This book presents both a compact summary of the voluminous research on Sexual Violence and a practical, evidence-based "how-to" treatment guide for mental health practitioners working in clinics and institutions that treat men who are sexually coercive and violent toward others. Those needing intervention may be college students, individuals seeking outpatient help, family batterers, or those who sexually abuse women and children. They may have been arrested for sex crimes or be incarcerated or on probation in sex offender treatment program, though most will never have been arrested. This clearly written and well-structured resource will help clinicians deal with all. The book first reviews research on the prevalence of sexually abusive behavior, along with diagnostic issues, assessment strategies, and risk assessment approaches, and then presents current integrated theories on the causes of sexually violent behavior. The primary focus, however, is the specific emotional and behavioral targets of treatment and the therapist skills and strategies that are effective in reducing sexual victimization. Cultural factors that influence treatment are identified and effective prevention programs for Sexual Violence are also described and evaluated.
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Sexual Violence
About the Author
William R. Holcomb, PhD, ABPP, MBA, has been a forensic psychologist for approximately 30 years. He received his doctorate from the University of Missouri-Columbia and later was awarded a diplomate certification of Forensic Psychology by the American Psychological Association. He has maintained an active clinical and consulting practice throughout his career. His primary areas of career focus have been competency, insanity, personal injury, and threat assessment evaluations and the treatment of criminal offenders in community, jail, and prison settings. He is currently a Professor and Program Director for Forensic Studies at Alliant International University in San Francisco, CA.
Advances in Psychotherapy – Evidence-Based Practice
Danny Wedding; PhD, MPH, Prof., St. Louis, MO
(Series Editor)
Larry Beutler; PhD, Prof., Palo Alto, CA
Kenneth E. Freedland; PhD, Prof., St. Louis, MO
Linda C. Sobell; PhD, ABPP, Prof., Ft. Lauderdale, FL
David A. Wolfe; PhD, Prof., Toronto
(Associate Editors)
The basic objective of this series is to provide therapists with practical, evidence-based treatment guidance for the most common disorders seen in clinical practice – and to do so in a “reader-friendly” manner. Each book in the series is both a compact “how-to-do” reference on a particular disorder for use by professional clinicians in their daily work, as well as an ideal educational resource for students and for practice-oriented continuing education.
The most important feature of the books is that they are practical and “reader-friendly:” All are structured similarly and all provide a compact and easy-to-follow guide to all aspects that are relevant in real-life practice. Tables, boxed clinical “pearls”, marginal notes, and summary boxes assist orientation, while checklists provide tools for use in daily practice.
Sexual Violence
William R. Holcomb
Alliant International University, San Francisco, CA and Coalinga State Hospital, CA
Library of Congress Cataloging in Publication
is available via the Library of Congress Marc Database under the
LC Control Number 2010921353
Library and Archives Canada Cataloguing in Publication
Holcomb, William R
Sexual violence / William R. Holcomb.
(Advances in psychotherapy--evidence-based practice ; v. 17)
Includes bibliographical references.
ISBN 978-0-88937-333-4 :c$37.50
1. Sex offenders--Psychology. 2. Sex offenders--Rehabilitation. 3. Violence in men. I. Title. II. Series: Advances in psychotherapy--evidence-based practice ; v. 17
RC560.S47H642010
616.85’8306
C2010-900848-0
© 2010 by Hogrefe Publishing
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Acknowledgments
I want to thank my friend Danny Wedding, who convinced me to write this book and who provided supportive encouragement and valued editorial insight as this work took shape. Of course, this book would not be possible without all the clients I have had across 35 years of work as a therapist in private practice, hospitals, mental health centers, jails, and prisons. From them I have learned so much. I have also been very fortunate in having many wonderful supervisors and colleagues who have helped me become a better therapist and forensic psychologist.
Dedication
To my daughter, Megan, who is very wise and always a joy for her father. This book is also dedicated to all my friends and supportive colleagues at Alliant University.
Table of Contents
1 Description of the Problem
1.1 Definition
1.2 Epidemiology
1.3 Effects of Sexual Violence on Victims
1.4 Sexual Coercion in the Community
1.5 Course and Prognosis of Sexual Violence
1.5.1 Differences Between Sexually Violent Persons
2 Theoretical Models to Explain Sexual Violence
2.1 Hierarchical-Mediational Confluence Model (HMC)
2.2 A Comprehensive Model of Prediction
2.3 An Integrated Theory of Sexual Offending
2.4 A Theory of Interacting Proximal and Distal Predictive Factors
2.5 Facilitators of Sexual Violence
2.5.1 Pornography and Sexual Violence
2.5.2 Alcohol Use and Sexual Violence
2.6 The Influence of Early Childhood Abuse and/or Neglect
2.7 Prevention
3 Diagnosis
3.1 Differential Diagnosis
3.1.1 Unreliability of Paraphilia Diagnoses
3.1.2 Problems with DSM IV-TR Criteria of Paraphilia
3.1.3 Significant Problems with the Diagnosis of Sadism
3.2 Co-Morbidity and Co-Occurring Diagnoses
3.3 Sexual Coercion and Hypersexuality
3.3.1 Sexual Coercion and Sex Hormones
3.4 Assessment Strategies
3.4.1 Psychosocial Evaluation
3.4.2 Psychometric Testing
3.4.3 Risk Assessment
3.4.4 Assessment of Sexual Fantasies
3.4.5 Polygraph and Viewing Time Procedures
4 Treatment
4.1 Does Treatment Work?
4.2 Reformulated Relapse Prevention
4.3 Different Pathways and Different Treatments
4.4 A Treatment Program That Does Work
4.5 Important Therapist Skills
4.5.1 Empathy
4.5.2 Genuineness
4.5.3 Warmth
4.5.4 Acceptance
4.5.5 Confidence
4.5.6 Supportiveness
4.5.7 Emotional Expressivity
4.5.8 Self-Disclosure
4.5.9 Open-Ended Questions
4.5.10 Flexibility of Style
4.5.11 Positive Attitudes
4.5.12 Rewarding
4.5.13 Humor
4.6 Support Versus Confrontation Versus Collusion
4.7 Motivational Interviewing
4.8 Schema Therapy and Cognitive Distortions
4.9 Targets of Treatment
4.9.1 Self-Esteem
4.9.2 Acceptance of Responsibility
4.9.3 Pathways to Offending
4.9.4 Victim Empathy
4.9.5 Social Skills
4.9.6 Healthy Attachment
4.9.7 Emotional Regulation
4.9.8 Deviant Sexual Fantasies
4.9.8.1 Behavior Modification
4.9.8.2 Pharmacological Interventions
4.9.9 Self-Management Plans
4.10 A Special Population—Individuals with Developmental Disabilities
4.11 Best Practices in Treatment of Sexually Violent Persons
4.12 Cultural Considerations in Sex Offender Treatment
4.13 Summary and Conclusions
5 Case Vignettes
Case #1 (Joe)
Case #2 (John)
Case #3 (MM)
Case #4 (JC)
6 Further Reading
7 References
1
Description of the Problem
Sexual violence remains a significant problem in our society. Mental health professionals too often confront the immediate consequences of sexual assault in emergency rooms, victim support centers, correctional institutions, mental hospitals, and outpatient clinics. Law enforcement personnel and child protective agencies are persistently faced with child sexual molestation, incest, intimate partner sexual violence, and rape. The good news in this horrific story is that the prevalence of sexual assault seems to have been going down in the United States since the mid-1970s, according to the National Victimization Survey (Catalano, 2005), but the incidence remains high and a significant presenting problem for mental health professionals.
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
