– CLIENT QUESTIONS –
Do you accept self-referrals?
Yes.
I’d like to talk to my GP about getting a Mental Health Treatment Plan, but I’m not sure how to talk to them about my problems. Do you have any recommendations?
Forensic treatment, like treatment for sexual problem behaviours, is not covered by Medicare. However, depending on the nature of your presenting problem—namely, if there are any clinical considerations—you may be eligible for a Mental Health Treatment Plan.
If, in addition to struggling with sexual problem behaviours, you are also struggling with mental health difficulties (e.g., anxiety, depression, substance misuse, trouble adjusting to a stressful event), you can: (a) talk to your GP about both sets of difficulties if you are comfortable, or (b) only mention the mental health difficulties. Note, however, that depending on the nature of your mental health difficulties—i.e., whether there is scope to address them within the context of treatment with me—I may request you see another professional to address these difficulties.
I am the partner/family member/friend of an adult who has engaged in sexual problem behaviours. Can I make an appointment for them?
Because your partner/family member/friend is 18 years of age or older, and it is an ethical requirement that psychologists communicate with adult clients directly, I request that they get in touch with me to schedule an appointment. (If you are a guardian, please contact me for more information.)
If you would appreciate support yourself, consider contacting PartnerSPEAK. As per the service’s website, “PartnerSPEAK provides advocacy and support for non-offending partners, family members, friends, or anyone else who is affected by a person’s involvement in child sexual abuse and child exploitation material”.
Is everything I say in treatment confidential?
Some forms of unreported offending, and possible future offending, must be reported to authorities as per relevant guidelines and legislation: e.g., Ethical guidelines on reporting abuse and neglect, and criminal activity (Australian Psychological Society), ‘Failure to disclose’ legislation (Crimes Act 1958), Mandatory reporting legislation (Children, Youth, & Families Act 2005).
I will discuss with you limits of confidentiality before the start of treatment.
Can I get both treatment for sexual problem behaviours and a sexual offending risk assessment report?
I am able to offer risk assessment reports before the start of treatment. However, once treatment has started, I am unable to provide risk assessment reports (initial or repeat). This is in line with best practice guidelines, which recommend against treating clinicians writing risk assessment reports for their clients. Once treatment has started, I am only able to provide treatment summary reports (i.e., reports summarising treatment goals, attendance, engagement, progress, recommendations, etc.). If you wish to obtain a risk assessment report once treatment has started, you will need to find the services of another psychologist. This will ensure that your report is considered by decision-makers to be objective and reliable.
Do I need to send you anything before my first session?
Prior to your first session, I will send you a consent and registration form, outlining relevant processes and procedures related to treatment and asking for general information about yourself.
If you agree to the conditions outlined in the consent form, I will ask you to provide a Mental Health Treatment Plan referral (if you have one) and any relevant supporting documentation: e.g., police/court documents, previous assessment/treatment reports. These documents will help me tailor treatment to your needs.
What can I expect from treatment?
What will I be working on in treatment?
To help prevent sexual problem behaviours, treatment addresses difficulties like:
– spending time with negative influences
– having trouble with intimate relationships
– feeing emotionally close to children
– thinking negative thoughts about women
– being alone and feeling lonely
– not caring about others
– being impulsive
– having trouble fixing problems
– feeling angry or thinking that others are out to get you
– excessive sexual desire (aka “sexual addiction”)
– problematic pornography/internet use (aka “pornography/internet addiction”)
– using sex to cope with difficult feelings
– problematic sexual interests: e.g., sexual interest in prepubescent children (pedophilia), non-consensual sex with adults, exhibitionism, voyeurism
– thinking unwise thoughts about sex
– having trouble collaborating with support services
How long is treatment?
The length of treatment, from the first to the last session, can vary depending on different factors (e.g., intensity of treatment needs, motivation). Generally, treatment requires around 20-30 sessions. Note that this is an estimate: some clients require fewer sessions, others more. To start, fortnightly sessions are recommended for most clients. This optimal frequency helps clients become comfortable with therapy and build momentum towards their goals. Once clients start to see positive changes in their life, sessions begin to be spaced out until the end of treatment.
If you are unable to commit to ongoing and regular treatment, this may affect the quality of your treatment. That said, I am happy to help you problem-solve barriers to you accessing ongoing and regular treatment, or explore alternative options available to you.
After the end of treatment, clients can return for occasional “booster” sessions (i.e., sessions to help maintain gains).
Do I have to also see a GP or psychiatrist?
Depending on the nature of your presenting problem, I may recommend you meet regularly with a GP or psychiatrist (if you are not already linked with one) alongside treatment with me. If you do not already have a psychiatrist, I can recommend psychiatrists who specialise in the pharmacological treatment of sexual problem behaviours (as a complement to psychological treatment).
Are there any reasons why you wouldn’t be able to see me?
If it would not be safe to provide you with psychological services in a Telehealth private practice context, I will (if possible) refer you to a more appropriate service.
If you present with mental health difficulties that would make it difficult for you to benefit from treatment for sexual problem behaviours (e.g., attention deficits making it difficult to remember appointments, hallucinations making it difficult to focus on conversation), I may request you see another professional to address these difficulties before starting treatment.
I will discuss with you conditions of treatment and exclusion criteria at the start of treatment.
I’m anxious about therapy. This isn’t so much a question as something I want you to know.
It is perfectly natural to have anxiety about therapy. Take a moment to offer yourself a bit of compassion: there is nothing wrong with you, most clients have anxiety about therapy.
Now, ask yourself: if your anxiety had a voice, what would it be saying right now? If you’ll allow me to venture a guess, I wonder if your anxiety would be saying something like “I’m afraid therapy will hurt” and “I’m worried I won’t be in good hands”.
I want you to know I hear your anxiety, and what it has to say. Therapy can, in fact, feel like a rollercoaster, with ups and downs. Change is rarely easy. Full disclosure: I can’t promise you a flat ride. But I can promise you a safe ride. To achieve this, I offer clients a calm, non-judgmental, supportive, and informative space at all times, from the very first to the very last session.
I’m attending therapy because I’m expected to (by a partner/family member/friend or the court). How can therapy possibly be helpful to me?
That’s a fair question. Even though you’re coming to therapy because others expect you to, I wonder if we can still find a way to make therapy a helpful space for you. Perhaps therapy can be both compulsory and helpful at the same time.
Your website says you’re a sex positive therapist. Does that mean it’s ok for me to do anything I want sexually?
Sex positivity, in therapy, does not mean allowing clients to do anything they want sexually. Quite the opposite: sex positivity means providing clients with a safe therapeutic space, where they can (a) talk openly about their problems with sex (e.g., the ways they have harmed others sexually in the past, excessive sexual desire, problematic sexual interests), so they can (b) develop insight into these problems and learn to live their sexuality in constructive ways.
What are your treatment approaches?
Risk-need-responsivity model of correctional rehabilitation
This approach outlines three best-practice principles: (a) the “risk” principle, which involves providing more intense treatment to clients at higher risk of harming others, (b) the “need” principle, which involves focusing treatment on difficulties related to risk, (c) and the “responsivity” principle, which involves providing treatment that is accessible and adapted to clients’ unique characteristics.
Good lives & Self-regulation models of treatment for people who have sexually offended
This approach helps clients identify their goals for a “good a life”, recognise their pattern of offending, understand how they may have relied on offending to live their “good life”, and develop instead prosocial strategies for living their “good life”.
Motivational interviewing
This approach helps clients stay connected with the reasons why they want to change or might benefit from change, to help them make change happen.
Cognitive behavioural therapy
This approach focuses on thoughts and behaviours, and the connection between them, to help clients make positive choices and actions.
Acceptance & commitment therapy
This form of cognitive behavioural therapy helps clients re-imagine their relationship with their thoughts and feelings, so thoughts and feelings have less of an impact on them, and so they feel freer to live kind and personally meaningful lives.
Mindfulness
This approach helps clients “step back” from their unhelpful thoughts and feelings, observing them from a safe position instead of getting entangled in them.
Client-centred therapy
This approach makes the client—and their unique identities, values, and goals—the focus of therapy, with the therapist acting as a guide.
Humanistic therapy
This approach treats clients and their problems through a non-medical lens of personal responsibility. Through this lens, clients and their problems are complex entities and experiences that cannot be reduced to “diseases” and “symptoms”. In the same vein, clients are not defined by their problems, and are capable of responding to problems in constructive ways.
Strengths-based approach
This approach highlights the strengths clients bring to and develop in therapy, and supports clients in using these strengths to make positive changes in their lives.
Compassion-based approach
This approach encourages clients to hold themselves gently during times of personal difficulty—instead of getting “stuck” in shame, self-judgments, etc.—to help them become more resilient and, thus, better able to treat others with kindness and live with purpose.
If you have another question about treatment for sexual problem behaviours, feel free to contact me. Keep in mind, however, that depending on the nature of your question, I may be unable to answer it over email and request we schedule a session instead to discuss your question.
– REFERRER QUESTIONS –
Do you accept referrals?
Yes.
My client has disclosed having engaged in sexual offending. Can I refer the client to you?
Yes. You can refer the client to me.
However, prior to referring the client, please find out if the client’s disclosure must be reported to authorities as per relevant guidelines and legislation: e.g., Ethical guidelines on reporting abuse and neglect, and criminal activity (Australian Psychological Society), ‘Failure to disclose’ legislation (Crimes Act 1958), Mandatory reporting legislation (Children, Youth, & Families Act 2005). If you require support with decision-making around reporting, you can seek ethical and legal advice (e.g., APS Member Advice).
If a report is required, I request the report be made prior to the client being referred. If a report is not required, once the rationale has been provided to me, the client can be referred.
– GENERAL QUESTIONS –
How does treating offenders help victims/survivors of sexual offending?
The main goal of treatment for sexual problem behaviours is to promote community safety, by preventing sexual victimisation.
A public health response to sexual offending involves a multi-pronged approach, including: (a) obtaining systemic buy-in (e.g., from government, private companies, the public); (b) providing support to people at risk of being, or who have been, subjected to sexual offending, and to their support systems; (c) providing support to people at risk of committing first-time or repeat sexual offending, and to their support systems. Service-providers worldwide are contributing daily to each prong (e.g., public awareness campaign designers, victim support services, correctional agencies). My forensic practice sits mainly within the third prong.
Does anyone actually need/want support for sexual problem behaviours?
Many people need/want support for sexual problem behaviours. For instance, see the 2023 Australian report titled “Identifying and understanding child sexual offending behaviour and attitudes among Australian men”. See also the 2023 article by The Guardian titled “Australia has resisted treating paedophiles before they harm children. Now that view is changing”.