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Book Review   |    
Kamlyn Haynes
Psychiatric Services 2010; doi: 10.1176/appi.ps.61.4.420
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by Frank C. DiCataldo; New York, New York University Press, 2009, 269 pages, $24

Dr. Haynes is a child, adolescent, and adult psychiatrist who has provided psychiatric care to Massachusetts youths in the juvenile justice system for the past ten years.

Sexual Offenders: Personal Construct Theory and Deviant Sexual Behaviourby James Horley; New York, Routledge, 2008, 152 pages, $55

Sexual Offending and Mental Health: Multidisciplinary Management in the Communityedited by Julia Houston and Sarah Galloway; Philadelphia, Jessica Kingsley Publishers, 2008, 288 pages, $49.95

Three books by mental health professionals have recently been published about the treatment of sexual offenders. Although the authors represent clinical viewpoints from three countries (United States, Canada, and United Kingdom) and speak to the needs of vastly different offender populations (juveniles, male offenders who sexually offend against children, and offenders with mental illness and a variety of offenses), the books share a common goal of correcting the frequently accepted notion that all sexual offenders are the same and cannot be treated.

Frank DiCataldo, author of The Perversion of Youth, is an assistant professor of psychology at Roger Williams University in Rhode Island. For the past 20 years, he has also been a practicing forensic psychologist in Massachusetts and has worked in adult corrections and juvenile justice settings. His well-researched and well-written book calls into question the validity of the assessment, treatment, categorization, and stigmatization of juvenile sexual offenders that have evolved over the past 40 years.

The author calls for a reexamination and overhaul of the system and paints a convincing picture that current practices are based on a societal "moral panic" rather than on any empirical data. He provides ample clinical examples that should convince even the least clinically experienced reader of the heterogeneity of juveniles who commit sexual offenses. This is a significant feat because one of his major points is that the current legal structure does little to separate out the rare repeat offender whose patterns of arousal are clearly deviant from those who offend for a myriad of unrelated and possibly noncriminal motivations. There are the juvenile sexual offenders who believe that they are having consensual sexual relations with partners who are two years younger yet who are under the age of consent. Such an "offender" may well be subject to action from sexual offender registry boards.

Any clinician will find Dr. DiCataldo's chapter on reviewing the actuarial tools designed to assess future risk of offenders remarkably complete and succinct. His chapter on collateral consequences delineates how current legal statutes ultimately lessen the chance that an adolescent who offends will be rehabilitated. Dr. DiCataldo's book is a courageous call for policy makers to reform the draconian nature of policy that is not justified scientifically and that is frequently harmful rather than rehabilitative for youths who sexually offend.

James Horley, author of Sexual Offenders, is an associate professor of psychology at the University of Alberta in Camrose. He has worked with sexual offenders for more than 20 years in various clinical settings, including prisons, forensic hospitals, and community agencies. Dr. Horley's stated objective is, "Regardless of whether you are convinced by my arguments, my main goal in writing this book is to challenge you to expand your own theoretical, clinical and personal boundaries." He urges his readers to expand their theoretical framework so that they can "consider the development, use and examination of varied and ultimately better approaches to assisting sexual offenders psychologically."

Dr. Horley makes a valiant effort in first describing personal construct theory and then suggesting how it may have some utility for instilling hope into the treatment of a population that all too frequently is seen as hopeless. It is certainly a laudable goal to better treat sexual offenders and to challenge the often accepted societal notion that sexual offenders are monsters. He notes though, that with the current lack of research to back up his efforts to date, his book really is an introduction into one seasoned clinician's attempts at expanding the possible treatment modalities for sexual offenders. He, like the other authors included in this review, reminds the reader that sexual offending is much more a legal construct than a precise psychological description to help clinicians to better understand an offender's motivations, strengths, pathology, or capacity to respond to treatment. Sexual offenders are a heterogeneous group of offenders who require various treatment modalities. Dr. Horley introduces the reader to a potentially useful approach.

Sexual Offending and Mental Health, edited by Julia Houston and Sarah Galloway, is an interesting book that seeks to "inform readers about the range of theoretical and legal issues relevant to working with sexual offenders." Dr. Houston is a clinical and forensic psychologist with Forensic Mental Health Services, Shaftesbury Clinic in London, and team leader of the Sex Offender Service (SOS). Ms. Galloway is a forensic community psychiatric nurse and lead nurse with SOS, which is a multidisciplinary service based within forensic mental health settings rather than criminal justice settings. SOS brings together expertise from psychologists, psychiatrists, community psychiatric nurses, social workers, and probation and police officers. It is a 17-year-old service that provides assessment and treatment not only for offenders but also for their victims and the nonabusing partners of offenders. This book details many of the innovative programs that SOS uses to reach a complicated clinical population.

Many chapters are superbly written, but there is some unevenness between chapters with regard to theoretical sophistication. Administrators of sexual offender programs may find helpful the chapter on multiagency and multidisciplinary work with sexual offenders. It describes studies that explore the difficulties of truly working as a team and the pitfalls that trap even the most seasoned of clinicians. Child protection agencies (and anyone with the role of advocating for victims) may value the chapter on nonabusing parents and their role in risk management. It describes assessment and treatment strategies aimed at the partners of offenders. The authors share clinical examples from a group that addresses, in a nonpunitive way, the conundrum in which many nonabusing parents find themselves. While keeping children's safety paramount, these groups aim to move the nonabusing parent from a position of paralysis to one of protective agency.

Although these three books have little in common other than the general topic of sexual offending, each strives to move forward the clinical field charged with treatment of sexual offenders. Without more study, research, and scholarly writing to separate out the offense from the very different types of offenders, we as a society are bound to stagnate in our responses to this heterogeneous population. Without a more complete understanding of offenders and sound development of efficacious rehabilitation techniques, we are bound to have an ongoing accumulation of victims and a steady increase in the unfair judicial treatment of offenders. Each of these three books sheds some light on a subject too often left in the dark.

The reviewer reports no competing interests.

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