Gibbels Charlotte, Kneer Jonas, Hartmann Uwe, Krueger Tillmann H C
GIBBELS, KNEER, HARTMANN, KRUEGER: Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
J Psychiatr Pract. 2019 Jul;25(4):242-257. doi: 10.1097/PRA.0000000000000395.
Sexual violence is a significant and devastating issue for men and women throughout the world. Its consequences are not only disastrous for victims of sexual violence but are also extremely costly (estimated cost of $41,000 per rape) for society. Successful treatment of sexual offenders is therefore an important goal for society as well as for victims and offenders themselves. Over the years, multiple treatment approaches for sex offenders have been developed. Treatment programs range from the risk-need-responsivity (RNR) model, which focuses on providing tailored treatment for high-risk and low-risk offenders, to psychodynamic models. This article presents an overview for clinicians of state-of-the-art offender treatment, describing the most common treatment approaches, in particular the RNR model, cognitive-behavioral programs (relapse prevention programs, sexual offender treatment programs), psychodynamic approaches (transference-focused psychotherapy, mentalization-based therapy), the Good Lives Model, as well as pharmacological options. In addition, it provides an evaluation of the various treatment programs. However, given the fact that most acts of sexual violence will never be reported to the police, the question arises if treating convicted perpetrators is enough. Do we need rather-in terms of preventive work-a program for potential sexual offenders and men with delinquent sexual fantasies? Given the prevalence of sexual violence and its impact on victims, society, and the medical community, it would be remiss not to try to reach potential/unconvicted perpetrators. This article offers novel ideas and a project the goal of which is to prevent sexual offenses against women by introducing the "I CAN CHANGE" program from Hannover Medical School.
性暴力对全世界的男性和女性来说都是一个重大且具有毁灭性的问题。其后果不仅对性暴力受害者是灾难性的,对社会而言成本也极高(估计每次强奸的成本为41,000美元)。因此,成功治疗性犯罪者不仅是社会的重要目标,对受害者和犯罪者自身也是如此。多年来,已经开发出多种针对性犯罪者的治疗方法。治疗方案范围从侧重于为高风险和低风险犯罪者提供量身定制治疗的风险-需求-反应性(RNR)模型,到心理动力学模型。本文为临床医生概述了最新的犯罪者治疗方法,描述了最常见的治疗方法,特别是RNR模型、认知行为项目(复发预防项目、性犯罪者治疗项目)、心理动力学方法(移情聚焦心理治疗、基于心理化的治疗)、良好生活模型以及药物治疗选择。此外,还对各种治疗方案进行了评估。然而,鉴于大多数性暴力行为永远不会向警方报案,问题就来了,仅仅治疗已定罪的犯罪者是否足够。就预防工作而言,我们是否更需要一个针对潜在性犯罪者和有性犯罪幻想的男性的项目?鉴于性暴力的普遍性及其对受害者、社会和医学界的影响,如果不尝试接触潜在/未定罪的犯罪者,那将是失职的。本文提供了新颖的想法和一个项目,其目标是通过引入汉诺威医学院的“我能改变”项目来预防性侵犯女性的行为。