Working with Sexual Offenders in Denial
Dr. Susan Grey Smith, Ph.D. LMFT
2014 Sex Offender Risk Assessment Advisory Board
(SORAAB) Training
Date: May,9 2014
Psycho Sexual Evaluation Risk Assessment of Sexual Offenders - 2014Health Easy Peasy
This document provides information about psychosexual evaluations and risk assessments of sexual offenders. It discusses that sexual offenses can involve coercive or nonconsensual sexual acts that lack consent due to factors like youth, cognitive limitations, intoxication, or threats of violence. Risk assessments are used to estimate an offender's risk of reoffending and identify treatment needs in order to reduce recidivism. Actuarial risk assessment tools that use statistical factors linked to recidivism are more accurate than unstructured clinical judgment alone. The document also covers diagnostic issues like pedophilic disorder and treating child sexual offenders.
Sexual harassment is defined as unwelcome verbal or physical conduct of a sexual nature that happens in the workplace or in public. It can include unwanted touching, sexual comments, suggestive materials, or name calling related to one's sex. Sexual harassment is illegal and can have negative effects such as decreased performance, job loss, stress, and relocation. Victims should first tell the harasser to stop if comfortable. A formal complaint can then be made to the employer or proper authorities by taking notes of incidents.
Prevention of the Sexual Abuse of Children (English Version)neilmcq
This course provides essential information for parents, child care workers, Directors of institutions, and the public in general on preventing the Sexual Abuse of children. There is a Spanish version at http://www.adiestrate.com/0201courses.asp?Categ=99
This document outlines a sexual harassment training presentation. It discusses why sexual harassment training is important, defines sexual harassment under Title VII, and explains who can commit or experience harassment. It describes quid pro quo and hostile work environment harassment and employer liability. The training reviews what isn't harassment and provides a hypothetical scenario for participants to judge. It outlines the objectives of harassment policies and provides general guiding principles. The training concludes by testing knowledge and emphasizing important points to remember.
This document provides information about sexual harassment and diversity in an educational setting. It defines sexual harassment and discusses the different types, including quid pro quo and hostile work environment harassment. It also outlines university policies and legal definitions related to sexual harassment. The document discusses cultural diversity on college campuses and provides tips for tutors working with underprepared students from diverse backgrounds. It stresses the importance of respecting different perspectives and cultures.
A talk for a group of psychiatric residents to introduce them to concepts and principles of sex therapy and the training involved in becoming a sex therapist.
Child Sexual Abuse
Published by Human Rights Law Network(HRLN), a division of Socio Legal Information Centre(SLIC). For more details about our works, visit us at http://hrln.org
Psycho Sexual Evaluation Risk Assessment of Sexual Offenders - 2014Health Easy Peasy
This document provides information about psychosexual evaluations and risk assessments of sexual offenders. It discusses that sexual offenses can involve coercive or nonconsensual sexual acts that lack consent due to factors like youth, cognitive limitations, intoxication, or threats of violence. Risk assessments are used to estimate an offender's risk of reoffending and identify treatment needs in order to reduce recidivism. Actuarial risk assessment tools that use statistical factors linked to recidivism are more accurate than unstructured clinical judgment alone. The document also covers diagnostic issues like pedophilic disorder and treating child sexual offenders.
Sexual harassment is defined as unwelcome verbal or physical conduct of a sexual nature that happens in the workplace or in public. It can include unwanted touching, sexual comments, suggestive materials, or name calling related to one's sex. Sexual harassment is illegal and can have negative effects such as decreased performance, job loss, stress, and relocation. Victims should first tell the harasser to stop if comfortable. A formal complaint can then be made to the employer or proper authorities by taking notes of incidents.
Prevention of the Sexual Abuse of Children (English Version)neilmcq
This course provides essential information for parents, child care workers, Directors of institutions, and the public in general on preventing the Sexual Abuse of children. There is a Spanish version at http://www.adiestrate.com/0201courses.asp?Categ=99
This document outlines a sexual harassment training presentation. It discusses why sexual harassment training is important, defines sexual harassment under Title VII, and explains who can commit or experience harassment. It describes quid pro quo and hostile work environment harassment and employer liability. The training reviews what isn't harassment and provides a hypothetical scenario for participants to judge. It outlines the objectives of harassment policies and provides general guiding principles. The training concludes by testing knowledge and emphasizing important points to remember.
This document provides information about sexual harassment and diversity in an educational setting. It defines sexual harassment and discusses the different types, including quid pro quo and hostile work environment harassment. It also outlines university policies and legal definitions related to sexual harassment. The document discusses cultural diversity on college campuses and provides tips for tutors working with underprepared students from diverse backgrounds. It stresses the importance of respecting different perspectives and cultures.
A talk for a group of psychiatric residents to introduce them to concepts and principles of sex therapy and the training involved in becoming a sex therapist.
Child Sexual Abuse
Published by Human Rights Law Network(HRLN), a division of Socio Legal Information Centre(SLIC). For more details about our works, visit us at http://hrln.org
Child sexual abuse refers to any sexual act perpetrated against a child. It can include contact acts like kissing, fondling, oral sex, as well as non-contact acts like sexual remarks, online solicitation, voyeurism, and showing pornography. Child sexual abuse has been linked to long-term negative mental health impacts in victims like depression, dissociation, post-traumatic stress disorder, anxiety, and substance abuse. Preventing child sexual abuse requires a community effort including mandatory reporting of suspected cases, educating children and teachers, and creating a supportive environment where victims feel comfortable coming forward.
1. Rape can have long-lasting psychological impacts on victims including feelings of guilt, dissociative amnesia, and post-traumatic stress disorder according to diagnostic criteria.
2. Victims often require a multidisciplinary therapeutic approach including emotional, medical, social, and forensic care to address safety, anxiety management, emotional processing, and prevention of recurrence.
3. Group therapy can help victims regain a sense of trust and belonging to move beyond feeling helpless.
Feminist therapy is based on several core concepts including the idea that the personal is political, a commitment to social change, and valuing women's experiences. The counseling relationship aims to be egalitarian and focuses on client strengths rather than pathology. Feminist therapists recognize how social and political forces can contribute to individual distress and work toward empowering clients and promoting social change for all oppressed groups.
Cognitive Behavioural Therapy: A Basic Overview (Presentation)meducationdotnet
This document provides an overview of cognitive behavioural therapy (CBT). It begins by outlining the learning objectives, which are to develop knowledge of CBT principles and techniques. The document then defines CBT as being based on the idea that emotions are governed by thoughts. It notes CBT aims to help people develop a more objective view by changing unhelpful beliefs. Conditions for which CBT has been shown to be effective are then listed, including depression, anxiety, eating disorders, and others. Key CBT principles like the A-B-C model of activating events, beliefs, and consequences are explained. Common cognitive distortions or thinking errors are defined and examples provided. The document concludes by describing how CBT is applied to
Dennis Rader, known as the BTK strangler, killed 10 people in Wichita, Kansas between 1974-1991. He bound, sexually assaulted, and strangled most of his victims. Rader was married with children and worked as a dog catcher and at Christ Lutheran Church. He was finally identified in 2005 through DNA evidence taken from his daughter that matched DNA found at crime scenes.
The Stanford Prison Experiment was a study conducted in 1971 by psychologist Philip Zimbardo that investigated the psychological effects of perceived power and roles on participants. 24 male college students were randomly assigned to be either guards or prisoners in a mock prison set up in the basement of the psychology building at Stanford University. The experiment was intended to last two weeks but was stopped after only six days as the guards began to exhibit increasingly cruel behavior towards the prisoners, including physical and emotional abuse. The findings supported the situational hypothesis that the prison environment itself was the primary cause of the escalating brutality rather than any dispositional traits of the individuals involved. The experiment raised serious ethical issues around informed consent and protecting participants from psychological harm.
This document discusses definitions related to gender identity, gender expression, sex, and sexual orientation. It notes that gender identity refers to one's internal sense of gender, which may differ from their sex assigned at birth. Sexual orientation refers to romantic or sexual attraction toward other people and exists on a spectrum. The document emphasizes that major medical and mental health professional organizations do not consider homosexuality a mental disorder and that efforts to change sexual orientation through conversion or reparative therapy have been found ineffective and potentially harmful.
The document is a presentation about sexual assault and harassment given by Zahra Dhanani from METRAC. It provides an overview of topics including definitions of sexual assault and harassment, social contexts, applicable laws, criminal justice processes, and other legal options. The presentation aims to provide accessible information about the law to help people make well-informed decisions.
Sexual Harassment PowerPoint PPT Content Modern SampleAndrew Schwartz
136 slides include: what is and is not sexual harassment, 6 types of sexual harassment, various classes of harassment, who is the harasser, what sexual harassment causes, the complaint procedure, the consequences and effects of sexual harassment, statistics, sexual harassment policies in other countries as compared to those in the United States of America and more.
The document discusses various topics related to child abuse including:
- A list of books and movies about child abuse.
- Statistics showing that around 10% of children experience abuse each year and 15% of girls and 5% of boys experience sexual abuse by age 18.
- Different types of abuse including physical, emotional, sexual, and neglect abuse.
- Signs that a child may be experiencing abuse such as injuries they cannot explain.
- Statistics on rates of physical, psychological, and sexual abuse in Canada over the last ten years.
- A brief mention of animal abuse and an example of a child abuser.
Feminist Therapy
Introduction
Feminist therapy puts gender and power at the core of the therapeutic process. It is built on the premise that it is essential to consider the social and cultural context that contributes to a person’s problems in order to understand that person.
This document provides an overview of Rational Emotive Behavioral Therapy (REBT) developed by Albert Ellis. It discusses Ellis' background and influences in developing REBT. The key aspects of REBT are that irrational beliefs cause emotional disturbances, and the goal of therapy is to identify and dispute irrational beliefs in order to develop more rational and adaptive ways of thinking. The counselor in REBT takes an active and directive role in challenging a client's irrational beliefs through logical questioning and debate.
This document provides information on preventing sexual harassment in the workplace. It defines sexual harassment as unwelcome sexual conduct that affects employment. There are two types: quid pro quo, where submission to sexual conduct is required for job benefits, and hostile work environment. Employers are responsible for preventing harassment and responding promptly to complaints. Employees can report harassment to supervisors, the EEO office, or file EEO complaints. The training teaches employees to recognize inappropriate sexual behaviors in the red, yellow and green zones and how to address harassment if it occurs.
This document discusses caring for survivors of sexual assault. It begins by acknowledging the author is a rape survivor and their journey to speaking out. It then provides statistics on sexual violence in India, including that a child is raped every 13 hours. The physical, mental, and psychosocial health consequences are extensive and can be both short and long term, including trauma, STIs, unwanted pregnancy, miscarriage, infertility and suicide. Survivors also face a high risk of re-victimization. Health professionals have a responsibility to provide compassionate, competent, and confidential care, including forensic examination, medical treatment, psychological support, and helping survivors access legal and social services. Younger children require special consideration and support. Overall the document stresses the
Sexual Harassment 101: What Every Manager Needs to Knowhrluminary
The intent of this presentation is to inform and educate HR and other members of management on the legal consequences of discrimination and harassment. The presentation focuses on the important role of supervisors and managers in creating and maintaining an environment free of harassment.
This document discusses sexual harassment at the workplace. It defines sexual harassment and outlines its forms such as physical, verbal, and visual. It also describes the types of sexual harassment including quid pro quo and hostile work environment. The document discusses the causes and effects of sexual harassment and how organizations can prevent it through clear policies, training, and addressing complaints. It outlines India's laws against sexual harassment and how the media has approached raising awareness of the issue.
This document provides an overview of restorative justice and restorative practices. It discusses:
1. The differences between restorative practice, which aims to build relationships proactively, and restorative justice, which repairs relationships reactively following harm.
2. A range of restorative practices like circles, questions, and conferences that can be used proactively or reactively.
3. The development of restorative justice as an alternative to punitive criminal justice systems that view crimes as offenses against society rather than individuals. Restorative approaches seek to involve victims and negotiate restitution.
The document discusses the purpose and goals of the prison system and rehabilitation of criminals. It notes there is disagreement around whether the purpose is punishment or rehabilitation. Rehabilitation aims to address the underlying causes of criminal behavior and reintegrate offenders into society by providing treatment programs, education, job skills training, and counseling. Effective rehabilitation programs have been shown to reduce recidivism rates. The goal of rehabilitation is to treat offenders and enable them to return to a crime-free lifestyle.
Child sexual abuse refers to any sexual act perpetrated against a child. It can include contact acts like kissing, fondling, oral sex, as well as non-contact acts like sexual remarks, online solicitation, voyeurism, and showing pornography. Child sexual abuse has been linked to long-term negative mental health impacts in victims like depression, dissociation, post-traumatic stress disorder, anxiety, and substance abuse. Preventing child sexual abuse requires a community effort including mandatory reporting of suspected cases, educating children and teachers, and creating a supportive environment where victims feel comfortable coming forward.
1. Rape can have long-lasting psychological impacts on victims including feelings of guilt, dissociative amnesia, and post-traumatic stress disorder according to diagnostic criteria.
2. Victims often require a multidisciplinary therapeutic approach including emotional, medical, social, and forensic care to address safety, anxiety management, emotional processing, and prevention of recurrence.
3. Group therapy can help victims regain a sense of trust and belonging to move beyond feeling helpless.
Feminist therapy is based on several core concepts including the idea that the personal is political, a commitment to social change, and valuing women's experiences. The counseling relationship aims to be egalitarian and focuses on client strengths rather than pathology. Feminist therapists recognize how social and political forces can contribute to individual distress and work toward empowering clients and promoting social change for all oppressed groups.
Cognitive Behavioural Therapy: A Basic Overview (Presentation)meducationdotnet
This document provides an overview of cognitive behavioural therapy (CBT). It begins by outlining the learning objectives, which are to develop knowledge of CBT principles and techniques. The document then defines CBT as being based on the idea that emotions are governed by thoughts. It notes CBT aims to help people develop a more objective view by changing unhelpful beliefs. Conditions for which CBT has been shown to be effective are then listed, including depression, anxiety, eating disorders, and others. Key CBT principles like the A-B-C model of activating events, beliefs, and consequences are explained. Common cognitive distortions or thinking errors are defined and examples provided. The document concludes by describing how CBT is applied to
Dennis Rader, known as the BTK strangler, killed 10 people in Wichita, Kansas between 1974-1991. He bound, sexually assaulted, and strangled most of his victims. Rader was married with children and worked as a dog catcher and at Christ Lutheran Church. He was finally identified in 2005 through DNA evidence taken from his daughter that matched DNA found at crime scenes.
The Stanford Prison Experiment was a study conducted in 1971 by psychologist Philip Zimbardo that investigated the psychological effects of perceived power and roles on participants. 24 male college students were randomly assigned to be either guards or prisoners in a mock prison set up in the basement of the psychology building at Stanford University. The experiment was intended to last two weeks but was stopped after only six days as the guards began to exhibit increasingly cruel behavior towards the prisoners, including physical and emotional abuse. The findings supported the situational hypothesis that the prison environment itself was the primary cause of the escalating brutality rather than any dispositional traits of the individuals involved. The experiment raised serious ethical issues around informed consent and protecting participants from psychological harm.
This document discusses definitions related to gender identity, gender expression, sex, and sexual orientation. It notes that gender identity refers to one's internal sense of gender, which may differ from their sex assigned at birth. Sexual orientation refers to romantic or sexual attraction toward other people and exists on a spectrum. The document emphasizes that major medical and mental health professional organizations do not consider homosexuality a mental disorder and that efforts to change sexual orientation through conversion or reparative therapy have been found ineffective and potentially harmful.
The document is a presentation about sexual assault and harassment given by Zahra Dhanani from METRAC. It provides an overview of topics including definitions of sexual assault and harassment, social contexts, applicable laws, criminal justice processes, and other legal options. The presentation aims to provide accessible information about the law to help people make well-informed decisions.
Sexual Harassment PowerPoint PPT Content Modern SampleAndrew Schwartz
136 slides include: what is and is not sexual harassment, 6 types of sexual harassment, various classes of harassment, who is the harasser, what sexual harassment causes, the complaint procedure, the consequences and effects of sexual harassment, statistics, sexual harassment policies in other countries as compared to those in the United States of America and more.
The document discusses various topics related to child abuse including:
- A list of books and movies about child abuse.
- Statistics showing that around 10% of children experience abuse each year and 15% of girls and 5% of boys experience sexual abuse by age 18.
- Different types of abuse including physical, emotional, sexual, and neglect abuse.
- Signs that a child may be experiencing abuse such as injuries they cannot explain.
- Statistics on rates of physical, psychological, and sexual abuse in Canada over the last ten years.
- A brief mention of animal abuse and an example of a child abuser.
Feminist Therapy
Introduction
Feminist therapy puts gender and power at the core of the therapeutic process. It is built on the premise that it is essential to consider the social and cultural context that contributes to a person’s problems in order to understand that person.
This document provides an overview of Rational Emotive Behavioral Therapy (REBT) developed by Albert Ellis. It discusses Ellis' background and influences in developing REBT. The key aspects of REBT are that irrational beliefs cause emotional disturbances, and the goal of therapy is to identify and dispute irrational beliefs in order to develop more rational and adaptive ways of thinking. The counselor in REBT takes an active and directive role in challenging a client's irrational beliefs through logical questioning and debate.
This document provides information on preventing sexual harassment in the workplace. It defines sexual harassment as unwelcome sexual conduct that affects employment. There are two types: quid pro quo, where submission to sexual conduct is required for job benefits, and hostile work environment. Employers are responsible for preventing harassment and responding promptly to complaints. Employees can report harassment to supervisors, the EEO office, or file EEO complaints. The training teaches employees to recognize inappropriate sexual behaviors in the red, yellow and green zones and how to address harassment if it occurs.
This document discusses caring for survivors of sexual assault. It begins by acknowledging the author is a rape survivor and their journey to speaking out. It then provides statistics on sexual violence in India, including that a child is raped every 13 hours. The physical, mental, and psychosocial health consequences are extensive and can be both short and long term, including trauma, STIs, unwanted pregnancy, miscarriage, infertility and suicide. Survivors also face a high risk of re-victimization. Health professionals have a responsibility to provide compassionate, competent, and confidential care, including forensic examination, medical treatment, psychological support, and helping survivors access legal and social services. Younger children require special consideration and support. Overall the document stresses the
Sexual Harassment 101: What Every Manager Needs to Knowhrluminary
The intent of this presentation is to inform and educate HR and other members of management on the legal consequences of discrimination and harassment. The presentation focuses on the important role of supervisors and managers in creating and maintaining an environment free of harassment.
This document discusses sexual harassment at the workplace. It defines sexual harassment and outlines its forms such as physical, verbal, and visual. It also describes the types of sexual harassment including quid pro quo and hostile work environment. The document discusses the causes and effects of sexual harassment and how organizations can prevent it through clear policies, training, and addressing complaints. It outlines India's laws against sexual harassment and how the media has approached raising awareness of the issue.
This document provides an overview of restorative justice and restorative practices. It discusses:
1. The differences between restorative practice, which aims to build relationships proactively, and restorative justice, which repairs relationships reactively following harm.
2. A range of restorative practices like circles, questions, and conferences that can be used proactively or reactively.
3. The development of restorative justice as an alternative to punitive criminal justice systems that view crimes as offenses against society rather than individuals. Restorative approaches seek to involve victims and negotiate restitution.
The document discusses the purpose and goals of the prison system and rehabilitation of criminals. It notes there is disagreement around whether the purpose is punishment or rehabilitation. Rehabilitation aims to address the underlying causes of criminal behavior and reintegrate offenders into society by providing treatment programs, education, job skills training, and counseling. Effective rehabilitation programs have been shown to reduce recidivism rates. The goal of rehabilitation is to treat offenders and enable them to return to a crime-free lifestyle.
This document discusses domestic violence perpetrators and the challenges in treating them. It notes that perpetrators are a diverse population with varied disorders, backgrounds, and potential for change. Successful treatment requires skillful collaboration across disciplines and a change in approach by human services professionals. Specifically, professionals must evaluate their attitudes, avoid confrontation, and focus on building rapport, empathy, self-worth and strengths in clients to improve motivation and outcomes. Treating this population is complex but respecting perpetrators as human beings seeking change is important to making a positive difference.
The video for this presentation is available on our Youtube channel:
https://youtube.com/allceuseducation A continuing education course for this presentation can be found at https://www.allceus.com/member/cart/index/index?c=
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Examines theories that attempt to explain the motivation for criminal behavior in order to help reduce recidivism and relapse among people with and without addictions in the criminal justice system
Factors Influencing The Way In Which Decisions Are Made Looking a.docxPOLY33
Factors Influencing The Way In Which Decisions Are Made:
Looking at all sides of a conflict is not an easy task. Several factors, which we may not be aware of, contribute to our understanding (or misunderstanding) and hence, influence the final choice. Consequently, people involved in the same conflict may arrive at different solutions caused by any of the following:
•
Context
the circumstances surrounding the issue, influences what parts are thought important or unimportant. For instance, if the individuals in a conflict are acquainted, the nature of the relationship matters. The bond between family members is very different than the one between friends .Gender, past experiences, education and age also act as a frame, modifying how the problem and the consequences are understood.
•
Values,
which are derived from personal beliefs, are grounded in traditional sources such as family, religion and school. They form an underlying framework which focuses our attention on certain aspects of a problem and may advocate for a particular choice. Values vary from individual to individual reflecting cultural, religious and other personal experiences and may play a greater role in conflict solutions arising in situations where points of law are not in question.
•
Principles
, which are sometimes derived from external sources such as institutions or ethical theories, typically provide guidance rather than specify an action. They can assist in prioritizing values by lending greater weight to one value over another. Conflicts which involve legal issues may be solved more readily by a direct appeal to known principles. Professional codes of ethics and
laws(
rules), then specify how principles are carried out. The four major principles guiding many institutional practices are: beneficence, non-
maleficence
, autonomy and justice (fairness). From these, courses of actions are derived. Which principle has priority in any one decision varies depending on personal beliefs, facts and other contextual information.
•
Ethical systems
are an important part of the process of justifying a particular action. The simple identification of principles and values is typically not sufficient to make a complex, difficult decision. At some point, justification for a particular choice begins to take place. Three of the more common ethical systems select different components of the conflict as a focal point: a person's motives, the consequences of the action, or an appeal to an external system of principles. As in the case with perspective, the action chosen is influenced by a tension between external forces such as obeying rules or finding a good outcome, and the character of individual (integrity).
Some philosophers argue that there really are only two systems for determining what is right or good. How "right" and "good" are connected through a course of action is the primary difference between two of the most common ethical systems which are
1.
Teleological Theor ...
The document discusses the history and research on effective rehabilitation programs for sex offenders. It covers several key points:
1) Early research in the 1970s concluded rehabilitation programs did not work, but later research from the 1980s onward found that some programs can reduce recidivism, especially those targeting criminogenic needs.
2) Effective programs are based on principles like matching treatment intensity to offender risk level, targeting dynamic risk factors linked to reoffending, and delivering treatment in a way that considers offender characteristics.
3) Cognitive-behavioral programs that teach pro-social thinking skills and address criminal thinking have been shown to change antisocial behavior and reduce recidivism when applied correctly.
This document outlines the agenda for a workshop on trauma intervention for people with disabilities. It discusses intermediate and long-term issues following abuse discovery, including trauma assessment, therapeutic treatment, and prosecution efforts. It then covers therapeutic intervention principles and strategies like education, social support, and clinical techniques. Specific challenges are described, such as disastrous responses to past abuse reports, coping mechanisms, and how abuse impacts development. The document provides guidance on functional versus dysfunctional family approaches to treatment.
Managing lateral violence and its impact on the team la ronge november 2013griehl
Lateral violence is a reality for many people working in the health care field. This presentation looks at causes and looks at ways to addresses bullying behavior.
This document discusses the need for a new approach to supervision for therapists working with trauma survivors. It notes the paradox that relationship is key to healing trauma, but supervision often focuses on productivity over relationships. It proposes adapting the Sanctuary Model, which redefines therapists, supervisors, and supervision to provide better support for trauma therapists. The model aims to address the "gaping hole" left by evidence-based practices that fail to consider meaning, purpose and social context in healing complex trauma.
The document outlines the code of conduct, marking system, course introduction, responsibilities, role, and ethics of physical therapists. Some key points include:
- Students must be on time, prepared, respectful and behave appropriately. Mobile phones are banned in class.
- The course will discuss the role, responsibilities, ethics, and accountability of physical therapists. It will also cover the change to doctoral-level education.
- As individuals, physical therapists must provide quality care, engage in ethical practice, and keep updated. They are also expected to be evidence-based and trustworthy clinicians.
- Ethical principles for physical therapists include respect for autonomy, nonmaleficence, beneficence, common good,
The document discusses whether psychopaths should be considered mentally disordered and subject to mental health legislation. It argues that psychopaths are not mentally ill, as their behaviors and personalities do not demonstrate biological abnormalities, injuries or diseases. While their actions deviate from social norms, this does not mean they have an illness. The document also discusses balancing individual rights and public safety when dealing with violent offenders. It concludes that indefinite detention of non-offenders cannot be justified and that a balanced approach is needed when dealing with offenders that poses serious risks if released.
Assessment Should We Withhold Life The Martinez Case.docxbkbk37
Mr. Martinez was a 75-year-old man hospitalized for an upper respiratory infection. He and his wife had requested no CPR. However, his oxygen was increased, causing respiratory failure. The case examines the ethical issues around limiting life support for Mr. Martinez given his directives, quality of life, his family's preferences, and relevant moral principles.
Occupational therapy in forensic settings aims to assess individuals' abilities following deprivation of freedoms and train them for independent living. Occupational therapists provide career counseling and self-esteem development to help offenders reintegrate into society after incarceration. Forensic settings include jails, prisons, forensic hospitals, and community reentry centers, with varying security levels and rehabilitation opportunities. Occupational therapy focuses on reducing deprivation and increasing skills through meaningful occupations to prevent recidivism.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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2. WORKING WITH THE SEX
OFFENDER IN DENIAL
Susan G. Smith, PHD, LMFT
& Garnie Nickell, MA, LPCC
3. Denial is not a river in Egypt.
Treatment resistance is largely the product
of processes of denial. (Schneider & Wright 2004)
4. Webster’s defines denial
as a statement saying that
something is not true or real; in
psychology denial is a condition
where someone will not admit that
something sad and painful is true or
real; or the act of not allowing
someone to have something.
5. Science . . . .
is based on
personal
experience, or on
the experience of
others, reliably
reported.
- Werner
Heisenberg
6. Denial is defined in the ATSA treatment
manual as “the failure of sexual abusers to
accept responsibility for their offenses.”
Association for the Treatment of Sexual Abusers (ATSA; Practice
Standards and Guidelines 2001)
It is characterized as an obstacle to treatment progress
and to compliance with treatment requirements.
7. While a person is responsible for
acting in the world,
s/he is not necessarily responsible
for the cognitive, affective,
and behavioral deficits
that realistically constrain
the range of options
to pursue valued goals.
(Levenson & D’Amora 2005)
9. Anna Salter
emphasized in her classic guide Treating Child Sex
Offenders and Victims: A Practical Guide (1988)
that “offenders must take responsibility for child
sexual abuse without minimizing, externalizing
or projecting blame onto others.” Salter also
categorized denial as physical
denial, psychological denial, and minimization of
the extent and seriousness of the sexually
offensive behavior.
10. The research does not convincingly
demonstrate that denial is a risk factor for
reoffending, nor that targeting denial in
treatment is associated with improved
treatment outcomes. (Yates 2009)
Treatment must be concerned with
responsivity – defined as the interaction
between the individual and the treatment.
The therapeutic relationship is the best
predictor of treatment success.
11. Why do people deny?
Freud’s Theory of Defense Mechanism
A reality-distorting strategy unconsciously
adopted to protect the ego from anxiety.
12. The relationship between anxiety and defense:
Neurotic anxiety
• Anxiety about our impulses
signals the need for their
repression
• We want things we do not
get; we fear our wants
• Anxiety plays a functional
role signaling the ego to
take action (repress
thoughts and feelings)
before being overwhelmed
Moral anxiety
• Experienced as guilt or
shame
• Fear of (internal)
punishment for failure to
adhere to our own moral
standards of conduct
• When impulsive behavior
gets us into trouble, we
begin to fear our own
instincts
13. Freud’s six types of defensiveness
• Repression where unacceptable impulses and thoughts
are pushed out of our awareness.
• Projection places what may be unacceptable in one’s
own mind into the mind of another.
• Displacement redirects emotional responses onto a
less dangerous substitute.
• Reaction formation converts a feeling into its opposite.
• Regression makes us retreat to an earlier, less
threatening age or stage.
• Rationalization invents a reason for bad behavior.
14. Depersonalization or the
denial of planning, sexual
deviancy, and relapse risk.
Even after an offender has acknowledged
responsibility for an offense, s/he may not
be psychologically prepared to admit s/he
is the type of person who could do
something like that.
16. The following factors
related to psychological
problems were found to
have no relationship to
recidivism. (Yates 2009)
• Self-esteem
• Anxiety
• Loneliness
• Negative mood
• Motivation for
treatment
• Lack of victim empathy
• Lack of remorse
• Denial
17. ALL OUR SCIENCE, MEASURED AGAINST
REALITY, IS PRIMITIVE AND CHILDLIKE.
- ALBERT EINSTEIN
18. Rehabilitation interventions are
directed at areas of deficit or
dysfunction. (Ward & Salmon 2009)
A major aim of therapeutic interventions with
offenders is to provide them with an array of
skills to effectively manage undesired states or
to pursue desirable ones in socially acceptable
and personally meaningful ways.
19. The primary vehicle for assessing and modifying
offenders’ cognitions is likely to be found in
the explanations provided by offenders
to account for their offenses.
(Schneider & Wright 2004)
20. A key distinction in determining
whether the offender will view treatment as
helpful or as a punishment
lies within the practitioner’s skill level.
(Prescott & Levenson 2010)
The process of change is difficult for most of us but
especially difficult for those who have offended others
sexually because it requires looking at our shadow side.
Will they feel coerced or invited?
21. The universe can be best pictured . . .
as consisting of pure thought.
- Sir James Jeans
22. Treatment or Punishment?
Problem reduction and well-being
enhancement versus the infliction of pain
as retribution for crimes committed.
24. Treatment providers cannot avoid
confronting the ethical challenge
created by the institution of
punishment within
the criminal justice system.
25. The issue of justifying punishment
arises in part because harms inflicted
on offenders may cause them
significant suffering and set back their
core interests, and also result in
marked hardships to family, friends,
and even the broader community.
(Ward & Salmon 2009)
26. Sex offender treatment is not punishment but
services are delivered within a punishment
context. As service providers,
we have to consider both.
Rehabilitation revolves
around skill
acquisition, well-being
enhancement, and
building a better life in
the future.
Punishment is
embedded in
accountability for past
actions and moral
questions of right and
wrong.
27. Science is the attempt to make the chaotic
diversity of our sense-experience correspond to
a logically uniform system of thought. . . The
sense-experiences are the given subject matter.
But the theory that shall interpret them is man-
made. It is. . .hypothetical, never completely
final, always subject to question and doubt.
- Albert Einstein
28. Because of the correctional context of
sex offender treatment,
it is not possible to insulate the role of program
deliverers or treatment providers from ethical
issues associated with punishment.
It is worthwhile for practitioners to have some
general familiarity with the different theories of
punishment and their clinical and ethical
implications. (Ward & Salmon, 2009)
29. Punishment elements
express censure and are intended
to be harmful, resulting in a
burden being placed on the
offender that directly causes
suffering, pain, and deprivation.
Assumptions about punishment
are reflected in the specific
policies and practices embedded
in the criminal justice system and
directly shape the professional
tasks constituting the roles of
correctional practitioners.
Treatment providers
have an ethical obligation to do
no harm and to seek to end
unjustified harms to offenders.
Failure would arguably make us
complicit in unacceptable
practices (Lazarus, 2004).
In a real sense, good
psychological practice is partly
determined by policies
underpinned by punishment
assumptions including decisions
on intervention
priorities, sequencing, and timing.
Punishment within the criminal justice system
must be unpacked to help clinicians skillfully
traverse ethical dilemmas.
30. Retribution theories
Retribution theories:
• Backward looking
• Fact that punishment does not
reduce crime not of major
concern; fitting to punish to
balance the moral ledger
• Failure to hold offenders
accountable is unacceptable
• Offenders are viewed as morally
deficient
• Victim’s rights and community
views are given priority
• Punishment will result in
acceptance of responsibility
Practice implications:
• Fails to satisfactorily unpack
the notion of just deserts
• May be threats to offenders’
human rights
• Impulsivity characterized as
failure of will rather than self-
regulation impairment
• Difficulty discriminating
between crimes and private
wrongs
• Restricted funding for
treatment and reintegration
programs
31. America is the land of the second
chance and when the gates of the
prison open, the path ahead should
lead to a better life.
-
George W. Bush, 43rd US President
32. Consequential theories
Consequential theories:
• Forward looking
• Focused on crime
prevention
• Goal is to reduce crime
• To deter, incapacitate, or
reform offenders is seen as
the most effective way to
reduce the crime rate
• Character reform
Practice implications:
• Reliably measure dynamic
and static risk factors
• Treatment is a means to
ensure community safety
• Looking for causal factors
generating behavior
• Extended supervision ,
geographical restrictions,
and community notification
• Interventions focus on
offender and do not include
families and the community
33. Problems with
consequential theories
• It is logically possible to
countenance the
punishment of innocent
people if the overall effect
may result in the reduction
of crime.
• Neglects the community’s
obligation to offenders to
provide and resource
reintegration initiatives.
• The impact of hard
treatments on offenders
and their families is rarely
considered.
• A desire to protect the
community can lead to the
lack of concern for the
human dignity and intrinsic
self-worth of offenders.
• May result in confrontation
rather than dialogue.
34. Shifting Paradigms
It is important to pay attention to the rights of
all stakeholders in the criminal justice system
including offenders because of their equal
moral status; thus communication theories of
punishment have a relationship focus.
(Ward & Salmon, 2009)
From this perspective, offenders are viewed as
one of us.
35. Communication theory
A hybrid theory of Anthony Duff (2002)
Communication theory:
• Forward and backward looking
• Punishment seeks to persuade
rather than force offenders to
take responsibility for crimes
• Offenders viewed as valued
members of the community
• Repair individual, relational and
social harm caused by the offense
• Wipe slate clean and obtain
redemption with dignity
• Community obliged to facilitate
reintegration
Practice implications:
• Engage in process of intense self-
reflection and self-censure
• Remorse and self-blame will
motivate to acquire skills to
achieve in lawful ways
• Realization they have caused
people to suffer will lead to firm
resolution to not do this again
• Apology and restitution
• Better lives mean safer
communities
• Strength-based community
oriented treatment approach
36. It is better to conquer yourself than to win a
thousand battles. Then the victory is yours. It
cannot be taken from you, not be angels or by
demons, heaven or hell. -Buddha
37. THE SECOND CHANCE ACT of 2007
formalizes President Bush’s Prisoner Re-entry Initiative (PRI)
• Ensures returning
prisoners have
opportunities to
transform their life and
build safer communities.
• Helps offenders break the
cycle and start a new life
as a productive member
of society through
individualized case plans
and services.
• Develops programs that
encourage offenders
toward safe, healthy, and
responsible family and
parent-child relations.
38. “I might have did it . . . ,” “Maybe I did it . . . ,” “I
don’t remember. . .but let’s just say I did,” are not
admissions but they are stepping stones suggesting
that further discussion is needed.
39. Although many have focused on denial as a black and white
construct, a large number of clinicians and scholars have
acknowledged that denial is not an all-or-nothing phenomenon
but rather a complex, multifaceted thought process.
40. Accountability and denial
as treatment obstacle or treatment target?
(Schneider & Wright)
Denial as a dichotomous variable
• Disavowal of having committed an
offense (full denial, absolute
denial, or categorical denial). A
person is either in or out of denial.
• Assumes denial results from
deliberate attempts to avoid blame
by deceiving
• Indicates poor treatment amenability
• Offenders have to admit they
engaged in inappropriate sexual
behavior before entering treatment.
• Otherwise clinicians are reinforcing
the illusion that offenders can benefit
from treatment without taking
responsibility for their offense.
Denial as continuous variable
• Refers to a broader range of
explanations provided by offenders
to justify or minimize offense-related
behavior.
• Likely to be grounded in cognitive
distortions.
• Requiring offender to be out of denial
before starting treatment is like
requiring them to cure themselves.
• Practice of not treating or dismissing
deniers from treatment increases risk
to the community by preventing
participation in treatment programs
that lower recidivism.
41. Types of Denial
Schneider & Wright 2004
Denial is a multifaceted
construct:
• Denial of the offense
• Denial of harm to the victim
• Denial of the extent of the
abusive behavior
• Denial of responsibility,
intent, or premeditation
• Denial of receiving sexual
pleasure
• Denial of relapse potential
Deeply ingrained forms of denial:
• Planning
• Grooming
• Deviant arousal
• Fantasizing
• Sexual gratification
• Need for help
• Future risk of harming
someone else
42. For incest offenders, denial was associated
with increased sexual recidivism. Effect
sizes were extremely small suggesting it
could be a minor risk factor. Denial was
not associated with increased recidivism
for offenders with unrelated victims. (Nunes
et. al. 2007)
Child molesters tend to admit more
frequently than rapists. (Nugent & Kroner
1996)
44. Denial is best viewed as a source of rich clinical
information about the offender’s view of the world
rather than as an obstacle that interferes with
treatment. (Schneider & Wright 2004)
45. Clinical approaches for addressing denial
and treatment resistance (Deming 2013)
The INSOMM Approach
• Motivation based
• Future focused
• “Good Lives” Model
• Address shame
• Address fear of
consequences
• Process the value and
purpose of taking
responsibility and its role in
treatment
46. Let us get down to the bedrock facts.
The beginning of every act of
knowing, and therefore the starting
point of every science, must be in our
own personal experience.
- Max Planck
47. Myth or fact?
• Denial and minimization are
efficient predictors of recidivism.
• Greater denial / minimization is
associated with lower motivation
and more negative perceptions of
treatment.
• Denial increases over the course
of treatment.
• Denial is better related to internal
processes of anxiety than to the
external process of deception.
• Only sex offenders minimize and
deny harmful behavior.
• The only way for a sex offender to
get the help they need is for them
to take responsibility for what
they did.
• Denial in treatment has been
upheld by the courts as a reason
to revoke probation.
• Denial is related to punishment
models of accountability.
• Clinicians can ethically treat sex
offenders without considering
the ethics of punishment.
• Offenders who complete
treatment have lower recidivism
rates than those who do not.
• More justifications and less
treatment rejection can reflect
acknowledgment of personal /
psychological problems.
48. It is the very essence of our striving for
understanding that, on the one hand, it
attempts to encompass the great and complex
variety of man’s experience, and on the other, it
looks for simplicity and economy in the basic
assumptions. The belief that those two
objectives can exist side by side is, in the
primitive view of our scientific knowledge, a
matter of faith.
-Albert Einstein
49. References:
Deming, Adam (January 29, 2013). Working effectively with the
treatment resistant sex offender. ACA Houston, Texas.
Freeman, James, Palk, Gavan, & Davey, Jeremy (2010). Sex offenders in
denial: A study into a group of forensic psychologists’ attitudes
regarding the corresponding impact upon risk assessment
calculations and parole eligibility. The Journal of Forensic Psychiatry
& Psychology, 21:1, 39-51. Routledge.
Glaser, Bill (2010). Sex offender programmes: New technology coping
with old ethics. Journal of Sexual Aggression, 16:3, 261-274.
Routledge.
Jung, Sandy & Nunes, Kevin (2012). Denial and its relationship with treatment
perceptions among sex offenders. The Journal of Forensic Psychiatry
& Psychology, 23:4, 485-496. Routledge.
Levenson, Jill & D’Amora, David (2005). An ethical paradigm for sex offender
treatment: Response to Glaser. Western Criminology Review, 6:1,
145-153.
50. Nugent, Patricia M. & Kroner, Daryl G. (1996). Denial, response styles, and
admittance of offenses among child molesters and rapists. Journal
of Interpersonal Violence, 11:4, 475-486. Sage.
Nunes, Kevin, Hanson, Karl, Firestone, Philip, Moulden, Heather, Greenberg,
David, & Bradford, John (2007). Denial predicts recidivism for some
sexual offenders. Sex Abuse, 19:91-105. Springer.
Prescott, David & Levenson, Jill ( 2010). Sex offender treatment is not
punishment. Journal of Sexual Aggression , 16:3, 275-285.
Routledge.
Schneider, Sandra & Wright, Robert (2004) Understanding denial in sex
offenders. A review of cognitive and motivational processes to
avoid responsibility. Trauma, Violence & Abuse, 5:1, 3-20. Sage.
Ward, Tony & Salmon, Karen (2009). The ethics of punishment:
Correctional practice implications. Aggression and Violent
Behavior, 14:4, 239-247.
Yates, Pamela M. (2009). Is sexual offender denial related to sex offense
risk and recidivism? A review and treatment implications.
Psychology, Crime & Law, 15:2-3, 183-199. Routledge.
51. I can treat others with
kindness, gentleness, and
without judgment, starting with
myself!