1
Description of the Problem
Sexual violence remains a significant problem in our society. Mental health professionals too often confront the immediate consequences of sexual assault in emergency rooms, victim support centers, correctional institutions, mental hospitals, and outpatient clinics. Law enforcement personnel and child protective agencies are persistently faced with child sexual molestation, incest, intimate partner sexual violence, and rape. The good news in this horrific story is that the prevalence of sexual assault seems to have been going down in the United States since the mid-1970s, according to the National Victimization Survey (Catalano, 2005), but the incidence remains high and a significant presenting problem for mental health professionals.
This book will present an overview of sexual violence as seen in many clinical settings, review key diagnostic guidelines, and assessment strategies, outline some of the current theories for understanding sexual violence, and then focus on effective treatment processes, and strategies. I will focus primarily on adult male perpetrators of sexual violence with both child and adult victims. Although there is growing awareness of female perpetrators (Schwartz& Cellini, 1995), the focus will primarily be on male perpetrators since males commit the vast majority of sexual violence incidents. Most important, I will use a broad definition of sexual violence to include not only the use of physical force, but sexual coercion utilizing position authority and verbal aggression. An important goal of this work will be to provide tools that mental health professionals can use in different institutional and community treatment settings to be more effective when working with perpetrators of sexual violence.
Another goal of this book will be to inform clinicians and the public with the most recent science on sexual violence. Unfortunately, there are many myths about sexual violence, and in particular sexual crimes, which are promoted by the monster archetype in our culture’s unconscious. This book will review research that challenges some of these myths. Among these myths are that sex offenders cannot be treated, that most sex offenders are arrested and not in the community, that sex offenders are almost sure to commit other sex offenses if released, that pornography causes sexual violence, and that all sex offenders are psychopathic and narcissistic. I strongly believe informed clinicians can make better decisions about prevention and effective intervention with sexually violent individuals.
1.1 Definition
Sexual violence can be defined in several ways. We will use the definition of Lalumiere, Harris, Quinsey, and Rice (2005) who provide definitions of rape and of sexual coercion. Rape is defined as,“The forceful act of sexual intercourse against a person’s will and/or any physical sexual contact performed with the use of threat or physical force” (p. 10). Sexual coercion is defined as,“Any physical sexual contact performed without a person’s consent using any coercive methods (e.g., using a position of authority or verbal pressure” (p. 10).
There have been some notable trends in official reports of rape crimes over the last few years that are supported by results from self-reported national survey data of victimization. Between 1982 and 1992, the prevalence of rape increased dramatically from 24 per 100,000 to 43 per 100,000. However, the rate of fo