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Understanding the Experiences of Individuals Convicted of Sexual Offences Taking Medication to Manage Problematic Sexual Arousal

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Understanding the Experiences of Individuals Convicted of Sexual Offences Taking Medication to Manage Problematic Sexual Arousal Navigating MMPSA: Understanding the Experiences of Individuals Convicted of Sexual Offences Taking Medication to Manage Problematic Sexual Arousal Rebecca Adelle Lievesley A thesis submitted in partial fulfilment of the requirements of Nottingham Trent University for the degree of Doctor of Philosophy. June 2019 Copyright Statement This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed to the owner of the Intellectual Property Rights. 2 Acknowledgements There are so many people I would like to thank for their support throughout this PhD. Firstly, my supervision team – Belinda Winder, Christine Norman and Phil Banyard for your continued support and perseverance. Bin – thank you for instilling in me a passion for forensic psychology and inspiring me to conduct research and pursue a career in this area. You believed in me, made this PhD possible and taught me how to be a researcher, for which I am forever grateful. Chrissy – thank you for your endless encouragement, support and guidance, and for making me see there was light at the end of the long part time PhD tunnel. And Phil - thank you for asking the questions I never quite understood, for challenging even the simplest assumptions and for making me think outside the obvious. I got there in the end, and this helped clarify my thinking, so thank you. I am also thankful to Helen, K, Jess, Mark and Craig – you gave up your time to provide invaluable support and guidance, proof reading, and you got me over the hurdles and the finish line! Thank you! The biggest thanks of all goes to my family and friends – your love, support and belief in me has been unconditional. You shaped me into the person I am today and made me feel like I could achieve anything. I genuinely could not have completed this PhD without you all keeping me grounded and on track, even if some of you never understood what a PhD was! James - thank you for everything. We met in the early stages of this research and you have supported me every step of the way throughout, calming me when I got stressed, being understanding when I needed to write, being enthusiastic about a topic you have no interest in, and believing in me when I doubted myself. I am so lucky to have had you by my side and now I can finally come on walkies with you and Bertie. I would also like to thank the staff at HMP Whatton for welcoming me without question, offering continuous support and advice, and sharing your tea and biscuits to help me through the data collection. Finally, thank you to the individuals who generously gave up so much of their time to participate in this research and tell me some of their most personal stories. Without you this would not have been possible and I am truly grateful. 3 Contents Copyright Statement ............................................................................................................................... 2 Acknowledgements ................................................................................................................................. 3 Author Publications................................................................................................................................. 8 Author publications from this thesis ................................................................................................... 9 Journal articles ................................................................................................................................ 9 Conference oral presentations ....................................................................................................... 9 Conference poster presentations ................................................................................................. 10 Author publications related to this thesis (journal articles and book chapters) .............................. 11 Author publications unrelated to this thesis (journal articles and book chapters) .......................... 11 Abstract ................................................................................................................................................. 13 Chapter 1 ............................................................................................................................................... 14 Introduction .......................................................................................................................................... 14 Research context............................................................................................................................... 15 MMPSA service at HMP Whatton ................................................................................................. 15 The evaluation............................................................................................................................... 16 Thesis aims and research questions ................................................................................................. 18 Thesis structure and outline of chapters .......................................................................................... 18 Chapter 2 ............................................................................................................................................... 20 Literature Review .................................................................................................................................. 20 Understanding sexual arousal ........................................................................................................... 20 General models of sexual arousal ................................................................................................. 20 Conceptualising ‘problematic sexual arousal’ .............................................................................. 28 Language use in this thesis ........................................................................................................... 33 Why is PSA problematic? .................................................................................................................. 34 Problematic sexual arousal and wellbeing.................................................................................... 34 Problematic sexual arousal and sexual offending ........................................................................ 35 Understanding PSA as a risk factor for recidivism ........................................................................ 42 Treating PSA in ICSOs ........................................................................................................................ 44 Psychological treatment approaches ............................................................................................ 44 Pharmacological treatment approaches ....................................................................................... 46 Chapter Conclusions ......................................................................................................................... 53 Chapter 3 ............................................................................................................................................... 55 Methodology ......................................................................................................................................... 55 Research aims and questions ............................................................................................................ 55 Methodological approach ................................................................................................................. 56 4 Research process .............................................................................................................................. 58 Ethical considerations and approval ............................................................................................. 58 Participant recruitment and sampling .......................................................................................... 62 Data collection .............................................................................................................................. 63 Data analysis and interpretation................................................................................................... 65 Summary and key points................................................................................................................... 72 Chapter 4 ............................................................................................................................................... 73 Study 1: ‘It’s like you’re chasing something that’s always out of reach’: Understanding problematic sexual arousal among individuals convicted of sexual offences ........................................................... 73 Introduction ...................................................................................................................................... 73 Method ............................................................................................................................................. 74 Participants ..................................................................................................................................
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