Best Practices in Sexual Offender Assessment and Management (Dangerous Behavior in Clinical and Forensic Psychology)

Description

This book provides a critical examination of assessment and treatment approaches for sexual offending, presenting cutting-edge insights from leading experts in evidence-based management of sexual deviance. It offers a systematic overview of the empirical literature and multifaceted research into clinical and criminal aspects, addressing gaps and advancements in public health and policy responses. The volume explores sex offender classification systems, risk assessment for recidivism, psychotherapeutic and pharmacological interventions, and the clinical and criminal correlates of common paraphilias. Special focus is given to best practices tailored for unique populations, making this an essential reference for clinical psychologists, correctional professionals, and students and researchers of sexual offenses. Preface Contents About the Editors and Contributors About the Series Editors About the Volume Editors Contributors Chapter 1: Introduction to Sexual Offending Chapter 2: Sexology 2.1 Introduction 2.2 Sexual Communication 2.2.1 Sexual Script Theory 2.2.2 Gender Roles, Sexual Scripts, and Consent 2.2.3 Future Research Directions and Clinical Interventions 2.3 Sexuality, Culture, and Society 2.3.1 Culture-Bound Conditions and Treatment Theory 2.3.2 Society, and Changes in Sexual and Dating Practices 2.4 What Is Known About Sexual Behavior 2.5 Gender Identity 2.5.1 Diagnosis and Treatment Considerations 2.5.2 Gender Affirmative Lifespan Approach (GALA) 2.5.2.1 Philosophical Foundations 2.5.2.2 Core Components 2.6 Sexual Dysfunction 2.6.1 Erectile Dysfunction 2.6.2 Premature Ejaculation 2.6.3 Desire Discrepancy 2.6.4 Sexual Therapy Approaches 2.7 Compulsive Sexual Behavior 2.8 Summary and Conclusions References Chapter 3: Classification Models for Individuals Who Have Sexually Aggressed 3.1 Introduction 3.2 Brief Critical History of Typological Research for Sexually Aggressive Individuals 3.2.1 Rational Methods of Generating Typologies from Clinical Experience 3.2.2 Empirical/Inductive Clustering Methods of Typology Generation 3.2.3 Dimension or Category? 3.2.3.1 Hypersexuality and the Paraphilias 3.2.3.2 Facets of Psychopathy 3.2.3.3 Paraphilic Coercion and Sadism 3.2.3.4 Sexual Age Preference 3.2.3.5 Taxometric Conclusions 3.2.4 The Integrated Approach to Generating and Testing Typological Models 3.2.4.1 Integration and Its Application 3.2.4.2 Some Important Contributions of the Integrative Program 3.2.4.2.1 Determining the Distribution of Core Variables Relevant to Sexual Aggression 3.2.4.2.1.1 Generating Assessments for Decisions 3.2.4.2.1.2 Research Strategies 3.2.4.2.1.3 Studying Etiology 3.2.4.2.2 The Role of Psychopathic Traits in Sexual Aggression 3.2.4.2.3 Hypersexuality and Its Nomological Network 3.2.4.2.4 Sexual Sadism and the Agonistic Continuum 3.2.4.2.5 The Integration of Developmental and Typological Models 3.3 Conclusions 3.4 Future Directions References Chapter 4: Psychodynamic Perspectives of Sexual Offending 4.1 Introduction 4.2 The Psychodynamic Perspective 4.3 Psychoanalytic Training 4.4 Review of Psychodynamic Theory Related to Sex Offending 4.5 Clinical Concepts Related to Sex Offending 4.6 The Efficacy of Psychodynamic Treatment 4.7 Conclusion References Chapter 5: Experiential and Existential Dimensions in Sex Offender Treatment 5.1 Introduction 5.2 Multiple Case Studies 5.3 Existential Givens 5.4 The Existential Concerns of Sex Offenders 5.4.1 Life and Death 5.4.2 Connectedness and Existential Isolation 5.4.3 Meaning and Meaninglessness 5.4.4 Freedom, Responsibility, and Guilt 5.5 Discussion 5.6 Limitations 5.7 Conclusions References Chapter 6: Gestalt Analysis of Sexual Offending 6.1 Sexuality in the Gestalt Perspective 6.2 Maturity as an Evolutionary Task and Competence to Contact 6.3 Sexual Violence and Its Forms 6.4 Origin of the Violent Pedophilic Relational Modality 6.4.1 The Impotence of the Body 6.4.2 The Exercise of Power 6.4.3 The Plastic Form of Sexuality 6.4.4 Clinical Research on the Subject 6.5 Origin of the Violent Relational Modality: The Rapist 6.5.1 Sexual Violence According to Gestalt Therapy 6.5.2 Anthropological Traces 6.5.3 The ‘Rape Drug’: Clinical Case 6.6 Peculiarities 6.7 Therapeutic Paths 6.7.1 Restore the Personality-Function of the Self 6.7.2 Access the Sensory-Motor Register. The Es-Function of the Self 6.7.3 The Organism-Environment Contact: The Ego-Function of the Self 6.7.4 Aggression and Sexuality 6.7.5 The Power of Hospitality References Chapter 7: Developmental Considerations for Sexual Offending 7.1 Introduction 7.2 Adverse Childhood Experiences 7.2.1 Prior Sexual Victimization 7.2.2 Physical Abuse and Maltreatment, Early Exposure to Family Abuse and Violence, and General Maltreatment 7.3 Theoretical Explanations 7.4 Pathway to Sexually Problematic Behavior 7.5 Factors Protective Against Sexually Problematic Behavior 7.6 Application of Developmental Considerations for Sex Offending References Chapter 8: Neuropsychological Considerations of Sexual Offending 8.1 Introduction 8.2 Pedophilia and Sexual Offending Against Children 8.3 Neuropsychological Assessment 8.4 The Motivation-Facilitation Model of Sexual Offending 8.5 Neuropsychology of Pedophilia and Pedophilic Disorder 8.5.1 Mixed Sexual Offense Studies 8.5.2 Pedophilia Studies 8.5.2.1 Pedophilia with Offense 8.5.2.2 Pedophilia vs. Non-Pedophilia with Offense 8.5.2.3 Contact vs. Non-Contact vs. Non-Offense Studies 8.5.2.4 Darkfield and Non-Offense Studies 8.5.3 Summary 8.6 Common Referral Questions 8.7 Theoretical Implications 8.8 Conclusions and Future Directions References Chapter 9: Best Practices in Sexual Recidivism Risk Assessment 9.1 Introduction 9.2 Sexual Recidivism Risk Assessment: Definition and Overview 9.3 Best Practice Considerations 9.3.1 Multiple Sources of Information 9.3.2 Ensuring Accuracy and Evaluating Information Credibility 9.3.3 Assessing Multiple Domains of Functioning 9.3.4 Use of Static and Dynamic Sexual Recidivism Risk Measures 9.3.4.1 Sexual Recidivism Risk Tool Classification and Critical Concepts 9.3.4.2 Static-99R and 2002R 9.3.4.3 Child Pornography Offender Risk Tool (C-PORT) 9.3.4.4 Violence Risk Scale-Sexual Offense version (VRS-SO) 9.3.4.5 STABLE 2007 9.3.4.6 Sexual Violence Risk-20 (SVR-20) and Risk for Sexual Violence Protocol (RSVP) 9.3.5 Use of Other Forensic and Nonsexual Recidivism Risk Measures 9.3.6 Applications of Sexual Recidivism Risk Assessment Information 9.3.6.1 Communicating the Sexual Recidivism Risk Level 9.3.6.2 Identifying Targets for Sexual Offense Intervention and Risk Management 9.3.6.3 Reassessment and Evaluating Risk Relevant Change 9.3.7 Ethnoculturally Diverse Populations 9.3.8 Consideration of Other Risk Mitigating Agents 9.4 General Conclusions References Chapter 10: Best Practices in the Assessment of Abuse-Related Sexual Interests 10.1 Introduction 10.2 Common Referral Questions 10.3 Approaches to Assessing Sexual Deviance 10.3.1 Self-Report 10.3.2 Psychophysiological Procedures 10.3.2.1 Polygraph Examination 10.3.2.2 Viewing Time 10.3.2.3 Penile Plethysmography 10.3.3 Proxy Measures of Abuse-Related Sexual Interests 10.4 Conclusion References Chapter 11: Clinical Versus Criminal Voyeurism, Exhibitionism, and Frotteurism: Theory, Assessment, Diagnosis, and Intervention 11.1 Chapter Introduction 11.2 Part I 11.2.1 Voyeuristic Disorder 11.2.1.1 Diagnostic Criteria 11.2.1.2 Prevalence 11.2.1.3 Frequency 11.2.1.4 Age of Onset 11.2.1.5 Scope of Problem 11.3 Exhibitionistic Disorder 11.3.1 Diagnostic Criteria 11.3.2 Prevalence 11.3.3 Frequency 11.3.4 Age of Onset 11.3.5 Scope of the Problem 11.4 Frotteuristic Disorder 11.4.1 Diagnostic Criteria 11.4.2 Prevalence 11.4.3 Frequency 11.4.4 Age of Onset 11.4.5 Scope of the Problem 11.5 Part II 11.5.1 Comorbidity 11.5.2 Differential Diagnosis 11.6 Etiological Theories 11.6.1 Courtship Disorder Hypothesis 11.6.2 Psychoanalytic Theory 11.6.3 Evolutionary Theory 11.6.4 Social Incompetence Hypothesis 11.6.5 Behavioral and Social Learning Theory 11.6.6 Sex Drive Hypothesis 11.6.7 Biological Theory 11.7 Clinical Assessment 11.8 Clinical Interventions 11.8.1 Therapeutic Techniques 11.8.2 Behavioral Techniques 11.8.3 Pharmacological Treatments 11.8.3.1 Androgen-Reducing Agents 11.9 Conclusions and Future Directions References Chapter 12: Clinical Versus Criminal Sexual Sadism: An Extended Review of Theory, Assessment, Diagnosis, and Intervention 12.1 Introduction 12.2 What Is Sexual Sadism? 12.2.1 Historical Overview 12.2.2 The Focus of Sexual Pleasure in Sexual Sadism 12.2.3 Categorical Diagnosis in DSM and ICD 12.2.4 Problems with Reliability of Categorical Diagnosis 12.2.5 The Status of Paraphilic Coercive Disorder and its Predecessors 12.2.6 Dimensionality and the Agonistic Continuum 12.2.7 A Dimensional Approach to Diagnosis: ‘coercive sexual agonistic disorder’ 12.3 Boundaries, Overlaps and Apparent Similarities: Comorbidity, Undifferentiated Conditions, and Differential Diagnosis 12.3.1 Personality and Personality Disorder 12.3.1.1 Sadistic Personality and Personality Disorder 12.3.1.2 Psychopathy 12.3.1.3 Other Personality Disorders 12.3.2 Paraphilic Disorders 12.3.2.1 Necrophilia 12.3.2.2 Other Paraphilic Disorders 12.3.3 Other Sexual Disorders 12.3.3.1 Compulsive Sexual Behavior Disorder 12.3.3.2 Sexual Dysfunctions 12.3.4 Other Mental Disorders 12.3.4.1 Psychotic Disorders 12.3.4.2 Anxiety and Stress-Related Disorders 12.3.4.3 Autism Spectrum Disorder 12.3.4.4 Substance-Related Disorders and Behaviors 12.3.4.5 Neurocognitive and Related Conditions 12.3.5 Non-sexually Sadistic Violence and Offending 12.3.6 Group Sexual Violence 12.4 Etiology 12.4.1 Biological Factors 12.4.1.1 Genetic Factors 12.4.1.2 Structural and Functional Brain Abnormalities 12.4.1.3 Endocrine Factors 12.4.1.4 Genital Abnormalities 12.4.2 Early Abuse and Trauma 12.4.3 Psychodynamic Explanations 12.4.4 The Role of Temperament and Personality 12.4.5 Adolescence and the Emergence of Sadistic Sexual Fantasy and Arousal 12.4.6 Conditioning: Sexual Fantasy, Masturbation, and Behavioral Tryouts 12.4.7 Proximal Factors in Enacting Behavior 12.4.8 Integrated Multifactorial Models 12.5 Prevalence and Association with Offending 12.6 Special Groups 12.6.1 BDSM 12.6.2 Rape 12.6.3 Sexual Homicide 12.6.4 Sexual Violence Against Children 12.6.5 People Who Have Not Offended 12.6.6 Adolescents 12.6.7 Women 12.7 Assessment 12.7.1 General Aspects 12.7.2 Identifying and Assessing Sexual Sadism 12.7.3 Objective Assessment of Sexual Sadism 12.7.4 The Sexual Sadism Scale (SESAS) 12.7.4.1 Development of the SESAS 12.7.4.2 Description of the SESAS 12.7.4.3 Psychometric Properties of the SESAS 12.7.4.4 Using the SESAS in Applied Forensic and Clinical Settings 12.8 Risk Assessment 12.8.1 Sexual Sadism as a Risk Factor for Recidivism 12.8.2 Application of Risk Assessment Instruments 12.8.3 Risk assessment Outcome and Conclusions 12.9 Treatment 12.9.1 General Aspects 12.9.2 Psychological Treatment 12.9.3 Pharmacological Treatment 12.9.4 Contextual Aspects: Integration, Countertransference, and Supervision 12.10 Management 12.10.1 Court Issues 12.10.2 Institutional Management 12.10.3 Post-Sentence Commitment or Detention 12.10.4 Release Decision Making 12.10.5 Legal Measures in the Community 12.10.6 Multi-Agency Management 12.11 Conclusion References Chapter 13: Clinical Versus Criminal Pedophilia: An Extended Review of Theory, Assessment, Diagnosis, and Intervention 13.1 Introduction 13.2 What Is Pedophilia? History, Definition, and Concept 13.2.1 Historical Overview 13.2.2 Conflation with Child Sexual Abuse 13.2.3 Diagnosis in DSM and ICD 13.2.4 The Status of Hebephilia 13.2.5 Future of Diagnostic Classification 13.3 Boundaries, Overlaps and Apparent Similarities: Comorbidity, Undifferentiated Conditions, and Differential Diagnosis 13.3.1 Personality and Personality Disorder 13.3.2 Paraphilic Disorders 13.3.2.1 Hebephilia and Ephebophilia 13.3.2.2 Other Paraphilic Disorders 13.3.3 Other Sexual Disorders 13.3.3.1 Compulsive Sexual Behavior Disorder 13.3.4 Other Mental Disorders 13.3.4.1 Psychotic Disorders 13.3.4.2 Depression and Suicide 13.3.4.3 Anxiety and Stress-Related Disorders 13.3.4.4 Developmental Disorders 13.3.4.4.1 Intellectual Disability (ID) 13.3.4.4.2 Autism Spectrum Disorder (ASD) 13.3.4.4.3 Attention Deficit Hyperactivity Disorder (ADHD) 13.3.4.5 Neurocognitive Disorders 13.3.5 Non-preferential Child Sexual Offending 13.4 Etiology 13.4.1 Biological Factors 13.4.1.1 Genetic Factors 13.4.1.2 Structural and Functional Brain Abnormalities 13.4.1.3 Endocrine Factors and Neurotransmitters 13.4.1.4 Neuropsychology 13.4.1.5 Other Evidence of Neurological Perturbations 13.4.1.6 Implications of Neurobiological Findings 13.4.2 Early Abuse and Sexual Behavior 13.4.3 Psychodynamic Explanations 13.4.4 The Role of Temperament and Personality 13.4.5 Social Learning and Conditioning 13.4.6 Adolescence and the Emergence of Pedophilic Sexual Interests 13.4.7 Proximal Factors in Enacting Behavior 13.4.8 Integrated Models 13.5 Prevalence and Association with Offending 13.6 Special Groups 13.6.1 Child Sexual Abuse 13.6.1.1 Early Typological Systems 13.6.1.2 The Massachusetts Treatment Center Child Molester Typology (MTC:CM3 and MTC:CM4) 13.6.1.3 Lanning’s Motivational Continuum Typology (1986, 2001, 2010) 13.6.1.3.1 Situational Offences 13.6.1.3.2 Preferential Offences 13.6.1.4 Behavioral Typology 13.6.2 Online Child Sexual Abuse 13.6.3 Minor Attracted Persons (MAPs) 13.6.3.1 Characteristics of MAPS and NOMAPS 13.6.3.2 Stigma 13.6.3.3 Barriers to Help Seeking 13.6.3.4 Support, Treatment, and Prevention 13.6.4 Young People 13.6.5 Women 13.7 Assessment 13.7.1 General Aspects 13.7.2 Identifying and Assessing Pedophilic Disorder 13.7.3 Objective Assessment of Pedophilic Disorder 13.7.4 Behavioral Rating Scales 13.7.4.1 Behavioral Rating Scales for Identifying Pedophilic and Hebephilic Interests 13.7.4.2 The Screening Scale for Pedophilic Interests (SSPI) 13.7.4.3 The Revised Screening Scale for Pedophilic Interests (SSPI-2) 13.7.4.4 The Screening Scale of Pedophilic Crime Scene Behavior (SSPC) 13.7.4.5 Correlates of Admitted Sexual Interest in Children (CASIC) 13.7.4.6 Using Behavioral Rating Scales in Applied Forensic and Clinical Settings 13.8 Risk Assessment 13.8.1 Pedophilia as a Risk Factor for Recidivism 13.8.2 Application of Risk Assessment Instruments 13.8.2.1 Risk Assessment in Contact Sexual Offenders 13.8.2.2 Risk Assessment in Online Child Sexual Abuse Material Offenders 13.8.3 Risk Assessment Outcome and Conclusions 13.9 Treatment 13.10 Management 13.11 Prevention 13.12 Conclusion References Chapter 14: Sexual Homicide 14.1 Introduction 14.2 Classifications of Sexual Homicide 14.3 The Role of Anger and Violence 14.4 The Role of Sadistic Fantasy 14.5 Key Distinctions Between Sexual Homicide of Women and Other Sex Offenses 14.6 Psychopathology 14.6.1 Serious Mental Disorders 14.6.2 Personality Disorder 14.7 Serial Sexual Homicide 14.8 Rehabilitating Perpetrators of Sexual Homicide: Assessment, Treatment and Management from Custodial Settings to the Community 14.9 Conclusion References Chapter 15: Human Sex Trafficking 15.1 Introduction 15.2 Overview of Sex Trafficking 15.2.1 Commercial Sex Acts 15.2.2 Commercial Exploitation of Children 15.3 Dynamics of Sex Trafficking 15.3.1 The Sex Traffickers 15.3.2 The Consumers 15.3.3 Sex Trafficking Case Example 15.4 Prevalence of Sex Trafficking 15.4.1 Demographic Locations of Sex Trafficking 15.5 Conceptual Frameworks 15.5.1 Macro-Economics: Supply and Demand Theory 15.5.2 Ecological Theory 15.5.3 Conflict Theory 15.6 Vulnerability to Sex Trafficking 15.6.1 LGBTQ+ Youth 15.6.2 Individuals with Special Needs 15.6.3 American Indian/Alaska Native Women 15.7 Trafficking as a Sexual Offense 15.8 Sexual Offender Assessment 15.9 Conclusion References Chapter 16: Neurodevelopmental Disorders and Sexual Offending 16.1 Introduction 16.2 Defining Neurodevelopmental Disorders 16.2.1 Intellectual Disability: Evolution of Terminology 16.2.1.1 Diagnostic Criteria for Intellectual Disability 16.2.2 Autism Spectrum Disorder: Evolution of Terminology 16.2.2.1 Diagnostic Criteria for Autism Spectrum Disorder 16.3 Prevalence Rates 16.3.1 Intellectual Disability 16.3.2 Autism Spectrum Disorder 16.4 Inappropriate Sexual Behavior and Sexual Offending 16.4.1 Harassment and Stalking 16.4.1.1 Case 1: Stalking and Criminal Sexual Contact 16.4.2 Child Molestation and Solicitation of Minors 16.4.2.1 Case 2: Soliciting Minor 16.4.3 Indecent Images of Minors 16.4.3.1 Case 3: Indecent Images of Minors 16.4.4 Sexually Inappropriate Touching and Public Lewdness 16.4.4.1 Case 5: Burglary with Intent to Commit a Sexual Offense 16.5 Explanations for Deviant and Criminal Sexual Behavior 16.5.1 Diminished Theory of Mind 16.5.1.1 Case 4: Indecent Exposure and Criminal Sexual Contact 16.5.2 Lack of Sexual Knowledge 16.5.3 Paraphilic Disorders 16.5.3.1 Counterfeit Deviance 16.5.4 Suggestibility and Confabulation 16.6 Sexual Offense Recidivism 16.6.1 Assessing Sexual Offense Recidivism Risk 16.6.1.1 Actuarial Risk Assessment Tools 16.6.1.2 Limitations of Risk Assessment Tools for Those with Neurodevelopmental Disorders 16.6.1.3 Measures of Deviant Sexual Arousal 16.7 Treatment Frameworks 16.7.1 Risk Need Responsivity Model 16.7.2 Good Lives Model 16.7.3 Risk Need Responsivity Model and Good Lives Model 16.8 Treatment Modalities 16.8.1 Behavioral Techniques 16.8.2 Cognitive Techniques 16.9 Conclusions and Recommendations 16.9.1 Recommendation 1: Individualized Treatment Across Settings 16.9.2 Recommendation 2: Advocate for Individualized Treatment Plan 16.9.3 Recommendation 3: Assess Sexual Knowledge and Include Sexual Education 16.9.4 Recommendation 4: Specialized Skills, Training, and Leadership Support 16.9.5 Recommendation 6: Consider Effects of Sexual Offender Legislation 16.9.6 Recommendation 7: More Research Is Necessary References Chapter 17: Personality Disorders, Psychopathy, and Sexual Offending 17.1 Introduction 17.2 Personality Disorder in Sexual Offending Samples 17.2.1 Base Rates of Personality Disorders in Sexual Offending Samples 17.3 Psychopathy in Sexual Offending Samples 17.3.1 Psychopathy: Conceptualization, Diagnosis, and Measurement 17.3.2 Psychopathy Base Rates and PCL-R Profiles in Sexual Offending Samples 17.4 Psychopathy and Personality Disorder in Sexual Offense Risk Assessment 17.4.1 Risk Relevance and Predictive Validity of Personality Disorder 17.4.2 Risk Relevance and Predictive Validity of PCL-R Measured Psychopathy 17.4.3 Use of the PCL-R in Sexual Violence Risk Assessment 17.5 Psychopathy and Personality Disorder in Sexual Offense Treatment 17.5.1 Psychopathy, Therapeutic Pessimism, and Service Integrity 17.5.2 Psychopathy and RNR Based Services: The 2-C Model 17.5.3 Psychopathy and Sexual Offense Treatment Outcome: Some Recent Findings and Conclusions 17.6 General Conclusions References Chapter 18: Special Considerations: Problem Sexual Behavior and Offending Patterns by Adolescents 18.1 Introduction 18.2 The Distinction Between Problem Sexual Behavior and Sexual Offending 18.3 Impact of Labeling 18.4 Contemporary Risk Assessment of Juvenile Sexual Offenders 18.4.1 J-SOAP-II 18.4.2 ERASOR 18.4.3 JSORRAT-II 18.4.4 Other Contemporary Assessments 18.4.4.1 PROFESOR 18.4.4.2 YNPS 18.5 Risk Feature Selection Lacking in Empirical Support 18.6 Tool Development and Application Preoccupied with JSOs 18.6.1 Prediction Modeling Design for a Solitary Outcome 18.7 Clinical Assessment Considerations and Techniques 18.7.1 Risk Factor Selection from Comprehensive Juvenile Characteristics 18.7.2 Risk Assessment Focusing on Re-offense Types with Multi-band Tools 18.8 Treatment Interventions for Preventing Sexual Recidivism 18.8.1 Treatment Intervention Issues for JSOs 18.8.1.1 Methodological Issues with Current Studies 18.8.1.2 JSOs as Generalists 18.8.2 Potential Avenues of Treatment Interventions for JSOs 18.8.2.1 Matching Individuals on Criminogenic Risk 18.8.2.2 Use of Multisystemic Therapy 18.9 Conclusions References Chapter 19: Special Considerations: Female Sexual Offenders 19.1 Scope of the Problem 19.2 Female Sex Offender Characteristics 19.2.1 Prior Abuse and Trauma 19.2.2 Mental Health and Substance Abuse/Misuse 19.3 Victim Characteristics of Female Sex Offenders 19.4 Offense Characteristics and Severity 19.4.1 Criminal Histories and Recidivism 19.4.2 Sentencing Outcomes 19.5 Typologies of Female Sexual Offenders 19.6 Offending in Educational Settings 19.7 Clinical Assessment Considerations and Techniques 19.8 Clinical Intervention 19.9 Conclusions and Recommendations References Chapter 20: Special Populations: Aging and Sexual Offending 20.1 Introduction 20.2 Method and Procedure 20.2.1 Search Methods 20.2.2 Data Collection and Analysis 20.2.3 Quality Assessment 20.2.4 Data Extraction and Synthesis 20.3 Findings 20.3.1 Area 1: Age of Onset 20.3.2 Area 2: Characteristics of Individuals Convicted of Sexual Offenses and of the Offense 20.3.2.1 Characteristics of Individuals Convicted of Sexual Offences 20.3.2.2 Offense Characteristics 20.3.3 Area 3: Age and Risk of Reoffending 20.3.3.1 Age as a Variable in Risk Assessment Tools 20.3.3.2 OSOs and Risk 20.3.4 Area 4: Treatment 20.4 Discussion and Conclusions 20.4.1 Limitations 20.4.2 Implications for Future Research and Clinical Practice References Chapter 21: Special Considerations: Child Sexual Abuse by Catholic Clergy 21.1 Introduction 21.2 Trends in Clergy Sexual Abuse 21.2.1 Victim Age 21.2.2 Victim Gender and Issues of Preference Vs. Opportunity 21.2.3 Clergy Power Dynamics and Status 21.2.4 Grooming by Clergy 21.2.5 The Potential Role of Celibacy 21.3 Clinical Assessment of Clergy 21.3.1 Paraphilic Assessment 21.3.2 Psychological Assessment 21.3.3 Sexual Risk Assessment 21.4 Clinical Intervention 21.4.1 Potential Approaches to Treatment 21.4.2 Treatment Outcomes 21.4.3 Primary Prevention Efforts 21.5 Conclusions 21.5.1 Implications for Clinical Management 21.5.2 Broader Prevention Efforts References Chapter 22: Special Considerations: Internet Sexual Offenders 22.1 Introduction 22.2 Offending Behaviors Against Minors over the Internet 22.2.1 The Use of Child Sexual Exploitation Material (CSEM) 22.2.2 Child Sexual Luring and Solicitation 22.2.3 Other Internet-Related Behaviors 22.3 Scope of the Problem 22.3.1 Profiles of Online Sexual Offenders Against Minors 22.3.2 CSEM Users: The Importance of Atypical Sexuality 22.3.3 Mixed Offenders: A High-Risk Subgroup 22.3.4 Online Sexual Solicitors: Opportunity More than Deviance? 22.4 Clinical Intervention 22.4.1 Assessing Offenders’ Level of Risk 22.4.2 Targeting Offenders’ Needs by Identifying Dynamic Risk Factors 22.4.3 Responsiveness to Treatment 22.4.4 iHorizon Treatment Programme 22.5 Police Intervention 22.6 Ongoing Prevention and Research Initiatives and Future Directions References Chapter 23: Victimology and Rehabilitation 23.1 Introduction 23.2 Theories of Victimology 23.2.1 Victim Precipitation 23.2.2 Lifestyle Theory 23.2.3 Routine Activities Theory 23.2.4 Deviant Place Theory 23.2.5 A Mixed-Theory Approach 23.2.6 Repeat Victimization 23.3 The Impacts of Sexual Assault 23.3.1 The Psychological Impact 23.3.2 The Impact on Physical Health 23.3.3 Interpersonal, Social and Economic Impacts 23.3.4 Victims Who Offend 23.4 Treatment Implications 23.4.1 Interpersonal and Relational Considerations 23.4.2 Trauma Informed Approaches 23.4.3 Specialist Trauma Treatments 23.4.3.1 Psychoeducation 23.4.3.2 Exposure-Based Therapy 23.5 Conclusions and Recommendations References Chapter 24: The Public Health Approach to SV 24.1 Introduction 24.2 Categories of Prevention 24.3 Primary Prevention 24.3.1 Primary Prevention—Individual Factor Intervention 24.3.2 Primary Prevention—Relationships Factor Intervention 24.3.3 Primary Prevention—Communities Factor Intervention 24.3.4 Primary Prevention—Societies Factor Intervention 24.3.5 Primary Prevention—Efficacy 24.3.6 Public Policy Support for Primary Interventions 24.4 Secondary Prevention 24.4.1 Secondary Prevention—Criminal Justice 24.4.2 Secondary Prevention—Public Policy Support for Community Groups 24.4.3 Secondary Prevention—Efficacy 24.5 Tertiary Prevention 24.5.1 Tertiary Prevention—Policy 24.5.2 Tertiary Prevention—Policy Effectiveness 24.5.3 Tertiary Prevention—Recommendations 24.6 Conclusion References Index