Sexual Compulsivity and Addiction

The Association of Group Climate and Working Alliance in Group Psychotherapy with Adult Male Sex Offenders

An emerging body of research suggests that sexual offenders’ experience of the group therapy environment likely affects the ultimate impact of treatment. For example, Beech and Fordham (1997) found that sexual offenders’ positive perceptions of the group were linked to change on various recidivism factors. In a related study that assessed 12 groups of sexual offenders in the U.K., Beech and Hamilton-Giachritsis (2005) observed that sex offenders’ ratings of group cohesion were associated with reductions in prooffending attitudes. According to the authors, despite these data it is not yet known how, and to what extent, perceptions of the group therapy climate are related to sexual offenders’ views of the working alliance with the group therapist. The current study sought to assess this association across a 24-week period in two outpatient groups of sexual offenders. Sexual offenders’ perceptions of group climate were assessed with The Group Climate Questionnaire—Short Form (GCQ-S; MacKenzie, 1983), a self-report instrument designed to obtain perceptions of a group’s therapeutic environment on three subscales: engagement, avoidance, and conflict. Perceptions of therapeutic alliance were assessed with The Working Alliance Inventory-Short Version (WAI-S; Horvath, & Greenberg, 1989), a 12-item measure that yields a general alliance score as well as bond, task, and goal component scores. A repeated measures study design was employed to evaluate sexual offenders’ perceptions of climate and alliance factors across 4 time points. Overall, results of this study strongly suggest that the therapeutic alliance in clinical work with sexual offenders is a significant catalyst for the unique therapeutic factors inherent in the group therapy modality.

Culture, Norms, and Process in Adult Sex Offender Groups: Getting Reacquainted with the Therapeutic Factors of Groups

Most clinicians who treat adult sex offenders utilize group therapy. However, facilitation of groups for sex offenders is often highly idiosyncratic, with great variance in the content and process of groups, clinicians’ views of intervention goals, strategies, and technique, and how the cultural fabric of the group is established. Moreover, clinicians who treat sex offenders typically have expertise in the assessment of risk, relapse prevention, and individual factors that impact the nature and magnitude of aberrant sexual beliefs and tendencies, yet have never had or don’t readily recall advanced training in group psychotherapy. To address this issue, this presentation will describe and delineate transtheoretical factors of group psychotherapy, including here-and-now processing, vicarious learning, group-as-a-whole phenomena, and developmental dynamics across the evolution of the group. Attention will be devoted to the relevance of these factors for adult male sex offender groups, with clinical case material used to illustrate significant themes.