LOCKING up people guilty of child abuse and not giving them treatment before they are released into the public domain "involves considerable risk of at least some of them reoffending," according to Ms Marie Keenan, of the Granada Institute in Dublin.
Repressed anger is a central part of the scenario which leads to adults sexually abusing children, and sending such people to prison increases their anger. Without treatment during imprisonment "some men will come out ready to abuse again and possibly more serious".
According to the Department of Justice there is one pilot treatment programme for sexual offenders in Irish prisons, with room for 10 inmates. In any one year, "five or six" of the approximately 300 imprisoned sex offenders would be men who had sexually abused children, a spokeswoman said. It is not known if any child sex abusers are receiving treatment.
The Granada clinic was set up two years ago under the auspices of the Order of St John of God. While it originally dealt with only paedophile clerics, it now treats lay child sex offenders and adult victims of abuse. Treatment is on an out patient basis, with the clinic ensuring that clients have reduced or no access to children during the period of treatment.
The men who attend the centre are guilty of all types of sexual abuse of children, from fondling to actual penetration. The victims have been of either sex and of almost any age, though most are over 12 years.
Treatment concentrates on trying to create empathy in the men for the suffering of their child victims, and forcing them to take responsibility for the decisions they make. Paedophiles or people who sexually abuse children have difficulty connecting with their own emotions, let alone those of others, she says.
"None of them have any friends. Some may be married, but they would never discuss their problems with their wives. We are looking at people who are closed down emotionally," she says.
It is, consequently, Very difficult to teach them to feel empathy or pity for their child victims. Almost all the men are attending treatment because they have been sent by their orders or their families, or have come to the attention of the social services. They are not there because they have felt remorse and want to be treated.
At a certain stage in their treatment the men have to tell group sessions what they have done, as part of the effort to make them take responsibility for the decisions they have made.
Ms Keenan says there is a "thinking feeling scenario" which she uses. It does like this:
The man feels rejected, isolated or insulted in some way, but represses the hurt. He feels anger. He feels lonely and withdraws into himself. He begins to search for escape from his misery, indulging in fantasy.
He thinks he may find relief in sex, has an erotic interest in children and has children available to him. Perhaps he has been befriending or preparing some child. The abuse occurs.
Asked why the last step in this process should occur - the selection of a child - Ms Keenan says: "We don't really know what causes this. However, the roots of sexual attraction and abuse of children lies in the childhood of the perpetrator. He has usually been abused or subjected to humiliation himself, has failed to develop the capacity for loving relationships with adults and seeks the satisfaction of his needs for intimacy with children."
She uses neither a sickness model nor an addiction model. Nor will she say that the men she sees have a personality disorder. All of us can abuse power, she says. It is better not to label.
Men who sexually abuse children "range from A to Z in terms of seriousness and treatability", she says. Men who take sexual pleasure from the pain or distress of their child victims - sadists - are perhaps impossible to cure, she says.
"I found it next to impossible to work with them. They are the highest risks and I really don't know if they can be treated." Such people would not be dealt with in an out patient clinic, she points out.
The research debate about curing child sex abusers is an ongoing one. "To prove anything you need longitudinal studies, and the research debate has not been going on long enough." The few long term studies that do exist have question marks over their methodology, she says.
Long term studies are needed because a person might not abuse for years after treatment and could then begin to abuse again.
"Therapy for men who abuse is relatively new, but we are learning a lot. We have a responsibility to victims to keep going."
People who have been treated "need to be very mindful for ever and a day of how they are in regard to power relations," she says, then adds that everyone needs to be mindful of such issues.
She suggests that more could be done in marrying the treatment and punishment of child sex abusers. People could, for example, be told they had to attend: treatment as well as going to jail. "We would be prepared to work with the idea of mandatory therapy."
