The Boundaries of Care and Control: Stakeholders Struggle to Navigate Challenges of Mandatory Sex Offender Treatment

Background and Purpose: After release from incarceration, people convicted of sex offenses are often required to attend mandated sex offender treatment (MSOT) as conditions of their supervised release. Additionally, they are often supervised by specialized sex offender probation units, which coordinate and monitor MSOT engagement, and oversee compliance with sex offender registration and notification requirements. Criminalization of therapeutic spaces and complicated interplay between therapeutic and criminal justice requirements and priorities creates ethical and practical challenges for all stakeholders involved. From their respective roles, both MSOT therapists and probation officers find themselves unhappily struggling to navigate sometimes competing commitments to participants, public safety, and professional expectations. This study explores how therapeutic and criminal justice providers understand their roles in the support and surveillance of people convicted of sex offenses, and reconcile inherent tensions associated with therapeutic service provision in coercive settings.

Methods: One-time semi-structured interviews were conducted with therapists and probation officers who work with people in mandated sex offender treatment (N=9). This stems from a cross-sectional study that used convenience and snowball sampling to interview therapists, probation officers, and MSOT participants. Semi-structured interviews utilized an interview guide and a phenomenological approach that allowed interviews to be participant-driven. Interviews were transcribed verbatim. NVivo software was used to manage the data and conduct thematic analysis. A combination of open, selected, and axial coding was used to analyze qualitative data.

Results: People convicted of sex offenses have unique and complex needs and barriers, which the professionals working with them must understand and learn to navigate. Four major themes emerged from the qualitative data: therapeutic training is crucial but lacking, the stakes of this work are very high, there is a dearth of trust between stakeholders, and the question of who is being served remains unclear. Within the first theme, interview data revealed the perceived importance of adequate training for probation officers and therapists working in this field, but also highlighted very low actual levels of training. In particular, therapists were often new to the field and “making it up” as they went along, often because low pay and difficult conditions made it hard to retain experienced therapists. The second theme that emerged was how high the stakes are for this work. Therapists’ decisions to report a client’s absence may result in their incarceration, for instance. The third theme revealed how little trust there is between stakeholders; both saw the other as having the potential to inflict harm on clients, and saw themselves as clients’ singular protector and advocate. The fourth theme reflected ongoing tensions about whether clients or the community who are really the intended beneficiaries of MSOT services, and whether therapists should make treatment decisions based on the needs and priorities of the client, the probation department ordering treatment, or the safety of the community writ large.

Implications and Conclusions: Presentation of findings from qualitative data, methodological challenges and limitations, and policy and practice recommendations can inform current and future discussions of social work in criminal legal spaces.