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Clinical Value of the FoSOD
The FoSOD holds promise as a measure to assess both current levels of
denial and treatment progress in general. "Most therapists agree
that the
first goal of treatment is to assist the perpetrator to acknowledge a problem
involving sexual behavior." (Schlank & Shaw, 1996, p. 18.) "To be
successfully treated, the offender must admit not only to the sexual offense
itself, but also to the harmfulness of the offense and his (or her)
responsibility for the offense" (Marshall & Barbaree, 1990; McGovern &
Peters, 1987). Perhaps even more important, the offender must acknowledge a
more pervasive problem with sexually deviant preferences and a tendency to act
out in certain situations to satisfy those urges. Each of these prerequisites
to successful treatment is measured by the FoSOD.
There currently
exists ample evidence that denial is not simply a defensive posture evidenced
by some offenders at the beginning of treatment. Instead findings suggests that
it is a complex pattern of behavior evidenced by offenders throughout
treatment, and that it is inversely related to well-established goals of sexual
offender treatment programs. In fact, many child molester treatment goals
(e.g., Salter, 1988; Green, 1995) are directly related to one or more of the
types of denial captured by the FoSOD. The treatment goal of accepting
responsibility for the offense, for instance, can be monitored through
attention to Denial of Intent (as well as other subscales). Appreciating the
harm to the victim can be monitored in the Refutation and Victim Desire scales.
Goals focused on understanding the abuse chain and the dynamics of offense
behavior are reflected in the Denial of Planning and Risk of Relapse scales.
Hence, the scales and subscales of the FoSOD explicitly identify specific
domains to be addressed in treatment, and provide a framework that can be used
to more clearly articulate the relationship between facets of denial and
established treatment goals.
Having a quantitative measure of denial,
along with a breakdown into its component scales, provides enormous potential
for expanding our knowledge of child molesters through research and clinical
application. The FoSOD allows us to measure several aspects of denial and to
map how each of the types of denial responds to treatment. Eventually, we can
characterize common patterns of denial throughout treatment, and provide
specific strategies to address particular forms of denial. This type of
research will assist in the development of treatment models that will help
guide therapists in identifying appropriate, timely, and individualized
treatment targets.
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