longer needs to be concerned about the offender. However, the restorative or rehabilitation model has a multi-dimensional effect. This model does not only provide the offender with the opportunity to reenter society as a productive and law-abiding citizen, but also provides both the victim and community with the opportunity to address the issue for the purpose of safety, reparation and healing, according to the authors. They also note that the latter type of response is gaining momentum both in the research community and in general society.

Significantly, Roseman et al. (2008) emphasize the fact that various treatment options may differentiate in effectiveness according to the differentiation of offenders. Not all child molesters have the same motivations or drives of their deviations. Hence it is important to recognize that the treatment chosen for any specific offender should adhere as closely as possible to the combination of disorders that accompany the offense.

Grossman, Martis and Fichtner (1999) describe specific treatment options within the somatic and cognitive-behavioral categories as either alternatives to incarceration or to be used within correctional facilities to rehabilitate sexual child abusers. The somatic category addresses surgical and medical treatments, while cognitive-behavioral therapies seek to rehabilitate the offender via psychiatric interventions.

According to Grossman, Martis and Fichtner (1999, p. 351), some somatic treatments are no longer commonly used in response to sexual child abuse. Surgery is the least commonly used method for sexual child abusers, mostly because of ineffectiveness in the case of neurosurgery and ethical issues in the case of surgical castration.

Neurosurgery involves removing parts of the hypothalamus in order to discourage male hormone production. However, as in all cases of brain surgery, the basic lack of knowledge regarding all the systems involved has proved this method to be limited in effectiveness along with being questionable in terms of ethics. Similarly, ethical issues have been increasingly used as a basis for discontinuing surgical castration, despite reports regarding its positive effects. The authors note that European figures specifically show the high level of effectiveness, where castration reduce recidivism significantly. However, more recent scientific reviews have countered such reports on both scientific and ethical grounds.

Much more popular in the somatic treatment category is medical treatments in the form of previously used oral and implanted estrogens, or the more recent and widespread use of antiandrogens. The former has proved to be overly adverse in effect to the extent that it invalidated any positive effect. Other drug types such as neuroleptics have also only had limited effects in treating sex offenders.

Grossman, Martis and Fichtner (1999, p. 351) refer to the advent of antiandrogen medications as "among the most important" of biological interventions for sex offenders. These medications reduce the serum level of testosterone, with the effect that devious sexual fantasies and behavior are also reduced. In addition, the authors cite studies indicating that such medications also reduce other sexual functions such as libido, erections, ejaculations, and sprematogenesis. In terms of somatic treatments, the authors indicate that antiandrogen medications have so far proven to be the most effective.

On the other end of the spectrum is psychological and behavioral treatment, as it specifically manifests in cognitive-behavioral interventions (Grossman, Martis and Fichtner, 1999, p. 354). Until this mode of treatment, psychological models as applied to treatment for sexual offenses involving children had little success, according to the authors. The rapid development of such treatments over the last two decades has increased the effectiveness of this therapy.

At the basis of cognitive-behavioral therapies is an attempt to change the belief system of sex offenders, eliminating their inappropriate behavior around children, and increasing their appropriate behavior. Common techniques used to achieve this include aversion treatment, covert sensitization, imaginal desensitization, and masturbatory reconditioning (Grossman, Martis and Fichtner, 1999, p. 354). These are often coupled with cognitive restructuring, or the modification of the offender's distorted cognitions that relate to his or her sexual behavior.

While many particularly in the professional community are beginning to view the benefits of the restorative model for sexual abusers of children in a positive light, authors such as Karen Kirsting (2005) acknowledge that they still face considerable challenges in implementing treatments. This is particularly so in societies who are fearful of reoffenses, and where offenders are viewed in an extremely negative light.

According to Kirsting, psychologists also face a challenging attitude from law enforcement authorities, many of whom favor the traditional retributive model for sexual offenses. She also notes that research is complicated by relatively low recidivism rates among untreated offenders. This makes it difficult to find a treatment that can be empirically proven as effective as opposed to non-treatment.

Despite this, the public perception of recidivism is that it is much more prevalent in sexual offenses against children than is actually the case. Furthermore, the public also perceives intervention strategies as highly ineffective. Therefore, the general belief is that offenders should be incarcerated as a means of removing them from society and from any possibility of reoffense. Kirsting however also notes that the research in favor of treatment is accumulating as new treatments and interventions are being developed. This provides some hope that alternatives to incarceration will not only be a viable research response in the future, but a public one as well.