Methodological Design

This research work is based on a descriptive and interpretive methodological design that, according to ^{Pereira (2011}), allows us to identify, describe, and understand the constructions and relationships that constitute a reality or phenomenon under study. In this sense, we conducted an analytic and qualitative systematic bibliographical review (^{Daset, Cracco, 2013}) in the different data bases, using key descriptors related to the research objective and search criteria that help us better approach and address this issue. This review was also supported by institutional resources and bibliographical publications of great scientific relevance on this issue, namely the national and international norms as well as resources from the SGIP and Spain’s Ministry of the Interior.

Procedures

According to the methodological design chosen, we have reviewed the scientific data bases ERIC, Google Scholar, ISOC, SCOPUS, Web Of Sciences, and Dialnet.

To gather information, in our search we used the descriptors: a) sexual aggressors, b) programs of socio-educational intervention in prison, c) programs of sexual aggressors, d) treatments for sexual aggressors in prison, and e) social reinsertion of sexual aggressors.

Finally, for a more comprehensive information search we used the following search criteria and filters: 1) period of publication from January 2005 to December 2022, 2) publications in Spanish or English, 3) indexed, peer reviewed academic publications, and 4) with a full text availability.

Based on the above, we found 45 bibliographic references that met such consultation criteria, although after reviewing their abstracts we discarded 9 papers with little relevance. Thus, we finally selected 36 scientific articles for the analysis of the information. To illustrate this methodological process better, we present the following visual chart that summarizes the selection criteria and the consultation procedure in the bibliographical review we conducted (Figure 1).

Source: own.

Figure 1 Methodological process of the systematic bibliographic revie 

Prevalence of sexual crimes

In the Spanish context, the total number of people convicted of sexual crimes in 2017 was 2,816 (Table 1), with 137 cases less than in 2018, that showed a total of 2,953 people convicted of sexual crimes. These numbers increased even more in 2019, with 3,401 convictions, followed by 2,922 in 2020 and a great increase of up to 3,960 cases in 2021 (^{INE, 2022}).

Regarding human trafficking, there were 52 cases in 2017; that is, 1.85%, while in 2021 there were 79 cases, reaching almost 2%. As for the crimes against sexual freedom and indemnity, these were the larger part both in 2017, with 98.15% of the cases, and in 2021, with 98%. Among the latter crimes we find sexual aggressions, which accounted for 12.7% of the total convictions in 2017, against 11.2% in 2021, while the ratio of rapes remained stable with 27 convictions for rape in 2017, constituting 0.96% of the cases against the 46 rapes of 2021, equivalent to 1.16%. Likewise, sexual abuses in 2017 represented 33.95% of the convictions for sexual violence, contrasting with 2021, when they increased to 39.2%. Besides, 11.36% of the cases in 2017 were abuse and aggressions to minors (under 16 years old), while in 2021 the percentage increased again to 18.64%. Sexual harassment, in turn, had 45 cases, 1.6% in 2017 and 74 cases, 1.87% in 2021, as well as 10.86% of cases of exhibitionism and sexual provocation in 2017 and 14.7% in 2021. Finally, the cases of crimes for prostitution and corruption of minors in 2017 constituted a total of 22.8%, unlike in 2021, when there was a significant reduction to 15% (^{INE, 2022}).

According to the Balance of Criminality (^{Ministry of the Interior, 2021a}), one of the possible causes of the increase of these variables might be the restrictions and social consequences of the lockdown during the health crisis of Covid-19 in 2020, but the increase in sexual crimes recorded might also be linked to better awareness to denounce these crimes, as well as the designation of sexual abuse as sexual aggression in ^{Organic Law 10/2022 of September 6}, as a comprehensive guarantee of sexual freedom.

Nevertheless, in the whole of Europe the number of cases recorded by the police is considerably higher than that of those who are ever convicted. In 2020 in Spain 9,516 cases of sexual aggression were recognized, which places the country in the fourth place after Sweden with 11,567 cases, followed by Germany with 30,957, and France is at the top of the list with 31,555. Regarding sexual violence sexual, cases follow the same order: Spain is in the fourth place with 11,112 cases, Sweden in the third with 21,144, Germany in the second with 41,079, and France in the first with 58,692. The last statistic, rapes recorded, puts Spain in the ninth place with 1,596, and France once again in first with 25,844 cases (Figure 2).

Source: own, after data from ^{Eurostat (2022)}.

Figure 2:  Prevalence of sexual crimes in four European countries in 2020 

We must take into account the fact that the numbers for each country differ according to the laws, the jurisdiction and the enforcement, so the data do not show the same values and the comparison between different countries does not provide real results. Thus, we know that in Sweden each rape against the same victim is recorded as a single case, and that accounts for such a high number of cases (^{Eurostat, 2022}).

Profiles of sexual aggressors

The typology of sexual aggressors and aggressions in a couple is often heterogeneous, and its description depends on the authors who deal with it and the variables they take into account, which may be the level de aggressiveness, the gravity of the crime, the rage, the attachment or the psychopathologies of the aggressor (^{Loinaz et al., 2009}; ^{Loinaz et al., 2010}). According to Cohen et al. (^{Fernández, Sanz, 2016}) there are four types of rapists. The first is the displaced aggression rapist, who uses humiliation to look down on the victim sadistically, and the woman who suffers the aggression often has a passive role, added to the absence of triggering factors of the rape. The second is the compensatory rapist, characterized by being an introvert who uses sex to compensate a lack of social life and a low self-esteem (^{Loinaz et al., 2009}; ^{Loinaz et al., 2010}). The third, the sexually aggressive rapist, uses physical violence because it arouses him and is characterized by being antisocial, distorting reality, and having short-lived relationships. Finally, the impulsive rapist has a criminal history and rapist while conducting other crimes to assault his victims.

There are also a number of factors that converge in a person who has perpetrated sexual violence, such as socio-economic level, family environment, individual psychological factors, the family model (^{Herrera et al, 2020}) and development during adolescence (^{Arcila et al., 2013}). ^{Echeburúa and Esbec (2014)} suggest a division into primary and secondary aggressors. The former are pedophiles, for whom conventional sexual relations with adults are of little interest. They have an appearance of good and seductive people, capable of attracting their victim easily. The latter, have proper sexual behaviors and commit sexual crimes when they are under high levels of stress, feeling guilty, unlike primary aggressors.

The abuse of alcohol and illegal substances is a significant factor in this kind of criminals, added to the antisocial disorder of the personality and schizoid features or those typical of the obsessive-compulsive disorder, which trigger a violent sexual reaction (^{Echeburúa, Esbec, 2014}; ^{Burgos-Jiménez et al., 2020}).

Program for Control of Sexual Aggression

One of the main programs of reeducation and socio-educational intervention in Spain is the Program for Control of Sexual Aggression (PCAS), a fundamental initiative for the treatment of those convicted of sexual crimes (^{Martínez-Catena, Redondo, 2016}). It was implemented in 1999, but it became relevant nationwide after 2005 (^{Ministerio del Interior, 2021}). Access to this program is voluntary, although it is regarded as a priority in the PIT and in the valuation of the processes of reinsertion and in cases of imminent freedom (^{Sordi, 2016}). It has been adapted and designed according to the needs, characteristics and possible external variables of sexual aggressors, in order to prevent recidivism, fostering healthy sexual behavior based on respect and free of violence, and favoring self-criticism and realistic analysis of this kind of activities (^{Ministerio del Interior, 2006}).

For that purpose, this program does an initial diagnostic evaluation of the sexual behaviors, social functioning, and cognitive distortions of the inmate, creating a personalized intervention model for a better reeducation and adaptation to an adequate life in freedom. After that there is a phase of treatment and intervention with a recommended duration of four weekly sessions for 9 to 11 months which can be extended up to two years. These professional actions are organized in two stages (^{Ministerio del Interior, 2006}): 1) the treatment to create awareness, through acceptation and commitment therapy (ACT) and cognitive-behavioral interventions that seek to attain the inmate’s own acceptation of his violent activities and criminal behaviors, with the aim of achieving a personal evolution, developing his self-esteem, values, and resilience (^{García, 2019}; ^{Martínez-Catena, Redondo, 2016}), and 2) the treatment to take control, which aims to develop cognitive-emotional processes, training in relaxation, emotional awareness, empathy with the victim, modification of the sexual impulse and analysis of his own behavior and personal history in order to prevent the risk of recidivism (^{Martínez-Catena, Redondo, 2016}; ^{Ministerio de Interior, 2006}).

According to the General Report of the Ministry of the Interior (^{Ministerio del Interior, 2021b}) this program was implemented in 2021 in 40 penitentiary establishments, with the participation of 457 inmates. ^{Redondo and Mangot (2017}) point out that the program has succeeded in reducing recidivism between 9 and 11%, against 17% of those who did not attend that program. In turn, ^{Redondo (2006a)} reports a decrease in recidivism from 4.5 to 13 percent.

Concretely, the risk of sexual violence is measured by psycho-social tools and instruments such as the Sexual Violence Risk Scale (SVR-20) developed by Boer, Hart, Kroppy and Webster in 1997, or the Risk of Sexual Violence Protocol (RSVP) designed by Hart, Kroppy and Laws in 2003 (^{García, 2019}; ^{Redondo, 2006a}). However, ^{Martínez-Catena and Redondo (2016)} mention the need of including the assessment of socio-educational factors that determine the processes of personal development and change, and highlight the efficacy of these treatments in aspects such as assertiveness, empathy, aggressiveness, anxiety before normalized sexual situations, loneliness and isolation, which are key to social reinsertion.

Likewise, in spite of its great effectiveness in preventing recidivism, the program shows some limitations in its implementation, such as the fact that it has not succeeded in motivating the inmates to participate, which leads to absenteeism in the sessions or makes it difficult to carry them out, as well as the lack of adaptation and personalization of the sessions according to the person’s criminological profile and needs de la persona (^{Redondo, 2006b}). On the other hand, ^{Martínez-Catena and Redondo (2016)} mention the need to intervene also in the socio-personal contexts of the inmates to achieve a comprehensive treatment and reinsertion process (^{Clegg et al., 2011}). Another limitation, pointed out by ^{Pérez (2019}), is the lack of collaboration of multidimensional professional teams of different specializations that enrich the interventions and activities in this program, as well as professional follow-up and accompaniment strategies.

It must be pointed out that, despite its effectiveness to prevent relapses of sexual aggressions, ^{García (2019)} underscores a notable tendency to recidivism in crimes against property. Therefore, it is important to provide support and socio-educational accompaniment throughout the journey to freedom of this population taking into account their return to their social spaces, resuming their relationships, searching for jobs, etc. (^{Burgos-Jiménez et al., 2023}), as the main measure to prevent criminal recidivism.

Program about Gender Violence for aggressors (PRIA)

Secondly, the penitentiary institution has the Program about Gender for Agressors (PRIA), applied as a pilot experience in 2001 and 2002, then revised and updated in 2004, to create a program for the prevention of aggression in the household, although it was not until 2010 that this specific strategy was implemented for gender violence in Spanish prisons (^{Ministerio del Interior, 2010}; ^{Sordi, 2015}). Through cognitive-behavioral therapy, this program seeks to eradicate attitudes of violence towards the aggressors’ couples and sexist beliefs in which sexual aggressions and sexual education are classified as key units in its contents.

The program consists of four phases. The first one is a diagnostic evaluation of the profile, needs and characteristics of the inmate through psychosocial interviews. The second phase includes the therapeutic interventions, organized in 11 thematic units covered in weekly group sessions of two and a half hours for six months, although these can also be individual in case reinforcement is needed (^{Ministerio del Interior, 2010}). These interviews are based on ecological cognitive-behavioral models with a gender perspective and self-reflection activities to foster empathy in the aggressors towards their victims, identify and express emotions, accept their own responsibilities, and generate a process of motivation to change (^{Sordi, 2015}). Salient features are the reformulation of the inmate’s sexual attitudes, and interventions for the management of jealousy, enjoyment of sexuality, promotion of values of respect towards the LGTBIQ+ community, and awareness of healthy habits in sexual behavior (sexually transmitted diseases, unwanted pregnancies …) (^{Ministerio del Interior, 2010}).

The third stage is the post-treatment evaluation, using the same instrument as the diagnostic evaluation, and a final follow-up phase, to verify the inmate’s process of change and evolution (^{Ministerio del Interior, 2010}). The latter phase includes strategies of support, reeducation and accompaniment to facilitate an adequate life in freedom (^{Burgos-Jiménez et al., 2023}).

The evaluation of the efficacy of these actions is based on the prevention of recidivism. In this sense, ^{Arrigoni et al. (2013)} value as the main results in this type of interventions a better management of conflict, attitudes of tolerance and sexual respect, and a decrease in sexist behaviors towards women, with 65% of cognitive reductions. Likewise, ^{Sordi (2015}) observed better results in its implementation in an open regime with only 4.6% of crime recidivism.

Regarding the limitations of this program, the inmates’ motivation to participate is a key aspect, since a lack of interest was observed that limited its efficacy and development due to a perception of its compulsoriness since it was a specific priority treatment program of the PIT to assess their evolution in the reinsertion processes (^{Sordi, 2015}). Thus, it is necessary to implement motivational dynamics and strategies that foment participation. In that sense, ^{Lila et al. (2012}, ²⁰¹³⁾ underscore the use of the motivational interview and relationships of support, closeness and professional therapeutic accompaniment as psychosocial and re-educational models that are fundamental for the development of identification and awareness of sexual aggressions.

We must also mention that ^{Sordi (2015)} identifies a number of risk situations among the participants in the program, such as unemployment (37%), drug addiction (24%) and having experienced family violence episodes during childhood (15.4%).

Program for the Control of Violent Behavior (PICOVI)

This program is designed for those convicted of aggressive and violent behaviors, both at a personal level outside prison and in the coexistence within prison, and who do not have specific programs of treatment for this issue, such as the PRIA or the PCAS (^{Ministerio del Interior, 2017}; ^{Montero, 2019}). Concretely, its aim is to train the inmates in self-regulation and emotional management, create an environment of comfort and coexistence within prison and foment competencies of communication, empathy, assertiveness, and respect (^{Ministerio del Interior, 2017}).

Through cognitive-behavioral and psychosocial therapies, the program aims to foster in the inmate an adequate management of aggressiveness and create a social relationships network (^{Ministerio del Interior, 2021b}; ^{Núñez, 2022}). The program is structured in three parts. The first is an introductory phase in which an initial evaluation is conducted and an explanation is given of what the program consists of and what its objectives are. The second phase is the intervention itself, and in the third there is a final evaluation. The evaluations are conducted using a number of different questionnaires and scales of values (^{Ministerio del Interior, 2017}).

The program’s contents address the identification of and reflection on sexual violence behaviors, sexual harassment at work, sexual aggressions to minors, and the physical and cognitive consequences of these behaviors for the victim and the aggressor (^{Ministerio del Interior, 2017}; ^{García, 2019}).

The program was applied in 2021 to groups in 14 penitentiary centers in Spain, with the participation of 123 men and 7 women (^{Ministerio del Interior, 2021b}), besides individual interventions in cases where it was needed, through motivational interviews (^{Ministerio del Interior, 2017}). Likewise, the central axis of the efficacy of these programs is the prevention of recidivism. ^{Echeburúa and Fernández-Montalvo (2008)} report a reduction of 14.1 points in the rate of recidivism in the inmates who participate in this type of actions (18.2% for the inmates who did not participate and 4.1% for those who did).

Regarding the limitations of its implementation, ^{García (2019)} reflects on the usefulness of methods that propitiate the participation and motivation for the inmates’ process of change, which might be limited by the questionnaires and scales of values offered by the program (^{Ministerio del Interior, 2017}). The author also mentions the need to intervene and follow up on the socio-family context and the return of the inmate, a fundamental element that conditions his return to life in freedom and committing the crime, whose professional task must be to offer comprehensive attention in the social reinsertion processes (^{Burgos-Jiménez et al., 2023}; ^{García, 2019}).

Program of Actions for the Equality between Men and Women in Prisons

The Program of actions for the Equality between Men and Women in Prison has been applied since 2009 with the aim of fomenting equality of opportunities, reducing the situations of discrimination against women convicted and fomenting a gender perspective at an institutional level, due to the scarce presence of women in this institution (^{Burgos-Jiménez et al., 2020}; ^{Ministerio del Interior, 2009}; ^{Montero, 2019}).

To that end, in collaboration with the Ministry of Equality and through the Institute for Women, a diagnosis was conducted to identify differences in treatment, opportunities, and actions among the women in Spanish prisons, which showed that women experience a stay of deprivation of freedom different from that of men and with fewer opportunities, especially in the final stage of sentence in the open regime and in facing their following life in freedom (^{Añaños et al., 2013}; ^{Burgos-Jiménez et al., 2020}; ^{Martínez, Cantero, 2020}; ^{Ministerio del Interior, 2009}).

This program proposes 122 specific and transversal positive actions in gender in prison, taking into account the frequency of the episodes of violence, harassment and sexual aggressions in this population, as well as their possible sequels (^{Burgos-Jiménez et al., 2023}). For this reason, socio-educational interventions and re-educational strategies that sensitize inmates about sexual aggressions and harassment, gender rights and identities, and that offers support measures for women and present behavioral models for inmates to foment social skills that promote personal and sexual-affective autonomy, diversity, reduce factors of social exclusion and facilitate the prevention of sexual violence are established as a priority (^{Del Pozo, Añaños, 2013}; ^{Ministerio del Interior, 2009}; ^{Wangen et al., 2020}). In this sense, actions related to the identification of situations of violence and sexual aggression, analysis of social myths and beliefs on these issues, and reproduction of healthy and affective habits for equality and sexual respect are designed (^{Ministerio del Interior, 2009}).

As for the participation in this program, the ^{Ministry of the Interior (2021b)} reports a maximum of 10,908 professionals, convicted women and men, although ^{Burgos-Jiménez et al. (2020)} highlight a greater involvement of the female population, especially in the ordinary regime, with 48.7%, which is rated as positive by 85.1% of the female participants. The convicted women refer to the efficacy of the interventions for the development of social and communicative skills, as well as strategies to prepare them for their life in freedom. Likewise, it has been noted that this program features a follow-up and evaluation plan of these actions for their improvement, adjustment and greater involvement of social and communitarian bodies and entities and functional structures (^{Ministerio del Interior, 2009}, ^2021b).

However, in spite of its actions in issues of equality, ^{Martínez and Cantero (2020}) observe a lower offer of sociocultural activities, of treatment and of paid employment for women in prisons, since these are institutions designed mainly for a male population. Also, the main limitation of this initiative is its lack of continuity in the open regime and in the last stages of the sentence, since ^{Burgos-Jiménez et al. (2020)} show a decrease of participation to 5.9% in the women surveyed for their study.

Program SerMujer.es

Finally, we must mention the relevance of the Program SerMujer.es (^{Ministerio del Interior, 2011}) for the prevention, treatment and attention to convicted women who are victims of gender violence. These interventions are aimed at decreasing the vulnerabilities and dependency generated by gender aggressions and violence in the female population convicted, fostering their self-esteem, promoting healthy attitudes of care and sexuality, as well as offering socio-communitarian resources of protection, help, and support (^{Montero, 2019}).

The program has been implemented nationwide and is made up of a professional team of multidimensional socio-educational intervention (^{Martín-Solbes et al., 2021}), in collaboration with the Institute for Women and Equality of opportunities of the Ministry of Equality since 2011. It is carried out through group interventions complemented with individual sessions, according to the needs of the participants (^{Burgos-Jiménez et al., 2020}; ^{Ministerio del Interior, 2021b}). Its duration is variable, although the group phase comprises around 48 weekly sessions and the individual phase is flexible, based on the characteristics of the women who need it (^{Ministerio del Interior 2021b}).

The program has a psycho-social and socio-educational character, and is organized by an intervention team that begins by selecting participants through diagnostic interviews (^{Burgos-Jiménez et al.,2020}; ^{Ministerio del Interior, 2011}). The initial phase of the intervention process aims to build cohesion and links within the group. Then, there is a phase of development to foment skills and attitudes, as well as provide tools and resources that will reduce their vulnerability, followed by a final phase of evaluation of goals and competencies achieved, and possible psychological support and future follow-up. These actions are supported by techniques of communication, individual psychological intervention, identification of violent or unequal situations, specific formation, and expression of their own emotions (^{Ministerio del Interior, 2011}).

In regard to sexual violence, this program has among its contents a conceptual unit that addresses the formation, reeducation and sensitization of women for a correct development of their sexuality and demystification, as well as the identification of sexual aggressions. Namely, it addresses issues of sexuality, masculine and feminine autonomy, birth control methods, sexually transmitted diseases, and inmates are motivated to have a healthy enjoyment of sex away from situations of submission to men (^{Ministerio del Interior, 2011}).

In 2021 there was a participation of 190 inmates in 18 penitentiary centers in Spain (^{Ministerio del Interior, 2021b}). ^{Burgos-Jiménez et al. (2020)} report a high participation of women convicted in the ordinary regime: 52.6%. These authors underscore the fact that this program is the best evaluated by female inmates, with 87.5% of positive evaluations among its participants, since it is a space that recognizes their needs, personal improvement and empowering to cope with the vulnerabilities generated by male sexual aggressions and violence.

However, among its limitations we can observe a reduction of its participation to 3.9% in the open regime, so the women express concerns about their social reinsertion and adaptation to life in freedom. Likewise, 25% of its participants point out the need of enhancing its contents and activities, since routines and lack of occupation in these punitive environments have negative repercussions in their mental health and emotional well-being (^{Burgos-Jiménez et al., 2020}; ^{Martínez, Cantero, 2020}).

As a summary, Table 2 shows the main characteristics of the intervention programs about sexual crimes in Spanish prisons.