5 107 PERSONALIZED MONITORING AND FEEDBACK 5.1 INTRODUCTION Cognitive behavioral therapy (CBT) is a relatively effective and widely used method to help men with a history of sexual offenses desist future sexual offending (Gannon et al., 2019; Hanson et al., 2009; Schmucker & Lösel, 2015/2017). CBT typically begins with a case formulation. Case formulation is the process through which patient and therapist collaboratively work towards the development of personalized working hypotheses about the processes and factors that cause and contribute to the problem behavior, in casu sexual offending behavior (Craig & Rettenberger, 2022; Persons, 2022; van den Bergh et al., 2022). Based on these hypotheses, patient and therapist develop a treatment plan, decide which problems need to be addressed, and prioritize them when necessary. Text box 5.1 provides an example of a patient, John, who seeks help from a CBT therapist because he feels sad and has low energy. CBT-informed forensic case formulations are biopsychosocial and learning theory-driven attempts to provide working hypotheses about the development and maintenance of a patient’s likelihood of (sexual) offending, resulting in a rationale for treatment and risk management interventions (Craig & Rettenberger, 2022). During forensic case formulation, hypotheses are formulated regarding dynamic risk factors and their interconnections. Dynamic risk factors are psychological, behavioral, and contextual features that are considered amendable to change, and their change alters the probability of future (sexual) offending (Bonta & Andrews, 2017; Eher et al., 2020; Heffernan et al., 2019; Mann et al., 2010; Olver et al., 2020; van den Berg et al., 2018; van den Berg et al., 2023; Ward & Fortune, 2016a; Ward & Fortune, 2016b). Hypotheses about patients’ dynamic risk factors, their interrelationships, and their associations with sexual (re)offending are further verified and strengthened through the collection of collateral information from criminal records, risk assessments, (neuro)psychological and neurological tests, as well as by information provided by relatives and friends. Based on the resulting insights and awareness, treatment goals related to dynamic risk factors are established. As treatment proceeds, patient and therapist evaluate the extent to which these goals have been achieved and consequently whether the risk of sexual reoffending can be considered decreased (van den Berg et al., 2018). According to the network-based model of risk of sexual reoffending (NBM-RSR; van den Berg et al., 2023), the risk of sexual reoffending can be considered the outcome of activity within a complex network of dynamic risk factors. Network analyses applied to dynamic risk factors of men with a history of sexual offenses have revealed a relatively strong role in the risk of sexual reoffending of factors such as social rejection/loneliness, cognitive problemsolving skills, impulsive behavior, and callousness (van den Berg et al., 2020; van den Berg et al., 2022). Based on these findings, it has been proposed that risk management and treatment strategies focused on these factors are most likely to reduce the overall probability of sexual reoffending (van den Berg et al., 2022; van den Berg et al., 2023). Although these
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