HOW DOES GROUP COGNITIVE BEHAVIOURAL THERAPY PREVENTSEXUAL OFFENDER RECIDIVISM?
ASAHINA Makiko *I. INTRODUCTION
The phrase, “support for offenders” makes us uncomfortable. Is it necessary to support offenders, rather
than victims? This is a natural question. It is hard to say that currently there is enough support for victims.
In some people’s opinions, support for offenders should not be prioritized over that for victims. When it
comes to sexual offenders, such an opinion seems more justifiable.
When we examine the goal for supporting offenders, on the other hand, the primary aim is to prevent
recidivism of the offenders. Those who receive the greatest benefit are ordinary citizens who have thepotential to be assaulted by the offender who might commit any crime again in the future, rather than theoffenders themselves. In other words, “support for offenders” is indeed activities for offenders but is also
regarded as one of the initiatives for protecting the society. We cannot conclude that we do not have to treat
offenders just because victims are not supported sufficiently. If there is an efficient method to prevent any
possible damages in the future and we are prepared to implement it, what we need to do is just do what wecan.
I have worked for correctional institutions for adults as well as minors (both are under the Correction
Bureau, the Ministry of Justice), and have assessed and treated offenders as a clinical psychologist. I often
had experiences to make me doubt the goals or significance of offender treatment, and every time I havesuch a doubt, I ask myself the question stated in the beginning and repeat an internal argument. It is suchan important point for me that I cannot start to prepare this paper without confirming the question statedabove. Based on the question, I would, focusing on sexual offenders, like to express my opinion about why
psychological therapy for sexual offenders is effective in terms of recidivism prevention and what is necessary
to make it effective, and as well I would like to explain the significance of promotion of feasible damage
prevention measures along with provision of psychological therapy.

II. SEXUAL OFFENDER TREATMENT IN JAPANIt was in May 2006 that correctional institutions in Japan established a system to provide a comprehensive
treatment programme over a period up to 11 months as special guidance for inmates convicted of sexual
offences. The measure was a response to growing calls for better recidivism prevention guidance at prisons,as a released inmate had kidnapped and murdered a school age girl in Nara in November 2004, and against
the background of enforcement of the Act on Penal Detention Facilities and Treatment of Inmates andDetainees in 2006 in place of the Prison Law enacted in 1908. Based on the findings of a sexual offender
treatment programme study group established in April 2005, sexual offence recidivism prevention guidance
was introduced into prisons, which followed a group cognitive behavioural therapy programme of Canada
where offender treatment is advanced. Group cognitive behavioural therapy was adopted because it was
regarded an optimum choice from viewpoints of recidivism prevention effects and cost performance(Correction Bureau and Rehabilitation Bureau, the Ministry of Justice, 2005).
At that time, there were questions from the media highly interested in sexual offender recidivism
prevention, such as why group cognitive behavioural therapy can prevent participants from reoffending, andabout what participants are talking in the programme and what would happen to the participants. My verbal
explanation failed to make reporters fully understand what the programme was like. There were many＊

Principal Specialist, Tokyo Juvenile Classification Home, Japan. Author’s Note: This paper is extracted from an article ofthe same name published in Japanese in the journal Human Mind (May 2018), 199, 51-57.

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requests from reporters to disclose how the programme was implemented, but this was not realized because
it would be difficult to understand the whole programme by observing only a part of the programme that
continues for up to 11 months, and also it would be difficult to gain participants’ consent to be observed byoutsiders who might hate them. As a result, there was a sceptical report that it was uncertain whether the
programme would be effective or not, although it had been developed by introducing a good method fromabroad. Another report said that it was doubtful that only talking in a group could prevent sexual offenders
from reoffending or that the programme would not be meaningful, as the participants surely pretend toregret their offensive behaviour.
In December 2012, when six years had passed since the start of the sexual offender treatment programme
at a correctional institution, the Correction Bureau, the Ministry of Justice published an evaluation study ofthe effects on those who were released during a period of three and a half years after the introduction of the
programme (Correction Bureau, the Ministry of Justice, 2012). The number of subjects of the study (treatedgroup and non-attendant group) was 2,147 people, including 423 recidivists who committed any type ofoffences (19.7%) and 224 recidivists who committed sexual offences (10.4%). Since the number of recidivists
was relatively small, there were only a few items that showed significant differences between the treatedgroup and the non-attendant group. However, when comparing estimated recidivism rates of all types ofoffences between two groups during a period of three years after release, the rate for the non-treated groupwas 29.6% and the rate for the treated group was 21.9% (significant at the 1% level). Accordingly, thetreatment programme had a certain recidivism prevention effect. As data are being collected since thepublication, the next report based on an increased number of subjects is eagerly awaited.

III. REALITY OF THE SEXUAL OFFENDER TREATMENT: REASONS WHY THEYCOMMITTED SEXUAL OFFENCES
What do participants do in the sexual offender treatment programme? About what do they talk whilegathering in a group, and why does such a talk prevent recidivism? Sexual offenders are a heterogeneous
population compared to other types of offenders, and they vary in terms of the process required for recidivism
prevention and their motive (Kidaka, et al., 2017). However, based on the variety, I would like to findsomething in common.
Participants in the sexual offender recidivism prevention programme (hereinafter called the “participants”)
first take time to realize why they committed the offences. Reasons for the offending behaviour should havebeen clarified during the investigation and the trial, as a phrase “all-out efforts are made to investigate a
motive” is often heard in the reports after an offender is arrested. When we asked sexual offenders theirmotives at the beginning of the treatment, however, very few of them understood the true reasons for theiroffences. Some simplified their motives as increased stress or sexual desire, while others denied their intent
to assault by saying that they thought they had gained the victim’s consent. Such poor understanding hasvarious reasons. In this report, I would like to discuss two points: (1) naturally, motivations for offending
behaviour cannot be expressed briefly; and (2) there are various motivations that participants are not willingto admit.
First, it is difficult to express the reason for offending briefly, referred to above in point (1). In general,
when exploring motivations for offending behaviours, we often focus on the movement of minds for a
relatively short period just before the assault, such as “getting angry with some behaviour displayed tothem” and “getting stressed out.” However, in many cases, these are only triggers, not true motives for theoffences. It is usually thought that an offender’s decision-making mechanism to resort to a violent act
triggered by some cause has been developed ceaselessly from a young age based on childhood experiences
or human relationships when they were students or after they went into the society. People have, in thecourse of living, created their own perspectives, sense of values, expectations for others and the outside
world, self-image, prospects, or other framework from experience, and become equipped with them. The
totality of these factors has an important role in deciding whether they hurt somebody when faced with anincident that may act as a trigger. Since a sexual assault is so unreasonable for a victim, we are apt to expect
offenders to express their motives as a kind of an excuse. However, in order to show an accurate motive, theoffender must explain such mechanism in detail, and giving a brief explanation is far more difficult than we
expect. Like reasons for acts to harm others, people who have committed drug abuse, wrist cutting, andexcessive eating and self-induced vomiting from eating disorders cannot well explain the reasons for these20

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acts.
Next, let me move on to point (2), it is difficult for participants to face many of the motivations. I would
like to explain this point by examining some examples.
Mr. A committed sexual offences as if venting anger or hostility which should have been directed tocertain people but he could not. Mr. A seemed to be a good person to people who were close to him.
However, he was so anxious about not being accepted by them if he betrayed their expectations. Therefore,out of fear, he kept pretending to be a good and kind person. He felt he became smaller and weaker while
pretending to be a good man, which made him feel hurt, and his anger accumulated. For Mr. A, a sexual
offence represents anger and functions as means to feel he had strength.
Mr. B committed a sexual offence in order to temporarily relieve his loneliness or solitude that he felt
because he was not accepted by the people around him. In order to justify the sexual offence, he denied andignored the rejection of a victim and tried to stay in a fabricated world in which the victim would not say no
to him. It can be said that Mr. B has lived a life without a sense of reality because he interpreted otherpeople’s feelings, relationships with others, or other matters at his own discretion, and tried to make his story
consistent.
Mr. C was too much hurt and depressed with something beyond the stress. In order to gain an intense
emotional experience that could relieve the hurt and shake off such depression, he committed a sexual
offence. Mr. C was overwhelmingly too obsessed to notice others’ pains or feelings. We could say that he was
addicted to sexual offences like drug abuse, and tried to survive by only thinking of sexual offences andactually committing them.
Each of the cases above indicates that reasons for sexual offences are closely related to the weakness,hurt, disappointment, and reality that offenders do not want to face. There are quite a few people who havecommitted sexual offences so that they can avert their eyes from reality. Furthermore, it is known that manyof those who commit sexual offences or other felonious and violent offences fail to cultivate the ability tounderstand and calm their feelings properly or express them verbally. We can understand that, whenparticipants try to explain the reasons for sexual offences in an easily understandable manner, they only
present tentative answers as required. They do not know any truth in themselves. Giving stereotypicalanswers does not mean that they intend to protect themselves or evade their responsibilities.
The treatment programme should give participants opportunities to make them look at problems they
have avoided thinking about or they have wanted to ignore if possible. For that purpose, it is necessary thatparticipants trust therapists and group members, and also themselves to tackle and overcome the problems.
At the beginning of the programme, we concentrate on creating trust in both other members and themselves.
Conversely, participants cannot explore a true reason for their sexual offences without having a certain levelof confidence in other members and themselves.

IV. REALITY OF THE SEXUAL OFFENDER TREATMENT: LIFE WITHOUTCOMMITTING ANY SEXUAL OFFENDING
When participants have focused on motives for sexual offences and understood what they wanted fromsexual offences to accept the reality of their own, they move into the next stage to examine how they canlive without committing any sexual offences. A sexual offence is merely one of the problems rooted in theirown lives, which has come to the surface. Offenders cannot pick up only a sexual offence-related problem toeliminate from their histories or cannot live a future life as if there were no sexual-offence related issues inthem. Accordingly, in many cases participants are required to make such a drastic change in their way ofliving.
Kidaka, et al. (2017) showed words of a participant, a sexual offence recidivist. He said that he hated
himself for having been imprisoned repeatedly, but he would have nothing left without sexual offences, andhe felt that he had lost the meaning in his life. He cannot picture his life without sexual offences while wishing
to stop being an inmate. He even lost the hope to live a life without committing a sexual offence. Although
this is an extreme case, any participant has somehow hesitation or doubt whether his life would turn for the21

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better. Even though they move on toward improvements, some of them may return to the unstable state
mentioned above.
Participants have a lot of things to do, change, and acquire so that they can live better lives withoutcommitting sexual offences. Although such an attempt makes participants feel burdened, it helps participants
have a positive outlook for future improvement by tackling tasks one by one. Therapists are required toencourage the participants to choose a realistic or relatively achievable task among all and keep showing
them that keeping on making efforts for a change would make them stay away from sexual crimes. Aftercompleting the programme, the participants themselves display their reality-testing ability to set their own
agenda and try to keep making efforts.
Bill Marshall, a leading expert on sexual offender treatment, mentions four points as characteristic of an
instructor who has an influence on participants to change: a therapist who is (1) empathetic; (2) warm; (3)rewarding desirable changes; and (4) somewhat directive. He pointed out that necessary factors for effective
sexual offender treatment are the same as those required for a therapist in general psychotherapy (Marshall,2005). Whatever task people may tackle, it is difficult for them to keep making efforts to change as they want.
Therefore, it is natural that conditions for a therapist to function effectively are the same as those for ageneral therapist. When supporting offenders, a therapist is also required to deal with them based on therecognition that they have difficult problems and they need support in order to keep making efforts.

V. POWER OF A GROUP
Participants bring certain patterns of human relationships developed in their lives to a place of group
activities. Some display wariness and resist communication, and some put on a brave front and devalue theothers by always boasting about themselves. Some behave amiably with a smile but hide their true feelings.
Some reveal too much emotion earlier than usually expected. Others express their emotions as little aspossible to suppress their reaction and check the others. These behavioural patterns are familiar to theparticipants, but in many cases some of them are dysfunctional because they give people a push to commit
sexual offences. Shimada (2017) noted an important point for cognitive behavioural therapy. He said it isnecessary to focus not on whether the offender’s behavioural pattern is factual, or socially desirable, but on
whether it pushes sexual offence behaviours in certain circumstances, which is the target of change. A group
activity is used for discussing and clarifying a participant’s attitude, sense of values, way of interpreting an
event, human relationships, and how to express emotions, all of which may function as a push to drive theparticipant to sexual offence behaviours. At the same time, it is necessary to offer an opportunity whereparticipants can try another new pattern of behaviour.
Since participants, as inmates, live in prisons which have a unique culture, and they can distancethemselves a little from their familiar thinking style or pattern of relationships which were adopted insociety. If by taking advantage of the distance a participant tries a different pattern and acquires it to thelevel that he can use it in real society, a prison may be regarded as a good place for such group activities.
In order to maximize benefits of group activities, group members are, in many cases, obliged to observe
rules. Although rules usually differ by group, many of the sexual offender treatment programmes incorrectional institutions adopt three rules, such as (1) to be considerate toward each other; (2) to speak
frankly; and (3) to maintain confidentiality (Furune, 2017). Mutual consideration in rule (1) and confidentiality
in rule (3) are important to ensure that participants can have a sense of security within a group. Attacking
others and themselves is not permitted, and what participants discuss within a group should not be disclosed
to the outside. Frankness in rule (2) is necessary for participants to learn more and acquire skills.
However, like rules in a real society, the rules in these groups are sometimes violated. There are sometimes
inconsiderate remarks and actions for a therapist or other participants, and some participants leak somesecrets to the outside. When a rule has been violated, the therapist and participants must discuss what
happened and learn a lesson from such violation. The therapist and participants examine a possibility thatthe participant who violated the rule again employed a psychological mechanism that had worked at the timeof the assault, and discuss what they can do to prevent recurrence. At the same time, if any participant washarmed by leakage of a secret, he must be treated carefully considering the fact that his safety is endangered,and group members must help him build up trust with other participants again. Ultimately, such support
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would help the participant build up realistic trust with the real world. They may notice that they had better
keep secrets because it is the best way to secure the safety of all group members, and they had better talkfrankly because frank talk would make participants learn more deeply. Then, participants would come toaccept the rule. It would be desirable that participants obey the rule not because a rule must be observed
but because they realize that the obedience is of great benefit to them.
In this way, a group is a society in miniature, and group activities give participants practical training.
They can imitate and learn, from other participants' sense of values, perspective, ways of thinking, how tointerpret them, ways of expression, how to behave, and other things. In this sense, we can conclude thatgroup therapy is significant in that it is not only inexpensive but also highly effective.

VI. FULFILMENT OF SUPPORT MEASURES FOR DAMAGE PREVENTION
Both sexual offenders themselves and general citizens welcome the realization of a society that deters
sexual offences. It is desirable that the society should adopt, one by one, systems which can be introduced,
for purposes including the improvement of the effectiveness of the treatment based on psychiatry andclinical psychology. Here, let me briefly introduce two overseas activities with a view to fulfilling damage
prevention support measures in a wider sense.
One is CoSA (Circle of Support and Accountability) which started in Canada in 1994. It is difficult to
introduce and expand CoSA in Japan due to a shortage of supporters who are volunteers, and Canada also
suffers from this shortage. However, a CoSA model is worthy of attention because it indicates one of theeffective support measures based on social inclusion. There is the sexual offender information registrationand disclosure system introduced to the United States in 1996. The system aims at promoting exclusion of
the sexual offender concerned from the region as well as conveying a message to residents, “Protect
themselves on their own.” In this sense, the system is oriented against the direction of CoSA. Although it isdifficult to introduce completely the same system as CoSA to Japan, we should examine the significance of
support measures in terms of their positioning among all recidivism prevention measures. In addition, we
should examine support measures by focusing on what message is conveyed to both offenders and residents
by such measures.
The other activity is the sexual offender registration and police clearance certificate system establishedin the UK in 1997 (Takushima, 2006). Under the system, applicants who want to work with children(schoolteachers, prep schoolteachers, therapists of lessons for children, coaches for club activities, etc.) are
obligated to submit police clearance certificates. Police clearance certificates are not issued to people withcriminal records, as offence information is registered. Unless they want to work with children, however, theircriminal records are not found by people around them and they are not socially isolated more than necessary.
It is known that child sexual offenders tend to choose a job that allows them to approach children easily.
The certificate system is useful for preventing recidivism, although it cannot deter first-time offenders. In
order to maximize the effect, school personnel who have lost jobs due to sexual contact with, or commercial
sexual exploitation of, young people－even though not prosecuted－should be covered by the registration
system to eliminate the chances of returning to children-related jobs. Since not a few tutoring schools or
schools for lessons are opened by individuals, teachers for such schools should be obligated to display thepolice clearance certificates in the classrooms. Such a system may be one of the support measures for sexual
offenders, because it would serve the interests of recidivists by lessening the possibility of recidivism.

VII. CONCLUSION
This report aims at describing, as specifically as possible, the content of the sexual offender treatment
programme based on group cognitive behavioural therapy for the prevention of sexual-offence recidivism.
The description is still abstract, and one of the reasons for the abstractness is that a change required for an
offender to stop recidivism differs from offender to offender. Still, there might be something common inchanges required for participants. Recidivism can be prevented with the following actions: (1) to assess
precisely a motive for a participant to have committed a sexual offence and related factors; (2) to set a
specific goal for a participant out of many tasks required for the prevention of reoffending; and (3) to help aparticipant make continuing efforts. It is concluded that evaluation of the treatment programme should be
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left to a future study to be done from the viewpoint of whether the programme is effective and which factorsof the programme have an impact on recidivism.
Prevention of sexual offender recidivism is a task worth realizing with all our efforts. We should not besatisfied with the existing system and treatment programme, because they are not completed. I believe it is
the responsibility of the people engaged in offender support to keep improving the system and programme
based on the evaluation of their effectiveness and learning hungrily from other fields and other countries forthe best system and programme.

REFERENCES
Toshiyuki Furune (2017) Group Work for Sexual Offenders (3): Therapeutic Environment and a Viewpoint ofa “Place.” Izumi Kadomoto, Hironori Shimada (ed.), Therapeutic and Educational Approach for Sexual
Offenders. Kongo Shuppan.
Correction Bureau and Rehabilitation Bureau, the Ministry of Justice (2006) Report of Sexual Offender
Treatment Program Study Group. http://www.moj.go.jp/content/000002036.pdf.
Correction Bureau, the Ministry of Justice (2012) Report of Analysis and Research concerning Recidivism ofParticipants in Sexual Offender Treatment Program in Correctional Institutions. http://www.moj.go.jp/
content/000105286.pdf.
Nobuyuki Kidaka, Yusuke Inozume (2017) Overview of Sexual Offenders: Statistical and Clinical Viewpoints.
Izumi Kadomoto, Hironori Shimada (ed.), Therapeutic and Educational Approach for Sexual Offenders.
Kongo Shuppan.
Marshall, W.L. (2005) Therapist Style in Sex Offender Treatment: Influence on Indices of Change, Sexual
Abuse: A Journal of Research and Treatment, 17(2), 109-116.
Hironori Shimada (2017), Therapeutic Theory for Sexual Offenders (2): Cognitive Behavioral Therapy. Izumi
Kadomoto, Hironori Shimada (ed.), Therapeutic and Educational Approach for Sexual Offenders. Kongo
Shuppan.
Akiko Takushima (2006) Sexual Offender Treatment in the U.K., Crime and Punishment. 43(2), 69-72.

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