Victim-Turned-Offender
by Nori J. Muster
Adolescence, Vol. 27, No. 106, Summer 1992
Abstract
Many juvenile sex offenders are also victims of sexual abuse. However, treatment primarily focuses on the juvenile's criminal acts in a confrontational, non-sympathetic manner. A survey of professionals in the sexual abuse treatment field assesses attitudes toward juvenile sex offender treatment. Those in the corrections field were the greatest supporters of confrontational and punitive therapy methods, while the majority favored flexibility in treatment.
Sexual child abuse is a growing problem in our society. A 1985 Los Angeles Times survey estimated that nearly 38 million adults in America were sexually abused as children (cited in Engel, 1989). Statistics show that one in three women and one in seven men are sexually abused by the time they reach the age of 18 (Cooney, 1987; Giarretto, 1982).
While children react to sexual abuse in a variety of ways, one common response is that abused children may become "sexually reactive." That is, they may touch or grab playmates and adults, mimic sex play on younger children (sometimes to the point of penetration), abuse animals, masturbate at inappropriate times and places, and use sexual language to antagonize adults. They may also have sexual girlfriend/boyfriend relationships as early as eight or ten years of age. When sexually reactive children enter adolescence, precocious sexual behavior becomes grounds for incarceration and correctional treatment. If juvenile sex offenders are not rehabilitated, they risk going on to become adult child molesters, rapists, or pedophiles (Engel, 1989; Forward & Buck, 1978; Straus, 1988).
Theoretical Viewpoints and Therapy
One school of treatment specialists promote confrontational group therapy as the most effective way to rehabilitate sex offenders. These experts argue that the first step in treatment is to break denial and minimization. They maintain that sympathetic treatment (helping offenders work through their own issues of victimization) would allow them to rationalize and avoid responsibility for their acts (Borzecki & Wormith, 1987; French, 1988; Stevenson, Castillo, & Sefarbi, 1989).
In a study comparing 34 adult sex offender treatment programs in the United States and Canada, researchers found that, "Throughout, the focus of such counseling is on the offender's accepting responsibility for his actions and the understanding of factors that precipitated commission of the offense" (Borzecki & Wormith, 1987). The researchers said they found similar trends in juvenile sex offender treatment programs.
Little has been published about juvenile sex offender treatment. However, therapists in the field are a good source of knowledge about current techniques. One treatment specialist said he begins his juvenile sex offender meetings by having each boy state the name of his victim and the nature of his offense. He admits that this weekly disclosure is emotionally painful, but he perceives it as necessary to make offenders "own up" to what they have done. The treatment specialist agreed that the therapeutic value of the process is analogous to lancing a boil to let the poison out, before healing can take place.
Confrontation is the standard procedure in most juvenile sex offender treatment groups. The offender issues are discussed first; the client's own victimization is addressed only after the juvenile "takes responsibility" for his criminal acts. In some states, the full range of adult treatment is now being used on juveniles, including drug therapy ("chemical castration"), aversion therapy, or penile plethysmograph assessment (DeZolt & Kratcoski, 1989). In some extreme cases, treatment may even include psychosurgery-castration, or castration.
Although some states subject juvenile sex offenders to the full range of adult treatment, no state mandates these treatments for children. Sexually reactive children are still treated sympathetically. But it could be argued that juvenile sex offenders who were abused fall somewhere between an adult sex offender and child victims of sexual abuse. Thus, juvenile sex offenders may be deserving of sympathetic therapy, especially if their behavior is a result of the abuse they suffered.
Survey of Experts in the Field
While little has been written about juvenile sex offender treatment, even less has been written about sympathetic versus confrontational treatment methods. To get more information on current attitudes, a questionnaire was mailed to 50 counselors and psychologists who work in the field of sexual abuse and sex offender treatment. A total of 18 usable surveys were received by the deadline. Three respondents were psychologists (17%), eight had master's degrees (44%), five had master's of social work degrees (28%), one had a bachelor's degree only, and one had M.E.D. certification only. Ten of the respondents (60%) worked in private practice, while the others reported working for public and private agencies. Eleven worked with child sexual abuse victims; 13 with adults molested as children; nine with juvenile sex offenders; and five with adult sex offenders. Ten of the 18 (60%) reported working with both victims and offenders. Thus, although the sample is small, it was a good mix of private and agency therapists who work with both offenders and victims.
The instrument was meant to assess preferences for confrontational or sympathetic treatment in three different age groups: child victims of sexual abuse who act out sexually, juvenile sex offenders who were victims of sexual child abuse, and adult sex offenders who were victims of sexual abuse. Figure 3* compares respondents' willingness to use sympathetic methods with each group. The specific statements analyzed in this chart are, "I would use sympathetic methods that are normally used with sexual abuse victims" and "Sympathetic forms of therapy tend to reinforce minimization and denial."
As expected, therapists said they would choose sympathetic methods most frequently with children (39% pro-sympathetic, compared to 17% anti-sympathetic). Juveniles ranked equally for pro-sympathetic and anti-sympathetic (33% to 33%), while adults ranked slightly less likely to have anti-sympathetic treatment (only 28% said they were anti-sympathetic).
Figure 4 addresses the controversy, "What should the therapist address first, abuse issues or offender issues?" The specific statements analyzed in this chart are: "Offender issues should be dealt with first," "Offender's own sexual abuse issues should be dealt with first," "Abuse and offender issues should be dealt with simultaneously," "The therapist should be flexible about what to work on first," and "Since offenders are criminals, only the criminal behavior need be addressed."
Overall, the categories "simultaneous" and "flexible" scored highest. No one responded that only criminal issues should be addressed in any of the age categories. The majority thought it best to address the victimization issues of children and juveniles before moving on to offender issues. In the case of adults, there was more support for beginning with offender issues (28% compared to 11% for victimization issues). However, the greatest majority (72%) felt the therapist should be flexible when dealing with adult sex offenders.
Figure 5 charts respondents' approval of the more severe forms of therapy with sex offenders: confrontational group therapy, aversion therapy with penile plethysmograph assessment, and castration.
While the questionnaire did not ask about using aversion therapy or castration with children, three respondents (17%) said they approve of confrontational group therapy for children. The preference for these three techniques was greatest with adults, but also high for juveniles. For example, 17% said they approve of castration for juvenile sex offenders.
In Figure 6, respondents were asked to specify when a sexual abuse victim should be responsible for aggressive sexual behavior. Of the 18 respondents, one third gave no answer, one third said "any age," "all life," "all ages," and so on. Another 28% named a figure between three and six years of age. Only one person said anything beyond kindergarten. Thus 61% thought children should be held responsible beginning at an age younger than six.
Discussion
The therapists in this study generally thought therapy should be flexible--not necessarily limited to the confrontational mode. They did not hold fast to the theory that offender issues must be addressed first, as evinced by the strong support for "simultaneous" and "flexible" approaches with all three age categories (see Figure 4). Given a choice of which issues to address first with juvenile sex offenders, more therapists chose victim issues over offender issues (28% compared to 17%).
The respondents did not attribute significant credibility to the notion that sympathetic forms of therapy reinforce minimization and denial. In the questions dealing with this issue, neither viewpoint had a majority in regard to juveniles (33% to 33%, see Figure 3, below). With adults, respondents seemed even less likely to support the "minimization and denial" contention (33% pro-sympathetic; 28% anti-sympathetic).
The data from these two questions supports a flexible approach and appears neutral on the question of minimization and denial. This contradicts the prevailing belief that most therapists belong to the "owning up" school of offender treatment. Half of the respondents didn't even cast a vote for pro-sympathetic or anti-sympathetic treatment with juveniles, indicating that they may have no strong opinion on the subject.
Who Says "Offender Issues Should be Dealt With First"?
In reviewing the survey data, it may be revealing to analyze who agreed with the statement, "offender issues must be addressed first," since this is one of the main tenets of the "owning up" school of therapy.
In the case of juveniles, there were three respondents (17%) who said yes. Of these, one therapist not only said yes to "offender issues first," but picked all the answers, including "offender issues first," "abuse issues first," "simultaneous," and "flexible." Apparently, he thought all issues were important. The second therapist who checked "offender issues first" worked for a state-run youth and family treatment unit. His program was based on the owning up philosophy, and thus it is logical that he would agree with this statement.
The third respondent who chose "offender issues first" described herself as a feminist counselor. There is a feeling among some feminists that juvenile sex offenders are let off too easy, while their young female victims are exploited. This issue was discussed in Child Sexual Abuse: A Feminist Reader, edited by Driver and Droisen (1989). While this may be a valid point in some respects, it can be argued that juvenile sex offenders are already treated too harshly. After all, many juvenile sex offenders are themselves victims of sexual abuse. As this study proposes, a sympathetic approach may rehabilitate more young male sex offenders, thus reducing the number who go on to become adult sex offenders. The aim non-confrontational therapy is not to protect youthful sex offenders from punishment, but rather to help them heal their wounds and make a commitment to recovery. Any method that helps in this regard should be welcomed by feminist therapists.
In the case of adult sex offenders, five respondents (28%) agreed with the statement, "offender issues should be dealt with first." Of the five, two checked all the answers, "offender issues first," "abuse issues first," "simultaneous," and "flexible." Two others indicated that they work within the correctional framework that supports owning up, and the fifth was the feminist counselor mentioned above.
If these findings could be generalized, it would seem that support for the anti-sympathetic, "offender issues first" philosophy has its strongest support among correctional-based therapists and feminists. This would be an interesting finding, since professionals in the corrections field give the impression that "offender issues first" is the only acceptable approach. Obviously, not all therapists agree.
A byproduct of the owning up model is behavioral therapists' promotion of aversion therapy and penile plethysmograph assessment as the ultimate cure, even for juveniles. In fact, these techniques are used in Washington state, and there is a growing movement to bring more aversion therapy into juvenile treatment. Not all therapists support aversion therapy, as the data in this study shows. In fact, supporters may be a minority of therapists in the overall field of psychology.
Some therapists consider it a mistake to introduce aversion therapy for general use with juveniles, since it is painful and embarrassing. It could be argued that the procedure itself simply adds to the abuse the juvenile has already suffered. Adolescents are in a transitional period, where their attitudes about sexuality are being formed. The penile plethysmograph apparatus, coupled with vile slide shows and audio suggestions--not to mention sniffing ammonia fumes or receiving mild electric shocks--could easily destroy an adolescent's ability to form normal attitudes about their own sexuality.
Who Supports Aversion Therapy?
Ten respondents (67%) said they approved of aversion therapy for adults (see Figure 3). This is more than half, but does not constitute a substantial majority. The respondents who chose this answer were spread across the spectrum of education levels, types of clients, and private or agency employment. Thus, if these results could be generalized, it appears that a majority of practitioners in the field of psychology approve of aversion therapy for adults.
Of the ten, six also approved of aversion therapy for juveniles. However, three qualified their answers with write-in comments like, "Depends on situation" and "Case by case basis." Only three respondents made no comment when they said they approve of aversion therapy for juveniles.
Surprisingly, though, seven of the ten respondents said they thought art therapy could be useful in treating juvenile and adult sex offenders. Since art therapy is generally non-confrontational and client-centered, this seems to indicate that the two schools can work together and share ideas for sex offender treatment.
Overall, the respondents were supportive of flexible, sympathetic treatment. These findings are significant, since they challenge the status quo of sex offender treatment. If the sample of therapists who took part in this study represent the general population of therapists, then there is more support for sympathetic offender treatment than those in the correctional field assume.
*Editor's Note: The illustrations are lifted from Adobe PageMaker and pasted into PhotoShop and therefore some of the type is pixelated, please forgive any inconvenience this may cause. Also, there is no Figure 1 or 2, due to using the same jpgs as used in the thesis files. In the thesis there were eight figures; only numbers 3, 4, 5, and 6 appear in this article.
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