Thursday, February 20, 2020

Experiencing and coping with the “sex offender” label: An international challenge - Can we handle what our clients have to say about it?


By Ingeborg Jenssen Sandbukt, David Prescott, LICSW, & Kieran McCartan, PhD.

Please note that this blog is longer than normal but we felt that breaking the blog into two would have been artificial and would have broken up the flow of the piece. Kieran

The first author (Ingeborg) recently completed a thesis that studied the concerns expressed by individuals convicted of sexual offenses. It examined their experiences with stigma, both in prison and post-release, in Norway. The study is based on qualitative interviews with eight adult men, all convicted of at least one sex offense. The eight men interviewed were relatively recently released from prison, and most were still subject to terms and conditions set by the Norwegian Correctional Services. Five had been sentenced to regular prison sentences, two had been sentenced to preventive detention, and one had been given a community sentence in addition to imprisonment.

These men’s experiences in prison involved hearing about and witnessing violence and threats towards other persons convicted of sex offenses. A few of the men had been bullied themselves by other prisoners. Internationally, these experiences are not unusual for people incarcerated for sexual offenses. Some of the men were advised by prison staff to come up with a believable cover story to avoid negative sanctions from other prisoners. In some cases, these men told others that they had been convicted for various petty crimes. In one case, a man had been advised by a prison officer to simply state that he had ben convicted of fraud involving welfare benefits. Not surprisingly, most participants did their best not to be recognized as a “sex offender” in prison, although some could not avoid the label. However, the all the men who took part in the research were all highly aware that they were unwanted and seen as outcasts by the prison community, never mind the general society outside of prison, which reemphasizes the stigma that sexual offending elicits in society.  

The experiences that these men had in prison are relevant to their post-release use of coping strategies. The results highlighted that the strategies used in most cases were a reaction to and a result of others’ perceived attitudes towards people convicted of sex offenses as a group. The strategies were not the result of a proactive desistence strategy.

Informants in this study experienced high levels of stress linked to being recognized as someone who had committed a sexual offense, even after release. In many ways they limited their own life opportunities as a result of trying to cope with the threats they perceived. The reasons for these responses are easy to understand. In prison they learned that their offenses would not be forgiven. They were told to lie to stay safe. After release, their families and friends cut them off. Courtesy stigma and episodes of informal notification by others of their crimes led them to believe that there was no chance of redemption. Finally, through the media, they learned that others with similar histories as themselves were considered monsters. As a result, and as a group, informants in this study withdrew and isolated more, and their self-images were in some cases affected negatively.

This study reflects broader research in the field internationally, with many participants experiencing broken bonds with family and friends and a negative portrayal in the media. Further, they have seen how they are considered to be “monsters” in public discourses, with the associated perception that they are always going to be a threat. This is very relevant to post-release experiences in Norway, as media accounts are widespread, and the country has a comparatively small population and a deep sense of community that binds people together. Therefore, media discourses feed into wider stigma.

These media processes and resulting stigma are especially important because Norway is often seen as exceptional when it comes to post-release reintegration and inclusiveness. These findings challenge this belief. Norway does not have official registration and disclosure policies for people convicted of a sexual offense, but the nature of the offense was enough to create an informal, persistent label that the men could not escape. In light of this, Ingeborg’s research examined participants’ perspectives of the way that they were perceived and labelled focusing on how it impacted their self-image and capacity to desist as well as integrate back into the community. The research found that some participants presented their futures with hope and enthusiasm, while others seemed somewhat hopeless. The men described how their status as a person convicted of sexual offenses did, and could possibly, limit their opportunities to live the life they wanted post release.

The recidivism rates for this group of offenders are low* in Norway, as in the rest of the world. The challenge is that research consistently finds that one of the greatest contributors to desistance is strong social bonds and pro-social networks, but the way that these men are labelled and viewed in society breaks these bonds and, therefore, makes reoffending more likely. What the participants wanted was to be able to be open about their conviction and treated like any other citizen even though they had once committed a sexual offense. Their stories indicate that there is a need to review the idea of the inclusive Norwegian society, concerning this topic.

What is the international relevance of these findings from Norway? These findings add to what has been known from earlier studies (Levenson, Prescott, & Jumper, 2014; McCartan, Harris, & Prescott, 2019). Namely, that understanding the service user perspective is central to public safety as well as successful treatment and integration back into the community. Perhaps the most puzzling aspect of studying the service user’s voice regarding their treatment experience is how little study has taken place. Why? How is it that programs don’t consider feedback? What gets in the way?

First, remember that understanding client experiences and client satisfaction is not the same as monitoring outcomes or checking in on the working alliance. Ensuring that clients are generally happy with services is not the same as ensuring that those services are working, even though the latter is unlikely without the former. It’s important to consider every angle of the experience in order to produce services that effectively build community safety.

Second, the working alliance is about more than just the relationship; this has been found to be important in community supervision efforts as well as treatment. The working alliance involves building agreement on the goals of rehabilitative efforts (which itself can require a wide array of interpersonal skills). It also requires agreement on the tasks of treatment and agreement on who the therapist is in the life of the client. Finally, the alliance involves delivering treatment, supervision and support in a manner that fits with the strong personal and cultural values of the client.

Third, the vast majority of research into the treatment of people convicted of sexual offenses is about the model used and its impact in reducing re-offending, and not about behavior change or harm reduction; both are helpful key performance indicators in treatment.

Fourthly, and perhaps the biggest barrier to honoring the service user’s voice, is the belief of agencies and individual clinicians that they are already doing it. It can be easy for professionals to assume that they understand each client’s internal experience of treatment and to form further assumptions and plans for treatment accordingly. Unfortunately, research from within our field (Beech & Fordham, 1997 ) and outside it (Bertolino & Miller, 2013) finds that therapists typically overestimate their effectiveness. This can become a bitter pill to swallow, especially when so many forms of psychological approaches already come with an implicit assumption that treatment is something we do to our clients rather than with them or on their behalf.

Finally, it is worth noting that if we are truly to help efforts at public safety, it makes perfect sense to study those who experience our interventions the most. As research indicates, they are often the ones most motivated to make treatment work.


* In a Nordic study of recidivism (Graunbøl et al., 2010), 3% of individuals convicted of sexual offenses in Norway recidivated within 2 years after release from prison, none of them into new sex crimes. Longer follow-up periods naturally provide higher recidivism rates, as indicated by a 5-year sexual recidivism rate of 8% in Norway (Grünfeld et al., 1998).

References

Beech, A. R. & Fordham, A. S. 1997. Therapeutic climate of sexual offender treatment programs. Sexual Abuse:  A Journal of Research and Treatment 9: 219–237.
Bertolino, B. & Miller, S.D. (Eds.) (2013). The ICCE Feedback Informed Treatment Manuals (6 Volumes).  ICCE: Chicago, Illinois.
Graunbøl, H.M., et al. (2010). RETUR En nordisk undersøgelse av recidiv blandt klienter i kriminalforsorgen.

Grünfeld, B., Noreik, K., & Sivertsen, E.A. (1998). Straffedømte sedelighetsovergripere. Hvor stor er tilbakefallsrisikoen? Tidsskrift for Den norske lægeforening, 118(1), 63-66.
Levenson, J.S., Prescott, D.S., & Jumper, S. (2014).  A consumer satisfaction survey of civilly committed sex offenders in Illinois. International Journal of Offender Therapy and Comparative Criminology, 58, 474-495.

McCartan, K.F., Harris, D.A., & Prescott, D.S. (2019). Seen and not heard: The service user’s experience through the justice system of individuals convicted of sexual offenses. International Journal of Offender Therapy and Comparative Criminology, 1-17.  doi: 10.1177/0306624X19851671.

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