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Working with perpetrators of sexual and violent crimes

“Nobody wakes up in the morning and out of the blue thinks ‘I’m going to commit a sexual crime today,’” says expert Independent Social Worker and forensic risk assessor Jo Hebb.

“Everyone of us is an amalgamation of experiences since we were in utero, even though we cannot typically actively remember before the age of four years old, what happens before that age remains in our memories and affects us. If something happens to a pregnant woman, such as being exposed to domestic abuse, that can affect the unborn child, there is significant and growing research in this area. There is a massive amount of brain development in those early years and then again in teenage years, and if someone is exposed to trauma, or an adverse childhood experience, then it can affect brain development, also certain genes can be switched on and others switched off, at the wrong developmental time creating difficulties. This can all impact on how that person develops and regulates themselves,” explains Jo.

“It is important to look at that the person’s history and delve into whether they were born into an environment where was criminality, domestic abuse, substance misuse or mental health difficulties,” said Jo.  These experiences can predispose someone to abusive behaviour, because of the way they think or learn to survive in the abusive or non-validating environments to which they are exposed.  “However, predisposing does not mean causal. Not everyone who has been sexually abused or experiences domestic abuse goes on to offend and it is important to look at each individual, how they cognitive process and what the function of their behaviour is.”

Jo typically gets two responses when she tells people she works with sex offenders: there is either a lot of interest or rude and unpleasant responses. Indeed, Jo says that if she were given a pound for every time someone asks her how she can “work with those dreadful people/animals”, she would be a very rich woman and be retired somewhere in the sunshine. However, she feels duty bound to share her knowledge and experience with newer, lesser experienced probation practitioners working with sex offenders before she goes anywhere. And with 30 plus years carrying our forensic risk assessments, working in medium security establishments as well as in the community and taking her Continued Professional Development incredibly seriously to ensure she applies due diligence in her duties, there is a lot of knowledge and experience to share.

“I was sacked when I became pregnant”

Prior to having children, Jo was in the Merchant Navy. “It’s not the sort of job you can do when you’re a mother and besides, I was sacked when I was pregnant. It seems shocking now but that was how it worked then, we didn’t expect anything different, there just wasn’t any maternity leave and I couldn’t take a baby to sea with me.”

Looking for a second career after having her children, Jo followed her passion for understanding crime and helping people explaining: “I don’t believe people just carry out a crime, something underpins their thinking and behaviour”.

She became a probation assistant and was later sponsored by the Home Office to train for her CQSW with probation. Following her training she became a probation officer working in courts, offender management and family courts as it was prior to the introduction of Cafcass. Of particular interest to Jo was working with mentally disordered offenders.

Following a secondment as a prison-based probation officer, Jo then worked in a secure mental health unit, utilising her social work training and became a senior forensic social worker. After a few years, Jo joined children’s services and became a team leader in a team for children with disabilities and additional needs and in child safeguarding before being head-hunted to work back at the secure unit and establish a new sex offender treatment service.

“I became the assessment and treatment service lead in the secure facility and set up the service.  I trained staff, wrote programmes and evaluation processes before managing the service once it was up and running,” explains Jo. However, she was then head hunted once more, this time to set up a treatment service for mentally disordered offenders across all areas of crime, although a large part of this work was with violent or sexual offenders.

But with the service encompassing all of England Jo was working between the north of the country and Devon and geographically the area was too large, which meant she was never at home, and she became fed up with all the travelling.

“We have to go into their world”

Alongside her probation work, Jo had established her own independent social work company being an expert witness in the family courts, which has been operational for over 20 years. She wanted to grow her business further but missed probation work and so seized the opportunity to join The Offender Personality Disorder (OPD) pathway programme, jointly commissioned by NHS England and the Probation Service to provide consultancy, training, reflective practice and clinical supervision to probation practitioners, in order to improve their understanding of difficult personality traits and be more effective practitioners with this client group, bringing about better outcomes for people on probation.

“I’ve been carrying out forensic risk assessments for 30 years, either for mental health tribunals, probation, social work, criminal and family courts or parole boards, mainly with adult offenders.  My passion is working with mentally disordered offenders or those with developmental disorders such as autism. It is so frustrating for individuals with autistic spectrum conditions, they cannot come into our world, so we have to go into theirs to ensure they can access and collaborate with assessments and treatment. I really enjoy the additional levels of complexity; it is important to me that I offer a fair and robust service to all individuals I assess,” said Jo.

Given the response she often gets to her line of work, Jo very sometimes tells people she’s a librarian if she cannot face getting into a discussion with people with mindsets about what a ‘typical’ sex offender is, as no one questions her ‘librarian’ status.  Had she not been a social worker she would probably been a librarian.  

“In fact, there is no such thing as a typical offender or a typical forensic risk assessment, they are always different and it depends in which arena it is being carried out, whether it is for the family courts, a mental health tribunal, for a local authority. It depends whether the person has been convicted or not, whether they are in a secure facility or the community, what the letter of instruction asks for, what you are presented with. The process can be typical but there is no such things as a ‘typical’ forensic risk assessment.”

Generally, the main aim of a forensic risk assessment, says Jo, is to assess the level of risk that a person might pose and the likelihood of whether the behaviour will be repeated. It is likely that the letter of instruction will ask for a management plan, which will outline in terms of the level of risk, what can be put in place to make the risk manageable. For example, if an offender has a partner, has that partner got the capability to protect her children.

“Many individuals are not aware of their cognitive processing and so do not understand why they have carried out a violent or sexual offence,” said Jo. “I look at underlying schema – their way of experiencing/seeing and responding to the world. Most individuals have had an adverse childhood experience; if that has not manifested into problematic behaviour, what has ameliorated that? If the behaviour is problematic, how does that manifest, what is the function and what is the thinking that underpins it?”

“I have to assess whether intervention is essential to reduce risk, or whether it is beneficial. It is possible to work with individuals who harm others to achieve a shift to the point where they understand themselves and are able to manage their behaviours, this could reduce risk and be considered essential. If intervention is about the individual’s wellbeing and unlikely to play a significant part on a change in risk level, it is likely to be judged to be beneficial for a person to have, rather than essential; then there is the question who should pay for it? You have to be realistic, resources are finite and currently very stretched, so I have a responsibility to differentiate between essential and beneficial intervention.   If the risk you are assessing is not related to further offending, it cannot be argued that intervention is essential. But if it is trauma-based and related to wellbeing, there might be other routes for assistance. While cash strapped local authorities might not agree to pay for intervention which is beneficial rather than essential, a GP might be able to signpost and refer for help.

“For me, when I’m carrying our forensic risk assessments, there is not a tick box of traits, it all comes down to a number of factors, the individual, their situation at the time of the offence or alleged offence, an interpretation of how their harmful behaviour comes about and how much of that they understand. You do need a lot of experience, because as an assessor you understand the how, why, when and where of the harmful behaviours, then advise on level of risk and likelihood of repeated harm, suggest risk management plans and possible interventions to reduce risk” adds Jo.

Taking CPD seriously

Jo is trained in a variety of tools and models including RM2000 (Risk Matrix), SOTP, SARA based on inter-partner violence, OASys and ARMS – tools used in the Probation Service, SVR20 (sexual violence), HCR20 (violence), RSVP (a structured guide for assessments of sex offenders), SAPROF which identifies protective factors and ARMADILLO, which is designed to assess individuals with development disorders. Furthermore, Jo has undertaken a Masters in the assessment treatment of sex offenders, A BSc (Hons) in working with mentally disordered offenders and is trained in intelligence and personality testing through the British Psychological Society and has training in a number of psychotherapy models. She also believes strengths-based approaches are more successful than judgemental punitive approaches.

“If a new tool comes out and I can see its utility, I train in it. I have never trained in something that I have not gone on to use,” explains Jo. "This means I pay particular attention to the tools I use and do not just rely on clinical judgement, which at best is accurate only 50% of the time.  Though tools tend only provide 70-75% accuracy so the training and experience gathered over 30 years plays a part in decision-making too.  I also ensure I keep update with research so that my understanding changes and grows along the evidence.  I can never be 100% sure I have accurately assessed an individual, however, I will have taken all reasonable steps, done my due diligence so to speak, to ensure as accurate and current evidenced-based assessment as possible.  ‘Doing this fits with my personal and professional ethics, values and standards,’" says Jo.

She invests heavily in CPD, carrying out at least two pieces of learning per month from reading articles to attending training courses or conferences, despite there being a minimum requirement from Social Work England to submit a minimum of two pieces of CPD per year along with registration renewal forms. Jo also delivers two sessions of reflective practice each month to probation staff, from which she also gains additional knowledge learning from those she takes through the process.

“I could not stand up in court and make recommendations if I didn’t constantly learn, remain current in respect of evidence and evolve as a professional,” said Jo.

Organisational anxiety

On receiving the letter of instruction, Jo also receives ‘the bundle’ – a file including all the relevant information about the individual and it has to be read in depth. “You have to read the lot – there may be a salient point hiding in there somewhere,” said Jo.

The Legal Aid Agency allocates only 5 hours for an expert to review the bundle, but Jo says she has yet to review a complete bundle in the allocated time, despite being a fast reader, with bundles generally being between 1000 – 2000 pages. She ensures she understands the bigger picture from which she plans her interviews, using the bundle and letter of instruction to work out what information she needs to further explore, to connect what is going on and identify risk. Face to face interviews are then conducted, ranging from five to 10 hours, tailored according to the need of the person being assessed, as well as taking into consideration any development disorders or communication needs.

“You can go into the interview process thinking that the person is neuro-typical but soon realise that is not the case,” said Jo, adding that she draws on two to three tools in each assessment using the structured clinical judgement ones to help structure her interview and thinking.

She factors in time for her to ‘walk away from the case’ to get some distance, before returning and reviewing the information in front of her to see if she has missed anything, ensure there is no bias, then does a final spell and grammar check before the report is submitted for quality assurance.  In the work she does for WillisPalmer, it is subjected to their Quality Assurance process, which might then pose questions for reflection and amendments. In total, it takes an average of six weeks from receiving the letter of instruction to filing the report.

On occasions, Jo has written a report saying that the assessed individual poses a low or very low risk and can return to the family home, which can be met with “organisational anxiety” from a local authority.  It is more common that recommendations are for no or supervised contact only, so a return home provokes anxiety in those whose responsibility it is to manage the risk. 

“I have sat in professional meetings, held after the recommendations are received, and found myself having to challenge the organisational anxiety - in my view it is not ethical to use professional anxiety to punish someone or keep a family apart if the evidence indicates a very low risk of repeated serious harm.”

Due diligence

Being an independent social worker can be isolating, without a team around you, it can be difficult to discuss cases and bounce ideas off colleagues. To this end, Jo has been proactive in surrounding herself with various colleagues and professionals who act as a sounding board when one of them needs to discuss a case, without giving away details of the people involved. Jo sees it as her responsibility to work in this way, given the predictive accuracy of tools used is somewhat limited. “I want to treat the client fairly by being up to date, doing my best, showing due diligence because I could impact negatively on someone’s life (such as by judging them to be a higher risk than they are) and I wouldn’t want to do that. It is ethical and responsible to be as well read and reflective as you can be to minimise the chance of acting unfairly towards somebody.”

Working with WillisPalmer provides Jo with both the opportunity to discuss cases with her case manager and the organisation also invests heavily in quality assurance meaning all report are scrutinised by highly experienced professionals prior to being submitted.

As a strong advocate of CPD, Jo is passionate about probation practitioners becoming regulated by an overseeing professional body with whom they would be registered, in the same way that social workers are registered with Social Work England.

“I know of probation practitioners who have carried out no CPD other than their mandatory probation training, it makes for a narrow understanding,” said Jo.

Jo said: “I was having a conversation just this week about a Newly Qualified probation officer being promoted to senior probation officer just two months after qualifying.  I wondered if a professional body would have standards about how much experience was considered acceptable before promotion to a senior grade”.

She raises concerns over the probation profession in the same way that #Respect4SocialWork has raised concerns for the social work profession. While calling for greater respect for the social work profession and a more balanced media portrayal of their work social workers carries out, #Respect4SocialWork is keen for social workers to stay in the profession for longer meaning that Newly Qualified Social Workers have access to knowledgeable and experienced social workers who can advise them about complex cases and pass on learning.

In her role within The Offender Personality Disorder pathway programme, Jo is keen to disseminate her knowledge and experience to colleagues and probation practitioners to ensure her learning is passed on before she retires from the profession.

“Its pay back for all those experienced professionals who were gracious enough to share their time and expertise with me throughout my career”.

Hostility

“Occasionally I get hostility from the people I work with,” explains Jo, “But anyone being assessed for anything – even a driving test – is likely to be anxious, which can result in hostility.   Sometimes that hostility is aimed at me because I am carrying out the assessment. The person being assessed has to talk about their sexual experience to a stranger. I try and put them at ease, I am always respectful to whomever I am speaking, I actively listen to what they are saying.”

“I try and have a ‘getting to know each other’ discussion, where I encourage them to ask me questions if they want to about my professional experience and what the aim of the assessment is. I explain my role and talk about confidentiality. I explain that they don’t have to answer anything if they do not wish to.  I try and encourage a relationship where we are working together on the assessment rather than me ‘doing it to’ them,” says Jo.

“Presentation can be cultural; you need to be aware of that. I urge the individuals I am assessing to put me right if I say something wrong and give them as much autonomy as I can. I ask them how they wish to be communicated with; some people, particularly those with developmental disorders, have preferred ways of communicating, such as the use of pictorial representation whereas others find it patronising, I try to go with what they prefer” adds Jo.

“The most important things in a forensic risk assessment are don’t make assumptions, never patronise someone, ask questions, actively listen to what they say and always be respectful,” Jo concludes.

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