Case Example: Jim Jones

Jim is a 34-year-old male who has attended 5 months of treatment in an outpatient Sexual Offender Treatment Program. He sexually abused a 14-year-old unrelated female. In treatment, he is described as being generally cooperative, but is unmotivated. He denies that he committed a sexual offense though he does admit touching the victim with her consent. He appears to understand the concepts and skills being taught in the program, but participates little and offers no feedback to others in the group.

Interpretive Assessment

An examination of the FoSOD Scoring Results should begin by first reviewing the 6 major scales. This is followed by a more specific review of the subscales and a review of the corresponding Critical Items that produced high denial scores.

In the current example, the client's responses revealed Moderate Denial for the major scales of Refutation [SR], Denial of Intent [SR], and Assertion of Victim Desire [SR]. Results also indicate Low Denial for Denial of Extent [SR], and High Denial for Denial of Planning [SR] and Denial of Risk of Relapse [SR].

When evaluating FoSOD responses, the first area of concern is whether the client has admitted to the offense. An assessment of the Refutation Scale[SR or CI] is needed to determine an answer to this question. In the current case, responses suggest a moderate level of denial, meaning that the client is not denying that something happened but that he is reluctant to admit that what happened was serious or truly an offense. The related subscales [SR] and associated Critical Items [CI] provide insight into what the client is reluctant to acknowledge about the existence of an offense.

In this case example, each of the Refutation Subscales [SR] and associated Critical Items [CI] reflects some level of denial except for the Focus on Self-harm [SR]. These Subscales [SR] and associated Critical Items [CI] indicate several related but contradictory assertions that warrant further exploration. For instance, the Victim Credibility Subscale [SR or CI] indicates that the offender alleges that the victim has lied about his behavior towards her. Furthermore, the offender contends that the lies were due to the victim's tendency to lie, and that also she was convinced by someone to make up false allegations against him. This raises questions concerned with the basis of his view of her character (i.e. liar) [CI], her motivation to lie (i.e. implied hidden agenda) [CI], and his theory about who put her up to it including their motivation to do so [CI]. Exploring these issues can reveal weaknesses or inconsistencies in the offender's construal that can help bring a more balanced view to these circumstances.

The offender's responses to the System Fairness Subscale [SR or CI] also suggest either generally antisocial attitudes (i.e. treatment is all about money), or (minimally) a perception that others are deliberately using him and are not really concerned with his best interests [CI]. This latter finding reflects a problem in creating a workable therapeutic alliance. It suggests a view likely to interfere with developing a desire to cooperate with therapeutic tasks or to disclose sensitive and potentially disgraceful information about himself.

Interestingly, the low Denial of Extent [SR] score demonstrates that he is not saying he did not do anything. However, the Victim Harm Subscale [SR] and related Critical Items [CI] suggests a belief that whatever occurred was not problematic or harmful, and has been blown out of proportion either by the victim or others.

A review of the two subscales of the Denial of Intent Scale [SR] reveals more information regarding Mr. Jones' view of his actions and attributions of responsibility. In particular, his responses indicate that he perceives himself to have acted because of some pressure or emotional state, and he construes his actions as a mistake in judgement that was embedded in some set of circumstances [CI]. The Assertion of Victim Desire Scale [SR] sheds further light on his perception of his role and that of the victim. These responses reflect a view that the victim wanted him to act as he did, and in some respects enticed him to act sexually toward her [CI].

It is notable that the Denial of Intent [SR] and Assertion of Victim Desire [SR] Scales have been found to be highly correlated with Cognitive Distortion Scales (i.e., Bumby Child Molest Scale, Hanson's Sexy Children Scale, and the MSI Justifications Scale), and are therefore likely to reflect entrenched, distorted views of the offense. (In contrast, the other scales tend to reflect a combination of intentional deceit and distortions.) As a result, it is unlikely that expectations or immediate demands to abandon questionable beliefs about the cause of the offense will be successful. Instead, interventions geared toward gradual reductions in distorted thinking are more likely to decrease these types of denial.

Examination of Denial of Planning [SR] and Denial of Relapse Potential [SR] show high levels of denial, with a strong position that the offense was not planned and could never happen again [CI]. These results are not surprising given that Denial of Planning [SR] and Denial of Relapse Potential [SR] tend to be the last aspects of denial to change. This is because these two facets require the offender to admit to a deliberate desire and plan to exploit a vulnerable child [CI]. This is especially difficult because the offender has to admit that he is the type of person who is likely to commit a sexual offense, and that the potential to re-offend exists because of his own tendencies, interests, and goals rather than because of any situational contingencies [CI].

Given all of these different aspects of denial, treatment progress is likely to be optimized through a strategic approach that considers both the FoSOD scores and other information about the offender or their current circumstances. One rule of thumb is to consider which of these areas may be the least defended, and therefore most open to exploration and suggestion. Given that the areas identified by the FoSOD reflect independent but related views of the offender, changes in one area are likely to have an influence on the others. Targeting, and altering, one domain at a time is likely to assist the clinician to bypass particularly rigid areas of client resistance and to move toward a more cooperative set. This flexible approach also builds on successes, and progressively establishes a foundation that allows the offender to consider new ideas about himself and his offense behavior.

In the current case, the FoSOD results point to multiple areas that are ripe for further exploration and improvements in accepting responsibility. One potential focus is on the offender's view that the treatment program is not designed with his best interests in mind [SR or CI]. Another focal point might be his view of the appropriateness or intrusiveness of his behavior, or its significance to the victim [SR or CI]. Yet another area that could be a rich starting point concerns the offender's contradictory views of the victim (i.e. liar, manipulator, overly-influenced, sexual temptress) [CI]. There are many other possibilities including his assumptions about how circumstances controlled his behavior, how impairments in judgment might have been involved, or what his rationale for his behavior indicates about his goals at the time of the offense.

Clearly, the FoSOD is not intended to prescribe the particular approach used to address the issues identified in this evaluation. Instead, the FoSOD application is designed to specify cognitive factors that limit offender accountability, to assist clinicians in assessing treatment progress, and to provide support in formulating targeted treatment strategies.

However, a word of caution is warranted. After administering the FoSOD it is highly recommended that the clinician does not use the specific test items to confront the offender. Instead, the targeted areas should be addressed within the specific therapeutic approach typically employed in one's program, and should consist of questioning or framework building that is consistent with the clinician's general style. It should be noted that inappropriate use of the test results or critical items (i.e., pointing out problematic responses on particular items or scales) will invalidate its later use, and make it unavailable to you as a resource. Additionally, it should be remembered that the test is designed to identify theoretically and empirically relevant areas of clinical inquiry, but not to serve as an intervention in itself.

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