The editors' clearly articulated goal for this book is to produce the first single-volume resource for forensic clinicians and law professionals who work with sex offenders. The book aims for breadth rather than depth. The summary on the back cover pronounces that the text describes the “best practices in clinical assessment, treatment, risk assessment as well as the legal issues that affect legislation associated with sexual offenders in the United States and elsewhere.”
The book contains 30 chapters composing seven parts: “Introduction,” “Neurobiology/Neuropsychology,” “Assessment and Diagnosis,” “Treatment,” “Juveniles,” “Special Populations,” and “Forensics.” The authors are not wedded to a single orientation or approach. Concepts are clearly articulated, and the text has a balanced feel. Formatting features in many chapters are very helpful, such as the tables, lists, and guides that summarize the main points.
The book adopts a perspective that situates knowledge about sex offenders within a broader forensic context. It was helpful to review a discussion of general approaches to violence risk assessment before reading the chapter on actuarial instruments for estimating risk in sex offenders. Similarly, a discussion of forensic considerations and forensic approach methodology is then particularized to sex offender-specific issues such as sexually violent predator evaluation.
The “Assessment and Diagnosis” section is a strength of this book. The chapter titled “Mental Illness and Sex Offending” provides an excellent review of the phenomenology of paraphilic sexual arousal. Also, the review of “Laboratory Measures of Penile Response in the Assessment of Sexual Interests” highlights the strengths of this assessment measure. The authors note that many courts in the United States have rejected the admissibility of penile plethysmography (PPG) evidence and conclude that, despite the clinical utility of PPG, testing will probably follow the course of dexamethasone suppression for mood disorders, and the use of PPG will diminish. The inadmissibility of PPG in some jurisdictions highlights the oft observed fact that scientific and legal utility do not necessarily mesh well.
Other sections of the book that deal with standard topics such as “Neurobiology/Neuropsychology” and “Treatment” do a capable job of summarizing information that is accumulating in a steady, incremental fashion; however, for those abreast of the sex offender literature, the book contains scant new material, and a more selective reading of the chapters' summaries of newer data and authors' opinions is the best approach. For neophytes to this area, however, a complete reading would be in order.
The book contains some contentious spots such as the chapter titled “Psychological Treatment of Sex Offenders.” The authors review relevant research and highlight the fact that evaluating the long-term effectiveness of sex offender treatment remains beset with difficulties. This topic leads to discussions that extend beyond the available research and toward authoritative opinions about the clear difference between the relapse-prevention model, which the authors conclude is ineffective, and a new model that combines the responsivity principle from the risk/needs model, Ward's Good Lives Model, and motivational interviewing. Together, these models downplay the need to focus on the offender's past offensive behavior and shift the emphasis to the future and the development of a more fulfilling life. Readers will have to draw their own conclusions about these types of authoritative opinions.
The “Special Populations” section is diverse and the generally succinct and pithy chapters summarize data in an easily accessible manner. Topics include: female sexual offenders, sexual boundary violations by professionals, stalking, child pornography and the Internet, sexual abuse by clergy, manifestations of sexual sadism, and intellectual disabilities and sexual offending.
In the “Forensics” section, there is relevant coverage for both the U.S. and Canadian reader on history, legal definitions, relevant policy, and legal case decisions on child pornography and the Internet, sexual predator laws and their history, and sex offender registries and community notification.
This book is best conceived as a starting point rather than a destination for sex offender information. In the final analysis, the editors' goal for a single-volume resource is met but comes with the inevitable tradeoff of a lack of in-depth coverage of some topics. If breadth is what the reader is seeking, I would commend this book. If more in-depth knowledge of specific topics is desired, the reader might begin with other books that are on point with the specific sex offender topic of particular interest. Another concern was the rather small font size, which could be challenging for tired eyes reading the book at the end of a workday.
I think the back cover comments get it exactly right by identifying this as an ideal text for forensic psychiatric fellowship training programs. I can think of no better primer on sex offenders for a forensic psychiatric fellow or resident. For the more seasoned forensic clinician, this book would be recommended only if the goal is to expand the breadth of knowledge into some new sex offender areas with burgeoning research.
Footnotes
Disclosures of financial or other potential conflicts of interest: None.
- © 2013 American Academy of Psychiatry and the Law
