Psychoanalysis in the Treatment of Sexual Offenders: An Outdated Concept or an Underestmated Potential?

Sonja Etzler & Julia Sauter

Psychoanalytic approaches in the treatment of sexual offenders have long been marginalized in favor of cognitive-behavioral interventions. However, is psychoanalysis truly outdated, or does it hold untapped potential in forensic settings? This keynote critically examines the role of psychodynamic concepts in offender treatment, addressing their relevance, effectiveness, and challenges.

We begin by presenting findings from both non-forensic clinical psychotherapy research and forensic applications. These findings provide a foundation for reviewing the challenges and potential benefits of psychodynamic approaches in offender treatment. We discuss how psychodynamic concepts could contribute to offenders’ clinical diagnostics and risk assessment. Additionally, we review results from the implementation of psychodynamic treatment in forensic settings. Finally, we discuss directions for integrating psychodynamic approaches into forensic treatment.

To illustrate the clinical utility of psychodynamic diagnostics, we will present a clinical case formulation in forensic treatment using Operationalized Psychodynamic Diagnosis (OPD-3). This case will demonstrate how psychodynamic conceptualizations can contribute to a deeper understanding of offenders’ psychological structures, risk factors, and treatment needs. By integrating these perspectives, we argue for a reconsideration of psychoanalysis in forensic settings and explore its potential to complement existing treatment approaches for sexual offenders.

Sonja Etzler, Ph.D. is a Senior Psychologist at the University Medical Center Freiburg. She works in the field of psychotherapy with a particular focus on psychodynamic approaches. Her research interests lie in forensic psychology, psychological assessment, and clinical psychology, with a special emphasis on the role of personality in deviant and criminal behavior. She has published extensively on these topics, contributing to the scientific understanding of risk factors, diagnostic methodologies, and treatment approaches for individuals with forensic and clinical concerns.

Prof. Dr. Julia Sauter heads the Department of Legal Psychology at the University of Kassel (tenure-track professorship). After studying psychology in Heidelberg, she worked as a therapist in the forensic psychiatric system and as a research associate at Charité Berlin. Concurrently, she completed her doctorate at the University of Mainz and obtained her license as a psychological psychotherapist. Before being appointed to the University of Kassel, she headed the Therapeutic Outpatient Clinic in Cottbus, Germany.