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Tackling Child Sexual Abuse (5/5): One Therapist’s Experience of Working with Sexual Offenders

Psychotherapist Juliet Grayson works at the root of sexual offending. Her client base includes those people who are at risk of committing a sexual crime, as well as those who have already done so. She is passionate about encouraging more therapists to work with this client group, in order to ‘Stop the First Offence’ rather than wait until a crime has been committed. In her final blog about her work, she shares her personal experiences of this work.


What is it like to work with a sex offender? Well, the first thing is that they are humans like the rest of us. In fact, he’ll probably have more in common with you than you’d imagine.  He’s unlikely to be an unsavoury man in a dirty old raincoat. Be prepared to be surprised by who comes through your door.

I have worked with many people who have troubling thoughts about children, but who have never acted out at all – neither touching a child, nor looking at child abuse images. They are usually desperate to keep children safe. Many are suicidal. If you want to hear one of these people talking, listen to this interview with James O’Brien on LBC Radio.

Assessment and when (not) to report

Some therapists feel the need to report everyone who admits to a sexual attraction to a child.  I have a different view. First, I get really clear about whether a child is at risk or not. I will ask about their access to children as part of my risk assessment: ‘Have you ever acted on your attraction?’ ‘Do you work with children?’ ‘Are you living with a child?’ ‘Do children visit your home?’ If there is no child at risk, then there is no need to report this client to the authorities. 

I urge therapists to have a proportionate response to reporting. Get StopSO training about working with these clients, and learn about the law. Remember, just because someone has an attraction that does not mean that he will act on it. There are lots of people who are attracted to someone else’s spouse, but they would never act on that attraction. So it is with people attracted to children. Many of them are able to manage it. They will never act on it.

But always be alert to the possibility that you may need to report. The dynamic risk factors can change, so that means a previously ‘safe’ client suddenly becomes a risk – because he has lost his job, his partner has left him, or he has started to drink more alcohol. Be clear with your client about where you draw the line. Ensure you have a supervisor that you can discuss this with, who is experienced with this client group. StopSO offers specialist one-off and short-term supervision where needed.

Therapists are not thought police

When working with a contact offender, voyeur or exhibitionist, be prepared to be shocked at the neglect and trauma he experienced in his childhood. I have been deeply moved by a non-offending paedophile’s willingness to be open. I was impacted in a positive way by a man who, in the past, had done horrific things. In therapy he was truly struggling to make sure that he doesn’t harm anyone, despite his strong desires. This work can be deeply satisfying.

My attitude is that I am not the thought police, and you are allowed to have whatever thoughts you want. You may be attracted to children. There is nothing illegal about having the attraction, so long as you never act on that.  I have never met anyone who wakes up in the morning and thinks, ‘I’d like to be a paedophile.’

Women and children offend too

Whilst the vast majority are men, I have worked with women who are sexually attracted to children. About one-third of people who commit sexual offences against children will be under 18 themselves. Recently, I was contacted by someone saying in an email, “I’m 14 years old, and I’ve been a paedophile all my life, can you help me?” I didn’t take him seriously at first. But when he told me that he was attracted to children between two and eight years old, I decided to help him. I was the first person he had told, and obviously he had no money to be able to pay for therapy. 

The final taboo may be that there are more women committing sexual abuse than we think.  Recently I heard about a mother who didn’t wear underwear and regularly exposed her genitals to her children, a nanny rubbing in ointment on a 12-year old’s testicles, and even a grandmother who was inappropriate.

Appreciate the client’s courage  

So throw your preconceptions to one side, be willing to be very direct and ask specific questions. But, remember the client is coming for help. If it is challenging for a normal client to start therapy, just imagine how difficult it would be to admit to an unusual sexual preference. How much courage has it taken this client to get to you?

Then feel satisfied as you think about the ripple effects of helping this client. You are helping more than one person. You are helping all the people who will not be harmed when this person is given the help (s)he needs to remain law abiding: your client, his or her family (families of perpetrators are the unacknowledged victims of sexual abuse), the potential victim(s), and their families.

The easier we make it for people with sexually inappropriate thoughts to ask for therapeutic help, the more we are protecting society and keeping our children safe.


Juliet Grayson

Juliet Grayson is a UKCP Registered COSRT and NLPtCA Accredited psychosexual therapist. She began by teaching horse riding. Her first therapy room was Richmond Park, where clients talked about their personal issues whilst riding. This led her to training as a counsellor. Then she trained in couples work at the Maudsley Hospital in 1994. Now she runs courses for therapists in “How to Work with Couples”. In 2001, Juliet was introduced to the Pesso Boyden System of Psychotherapy (PBSP), an approach she loves. She runs PBSP personal development workshops in various locations. She is known as ‘The Therapist’s Therapist’. She wrote Landscapes of the Heart: The working world of a sex and relationship therapist. Juliet was a co-founder of StopSO the Specialist Treatment Organisation for Perpetrators and Survivors of Sexual Offences, and chaired it from 2012-2019. She now offers her experience as an independent consultant in the field of sexual offending, and is passionate about providing therapy to people to reduce sexual offending. 

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