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Stalking affects hundreds of thousands of people around the world every year, and criminal justice and mental health professionals are often required to manage or treat stalkers or their victims. This research paper provides an overview of the phenomenon of stalking, its legal status, explanatory models, and victimology and impact. A detailed description of best-practice assessment procedures for perpetrators and victims and treatment/management considerations for both groups is also provided.
What Is Stalking?
Stalking is a problem behavior characterized by repeated and unwanted intrusions inflicted by one person upon another in a manner that causes reasonable fear and/or distress. Intrusions typically come in the form of unwanted communications, such as those via telephone (including SMS), electronic media (e-mail, social networking websites), letters, or graffiti. In many stalking episodes, intrusions will also take the form of unwanted contacts, including loitering near the victim, following, maintaining surveillance, and making approaches. In addition to these core stalking behaviors, a range of other forms of harassment are often present, including property damage, theft, malicious use of the Internet (e.g., creating defamatory websites), sending or leaving unsolicited materials (ranging from gifts to items intended to frighten or implicitly threaten, such as dead animals), inveigling others to harass the victim, vexatious complaints, uttered threats, and assault.
The defining features of stalking behavior are that it is repeated, is unwanted, and causes significant distress. Even within this broad definition, stalking has been shown to occur in two basic patterns (Purcell et al. 2004). The first is a short-lived burst of self-limiting intrusions that occur over the course of a day or two and usually involve unwanted approaches by a stranger or distant acquaintance. The second involves both unwanted communications and contacts, and frequently other associated behaviors, tends to be perpetrated by an ex-intimate or acquaintance, and persists for weeks, if not months. The latter type tends to have a far greater psychological and social impact on the victim and is more frequently associated with threats and physical assault, so is more likely to attract criminal justice or mental health attention. In recent years, stalking behaviors have also been observed in a purely virtual environment, a phenomenon labelled “cyberstalking.” Those who engage in cyber-stalking use the mechanisms of the Internet to harass their target(s), but do not engage in the aforementioned behaviors commonly seen in “off-line” stalking. Studies of this behavior are few and bedevilled by problems with definition and methodology. The best investigation to date concluded that, while Internet-based harassment is common, pure cyberstalking is actually rare and most victims who experience stalking via the Internet are also targets of off-line stalking behavior (Sheridan and Grant 2007).
Stalking is a relatively new crime in most jurisdictions; the Californian law of 1990 was the first legislation specifically intended to prevent the behavior. By the end of the 1990s, stalking laws had been introduced in most English-language jurisdictions, with many countries in mainland Europe following suit throughout the first decade of the 2000s. The first wave of anti-stalking laws (1990–1999) usually conceptualized stalking as a precursor to assault, and so the purpose of the law was to prevent physical attack. More recently, stalking has been conceptualized as harmful in and of itself, and the introduction of the second wave of laws (those implemented since 2000) has tended to focus less on violence, although this is still a concern. Anti-stalking legislation is relatively uncommon outside of Australasia, Europe, and North America. Where present, it is usually included in domestic violence laws and so is typically poorly defined and largely restricted to female victims of ex-intimate partners.
Depending on jurisdiction, anti-stalking legislation typically requires three elements to prove the offence. The behavior or conduct element is usually defined as a “course of conduct,” or conduct engaged in on more than one occasion (intentionally broad so as to allow for early intervention). There is no requirement that the individual instances of behavior be unlawful (e.g., repeated nonthreatening telephone calls would satisfy a course of conduct, although none would be illegal in isolation). Some jurisdictions leave the behavior element at this point without further defining the nature of the acts that constitute harassment or stalking, while others go on to define the types of conduct that are prohibited. The second necessary element is perpetrator intent. Most anti-stalking laws require either that the perpetrator intended to harass or cause harm to the victim or that they ought to have known that their behavior could have had that effect (akin to being reckless as to the effect of their behavior). The final element, which is present in many North American and European jurisdictions, although not in Australasia, is that the victim experiences the behavior as intimidating and feels fear or apprehension as a result. Two levels of proof are often required: a subjective standard (this victim felt fear) and an objective standard (a reasonable person would have felt fear). In many jurisdictions, stalking is divided into misdemeanor or felony offences, depending on the nature of the behavior engaged in. Furthermore, many anti-stalking laws provide for the civil option of a protection order for the victim, breaches of which are a criminal offence. Stalking laws have provoked considerable discussion, which is summarized by Kapley and Cooke (2007) and Mullen and colleagues (2009a).
Estimates of the prevalence of stalking vary according to the definition, sampling, method of enquiry, and willingness of participants to respond and answer candidly. Nonetheless, estimates are remarkably consistent across location and time, with lifetime victimization rates of 17–30 % reported for women and 4–12 % for men (Purcell et al. 2002; Smith et al. 2011; Stieger et al. 2008). Reported prevalence rates in the USA tend to be lower than other countries (7 % for women and 2 % for men) as the national survey included only those victims who experienced the stalking as dangerous or life-threatening (Basile et al. 2006). Victims are largely female (70–80 %) and stalkers are predominantly male (80–85 %), with 20–25 % involving same-gender stalking, usually malemale.
Explaining Stalking Behavior
Stalking, like any complex human behavior, is a product of a range of psychological, social, and cultural influences. People stalk out of anger, hope, lust, ignorance, or a combination of these factors. The influence of psychopathology, discussed later, is also relevant in many cases of stalking, either as a direct or indirect causal factor. To date there are no comprehensive theories to explain the variety of stalking behavior that is observed. Some single factor theories have been described, most commonly disrupted attachment (Meloy 2007). This theory posits that stalking is a consequence of insecure and, specifically, preoccupied attachment. Research has supported aspects of this theory, finding that stalkers do indeed often present with insecure adult attachment, although there is little evidence for a specifically preoccupied style. Proponents of stalking as an expression of disrupted attachment tend to focus on those seeking relationships and do not address other possible trajectories into stalking behavior. Moreover, the mechanisms by which insecure attachment produces stalking in some contexts but not in others, even within the same individual, have not been adequately explained. Nonetheless, there does seem to be some evidence for chronically disturbed attachment style in some stalkers.
Where attachment theory examines distal dispositional characteristics that may lead to increased proclivity to stalk, Spitzberg and Cupach’s (2007) application of relational goal pursuit theory to relationship-based stalking suggests more proximally relevant factors. In this theory, the goal of possessing a particular relationship becomes entwined with the perpetrator’s value system and is integral to their sense of self-worth and life happiness. In this context, pursuit of the goal (a relationship with the victim) takes on disproportionate significance. The failure to achieve the goal in spite of persistent attempts results in rumination and consequent negative emotional states, which the perpetrator attempts to escape by further efforts to achieve the desired goal. This is perhaps the most well-explicated theory of stalking behavior, although it also does not account for the variety of trajectories seen in stalking behavior, and to date it remains largely untested. A significant gap in the stalking literature remains, awaiting a truly comprehensive multifactor theory that adequately explains this complex behavior.
In the absence of such a theory, many classification systems have been developed in an attempt to reduce the heterogeneity of stalkers into manageable categories that can assist decision-making. These taxonomies vary depending on the needs of the authors and audience. Those developed by clinicians emphasize the goal of treatment and management, while those for law enforcement tend to be used more as shorthand for management and referral options. In both realms, classification schemes tend to focus on three variables: mental disorder, prior relationship, and motivation. The earliest classification schemes focussed heavily on psychopathology, reflecting the fact that stalking behavior was seen as a manifestation of emotional and psychological disturbance. By the mid-1990s, prior relationship and affective state were also considered useful ways of differentiating stalkers. More recently, Mohandie and colleagues (2006) proposed a scheme based on the nature of the prior relationship and the context in which the stalking occurred. This scheme in particular may be useful for law enforcement personnel as it is relatively easy to apply based on minimal information. Many typologies have been proposed, and a useful review is provided by Pinals (2007).
A Multiaxial Classification Scheme
One of the most commonly used typologies, endorsed by the Group for the Advancement of Psychiatry Committee on Psychiatry and the Law, is that of Mullen et al. (2009). This typology, based originally on a sample of 145 Australian stalkers, took the unique step of proposing classification on multiple axes to determine type. The first axis is the nature of the prior relationship between stalker and victim; the second, the initial motivation for and context in which contact with the victim occurred; and the third, the presence and nature of any psychiatric diagnoses. Using these three axes, five stalker types were identified, which are described below. More lengthy descriptions can be found in Mullen et al. (2009).
The Rejected: These stalkers begin to stalk following the dissolution of an intimate relationship, however brief, in an attempt either to reclaim the relationship or to exact revenge against their former partner for leaving. In many cases, both of these motives are present at different times. Not typically affected by severe mental illness, these stalkers tend to present with antisocial, narcissistic, borderline, or paranoid personality traits, depression, and/or substance use disorders. In a minority of cases, dependent and obsessive-compulsive personality traits are evident.
The Resentful: These stalkers target an acquaintance or stranger, but invariably someone who they perceive has mistreated them, either in their own right or because they are representative of some organization that has provoked the stalker’s ire. The stalking usually begins with the aim of righting the perceived wrong and over time becomes the only way to assuage feelings of resentment and regain their lost sense of power and control. These stalkers often suffer from paranoid or narcissistic personality disorders and occasionally present with paranoid delusions incorporating the stalking victim(s).
The Incompetent Suitor: These individuals target strangers or acquaintances with the initial intention to pursue a friendship or date. The stalking is an inept and often self-centered attempt to achieve that outcome. Over time it may take on an angry or aggressive tone as the stalker’s wishes are thwarted, but this group typically does not stalk for an extended period, instead transferring their interest elsewhere. While many stalkers who fall into this category do not experience any form of mental disorder, this behavior does emerge in the context of impaired social skills and interpersonal deficits, and intellectual disability or developmental disorders are not infrequent. Also found in this group are narcissistic individuals who are assertive, overbearing, and simply can’t imagine why any woman would refuse the opportunity to date them.
The Intimacy Seeker: These stalkers target acquaintances or strangers in an expression of their love and seeking love in return. Usually the stalker persists in an affectionate and amorous way, but very occasionally they can become angry and vengeful if they realize that the longed-for relationship is under threat. Often driven by a severe mental illness, these individuals may believe that they already have a mutually loving relationship with the victim, even in the absence of any true connection. Conversely, they may be intensely infatuated and believe that the idealized relationship is possible if they persist. Overvalued ideas of intimacy are almost ubiquitous in this group, arising either out of a severely disturbed borderline personality or at the more extreme end, a delusional disorder or schizophrenia with erotomanic delusions.
The Predatory: These men most often target strangers with the goal of achieving some form of sexual gratification, usually deviant. They use stalking as part of a wider repertoire of sexually inappropriate behaviors, and their stalking is usually characterized by surreptitious loitering, following, spying, and, in many cases, sexual violence. The predominant diagnoses in this group are paraphilias, depression, and substance misuse.
Stalking is a set of behaviors, not a diagnosis, but studies suggest that at least 80 % of community referred stalkers have some form of psychiatric condition (McEwan et al. 2009). Personality disorders, schizophrenia, and major mood disorders are the primary presenting problems (McEwan et al. 2009; Rosenfeld 2003). In their retrospective file review of a forensically derived sample of stalkers, Mohandie and colleagues (2006) found 46 % had a probable diagnosis of mental disorder. Referral bias limits the generalizability of these findings, in that forensic samples are weighted towards more serious offending and severe mental illness.
There is a higher prevalence of major mental illness among those who stalk public figures (James et al. 2009). Over 80 % of individuals who made inappropriate communications or approaches to the British Royal Family were found to have a major mental disorder. In a study of individuals who pursued and ultimately physically attacked a Western European politician, over half were mentally disordered, most of whom were psychotic.
Suicidal ideation is also common among stalkers. Using retrospective file review, Mohandie and colleagues (2006) identified suicidality in 25 % of 763 North American stalkers, while McEwan and colleagues (2009) observed that one in ten of their Australian sample reported suicidal ideation. In a 3-year follow-up, McEwan and colleagues (2010) found that 3 of 138 stalkers (2.2 %) had committed suicide. Though small, these numbers represent substantially higher rates, indeed six times greater, than would be expected among psychiatric patients or community-based offenders. In all three cases, the stalker had a history of suicidal ideation or intent. This finding is of particular concern because suicidal stalkers pose an enhanced risk of violence towards their victim and third parties. Stalking risks will be discussed further in a later section.
Particular psychopathology is found more commonly in certain types of stalker, as noted in the multiaxial classification scheme presented earlier. For instance, personality disorders or traits predominate in Rejected stalkers though morbid jealousy of delusional intensity is also encountered in this group. Intimacy seekers are far more likely to have serious psychopathology, in the form of psychotic disorders, and female stalkers have higher rates of psychosis than their male counterparts (Meloy and Boyd 2003). As elaborated later, the risk of serious violence in the stalking situation is greater when the stalker has a nonpsychotic as opposed to a psychotic condition.
Earlier assumptions that stalkers have above average intellectual functioning have been called into question by a prospective study of stalkers referred to a clinic specializing in their assessment and treatment (MacKenzie et al. 2010). Intelligence testing found a mean intelligence quotient (IQ) in the average range (91.59 [SD 16.2]), with a verbal IQ significantly lower than performance IQ. These findings have important implications for psychological intervention programs for stalkers, which must reflect their cognitive abilities.
Victims And The Impact Of Stalking
Stalking is an event that has a perpetrator and a victim. The victim is pivotal to stalking because stalking is, in effect, a victim-defined crime. Behaviors that are inappropriate and gauche are transformed into behaviors which are harmful and illegal by the apprehension that is evoked in the victim. While the line between the inappropriate and the fear inducing is in some respects influenced by the tolerance and sensitivities of the victim, most stalking that comes to the attention of the criminal justice system could be expected to provoke fear or disquiet in the majority of people.
Stalking has been viewed as a product of failed relationships and a form of domestic violence perpetrated by men against women. Earlier in the evolution of our understanding of stalking, the concept generalized from behavior directed at the famous to that of males who battered their partners. While lending attention to a long neglected issue, the concept of stalking is problematic when used to describe behaviors that occur in the context of an ongoing relationship. To begin with, the focus on stalking as a form of domestic violence has predominantly been on women as victims and men as abusers, while those who stalk former intimates can be female and victims can also be male. More importantly, while behaviors akin to stalking undoubtedly emerge among cohabiting partners, especially in relationships characterized by jealousy, this usually comprises behaviors that are aimed at information gathering (e.g., monitoring, surveillance) or coercive physical or verbal abuse and threats. A distinction should be made between such conduct and stalking. The aim of stalking is to make one’s presence felt where it would not otherwise exist. Where there is an ongoing relationship, however conflicted and potentially damaging, the behavior should be classified as a form of terrorizing and controlling intimate partner violence, not as stalking. Confusing the two is semantically and practically problematic as approaches to assessing and managing stalkers will be ineffective in situations where the stalker and victim continue to cohabitate.
A number of classifications have been proposed for stalking victims, all of them based upon the preexisting relationship, if any, between victim and stalker. The following is a relational classification of stalking victims, derived from the typology proposed by Mullen and colleagues (2009):
- Former sexual intimate. The most common victim profile is a woman who previously shared an intimate relationship with the stalker, usually male, though women can be perpetrators and stalking can also arise in the context of same-gender relationships. This category includes only those cases in which the relationship has been explicitly terminated.
Acquaintances, who can be:
- Family/friend. Rejected stalking may follow the breakdown of a close friendship or estrangement from a family member. Occasionally, Resentful stalking can emerge in relation to some perceived injustice (e.g., dispute over a family estate).
- Professional relationship. As below, those in the health, law enforcement, and teaching professions are especially at risk.
- Casual contact. Intimacy seekers, Incompetent suitors, and Predatory stalkers may all target their victim in the context of a casual social encounter. Neighbor stalking usually falls into this category, most often involving a Resentful stalker incited by disputes over noise or a fence line.
- Workplace contact. Where the victim meets their stalker in a workplace context. The stalker may be in a subordinate or superior position, or in some cases a client or customer. Those without any real connection to the victim:
- Stranger. Some victims have no prior knowledge of their stalker. The stranger may identify themselves, but some remain anonymous.
- The famous. As noted below, prominent figures such as politicians and media personalities attract a range of stalker types, particularly Intimacy seekers and Resentful stalkers. Some celebrities suffer the attentions of multiple stalkers.
To this can be added secondary victims, who are impacted by stalking as a consequence of their relationship to the primary victim (e.g., the victim’s partner or other family members, coworkers, or neighbors). Stalking tends to have a “ripple effect” on the victim’s social network. In some instances, stalkers pose a greater risk to secondary victims than their primary target.
It has long been observed that stalking can have damaging, if not devastating, consequences and it is the reason, ultimately, that stalkers have attracted the interest of mental health professionals. Stalking impacts upon the victim, the third parties, the stalker themselves, and the community as a whole. Such impacts have received systematic attention over the past decade. The initial studies were mainly descriptive and highlighted the psychological, occupational, and social impacts of these behaviors (Pathe´ and Mullen 1997). Subsequent large epidemiological studies (e.g., Purcell et al. 2002; Purcell et al. 2005) found that stalking was prevalent in Western nations and also confirmed the higher rates of psychiatric morbidity among victims of stalking.
Victims of stalking commonly report a profound sense of violation and loss of control over their lives. Many experience a pervasive mistrust of others that can persist long after the stalking has ceased. In their epidemiological study that compared matched controls, victims of brief harassment, and victims of protracted stalking (>2 weeks), Purcell and colleagues (2002, 2005) found that the rates of general psychiatric morbidity were significantly higher among those who reported a history of protracted stalking (36 % vs 19 % for controls and 22 % for brief harassment). Those subjected to severe stalking were also more likely to report recent suicidal ideation (10 %) and clinically significant levels of posttraumatic symptomatology (three times more likely than the briefly harassed group).
More recent studies of stalking victims have considered groups who are particularly vulnerable to stalkers. These include health professionals (Whyte et al. 2011) and public figures (Mullen et al. 2009), but there is also anecdotal evidence of higher rates of stalking victimization in other professions such as teaching and law enforcement. Studies to date suggest that the lifetime risk for a health professional being stalked by a client or patient is 20 % (Purcell et al. 2005), and those working in the mental health field, by virtue of the patients they encounter, may be more susceptible to such behaviors. One of the commonest motivations for stalking health practitioners is morbid infatuation, where a lonely, disordered patient misconstrues sympathy and attention as romantic love. These patients-turned-stalkers can be categorized as Intimacy seekers. Resentment is another common motivation, stemming from some supposed injury or dereliction. These stalkers fall into the Resentful category. A smaller group is pursuing reconciliation or revenge following the termination of a (usually long-term) therapeutic relationship (Rejected stalkers). The impact of stalking on health professionals can be significant, with over 70 % of affected psychologists in one study (Purcell et al. 2005) modifying aspects of their personal and professional lives, some of whom relocated their practice and/or their private address. Almost a third contemplated leaving their profession altogether, this figure rising to nearly 50 % among those whose stalker made malicious complaints to their professional registration board.
Assessments of stalkers or victims often take place in a stressful context. For the stalker, this may be as part of a presentence or parole report, or in a mandated treatment situation. For victims, help is often sought when the pressures of the stalking become overwhelming and they feel that they can no longer cope on their own. Stalkers tend to deny, minimize, rationalize, and justify their behavior. Victims often minimize the experience of stalking and overemphasize their responsibility for the harassment. In both scenarios, obtaining collateral information about the stalking episode is essential. Where available, police or court documents summarizing the behavior are invariably useful, as are accounts by those associated with the victim or stalker. When possible, it is usually best to avoid having contact with both the victim and stalker. Victims may experience attempts to obtain collateral information as simply another unwanted intrusion by someone acting on behalf of the stalker, while for stalkers, having a professional make contact with the victim can be understood as implicit support for an ongoing “relationship” or as an opportunity to obtain new information about the victim.
Assessing A Stalker
It is usually possible to form hypotheses about the motivation for stalking reasonably quickly. Information about the prior relationship between victim and stalker and about the apparent initial motivation can be gleaned from collateral sources or identified very early in an assessment. Often the best way of determining motivation is to simply ask the stalker what drove them to this behavior or what they originally wanted to achieve. A central aspect of the assessment is conducting a functional analysis of the stalking. This involves examining the common situational, emotional, and behavioral antecedents to and consequences of each intrusion. An analysis of this kind can provide useful information upon which to base hypotheses about the cognitive and emotional states associated with offending and the skill deficits that might lead them to stalk rather than use a more adaptive strategy to achieve their goals.
For mental health clinicians, particularly those with forensic expertise, the assessment will be like most others, with slightly more emphasis on the individual’s experience of other, similar interpersonal situations. For example, for a Rejected stalker, additional questions about prior relationships and breakups would be relevant, and for a Resentful stalker, enquiry into how they have handled previous injustices or disputes would be useful. Where sexually deviant behavior is present, a full sexual behavior assessment is appropriate, as for sex offenders. If the clinician is not trained in assessment and diagnosis of psychopathology, referral to an appropriately qualified expert is strongly recommended.
Assessing A Victim
Some stalking victims present for mental health intervention after the stalking has ceased. They are commonly seeking help to deal with post-trauma symptoms and reconstitute their life. An appraisal of the risk of recurrence of the stalking may also be appropriate. Many more stalking victims seek assistance when the stalking is ongoing, and the priority in these instances is to ensure all reasonable steps are taken to protect the victim’s safety and privacy. Some may be engaging in behaviors which place them and other parties at risk (e.g., retaliating against their stalker), necessitating urgent guidance. Around 10 % will have suicidal ideation requiring assertive intervention.
As a consequence of their experiences, many stalking victims are distrustful, and some will have previously encountered negative attitudes from the “helping” professions. In engaging stalking victims, it is essential that the assessment is conducted by a professional familiar with stalking issues and the available interventions. It is important at the outset that stalking victims are reassured that the stalking is not their fault and that they are not alone in their ordeal.
Stalking victims require a comprehensive assessment, including a full psychosocial history that encompasses past victimization and a detailed account of the stalking. This includes the nature of the victim’s prior relationship with the stalker, a description of the onset of the stalking, and the frequency and nature of the intrusions, as well as any strategies employed to end the stalking. How effective were these measures, and has anything exacerbated the behavior? Have they involved the police, and if not, why not? Are there any current protective injunctions, or is the stalker subject to any other legal directives? Is the stalker known or suspected to be mentally ill, and if so, are they known to the mental health system? Some victims, especially those stalked by strangers, may have limited information, but victims should be encouraged to bring as much documentation as possible to the assessment (including any evidence of the stalking in the form of letters, e-mail, phone records, photographs, court orders, or witness statements).
Stalking victims should be questioned about suicidal inclinations, any homicidal intent towards the stalker, and any measures they may have taken to defend themselves (e.g., keeping weapons in the house). One should endeavor to gauge the victim’s current level of support, others affected by the stalking, the victim’s employment situation, and mental health status. Are they suffering current anxiety or depressive symptoms, and how have these been managed? Maladaptive coping mechanisms such as substance abuse or gambling are not uncommon and may require specific interventions.
In any stalking situation, a primary concern for the victim is the likelihood of further damaging behavior. Often their worries focus on the likelihood of physical violence, the likelihood that the stalker will persist, or if they have stopped, that they will start again. Therefore, for those charged with managing stalking situations, risk assessment is a primary focus. For those working with stalkers, an additional concern is the potential for psychological and social harm to the perpetrator and what this means for other areas of risk.
While the stalking risk assessment literature continues to lack strong retrospective or prospective studies of representative samples, a sizeable body of published work now exists, and relevant information can also be gleaned from the much larger body of research into violence and offending risk assessment more generally. Two structured professional judgement tools for assessing stalking have been published and are undergoing validation trials – the Stalking Risk Profile (SRP) (MacKenzie et al. 2009) and the Guidelines for Stalking Assessment and Management (SAM) (Kropp et al. 2008). Where these tools are not available, clinicians and law enforcement personnel must rely on clinical experience and integrating the literature themselves.
Risk Of Persistence Or Recurrence Stalkers that persist for at least 2 weeks are at increased risk of continuing for months. Those with a prior relationship with the victim tend to stalk for longer, and as a rule, women tend to be more persistent than men. By far the strongest predictor of extreme persistence is psychosis, and these stalkers are unlikely to desist without mental health intervention. Recurrent stalking appears to be the domain of the personality disordered and those who share the victim’s children, property, or locale, although a lack of research makes firm conclusions difficult (Rosenfeld 2003).
Risk Of Violence As a group, ex-intimate partners present the greatest risk of violence, with up to half in this category using physical violence against their victim or a related third party (McEwan et al. 2007). Identified risk factors for violence for all stalkers include:
- Demographic variables. It has been repeatedly shown that the gender of the stalker or the victim has no impact on the prevalence of either threats or assault, and same-gender stalking victims are at equal risk of violence (Strand and McEwan 2011).
- Stalking behaviors. Stalkers who follow, loiter near, accost the victim, or enter the victim’s home are at increased risk of violence. Escalations in the intrusiveness or intensity of the stalking have not been subject to research, but should be treated as periods of increased risk.
- Threats. Threats are common in stalking situations and have been shown to be a risk factor for violence, particularly for ex-intimate partner violence (McEwan et al. 2007).
- Prior violence and criminal behavior. The evidence is inconsistent; however, on balance, it seems that prior violence in particular is a predictor of stalking-related violence (McEwan et al. 2007).
- Mental disorder. Psychotic stalkers have consistently been found to be less violent than nonpsychotic stalkers; however, the presence of other risk factors should not be discounted because the stalker is psychotic (McEwan et al. 2009). The relationship between personality disorder and violence in stalkers is unclear, although findings from the wider risk assessment literature indicate that antisocial personality disorder in particular is related to violence.
- Substance misuse. Substance misuse is associated with stalking violence, likely having a compounding effect on other risk factors.
Formulation And Treatment Planning For Stalkers
Clinical formulation links assessment information with a systemic treatment and management plan. A good formulation will explain the mechanisms underlying the stalking and direct interventions to stop it. For the clinician assessing a stalker, the central focus of formulation is the stalking behavior itself rather than the presence of psychopathology or other matters. A detailed explanation of how to formulate stalking behavior is beyond the scope of this research paper, but some guidelines are available in McEwan et al. (2011).
Treatment And Management
Management of stalkers often involves the use of the criminal justice system, which is described further below. Presented here are options for interventions designed to address the underlying causes of the behavior in conjunction with such environmental management strategies. The information provided in this section assumes the availability of an appropriately trained and supported mental health practitioner and a client that is willing and/or mandated to attend treatment. Whenever possible, treatment of stalkers should be undertaken by a clinician experienced in working with offenders, who has training in structured risk assessment, familiarity with the stalking research literature, and an understanding of local stalking laws. Those who work with stalkers (or their victims) should also be cognizant of the risks of such work and should take appropriate steps to ensure their own safety and security (Pathe´ 2002).
There is limited information available about the efficacy of offence-specific psychological interventions for stalkers, with Rosenfeld and colleagues’ (2007) trial of dialectical behavior therapy the only published study. Treatment strategies described by these and other authors (e.g., MacKenzie and James 2011) take a cognitive-behavioral perspective and focus on helping the stalker to develop skills that they can apply in situations where they have previously used stalking (e.g., emotional regulation, problem solving, and communication skills are all targets of psychological intervention). Which particular skill deficits are most relevant to an individual stalker, and the prioritization of one skill over another, should be evident following a comprehensive formulation as outlined above. In addition to skill development, another central aspect of treatment is helping the stalker recognize potential triggers for stalking behavior, identify high-risk thinking and behavioral patterns, and implement alternative strategies.
As with any offender treatment, attention must also be paid to the client’s readiness to desist from their behavior. Treatment readiness can be defined as having appropriate motivation, capacity, and ability to engage in treatment so as to maximize the likelihood of therapeutic change. Where motivation to engage is low, time should be spent helping the client identify personal goals that would be assisted by avoiding stalking in the future, encouraging the view that they are able to change their behavior, and reducing emotional distress that might be provoked by thinking or talking about their offence.
Maximizing treatment readiness may require other issues to be dealt with prior to beginning any offence-specific interventions. Perhaps the most common factors that interfere with a stalker’s capacity and ability to engage in offence-related treatment are active symptoms of mental illness and substance misuse. As discussed previously, these may also be risk factors for further stalking behavior, and so appropriate treatment can both reduce risk and increase the client’s opportunity to engage in other offence-related interventions. Mullen et al. (2009) provide a detailed description of the management of mental disorders in stalkers. In essence the appropriate treatments are no different to those offered to non-stalkers, although consideration of risk may lead to increased emphasis on the safety of the client and others and so greater impetus for involuntary treatment. Similarly, where substance misuse is present, interventions offered to individuals who do not stalk are usually appropriate, although with due consideration of the need to protect the stalking victim while treatment for substance misuse is undertaken.
Strategies To Combat Stalking These approaches need to take account of the individual circumstances, including the prior relationship between victim and stalker; the presence of shared children, property, or workplace; the methods of harassment; and the assessed risk to the victim and/or other parties. In most situations, the victim should be encouraged to inform relevant people of the stalking, so they are alert to the problem and better equipped to protect the victim and themselves. It is important to advise victims at the outset to avoid all contact with their stalker. Attempts to appease the stalker through “one last meeting,” or to explain, yet again, why the relationship ended, are, in effect, perpetuating the “relationship” and reinforcing the stalker’s efforts.
Using Anti-Stalking Laws As stalking is a criminal offence in many jurisdictions, informing the police may not only offer a resolution but also open an official paper trail documenting the stalker’s course of conduct. To maximize the likelihood of police action, victims should be encouraged to keep a clear chronological record of harassing intrusions and any tangible evidence of the stalking. While there are few surveys of police responses to stalking complaints, those that exist show that in the majority of cases, stalkers are charged with offences other than stalking (e.g., trespass), even where specific anti-stalking legislation exists. Anecdotal evidence suggests that police often recommend that the victim obtain a protective injunction, enabling them to prosecute a breach; however, this strategy may carry some risks (see below). Storey and Hart’s (2011) investigation of 32 cases showed that legal intervention is one of the more effective tactics to stop stalking. This includes everything from a formal police warning to a conviction. Informal warnings from police were shown to be ineffective in this study.
Protective Injunctions Also termed restraining, non-molestation, apprehended violence, protection, no contact, or intervention orders, their use against stalkers remains a contentious issue. These orders should not be used indiscriminately with stalkers as they have the potential to inflame the situation, provide a false sense of security, and exacerbate the victim’s distress. Protective injunctions are more likely to be effective if they are properly policed, and the perpetrator is an Incompetent suitor or a Rejected stalker who has less invested in the relationship (e.g., a brief relationship with no children) and with a nonviolent, law-abiding background. These orders are less likely to succeed with Intimacy Seekers, especially those with erotomanic delusions, and Rejected stalkers who have a strong investment in the relationship (long-standing, shared children and assets) and/or an antisocial personality disorder, morbid jealousy, or a history of domestic violence.
Privacy, Safety, And Security There are a range of measures that can enhance the victim’s security. These are beyond the scope of this research paper but are detailed in Pathe´ (2002). Victims and potential victims such as health practitioners should try to ensure that as far as possible all personal information is removed from the public domain. This includes delisting their telephone and fax numbers, obtaining a post office box address, and removing their name from the electoral roll and property titles. Stalking victims should be cautious in their use of social networking websites such as Facebook and Twitter and take appropriate steps to protect their privacy.
Clinical Management Of Stalking Victims Cognitive-behavioral approaches have been recommended with stalking victims. As a consequence of their stalking experiences, a victim’s previously held beliefs in their strength and resilience are replaced by feelings of extreme vulnerability, and their previous assumptions about the reasonable and predictable nature of the world are shattered. Cognitive-behavioral therapies aim to correct the unhelpful assumptions that underlie their anxiety and depression and the avoidance behaviors that frequently emerge in this context. Priority should always be given to the client’s safety, and if the stalking is ongoing, some avoidance behaviors may be entirely appropriate. For stalking victims presenting with chronic or complex posttraumatic stress disorder, dialectical behavior therapy (DBT) may prove efficacious (Mullen et al. 2009b).
Although there is a dearth of randomized clinical trials for pharmacological agents in the treatment of stress-related syndromes, those most frequently used with victims of stalking, as an adjunct to psychological approaches, are the selective serotonin reuptake inhibitor (SSRI) antidepressants. These agents have demonstrated efficacy for stress-related symptoms, panic, and depression. Care should be exercised in prescribing benzodiazepines for anxiety, as the symptoms, and thus the need for treatment, may be protracted, increasing the risk of drug dependence. Furthermore, the benzodiazepine agents such as Valium may diminish alertness and self-control, which can exacerbate the victim’s feelings of vulnerability.
Other Therapies Wherever possible, the victim’s partner and other relevant family members and supports should be involved in their management and the development of a safety plan. They frequently share in the victim’s distress and may have been more directly impacted than the primary victim. They often seek information to try to make sense of the stalking, and educating significant others can alleviate pressure on the victim, by stemming criticism and unhelpful advice. Some may require referral for separate counselling.
Group therapies and support organizations can provide some validation for stalking victims and assist in reducing the victim’s sense of isolation and self-blame. They are a useful source of information, support, and advocacy. Stalking victim groups need to be mindful of security at the meeting venue and the confidentiality of their members.
Stalking is a complex and damaging behavior that has commanded the attention of behavioral scientists, mental health professionals, the legal system, and the general public. Stalkers vary according to their motivations and psychopathology, and this determines their level of risk in multiple domains, and their management. While theories of stalking are not well understood, this problem behavior is amenable to psychological and environmental interventions. The mental health and criminal justice systems have a key role to play in bringing stalking episodes and victim suffering to an end.
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