COURSE DESCRIPTION

Advanced course enabling EMDR therapy clinicians to work effectively with clients who are sex offenders. Provides a foundation and sharpens the EMDR therapy clinician’s practice by focusing on contextualizing and implementing current knowledge and theoretical bases for EMDR case conceptualization and treatment throughout the eight phases.

COURSE ABSTRACT

Theoretical models of sex offending etiology offer EMDR treatment providers a foundational understanding of factors contributing to criminal behaviors and a clear pathway to target selection. Dynamic risk factors (in addition to pointing to EMDR targets) are related to recidivism (Van den Berg, van Beek, Bouman, Janssen, Smid, & Gijs, 2024; Van den Berg, van Beek, Smid & Borsboom, 2020; Van denBerg, Kossakowski, Smid, Babchishin, Borsboom, Janssen, van Beek, & Gijs, 2022), presenting the EMDR therapist with a strong justification for treatment. A knitting approach draws from prominent models of sex offender drivers to ultimately coalesce in The Pathways Model (Ward & Siegert, 2002), a multifactorial model that attributes sexual offenses to cultural values and systems of belief, family dynamics, developmental issues, biology, and situational elements. The origin of the driver is the treatment target in EMDR (Ricci & Clayton, 2016). Additional factors which contribute to sexual offense behaviors include implicit beliefs, vulnerabilities, and self-regulation style (Ricci, Clayton, & Shapiro, 2006; Ricci & Clayton, 2016). These allow for offense behaviors in the right circumstances or when triggered by idiosyncratic cues (Ricci & Clayton, 2016). Early maladaptive schemas have also been the focus of the etiology of compulsive sexual behaviors (Efrati, Shukron, & Epstein, 2020; Keulen-de Vos, Giesbers,  & Hulsken, 2023). 

Given the severity of consequences of sexual offences (Finkelhor, Turner, & Colburn, 2024), there is a paucity of research and case studies exclusively on the EMDR treatment of sexual offenders. Nevertheless, there are several well-documented cases of the use of EMDR to treat sexual offenses that will be reviewed. Ricci & Clayton (2008) used a penile plethysmograph and the Sex Offender Treatment Rating scale as measures of improvement in the use of EMDR in the treatment of child molesters. A reduction of a child molester’s pathological sexual arousal was achieved over the course of 32 EMDR sessions (Wright & Warner, 2020). EMDR was employed to treat sex addiction, a common correlate to sexual offending (Cox & Howard, 2007). Ten Hoor (2013) used EMDR effectively to focus precisely on the cognitive distortions of a sex offender. Dohrmann (2009) proffered a dissertation in which EMDR was implemented and a reduction in risk of offending was found. Finley’s dissertation (2002) found that justifications for offender behavior were reduced using EMDR. Finley’s paper cites criminogenic factors developed by Hartung and Philbrick (1997) to assist in the effective use of EMDR with convicts with a history of trauma, addiction, dissociation, and personality disorders. Given the overwhelmingly prevalent use and harmful role of sexual fantasy in some sexual offenders, bilateral stimulation was used to diminish vividness, sensations, pleasure, emotional intensity, and sexual arousal of sexual fantasies (Bartels, Harkins, Harrison, Beard, and Beech, 2018; Allen, McKillop, Katsikitis, and Millear, 2022). Robert Miller (2010) developed the EMDR Impulse-Control Protocol, based on his Feeling-State theory of impulse control disorders. Sexual offense behaviors themselves may elicit traumatic memories at levels of other traumatizing events (Clark, Tyler, Gannon & Kingham, 2014), and EMDR was used to treat these offense-related traumatic memories. These theoretical models and studies will provide participants with a solid foundation for the EMDR treatment of sexual offenders.

Building on the theoretical models of sexual offense etiology (Efrati, Shukron, & Epstein, 2020; Keulen-de Vos, Giesbers,  & Hulsken, 2023; Ricci & Clayton, 2016; Ward & Siegert, 2002; Van den Berg, van Beek, Bouman, Janssen, Smid, & Gijs, 2024; Van den Berg, van Beek, Smid & Borsboom, 2020; Van denBerg, Kossakowski, Smid, Babchishin, Borsboom, Janssen, van Beek, & Gijs, 2022) and the documented use of EMDR in the treatment of sexual offenders (Allen, McKillop, Katsikitis, and Millear, 2022; Bartels, Harkins, Harrison, Beard, and Beech, 2018; Clark, Tyler, Gannon & Kingham, 2014; Cox & Howard, 2007; Dohrmann, 2009; Finley, 2002; Hartung & Philbrick, 1997; Miller, 2010; Ricci & Clayton, 2008; Ten Hoor, 2013; Wright & Warner, 2020) participants will be guided in case conceptualization, target selection, and implementation of EMDR treatment throughout its eight phases. The origin of the offense driver is the treatment target in EMDR (Ricci & Clayton, 2016). For many who sexually offend, their own experiences of and responses to childhood sexual abuse or other childhood adversity influence their beliefs about sexual offending and their perception of their victims (Wright & Warner, 2022). Offense driver assessment in Phase 1 History Taking may uncover various groupings including implicit core beliefs like entitlement to offend, vulnerability factors such as deficits in social skills or role models demeaning and objectifying women, distorted sexual scripts, or deficits in self-regulation (Ricci & Clayton, 2016). Using offense driver theory to uncover etiological memories will help providers astutely develop multiple EMDR treatment plans for individual clients, each targeting a general group of offense drivers. To facilitate generalization of treatment gains, providers may make use of clusters to target numerous incidents holding similar offense driver etiology. Phase 2 Preparation calming techniques may be emphasized as a means of self-care that may heal the drive to offend. In Phase 3 Assessment, negative and positive cognitions will help the sexually offending client strengthen their belief that change is possible and will begin to bring awareness to their changing somatic reactions to earlier memories. Phase 4 Desensitization, Phase 5 Installation, and Phase 6 Body Scan will illuminate the reality of change. Phase 7 Closure can prepare incarcerated clients and clients at risk of reoffending with the transition necessary to avoid harm. Phase 8 Reevaluation allows both client and provider to check treatment gains or setbacks and to check for potential new targets when additional memories begin to hold new meaning for the sexually offending client. Wright, Palmer, Kelly, & Derefaka (2024) found that after EMDR therapy, men convicted of sexual offenses against children reported pro-social changes in their views of their offending behavior and victims, reduced preoccupation with sexual fantasy, reduced sexual arousal related to children, and increases in desire for healthy adult relationships.

COURSE OBJECTIVES

Upon completion of this course, participants will be able to:

1. Recall six drivers of sex offending.
2. Compare the purpose of standard treatment for sex offenders to EMDR therapy for sex offenders. 
3. Describe how bilateral eye movements may impair deviant sexual fantasies and decrease the desire to engage in sexually fantasized phenomena.
4. Explain the potential increase in self-compassion and the positive disturbance that sex offenders may experience after EMDR treatment of their own history of child sexual abuse.
5. Identify how to derive an EMDR target from an offense driver.
6. Differentiate between best use of the standard EMDR protocol and an addiction protocol in the treatment of sex offenders.

Schedule