The paradox of forensic care : Supporting sexual offenders

Downs, Claire and Fletcher, Ian and Rayner-Smith, Kelly (2020) The paradox of forensic care : Supporting sexual offenders. PhD thesis, Lancaster University.

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Abstract

Perceptions of sex offenders are often negative due to the nature of their crimes, leading them to be viewed as a homogenous group. Previous research, has, however, suggested that for sex offender treatment to be effective, it needs to address the individual’s specific criminogenic needs within a compassionate and on-judgemental setting. Given the significant impact of sexual abuse, understanding what factors promote treatment effectiveness and influence compassionate care is needed. This researched explored specific sex offender populations, child sex offenders and sex offenders with learning disabilities (SOwLD). The paradoxical nature of forensic services is considered, given the emphasis placed on compassionate care needed in the treatment of sex offenders, and the requirement for security to manage risk. The challenge in providing patient-centred care was acknowledged when treatment was mandated or delivered in secure environments, a common occurrence in forensic services. In Chapter 1, qualitative research that explored the therapy experiences of child sexual offenders was synthesised. The themes reported within the eight identified studies were compared, resulting in the emergence of five superordinate themes. Results indicated the importance of non-judgemental, empathic, and compassionate support in improving meaningful engagement. In Chapter 2, a qualitative research study was conducted which explored nursing professionals’ experiences of working with SOwLD. This study identified the challenges and benefits of working with this population. Interpretative Phenomenological Analysis was used to develop themes from the narratives of eight nursing professionals. Two superordinate themes emerged: Becoming Janus and The pervasive influence. A lack of support or progress could increase job-demands, in turn risking compassion-fatigue. Consideration is given to how staff wellbeing can be improved when working with this population. In Chapter 3, a critical appraisal was conducted to explore the use of labelling language within research and healthcare services, including how this could be changed.