ATSA Forum - Vol. XXIX, No. 4
Fall 2017  (Plain Text Version)

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In this issue:
Regular Features
 Editor's Note
 President's Message
 Why is Juvenile Polygraph Not Recommended by ATSA?
Featured Articles
 Responding to Problematic Technology Use:
Creating a Therapeutic Toolbox

 Looking After Ourselves and Each Other
 Utilizing Recreation Therapy as Part of the Treatment Model
 Understanding and Preventing Adolescent Pedophilia TEDMED Talk
 Step One of Cultural Competency Addressing Privilege & Power
Students' Voice
 Assessment of Deviant Preferences Using Novel Behavioral Assessment Procedures
 A Studentís Guide to the ATSA 2017 Conference
Book Review
 RNR Principles in Practice In the Management and Treatment of Sexual Abusers
 2017 ATSA Conference Events
 Preventing Harmful Sexual Behaviors in Youth: An Infographic from the ATSA Prevention Committee
 Welcome Incoming Board Members
 2017 ATSA Awards
 ATSA Professional Code of Ethics 2017 Revisions and Additions
 New ATSA Members

Responding to Problematic Technology Use:
Creating a Therapeutic Toolbox

David L. Delmonico, Ph.D.
Duquesne University
Pittsburgh, Pennsylvania

Elizabeth J. Griffin, MA, LMFT
Internet Behavior Consulting, LLC
Minneapolis, Minnesota

Correspondence:  David Delmonico; Duquesne University; Canevin Hall; Pittsburgh, PA 15236; (412) 396-4032;


David L. Delmonico, Ph.D.

Elizabeth J. Griffin, MA, LMFT

There is a growing body of research related to individuals who use digital technology to commit their sexual offense.  Much of the focus in the field has been on understanding the characteristics of online sex offenders, and the risk they pose to the community; however, little has been written about treatment of the individuals who commit an online sexual offense.  A number of models specific to working with sex offenders have been applied to the treatment of online sex offenders.  One model that has been found to be useful is the Risk-Need-Responsivity model. The Risk-Need-Responsivity (RNR) model suggests treatment providers think in terms of identifying the level of risk to the community, identifying the criminogenic needs, and developing treatment strategies based on specific client needs (Andrews & Bonta, 2010). 

The risk principle states that the intensity of treatment should be matched to the level of risk with the most intensive levels of intervention reserved for higher risk offenders, and lower intensity or no intervention applied to lower risk offenders.  Research regarding individuals who commit their sexual offenses using technology suggests that many are low risk for sexual recidivism (Seto, 2013). Online-only sex offenders have been found to have recidivism rates nearly one‑half (approximately 7%) (Faust, Renaud, & Bickart, 2009; Seto, 2011) of their contact counterparts (approximately 13%) (Hanson & Morton-Bourgon, 2005). Given this low recidivism rate, it has been suggested that online sex offenders, with no history of a past contact sexual offense, need little to no treatment. However, initial research has identified potential dynamic risk factors to address online sex offenders who are in treatment.

The need principle states the most effective interventions are those that target a client’s criminogenic needs, or dynamic risk factors.  Dynamic risk factors are those factors associated with risk for re-offending, but which can be changed through intervention, thereby reducing risk and recidivism.  Given the limited research regarding online sex offenders, the specific dynamic risk factors that lead to risk reduction have yet to be identified (Henshaw, Ogloff, & Clough, 2017; Seto, 2013).  The research has identified several psychological problems and behaviors associated with online sex offending. These include (1) emotional regulation (Beech & Elliott, 2009); (2) social skills/intimacy (Beech & Elliott, 2009); (3) deviant arousal (Beech & Elliott, 2009); (4) online hypersexuality (Krueger, Kaplan, & First, 2009) and (5) problematic Internet use (Beech & Elliott, 2009; Taylor & Quayle, 2003). 

Problematic Internet use is often an overlooked area of intervention in sex offender treatment programs. There is little information in the literature on how best to intervene with problematic technology use among online sex offenders, and how to assist them in developing healthy technology alternatives. The need for this information has become increasingly important as courts are recognizing that broad restrictions against sex offenders, regardless of the nature of the sex offense, or how technology was used in the commission of the offense, are overgeneralized and violate an individual’s freedom of association, speech, and privacy protections (Chan, McNiel, & Binder, 2016).  The courts are recognizing that access to technology is necessary for the tasks of everyday living, and denying access is likely to be unconstitutional. Additionally, a literature review by Chan, McNiel, and Binder (2016) found there was no evidence that restrictions or bans on individuals from the Internet and/or social media were successful in reducing sexual offense behavior.  Given the evolving technological landscape, and the recognition of constitutional rights of individuals who commit sexual offenses, most sex offenders will have access to technology and the Internet with some limitations or monitoring. 

When courts deny Internet access there is little opportunity for individuals who committed their sexual offense in the online world to learn healthy technology habits.  Additionally, there is no opportunity to practice and experiment with re‑integrating technology use while under the guidance and support of community supervision and treatment.  It is important to remember that clients will eventually have access to technology; therefore, addressing problematic Internet use and developing healthy technology habits while under supervision is crucial.  This article provides treatment activities that address both problematic Internet use and the development of healthy technology habits.

The treatment activities in this article will incorporate elements of responsivity from the Risk-Need-Responsivity model.  The responsivity principle states that interventions should be delivered in a manner consistent with a client’s learning style, abilities, and personal circumstances.  Important considerations in the responsivity principle include motivation to change, cognitive abilities, cultural considerations, mental disorders, etc.  In addition, it is important to consider adult learning theory, which suggests information retention by adults is improved when paired with multiple modalities (e.g., visual, kinesthetic, auditory, etc.) (Aivio, 1971; International Learning Styles of Australia, 2010).

Six practical treatment activities addressing problematic Internet use are described below. While problematic “Internet” use is the term in the literature, it is important to consider this behavior more broadly given advancements in technology, therefore this article will use the term problematic “technology” use.  These activities encompass the spirit of responsivity through their creativity and multiple modalities for teaching information. A webpage has been established where the complete treatment activities, along with instructions on using each activity are provided.  This webpage is the start of a “Therapeutic Toolbox” that can be used to address problematic technology use for online sex offenders.  In addition, the webpage lists other resources that may be useful when addressing problematic technology use.  The URL for the webpage is:

Treatment Activities

The Psychology of Technology - This treatment activity is a three-part activity designed to assist clients in understanding the influence of technology on their behavior. It teaches concepts such as the Online Disinhibition Effect (Suler, 2004) and The CyberHex (Delmonico, Griffin, & Moriarity, 2001). These concepts assists the client in understanding that online behavior can be influenced by various features of technology. The hope is that clients will gain a better understanding of the influence of technology on their behavior.  In doing so, clients will develop skills that are effective in managing the Psychology of Technology in the online world.

Digital Footprints – Every individual that uses technology leaves a Digital Footprint of the places he/she has been and the things he/she has done.  This exercise explains the concept of the Digital Footprint, and the impact of digital footprints when using technology.  Clients are provided with a copy of footprints printed on paper as a metaphor for their Digital Footprint.  They are then asked to do several activities with the footprints to assist them in understanding and visualizing how their use of technology may impact their Digital Footprint.  The exercise ends with a reflection of the client’s “online reputation” and how he/she can more positively influence that reputation. 

The “Lawyer” - In this treatment activity The “Lawyer” character is used as a metaphor to assist clients with understanding the cognitive distortions/thinking errors that may blame, justify, deny, or minimize their online sexual offense behavior. The treatment activity includes a picture of an action figure that looks like a lawyer. For many clients, their online sexual offense feels ego dystonic – that is, they do not fully understand how or why they would allow such behavior to occur.  Their internal “Lawyer” comes to their aid by defending their behavior and reducing the need to take full ownership and responsibility for their actions.  The goal of this exercise is to assist clients by teaching them to become aware of their internal “Lawyer”, “own” and take responsibility for the role their “Lawyer” has played in their online sexual offense behavior, and finally, to learn to manage their “Lawyer” to the point that he/she is not interfering with their treatment progress.  In order to take full advantage of this exercise, clinicians should consider purchasing an action figure that looks like the “Lawyer”.  The “Lawyer” can be purchased through the website  (No actual lawyers were harmed in the creation of this treatment activity and apologies are offered in advance if any lawyers are offended by the use of this metaphor).

Word Webs This treatment activity is focused on individuals who have viewed child sexual abuse (child pornography) images online.  Due to the Psychology of Technology, individuals can often frame the viewing of online child sexual abuse images as a victimless crime.  Those who possess/view/distribute child sexual abuse images can minimize their behavior, and often feel they are different from individuals who commit contact sexual offenses.  The Word Webs can assist clients in understanding that possessing/viewing/distributing child sexual abuse images is problematic and not a victimless crime.  In this treatment activity a “foundation” world is placed in a center circle on a piece of paper (in this case we have used the term child pornography on one word web, and the phrase child sexual abuse images on another word web).  Clients are then asked to place associated words in empty circles around the page.  When processing this activity, clinicians should focus on comparing the two Word Webs with the goal of helping the client understand that viewing child sexual abuse images is not a victimless crime.  This treatment activity can be used with variety of “foundation” words and may be helpful to the individuals who have committed an online sexual offense. Examples include sexting, BDSM, sting operations, etc.

The Technology Health Plan – This treatment activity is used to differentiate between technological behaviors that are off limits from those that are healthy, safe, and therapeutic.  The activity uses three concentric circles – one red, one yellow, and one green. What makes this treatment exercise effective is the inclusion of a green zone that focuses on determining positive and healthy technology-based behaviors. This activity is designed to develop client awareness, and assist in setting set boundaries for healthy technology use.  The Technology Health Plan may be modified at various points in treatment since clients will gain new awareness regarding their technology behaviors, and will need to shift items between zones, delete items, or develop new items.  The reality is, regardless of technology restrictions, clients will be exposed to technology and should be prepared in advance to deal with such exposure.  The Technology Health Plan accomplishes this goal.

The Technology Toolbox – The purpose of The Technology Toolbox is to remind clients (and clinicians) that technology can be an asset in the treatment process.  While it is easy to focus on the negative aspects of technology, eventually, clients will need to learn healthy ways to use technology in their daily lives.  Clinicians should work towards equipping clients with a Technology Toolbox in order to explore healthy and safe technological resources.  The treatment activity suggests several areas of technology (e.g., webpages, chatting, social media, streaming, podcasts, online universities, etc.) that can assist clients in understanding the healthy use of technology and to provide alternatives to problematic technology use.  The client is encouraged to explore and find additional technologies that may be helpful to continued healthy use of technology.  Clients are reminded throughout this activity that they need to seek permission and guidance from their treatment provider, probation officer, and support group before exploring positive and healthy technology behavior. 


This article highlights the needs posed by clients who use technology to commit online sexual offenses, addresses the problematic use of technology, and provides practical treatment activities encompassing the spirit of the responsivity principle.  Clinicians typically understand that problematic technology use needs to be addressed in treatment; however, they are often at a loss for how best to address this issue.  The treatment activities in this article provide clinicians with an opportunity to discuss with clients both problematic and healthy use of technology.  These treatment activities are the start of creating a “Therapeutic Toolbox” that will assist clients in developing positive and healthy technology habits.  Visit for more information on the activities described in this article and other resources related to problematic technology use.


Aivio, A. (1971). Imagery and verbal processes. New York: Holt, Rinehart, and Winston.

Andrews, D. A., & Bonta, J. (2010). The psychology of criminal conduct. Routledge.

Beech, A. R., & Elliot, I. A. (2009).  Understanding online child pornography use:  Applying sexual offense theory to Internet offenders.  Aggression and Violent Behavior, 14, 180-193.

Chan, E.J., McNiel, D.E., & Binder, R.L. (2016). Sex offenders in the digital age. The Journal of the American Academy of Psychiatry and the Law, 44, 368-375.

Delmonico, D., Griffin, E., & Moriarity, J. (2001). Cybersex unhooked: A workbook for breaking free of compulsive online sexual behavior. Gentle Path Press.

Faust, E., Renaud, C., & Bickart, W. (2009, October). Predictors of re-offense among a sample of federally convicted child pornography offenders. Paper presented at the 28th annual conference of the Association for the Treatment of Sexual Abusers, Dallas, TX.

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Taylor, M., & Quayle, E. (2003). Child pornography: An internet crime. Psychology Press.