ATSA Practice Guidelines And Ethics: Dealing With Sexual Offenders

Wednesday, December 15, 2021 6:33:03 AM

ATSA Practice Guidelines And Ethics: Dealing With Sexual Offenders

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But if their concern is how depressed and isolated they feel, I should think all therapists are trained to deal with that -- and maintain the warm, concerned connection they would have with any other client. Important Note: This blog is a commentary about mandatory reporting laws in the US as they may apply to child maltreatment. Mandated reporting laws in the US are state-by-state and too critical for any blog to offer conclusive advice to a wide audience. Professionals might have reporting duties contrary to this discussion or beyond the scope of this opinion piece e. Individuals should determine what the reporting requirements are in their respective jurisdictions, and comply with them accordingly. When a mandated reporter receives credible information about criminal sexual conduct involving a child, reporting child sexual abuse may be an easy call.

But those cases are the exception. Professionals often encounter ambiguous information about inappropriate sexual conduct, including non-contact sexual behaviors. There is not much ground in between. Despite the good intentions behind mandated reporting, there are competing concerns and legitimate controversies around mandated reporting, under both US and Canadian laws. The US, Canada, Australia, and many other countries have some form of mandatory reporting. Mandated reporters typically include teachers, mental health professionals, social workers, law enforcement, health care workers, and child care providers, among others.

In the US, 48 states have mandatory reporting laws that require specific professionals to report suspected child maltreatment. As of , 18 US states require everyone to report suspected child maltreatment. When a privileged relationship exists, professionals need to consider whether their first duty is to client privacy and confidentiality, or to mandatory reporting. Breaking client privacy, even with legal justification , is likely to be detrimental to the therapeutic relationship. The decision to report, or not report maltreatment can be life-altering for children and for clients. For professionals, an errant decision, in either direction, can have far-reaching consequences for many individuals, including themselves.

Privileged Communication and Mandatory Reporting. Physicians, clergy, psychotherapists, chemical dependency counselors, and others with privileged communication advance the public interest of providing professional expertise to society — making confidential services available to individuals who might not seek professional help for fear of reprisals. The precepts of privileged communication are established by a combination of laws and professional ethics that seek a balanced outcome that both helps individual clients and serves the public interest.

Sometimes the balance is tenuous, but privileged communication is essential to many professional relationships. But confidentiality is foundational in most therapeutic relationships and therefore privileged communication is essential. As a result, most licensed mental health professionals generally do have a privileged relationship with clients. Redmond , U. The requirements of this privilege are: 1 the communications must be confidential, 2 the therapist must be a licensed psychotherapist, and 3 the communications must occur in the course of diagnosis or treatment Mitrevski, Some might view mandatory reporting as a moral responsibility, but when one is operating under the auspices of a professional license, they must understand the obligations and the limits of relevant laws and professional ethics.

The same set of laws and professional ethics that extend privileged communication to licensed mental health professions, also establish the requirements of mandatory reporting. Professionals often learn about client conduct that ranges from sordid to illegal. There are very few cases where licensed mental health professionals may violate privileged communication. Mandatory reporting is one exception, and clients should be forewarned. When confidentiality attaches to a professional relationship, privileged information belongs to the client. Clients need not invoke the right. Mental health professionals have legal and ethical responsibilities to zealously protect privileged communication with their clients, even in forensic settings.

Regardless of whether clients understand their rights to privileged communication, therapists should respect and maintain both privileged communication and data privacy unless clients specifically waive those rights. Who is the Subject of Mandated Reports? Perhaps the most common confusion about mandatory reporting is not understanding who is the subject of a child maltreatment report. Generally, the subject is not the alleged abuser but rather a specific child or children who may have been abused or neglected, might be in a harmful situation, or otherwise meet a statutory definition for reporting maltreatment.

There are two important considerations: 1 in most states, reporting laws are predicated on suspected maltreatment by a parent, care provider, or someone in a position of authority; and 2 reporting requirements depend on whether suspected maltreatment is current or historical. In keeping with these general guidelines, reporting laws in the US vary by state. Sexual Offenders and Mandatory Reporting. In providing treatment to those who have sexually offended, psychotherapists might be the first to discover new child victims. It is the indistinct cases of child maltreatment that frequently create professional hazards for therapists.

These circumstances can occur repeatedly within sexual offender treatment settings because clients are typically expected to disclose their entire sexual history, including not only all victims, but in some cases every sexual transgression going back to puberty. Developmentally appropriate, research informed interventions are utilized with adolescents who have engaged in sexually abusive behavior. References Finkelhor, D. Caldwell, M. Study characteristics and recidivism base rates in juvenile sex offender recidivism. Hanson, R. The principles of effective correctional treatment also apply to sexual offenders: A meta-analysis. Criminal Justice and Behavior, 36 American Psychological Association American Psychological Association: Washington, D.

Prescott D. Righthand, S. Youths who have sexually offended. A review of the professional literature. Practice standards and guidelines for members of the Associate for the Treatment of Sexual Abusers. Adolescent sexual aggression: Risk and protective factors. Pediatrics, unpaginated electronic article. Sexual coercion experience and sexually coercive behavior: A population study of Swedish and Norwegian male youth. Child Maltreatment, 15 , Criminal Victimization, Michael Rand. September NCJ Worling, J. Behavioral Sciences and the Law, 28, Elliott, D.

Criminology, 32, Huizinga, D. Developmental sequences in delinquency: Dynamic typologies. In Crockett, L. Pathways through adolescence Mahwah, NJ: Lawrence Erlbaum. Loeber, R. Journal of Child and Family Studies, 6, Violent juvenile sex offenders compared with violent juvenile nonsex offenders: Explorative findings from the Pittsburgh Youth Study. Seto, M. What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis. Psychological Bulletin , Masten, A. Resilience in development. Lopez Eds. New York: Oxford University Press. Youth violence perpetration: what protects? What predicts? Journal of Adolescent Health ; Hoge, R. Treating the Youthful Offender. Guilford Publications, Inc. Fanniff, A.

Specialized assessment and treatment of adolescent sex offenders. Aggression and Violent Behavior, 11 , Chaffin, M. The case of juvenile polygraphy as a clinical ethics dilemma. Turpel-Lafond, M. Issue report: Phallometric testing and B. The assessment and treatment of deviant sexual arousal with adolescents who have offended sexually. Journal of Sexual Aggression, 18, Rice, M. Further, this meta-analysis showed that phallometric testing predicts sexual re-offence in distinct subgroups of sexual offenders against children.

There are criticisms of the methodology used to determine the reliability and specificity of penile plethysmography. There is a criticism of this discrepancy for lacking consistency in the standards of whether or not subjective reports are useful. There is also criticism regarding the possibility of sampling bias being greater in male subjects of penile plethysmography than in female subjects of vaginal plethysmography, males being generally more aware of their physical sexual responses than females in most cultures may cause the male volunteers to be almost exclusively individuals who have category specific erections due to those with nonspecific erections fearing erection in taboo contexts and therefore not signing up for the studies.

This effect may explain apparent male specificity as a result of methodological bias. The difference between tests of volunteers and tests of convicted or suspected sex offenders in penile plethysmography results may be caused by the sex offender group often effectively lacking the choice not to volunteer, without difference in erection patterns from the average population. One criticism of reoffending studies is that cultural attitudes that assume that men are sexually attracted to what they phallometrically respond to may cause men with no actual sexual interest in children to identify as pedophiles due to knowing that they phallometrically respond to them, making them more likely to be convicted again.

The penile plethysmograph has value in screening organic versus psychogenic erectile dysfunction in urological polysomnography centres. When applied during nerve-sparing surgery , electrical stimulation penile plethysmograph is an erectile dysfunction prognostic. The patient is provided with objective information on his specific outcome which aids in planning for further erectile function therapies. Studies examining the efficiency of using penile plethysmograph to distinguish pedophilic men from non-pedophilic men, including hebephiles , show that a majority can be correctly assigned to the proper category. Specificity of these tests is defined as the accuracy of the test to identify non-pedophilic or non-hebephilic individuals as such.

Meta-analytic research has shown that sexual offenders against children show greater responding on phallometric tests for pedophilia and hebephilia than controls. Other studies have examined the sensitivity and specificity of circumferential phallometry to identify different sexual interests in children. A single study has examined the accuracy of a circumferential phallometric test for hebephilia.

Another study examined the possibility that juvenile sex offenders might be able to suppress arousal deemed deviant. Sexual arousal in response to older adult women or peers was deemed age appropriate; sexual arousal in response to significantly younger females was deemed inappropriate. Many of the juveniles who denied responsibility for their offenses showed no sexual arousal at all—however about one-third still showed age inappropriate arousal despite denying responsibility for their offenses.

Phallometry might distinguish men with erotic interests in cross-dressing from non-cross-dressers. There is some evidence that phallometry can distinguish groups of men with biastophilia a paraphilia involving rape from groups of men without it. In general, phallometric test results are employed as part of the sentencing and rehabilitation phase of forensic systems, but not for determining whether a specific defendant is guilty of any specific offense against any specific person. In the United States , a scientific technique could not be used as evidence in court unless the technique was "generally accepted" as reliable in the relevant scientific community. This was known as the Frye standard , adopted in In , the doctrine was rejected by the Supreme Court of the United States in favor of a more comprehensive "reliable foundation" test in Daubert v.

Merrell Dow Pharmaceuticals. In the Daubert standard , the "generally accepted" test was no longer determinative. Several other factors could now be considered, including whether the technique had been published and peer reviewed. Myers notes, "Courts that have considered penile plethysmography generally rule that the technique is not sufficiently reliable for use in court. In United States v.

Powers the court excluded the penile plethysmograph test because it failed to qualify under Daubert's scientific validity prong for two reasons: the scientific literature does not regard the test as a valid diagnostic tool, and "a vast majority of incest offenders who do not admit their guilt, such as Powers, show a normal reaction to the test. The Government argues that such false negatives render the test unreliable. According to Barker and Howell, penile plethysmography PPG does not meet the legal threshold for the guilt phase for the following reasons: [48].

In State of North Carolina v. Spencer , [51] the court reviewed the literature and case law and concluded that penile plethysmography was scientifically unreliable: "Despite the sophistication of the current equipment technology, a question remains whether the information emitted is a valid and reliable means of assessing sexual preference. More recently, a substantial amount of research data has been gathered and reviewed, and significant steps have been taken toward standardization. Phallometry is widely considered appropriate for treatment and supervision of convicted sex offenders : "Courts have permitted plethysmographic testing for monitoring compliance by convicted sex offenders with the conditions of their community placement as part of crime-related treatment for sexual deviancy.

During the Catholic sex abuse cases , the reliability of the test was questioned by some officials in the Roman Catholic Archdiocese of Philadelphia. Later, these officials chose to seek therapy at an institution where the plethysmograph was not used. Courts in Canada came to a similar conclusion as those in the United States. A level of reliability that is quite useful in therapy because it yields some information about a course of treatment is not necessarily sufficiently reliable to be used in a court of law to identify or exclude the accused as a potential perpetrator of an offence.

In fact, penile plethysmography has received a mixed reception in Quebec courts: Protection de la jeunesse — , [] R. Blondin , [] Q. Morin and C. Efforts to use penile plethysmography in the United States as proof of disposition have largely been rejected: People v. John W. State , S. Powers , 59 F. Spencer , S. Myers et al.

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