A Case Study Comparison of Brief Group Treatment and Brief Individual Treatment in the Modification of Denial Among Child Sexual Abusers
Problem Statement. O'Donohue and Letourneau (1993) demonstrated success in modifying denial among child sexual abusers with brief group treatment when probable incarceration existed for subjects who did not admit. This current study replicated and enhanced their treatment model while omitting the adverse legal consequences for subjects remaining in denial. Brief individual therapy was used as a comparison treatment condition. Factors theoretically contributing to denial were explored. Methodology. Ten subjects were evaluated as individual case studies in two non-randomly assigned treatment conditions. Five subjects received nine group therapy sessions and five received nine individual therapy sessions. Subjects were selected from three counties through probation, child welfare, and other treatment providers. The Perception of Consequences Questionnaire (PCQ) was developed to measure subjects' beliefs and perceptions of what would happen if they admitted to the abuse. Five theoretical domains were measured: reaction of family, internal reactions, social, legal, and financial consequences. Pretest and posttest assessments included the MMPI-2, the PCQ, and a denial assessment interview with non-blind, independent raters. Results. At posttest, four of the five subjects (80%) in group treatment admitted to the offense, while two of the five subjects (40%) in individual treatment admitted. The two subjects with the highest pretest PCQ scores were the first to admit. The legal and financial domains had the strongest correlation with treatment outcomes. Subjects in partial denial at pretest anticipated more negative social consequences at posttest than others. Defensiveness on the MMPI-2 increased regardless of treatment outcomes. A case study account is provided for each subject's treatment. Conclusions. Some inherent therapeutic aspects of the brief group treatment model appear to be effective in the modification of denial among child sexual abusers without adverse legal consequences. In spite of the changing legal contexts for treating sex offenders in denial, this model is effective. The PCQ offers a useful and systematic measurement of offenders' perceptions of consequences for admitting. Measuring defensiveness on the MMPI-2 has limited utility in distinguishing between offenders who admit their offense and those who do not. Larger replication studies are needed to identify essential treatment components which facilitate admissions.
Cognition and Perception, Counseling Psychology
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