台灣性侵害加害人心理處遇治療歷史沿革，實務經驗、過程與挑戰之探討

The Approach of Taiwan Sex Offenders Treatment Programs: History, Practice Experience, Process, and Challenge

西元1994年刑法納入強制診療之規範，開始了性罪犯應該被治療的觀念。綜觀1994年至1999年我國對性侵害防治之立法，有別於其他人犯之處遇型態，建立起相當特殊之「刑前鑑定治療」、「獄中治療輔導」及「刑後社區治療輔導」制度。從把性侵害犯罪當成是一般犯罪行為，到性侵加害人須接受診療的觀念，這其中的轉變，涵蓋的思維包括：

一、性侵加害人可能是有心理疾病的。二、心理治療可以協助避免再犯。延續著這群人可能有著心理疾病的觀念，給予心理治療以協助這群人疾病好轉。由於觀念的改變，性侵加害人必須接受強制治療，開始引入大量的醫療資源。在司法精神醫學與心理治療工作中，治療師除了個案的內心世界，也需注意個案的外在世界，個案對他人的傷害及處於服刑狀態都是外在的現實面。心 理治療要針對個案心理真實面的想法感受進行探索，如何能協助個案更為守 法，外部現實的需求是一項困難複雜的任務，需要平衡內在要求和外在法律的 衝突，這也是司法心理治療的一項重要目標。

 

The concept that sex offenders should be treated under criminal code was introduced in 1994 with the inclusion of mandatory medical treatment. From 1994 to 1999, our legislation on the revention and treatment of sexual assault was different from other types of offenders and established a pecial system of “pre-sentenceidentification and treatment”, “in-prison treatment and counseling” and “postsentence community treatment and counseling”. From treating sexual assault as a general criminal act to the concept that sexual assault perpetrators should receive medical treatment, the changes of ideas behind this change include: 1. Sexual assault perpetrators may be psychologically ill. 2. Psychotherapy can help avoid recidivism. Continuing the notion that this group may have a mental illness, psychotherapy should be introduced to help them mentally. As a result of this change in perception, sexual assault perpetrators are required to undergo mandatory treatment, and therefore significant of medical resources are introduced. In judicial psychiatry and psychotherapy, the therapist needs to pay attention not only to the inner world of the client, but also the outer world of the client, where their harmful actions and their sentence status are actually at, the outer reality. Psychotherapy should explore clients’ true psychological feelings and houghts, and help them on how to be more lawabiding. Satisfying one’s needs in external reality is a difficult and complex task, which requires balancing the conflict between internal needs and the external law, which is also an important objective of judicial psychotherapy.