Motivational interviewing in the treatment of sexual offenders

by D.S. Prescott & J. Porter

D.P. Boer, R. Eher, L.E. Craig, M.H. Miner, & F Pfäfflin (Eds.),
International perspectives on the assessment and treatment of sexual offenders
(pp. 373-396).
Wiley-Blackwell: Chichester, West Sussex, UK (2011)

Published in conjunction with IATSO.
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There are people who have sexually abused, make it all the way through treatment and, find real value along the way. On the other hand, some individuals fall by the wayside or even cheat their way through treatment. Clearly individual disposition and situational factors are important. The question is: what can clinicians do to help clients stay the course and truly maintain change? How do professionals help build healthier lives as well as safer communities?

First, we should consult our own feelings and experiences. Imagine approaching a mental health professional to discuss some intimate area of your life that you want to improve. Imagine that the professional lists three reasons why it’s important that you make this change, gives you a stack of evidence-based articles to read about the dangers of your current behavior, and then tells you in clear and bold terms to make the change. The immediate information provided and the urgency of the call for action by the professional is not new for you. Although on some level you agree with the advice and directive, you still haven’t had the chance to turn this over in your own mind while talking with another person. What would you be thinking? What would you be feeling?

Now consider the experience of a client who has sexually abused. Imagine the most shameful thing you’ve ever done or had happen to you. Now pretend that you have to talk about this experience in a group of strangers as part of treatment, with a forensic psychologist, surrounded by people who might tell others about your life experiences and secrets. The group is going to ask you questions to make sure you review this experience repeatedly at the deepest level. Imagine that you do not trust either the psychologist or your peers, and someone has told you that you may need to role-play this experience in front of the group. By using case examples, this chapter describes how professionals can use motivational interviewing in their work with people who have sexually abused. This is nowhere near a comprehensive introduction on the topic, but an attempt to encourage readers to explore this topic further through clinical skills training with qualified trainers who can provide objective feedback on their practice.