In my final year of graduate school, I interned at a nonprofit agency where I was fortunate to have a great supervisor and experienced colleagues. They asked me whether I would feel comfortable working with Steve (pseudonym), a client who was on parole for sex offenses and was seeking additional support beyond mandated treatment.
Several factors emboldened me to say yes. First, I would be this client’s ancillary counselor; he was already working with another clinician with expertise in this population. The fact that his issues were beyond my competence would have precluded my working with him except for this contingency.
Second, at 58 years old, I’m not easily intimidated. Still, I was conscious of my limitations as a new counselor with no experience with this population and no training specific to this type of client. But ultimately, my support among a team of solid practitioners and a great supervisor made me think, “If not now, when?” So I took the leap and said yes.
This opportunity to work with a person who had committed sex offenses confirmed my trust in the power of a strong therapeutic alliance. Although this client tested me and I struggled at times, I discovered a capacity within myself that I had not experienced before. I learned about the barriers this population faces in rehabilitation from incarceration and developed a unique approach to help him regain a sense of connection to others. In the process, I gained a deep appreciation for the client. The following is the story of my experience working with Steve, who gave me permission to share his story, and what I learned.
I started working with Steve in the middle of the pandemic. Because Steve had spent the last several decades incarcerated, he was not up to speed with computers and was unsure about how to do telehealth. I arranged to meet him at a local Starbucks so I could help him set up Google Meet or Zoom on his computer. As a clinical rehabilitation counselor, helping clients with accessibility issues is important to me. Steve’s physical health and mobility were challenges for him and critical considerations in our work together.
When I walked into Starbucks, I saw a large man seated in a corner, arms crossed over his chest and a guarded expression on his face. It was Steve. He offered me a coffee, which I declined, but I told him I needed to visit the restroom before we started. I purposely left my jacket and handbag on the table where we sat. This was not a preplanned gesture but an instinctive response to his body language. Establishing trust would be crucial to working together. And what better way to gain trust than to give it?
In those 45 minutes, we focused on practical issues and had a few laughs around computer frustrations. I later learned Steve spent most of his life in various prisons. The last stint meant he’d entered prison before personal computers were common and the social media that we know today was not invented yet. He told me later that my willingness to help him with his computer in person was a deciding factor in his ability to let me into his confidence.
Finding the right approach
Another clinician worked with Steve on his sexual impulses, and I consulted with her once a month. We developed a good working relationship, and her support and expertise allowed me to focus on other issues Steve had. Steve’s stated goal for our work together was socialization. This posed some challenges, however, because his opportunities for socializing were severely restricted by his parole. At the very least, our counseling sessions provided the much-needed human contact he craved.
I scoured libraries, the internet, and the Association for the Treatment and Prevention of Sexual Abuse for articles on working with people who commit sex offenses to glean recommended evidence-based treatments. Several articles recommended using cognitive behavior therapy (CBT), motivational interviewing, self-regulation and other skills-based interventions. I knew Steve’s other therapist was working with him on self-regulation, so I consulted a colleague who encouraged me to use motivational interviewing.
I also received support from our agency’s psychiatric nurse practitioner who identified that most of Steve’s issues stemmed from complex posttraumatic stress disorder. It took months for Steve to trust me because of traumatic experiences with mental health clinicians who, 40 years ago, had tried to “cure” him of his attraction to men and had deemed him “incurable.” Steve signed a release of information form so that his two mental health clinicians and psychiatric nurse practitioner could communicate with each other about his case.
During his counseling sessions with me, Steve vented his frustrations about his parole officer and expounded on how he had been victimized by his family, friends and the system. He was initially unwilling to take responsibility for his predicament, but he provided me with opportunities to validate his feelings: He had been victimized early in his life like many who later commit sex crimes. His experiences included traumatic attachments, early seduction and sexualization, assault, and traumatic brain injury. It took months before he could admit that he was responsible for his subsequent actions. But through the use of CBT interventions, he was able to understand that just as adults had taken advantage of him sexually without his consent, he had replicated that behavior with others because it was all he knew.
In a 2013 article, “Treatment of sex offenders: Research, best practices, and emerging models,” published in the International Journal of Behavioral Consultation and Therapy, Pamela Yates said that counselors can help maximize treatment gains with this population by “demonstrating empathy, respect, warmth, friendliness, sincerity, genuineness, directness, confidence, and interest in the client.” Yates also noted that establishing a positive treatment environment contributes to positive outcomes, meaning clients are less likely to reoffend. After reading Yates’ list of characteristics, I felt reassured that the best approach with Steve was to lean into cultivating unconditional positive regard.
I asked permission when offering interventions. For someone who has been stripped of power in repeatedly traumatizing ways and who then acted out by traumatizing others, using this motivational interviewing protocol dramatically changed the tenor of our sessions and created a more collaborative environment.
Mindfulness, on the other hand, which is a clinical approach I often use with clients, was not something Steve could tolerate yet. I learned that many people with complex and chronic trauma find somatic mindfulness, which puts them in intimate touch with their bodies, to be overwhelming. Steve had difficulty connecting with mindfulness exercises and said he preferred to talk instead.
Using art to build connection
I was aware that society’s implicit assumptions around people who commit sexual crimes were influencing me negatively even before meeting Steve, so I knew I had to be mindful of my own biases or prejudices. To avoid any personal biases, I approached our sessions with curiosity and empathy.
As I got to know Steve, it was easy to feel warmth for him. He was affable and gallant in an old-fashioned way, and he longed for connection. Some of his affability did seem manipulative at times, yet I was moved by his vulnerability. He hungered for attachment. He was a fundamentally social person who enjoyed interacting with many kinds of people, so he found his inability to interact easily with others because of his strict parole conditions to be especially difficult.
His traumatic history often led him to objectify and sexualize people he was attracted to. He regularly mentioned young men he had seen on the bus or at the store that he found sexually attractive. During one session, Steve was telling me about his attraction to a young man who was a cashier at the supermarket he frequented. I listened, at first inwardly groaning at the repetitive, seemingly reflexive nature of his attractions; he didn’t really differentiate between one object of lust and another. In an attempt to understand and distinguish this particular attraction from the others he had mentioned, I decided to try to help him become more aware of and specific about his sexualization of these men, so I asked, “What do you find attractive about this man?” Steve became poetic as he described the cashier’s physical beauty — his face, hair, hands, posture and smile. I could picture this cashier vividly, and I could feel vicariously how this young man affected Steve.
Struck by this, I blurted out, “You’re a lover of beauty!” Steve looked startled. I explained, “You’re moved by beauty. That’s a value.” As a professional ballet dancer, I am also moved by beauty and understand viscerally how someone can be aesthetically driven.
That exchange sparked an idea of a way to help him feed his longing and loneliness. If he could not find connection with the humans that were off limits to him due to stringent parole, maybe he could find it in other kinds of beauty such as art, films and photography.
I began to share movie recommendations with him. I first recommended Wim Wenders’ documentary Pina (a film about the German dance choreographer Pina Bausch) because of the way this film handles topics such as attraction, desire, power and violence. I knew Steve may be titillated by the dancers’ beautiful bodies, but I hoped it also spurred a deeper dialogue on difficult interpersonal dynamics. I also hoped he might feel nourished by the sheer splendor of the film.
After the first time he watched the film, his comments were superficial yet enthusiastic. But his observations became more nuanced with each viewing. The film inspired him and awakened in him a love of performance, especially musical theater, and he started finding musicals and other theatrical performances to watch on his own. I found myself wondering if he might have had a career in the arts if his life had worked out differently. It also amazed me that my previous career as a professional ballet dancer enabled us to share a connection, and I began to think about how to spark a desire in him for self-cultivation and expression.
We looked at photographs of muscular, kinetic statues such as Gian Lorenzo Bernini’s Apollo and Daphne because I wanted him to see that sensuality and beauty can be found and fed in ways besides sex. I justified this clinically with the idea that sublimation is an effective, mature defense mechanism where his unacceptable impulses could be transformed into socially allowable behavior.
With my supervisor’s permission, I asked Steve to watch the classic Luchino Visconti film Death in Venice and used his identification with both characters — the older Gustav von Aschenbach as well as the young boy Tadzio to whom von Aschenbach was drawn — to explore his difficult history. Steve had been objectified like the young boy Tadzio. Steve often talked about how attractive he was in his youth and how older men had preyed on him. But now he identified more with von Aschenbach, the older, dying character who becomes longingly obsessed with Tadzio. The film allowed him to externalize his narrative and see himself portrayed in these characters. The poignancy of the film, which takes place during a cholera plague in Venice, also did not escape Steve. In his strict parole during the COVID-19 pandemic, he was as isolated as von Aschenbach was by the social restrictions of the early 1900s European society during the cholera epidemic.
Identifying with the beautiful youth and the dying man awakened an existential awareness in him that I believe helped him take responsibility for his actions. Sharing my passion for art and performance helped me connect with Steve, which then helped him see that beauty, sensuality and connection can be found in the arts. In this way, I believe he felt less alone.
People who commit sexual offenses in the United States, those labeled “registered sex offenders,” become pariahs. They cannot easily find work or places to live. On parole, they are subject to random lie detector and drug tests for which they must pay. Their crimes end up defining them for the rest of their lives. Imagine the worst thing you’ve ever done. Now imagine that is all anyone ever sees you as for the rest of your life. This negative stigma that follows people who commit sexual offenses can make it more challenging for them to change or for others to notice if they do change. By engaging Steve’s aesthetic side through the arts, I offered Steve a different way to experience himself — one that contrasted with the negative stigmas he often faced.
Doing no harm
My desire to help Steve also led to one crucial mistake. After the holidays and a health crisis, Steve became deeply depressed. I became concerned for his mental and physical health. His parole officer had forbidden his attendance at 12-step meetings and prevented any possibility of him joining a support group for LGBTQ+ individuals at a local center by divulging his entire history to the director, who decided they did not want to have him anywhere near the center.
Although Steve was no longer in prison, his current living situation resembled it: He lived in a one-room apartment, which was the size of a prison cell, and he had no contact with people other than his various doctors, mental health team and pastor. This isolation was a factor in his depression, so I met with his parole officer, the other mental health counselor and the psychiatric nurse practitioner to discuss ways to address this issue. I hoped to advocate for more lenience in allowing him outlets and contact in the community. I wanted his parole officer to understand that Steve’s depression and loneliness could lead to his reoffending because prison offered a built-in community and opportunities for sex.
The result of this meeting, however, was that the parole officer felt she was being attacked and became defensive. And Steve paid the price. She cracked down on him and told him in no uncertain terms that she believed he had manipulated me. I chastised myself for being so naive as to mistake my agenda as a mental health clinician advocating on behalf of my client for the parole officer’s agenda. Her job was to safeguard citizens from someone who was perceived as a dangerous criminal. Steve’s feelings were irrelevant to her. In retrospect, I see now that this situation was a parallel process where I experienced the parole officer’s stringency alongside my client. In my zeal for and identification with Steve’s plight, I did not think to put myself in the parole officer’s shoes and see how she might feel when confronted with three mental health practitioners petitioning for leniency.
I apologized to Steve saying, “I thought I was helping but instead I made things worse for you. I am so sorry! I was naive. Let’s try to repair this situation.” Acknowledging my mistake was crucial for the repair, and from Steve’s perspective, it vindicated his own experience by having me come up against the restrictions he faced. By the end of my internship, we had recovered from my mistake and our alliance was stronger because of it. Saying goodbye was emotional for both of us. We had forged a relationship in which, I believe, Steve felt seen in a way he never had been, and I was moved that he allowed me into his confidence to the extent that he did.
It’s important to note that Steve successfully navigated another nine months of parole without reoffending. He recently wrote to me and said, “Our trust didn’t begin because you left your purse at Starbucks — it happened because I connected with you and your willingness to step out from behind a desk and meet me where I was comfortable.”
At the end of my time working with Steve, I asked him what he gotten out of therapy with me, besides having someone to vent to and meet with once a week. He said he had learned to trust more because of our relationship. In particular, he mentioned our first meeting at Starbucks as being pivotal in building this trust because I took the time to meet him in person and help him with his technology. He also said he felt I cared for and understood him, and that made him feel like a human being.
This experience working with Steve taught me a few lessons as well. I learned how being curious and willing to take risks are essential components of this profession. If I had allowed Steve’s status as a “sex offender” to prejudice me, I would not have been able to engage with him with as much spontaneity and enthusiasm as I did.
I learned that motivational interviewing and asking for permission before using a clinical intervention helps empower the client. Steve appreciated every opportunity to feel that therapy was his choice rather than an imposition, and this empowerment helped disarm his defenses and enabled his trust to grow.
I learned the critical importance of consultation. I not only received essential guidance and support but also gained confidence through clinical consultation. It took a village. I would like to thank my colleagues Sarah Williams, Casey VanHoutan, Krista Fuqua, Marisa Monahan, Marie Mellberg and the other colleagues who provided advice, consultation and guidance while I worked with this client.
I learned the importance of doing no harm and how easy it is to lose my perspective in countertransference. Even the best of intentions can hurt in situations with conflicting agendas.
Finally, I learned how leaning into the therapeutic alliance is both challenging and rewarding. It enabled me to care deeply about someone whom our society judges and condemns. Ultimately, recognizing that Steve has a love of beauty was the linchpin that evoked his humanity, strengthened our connection and was profoundly moving for both of us. At our last session together, Steve wept because we would not be able to continue working together; I think he felt truly seen by me. I was also moved to tears by his willingness to come on the journey with me, a new counselor. He trusted me in spite of my inexperience and offered me the opportunity to deepen my own humanity.
Lavinia Magliocco is a clinical rehabilitation counselor and licensed professional counselor associate at Three Firs Counseling LLC. The practice specializes in working with chronic illness/disability and complex trauma. Prior to becoming a counselor, she was a professional ballet dancer in New York City, a professional writer and therapeutic Pilates teacher at her studio Equipoise — Enlightened Exercise LLC. Contact her at email@example.com.
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Insightful. Thank you.
I appreciate your comment! Thank you!
I agree. Very insightful, informative and inspiring. Thank you
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