Working With Sex Offenders When You Think Like a CAT Person

Bermingham, D., 1998. Working With Sex Offenders When You Think Like a CAT Person. Reformulation, ACAT News Spring, p.x.


Working With Sex Offenders When You Think Like a CAT Person

Donald Bermingham

I have been using CAT since 1983 and have been a consultant psychiatrist in Huntingdon since 1987. From 1990 until November 1997 I was psychiatric advisor to a prison wing dealing almost exclusively with male sex offenders.

Background

Around 1990 the Home Office decided that "something must be done" about the rehabilitation of sex offenders. Wings in several prisons were designated as sex offender treatment wings with up to one hundred offenders on a wing. Prison staff (officers, probation, psychology etc.) were given some basic training in group skills, mainly within a CBT framework, and Home Office psychologists devised a tightly structured 60 session programme to be delivered - The Sex Offender Treatment Programme or SOTP. My role was to give support to the teams delivering the SOTP and to assess individual prisoners as to their suitability for the programme.

In reality my role developed in three main directions:

1. Facilitating the therapeutic milieu of the wing.

2. Assessing prisoners, and taking on those with active mental illness.

3. Supporting the staff.

Reflections

1. Facilitating the therapeutic milieu of the wing

This proved the most useful and perhaps the most CAT like. Previously, sex offenders were often secluded for their own protection. Known as "Rule 43" or "Being on the Rule". The response to their abuse was either overwhelming counterabuse or exclusion. On the wing all prisoners were asked to give up Rule 43 status in return for a guarantee of safety and confidentiality. Any acts against them either on the wing or off it resulted in the perpetrator being transferred within 24 hours to another prison. In seven years there were very few incidents and all were dealt with as had been promised. Staff on the wing were selected for their ability to treat prisoners in a firm, structured, but non-judgmental way. In CAT terms the VictimAbuser dilemma was addressed.

2. Assessing prisoners, and taking on those with active mental illness

I need say little about the assessment of individual prisoners except that the same non-judgmental approach was taken. There was a high incidence of prisoners coming to the wing in denial of their crimes and subsequently admitting them: Those who continued to deny were transferred.

3. Supporting the staff

The issues for staff support were principally those that any supervisor will be familiar with in cases where the trainee has a patient with a Victim-Abuser dilemma. Avoiding the invitation to join in the dance, avoiding being a victim or using their power to abuse. Also avoiding continuing the abuse outside of work, for example, officers feeling that they couldn't cuddle or bath their children in case this was the first step to offending. Helping them to see that this was "victim behaviour".

Concluding Thoughts

Sadly I feel that the impetus has gone from the heady days of 1990. The emphasis is now on measuring change with psychometry and penile plethysmography which I view with some suspicion as a form of pseudoscience. What remains is a structure in which the prisoner can feel safe, listened to and not abused or excluded. If this survives, then so does the potential for change.

Donald Bermingham

Full Reference

Bermingham, D., 1998. Working With Sex Offenders When You Think Like a CAT Person. Reformulation, ACAT News Spring, p.x.

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