Sex Offender Treatment Research Articles

Using the Violence Risk Scale-Sexual Offense version in sexual violence risk assessments: Updated risk categories and recidivism estimates from a multisite sample of treated sexual offenders.

The present study sought to develop updated risk categories and recidivism estimates for the Violence Risk Scale-Sexual Offense version (VRS-SO; Wong, Olver, Nicholaichuk, & Gordon, 2003-2017), a sexual offender risk assessment and treatment planning tool. The overarching purpose was to increase the clarity and accuracy of communicating risk assessment information that includes a systematic incorporation of new information (i.e., change) to modify risk estimates. Four treated samples of sexual offenders with VRS-SO pretreatment, posttreatment, and Static-99R ratings were combined with a minimum follow-up period of 10-years postrelease (N = 913). Logistic regression was used to model 5- and 10-year sexual and violent (including sexual) recidivism estimates across 6 different regression models employing specific risk and change score information from the VRS-SO and/or Static-99R. A rationale is presented for clinical applications of select models and the necessity of controlling for baseline risk when utilizing change information across repeated assessments. Information concerning relative risk (percentiles) and absolute risk (recidivism estimates) is integrated with common risk assessment language guidelines to generate new risk categories for the VRS-SO. Guidelines for model selection and forensic clinical application of the risk estimates are discussed. (PsycINFO Database Record

448 Psychopathological predictors of pedophilic sexual interest in a sample of convicted child sexual offenders

Pedophilic sexual interest is an important risk factor predicting criminal recidivism among child sexual abusers. Despite its important role in the treatment of child sexual offenders, there is a lack of knowledge on the nature of pedophilic sexual interest. Accordingly, the aim of this study was to test the predictive role of a set of personality and psychopathology dimensions in pedophilic sexual interest, in a sample of convicted child sexual abusers. Forty-three men (inmates) convicted for child sexual abuse were evaluated according to some personality and psychopathological dimensions: trait-affect, levels of trait impulsiveness, personality (according to the Big Five model), and state psychopathological symptoms. Child sexual abusers completed the self-report questionnaires (assessing the personality and psychopathology dimensions), in an interview-style, conducted by the researcher. Pedophilic sexual interest was measured with the Screen Scale for Pedophilic Interests, which is completed using the offenders’ official criminal records.

Juveniles with Sexual Behavior Problems: A Treatment Program Evaluation

AbstractJuveniles commit a significant portion of the sexual abuse perpetrated on other children. Treatment for juveniles with sexual behavior problems has moved from modified adult treatments to more developmentally appropriate approaches. Although cognitive-behavioral therapy is the most commonly used approach, research indicates that inclusion of significant others in the juvenile’s life is important when working with these youth. The inclusion of the juvenile’s family is seen as especially vital in treatment success. The current article reviews treatment outcomes, as measured by recidivism (re-offense) rates, for juvenile males completing a county juvenile sex offender treatment program. The program emphasizes family involvement and collaboration with juvenile probation officers, correctional officer, attorneys, and judges in the ongoing treatment as well as support of the juvenile and his/her family. Results indicate a sexual recidivism rate of 7.2% which is consistent with meta-analyses of research on sexual recidivism in treatment programs. The recidivism rate for non-sexual crimes was 33.7%, which is lower than typically reported in meta-analyses of treatment outcomes. The treatment program was equally effective for all juveniles, regardless of race.

When Juveniles Commit Sexual Offenses: Considerations and Recommendations for Judges

AbstractConsidering sexual offenders’ impact on victims, families, and communities, one cannot understate the importance of utilizing evidence‐based dispositions with juvenile offenders adjudicated for sexual offenses. This proves difficult, however, as the body of literature regarding juvenile sexual offenders is complex and often misunderstood. Research on how juvenile sexual offenders experience – broadly construed – the juvenile justice process is particularly sparse. The research that is available about juvenile sexual offender treatment, recidivism, and outcomes in general tends to be mixed as to the best way to deal with this distinctly stigmatized population. Thus, the purpose of this review article is primarily educational in that we summarize the highlights of current research and thinking in regards to juvenile sexual offenders with which judges should be familiar, and subsequently offer practice recommendations. The ultimate goal in offering and applying these recommendations in juvenile court settings is to help alleviate potential collateral consequences, increase positive long‐term outcomes for juveniles, and increase public safety.

An Etiological Approach to Sexual Offender Assessment: CAse Formulation Incorporating Risk Assessment (CAFIRA).

Case formulations (CF) have been the cornerstone of effective practice in clinical psychology since the 1950s and now form one of the core competencies in clinical and forensic assessment. The use of CFs within forensic settings is becoming more relevant when working with offenders who have experienced significant trauma, suffered from personality disorder, and have displayed sexually abusive behavior. Furthermore, most North American and European jurisdictions insist that expert witnesses adopt an idiosyncratic approach to risk assessment and consider the characteristics of the individual as part of a wider formulation of the problem behavior. This article focuses specifically on CF incorporating risk assessment procedures of sexual offenders. While empirical support for the use of risk analysis and formulation in managing offending behavior generally, and sexual offending behavior in particular, is limited, there is mounting evidence to suggest that CF can improve understanding of an individual's problem sexual behaviors. We argue that by integrating risk formulations into the CF provides a conceptually robust link between the etiologically development of the problem sexual behavior and effective assessment and risk management of sexual offenders. As forensic treatment programs increasingly moved toward strength-based approaches, in keeping with the Risk-Need-Responsivity principles Andrews and Bonta (2004), and the Good Lives Model Ward and Stewart (Prof Psychol Res Pract 34:353-60, 2003) of offender rehabilitation, the use of CFs in the assessment, treatment, and management of sexual offenders is indispensable. We present an etiological framework for understanding risk in an individual sexual offender by integrating a case formulation model to include the use of (static, stable, and acute) actuarial and clinical risk assessment measures as well as protective risk factors, referred to as the CAse Formulation Incorporating Risk Assessment (CAFIRA) model.

Comparing Women's and Men's Sexual Offending Using a Statewide Incarcerated Sample: A Two-Study Design.

This study identifies the characteristics that distinguish between women's and men's sexual offending. We compare women and men currently incarcerated for a sex offense in one state using two data sources: administrative data on sex offenders in the state prison (N = 9,235) and subsample surveys (n = 129). Bivariate and logistic regressions were used in these analyses. Women account for a small proportion (1.1%, N = 98) of incarcerated sex offenders. In the population, women and men were convicted of similar types of sex offenses. The subsample was demographically similar to the population. In the subsample, women were more likely than men to have a child victim, be the parent/guardian of the victim, have a co-offender, and repeatedly perpetrate against the same victim. Findings suggest that women convicted and sentenced for a sex offense differ from their male counterparts, with predictive factors being dependent upon the age of their victim(s). Sex offender treatment interventions developed for men are poorly suited to and may have limited efficacy for women.

Narrative Roles Among Contact Versus Noncontact Sexual Offenders.

The current study explored narrative roles among individuals convicted of a sexual offense. Narrative roles in a criminal context are defined as specific personal accounts utilized by offenders to justify illegal behavior. The chosen theoretical framework recognized four primary offender roles: Revengeful Mission/Romantic Quest, Professional, Victim, and Tragic Hero. A total of 23 interviews were conducted with individuals convicted of a sexual offense (n = 11 contact, n = 12 noncontact) to explore and compare narrative roles between contact and noncontact offenders. Interviews were conducted using a phenomenological approach and coded via Framework Analysis, a qualitative data analytic method. Findings revealed a general pattern of narrative themes among offenders, along with a tendency for contact offenders to endorse Revengeful Mission/Romantic Quest narrative roles and noncontact offenders to endorse Tragic Hero narrative roles. Findings suggest that incorporating narrative roles into conceptualization and treatment of sexual offenders may help with tailoring treatments more effectively.

Structuring Relief for Sex Offenders from Registration and Notification Requirements

A wide array of collateral sanctions envelops convicted sex offenders. Among the most debilitating are registration and notification requirements, which are governed by both state and federal laws. Notification statutes in particular carry with them a host of negative ramifications for the individuals affected but also impose cost on public coffers and public safety. Ex ante limitations on such restrictions would be most effective but are also largely politically unpalatable. Therefore, individual relief provisions, perhaps along the model of Model Penal Code: Sentencing, should be adopted and extended to sex offenders. Overall public safety and the reintegration of sex offenders would be served best if the United States moved away from public notification, limited registries to those convicted of sexual offenses and at high risk of committing another serious sex crime, and invested more heavily in prevention and the treatment of sex offenders.

Pourquoi une consultation spécifique pour auteurs d’infractions à caractère sexuel : regard sur six années à l’Unité de Psychiatrie et Psychologie légales de Ville-Evrard

This research deals with a retrospective look on the 241 inpatients who crossed the threshold of this Specialized Consultation between January 1, 2010, and September 30, 2016. This research aims to highlight socio-demographic and psychopathological features, if any, and to form opinions and hypotheses concerning the treatment of inpatients under mandatory judicial cares. MethodsTo conduct this research we grounded our hypothesis in a systematic review of files, the gathering of the data contained in those files, and analysis of psychological assessments, and court decisions when available. The data was collected and then compared with the national statistics on crimes in 2015 (ONDRP) and the National Judicial Record. This review concludes with a literature review using databases such as Medline, PubMed, CAIRN, Science Direct searching for the term “Court Ordered Cares”, “Sex Offenders treatment program”, “Criminological Dangerosity Risk”. ObjectivesThis paper aims to determine if there are peculiarities between our active list compared against the national records. What are the main Court Ordered Cares, their length, and what sort of treatment could be initiated within the short term? ResultsThis Specialized Consultation were created 6 years ago in response to an increase in the mandatory supervision involving the psychological treatments of sex offenders. The Paris suburbs (banlieue) were unequally represented at that time and one of the authors of this research decided to start a new consultation designated for this specific population of « patients ». This paper sought to determine if there were some differences between our sample and the national data, from either a psychopathological point of view, or in the categories of crimes. One of our findings was that the length of the mandatory cares mirrored the severity of the judicial sanctions. The mean length of a court ordered care following a sentence, for an offense (exhibitionism, minor sex offenses) was comprised between eighteen months and three years for 76 % of individuals, whereas in cases of serious crimes (rapes e.g.), the length was comprised between three and six years in 71 % of the cases. It could reach a length of six to ten years or more in 15 % of the cases. It might be interesting to consider mandatory cares less than twelve months would not allow for the development of therapeutic bond and thus may prove less effective. Despite a judge's beliefs and hopes, a court ordered care rarely leads to long-term therapy as the probationer tends to regard them as an extension of judicial sanction.

Relationships Between Treatment Delivery, Program Attrition, and Reoffending Outcomes in an Intensive Custodial Sex Offender Program.

Retention of sex offenders to the completion of treatment is critical to program adherence to risk need responsivity (RNR) principles; however, it is also important to consider the potential interaction between attrition and treatment outcomes such as reoffending. The first aim of this study was to evaluate the influence of changes to treatment delivery in a residential sex offender treatment program (SOTP), including introduction of rolling groups and systematic emphasis on positive therapist characteristics, on likelihood of program noncompletion ( n = 652). Pooled regression modeling indicated that these operational interventions were associated with a significantly increased likelihood of program completion. We also examined whether variance in rates of participant attrition was related to reoffending outcomes for program completers ( n = 494). Incidence of attrition within completing participants' treatment cohorts had a significant negative association with hazard of sexual reoffending that was not accounted for by pretreatment risk. Results are discussed in terms of their implications for treatment delivery processes that aim to optimize both participant retention and treatment effectiveness.

Can circles of support and accountability (CoSA) significantly reduce sexual recidivism? Results from a randomized controlled trial in Minnesota

This study evaluates the effectiveness of Minnesota Circles of Support and Accountability (MnCOSA), a sex offender reentry program implemented by the Minnesota Department of Corrections in 2008. Using a randomized controlled trial, this study compares recidivism and cost–benefit outcomes among sex offenders in the MnCOSA (N = 50) and control groups (N = 50). The results suggest MnCOSA significantly reduced sexual recidivism, lowering the risk of rearrest for a new sex offense by 88%. In addition, MnCOSA significantly decreased all four measures of general recidivism, with reductions ranging in size from 49 to 57%. As a result of the reduction in recidivism, findings from the cost–benefit analysis reveal the program has generated an estimated $2 million in costs avoided to the state, resulting in a benefit of $40,923 per participant. For every dollar spent on MnCOSA, the program has yielded an estimated benefit of $3.73. Although difficult to implement, the CoSA model is a cost-effective intervention for sex offenders that could also be applied to other correctional populations with a high risk of violent recidivism.

Does the adapted sex offender treatment programme reduce cognitive distortions? A meta-analysis

PurposeFor the 3.8 per cent of people with intellectual disabilities (IDs) who have offended sexually, the main form of treatment is the group-based, cognitive-behavioural, adapted sex offender treatment programme (ASOTP) that focusses on challenging cognitive distortions condoning sex offending. The purpose of this paper is to provide an evaluation of how effective the ASOTP is at reducing ID sex offenders’ cognitive distortions.Design/methodology/approachThree databases were searched systematically: PsycINFO, MEDLINE and Web of Science. Six studies met the inclusion criteria, yielding 118 participants. Using a random-effects model, effect sizes were calculated using pre- and post-treatment scores on a measure of cognitive distortions. The standardised mean difference (SMD) was 1.77 (95 per cent CI: 1.06, 2.46), which was statistically significant (p<0.001) and “large”. Sensitivity analysis demonstrated that this SMD was robust, and a check for publication bias revealed that it was unlikely that the “file drawer problem” confounded the meta-analysis.FindingsThese results indicated that the ASOTP can significantly reduce ID sex offenders’ cognitive distortions, regardless of treatment length, IQ level, language abilities, or offence type. Consistent with earlier reports, longer treatment resulted in the greatest reductions: the optimum treatment length was 24 months.Research limitations/implicationsThe ASOTP’s current evidence is comprised wholly of case and quasi-experimental studies, none of which employed control groups. This paper highlights how there is a dire need for high-quality experimental evaluation of the ASOTP.Practical implicationsClinicians are advised to continue using the ASOTP as the main treatment for ID sex offenders until the effectiveness of the ASOTP is further examined using randomised controlled trials.Originality/valueThis is the first meta-analytic review of the effectiveness of the ASOTP.

Keep Safe: the development of a manualised group CBT intervention for adolescents with ID who display harmful sexual behaviours

PurposeThe purpose of this paper is to focus on the development of Keep Safe, a manualised group intervention for adolescents with intellectual disabilities (ID) who display harmful sexual behaviour (HSB) as the initial phase of a feasibility study. National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. Aims included taking account of adolescents’ and families’ needs, motivations and practical commitments, integrating best- practice and being accessible and appropriate across different types of services.Design/methodology/approachKeep Safe development progressed from the practitioner/researcher collaborative young sex offender treatment services collaborative-ID through a project team, Keep Safe development group, comprising a range of practitioners with a variety of clinical expertise across services and an Advisory Group of people with ID. An expert-consensus methodology based on the Delphi method was used. The iterative process for the manual draws on the slim practice-based evidence from UK, New Zealand, North America and Australia.FindingsKeep Safe comprises six modules distributed through 36 term-time young people’s sessions, alongside 16 concurrent parental/ carer sessions (some joint). The main focus of Keep Safe is to enhance well-being and reduce harm. Four initial sites volunteered as feasibility leads, and two more were added as recruitment was more difficult than foreseen.Originality/valueNational reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. This study is innovative and valuable given the recognition that research and practice is significantly lacking in this area.

Status quo of German-speaking medical students' attitudes toward and knowledge about central aspects of forensic psychiatry across four European countries

While forensic psychiatry is of increasing importance in mental health care, limited available evidence shows that attitudes toward the discipline are contradictory and that knowledge about it seems to be limited in medical students. We aimed to shed light on this subject by analyzing medical students' central attitudes toward and their association with knowledge about forensic psychiatry as well as with socio-demographic and education-specific predictor variables. We recruited N = 1345 medical students from 45 universities with a German language curriculum across four European countries (Germany, Switzerland, Austria and Hungary) by using an innovative approach, namely snowball sampling via Facebook. Students completed an online questionnaire, and data were analyzed descriptively and multivariably by linear mixed effects models and multinomial regression. The results showed overall neutral to positive attitudes toward forensic psychiatry, with indifferent attitudes toward the treatment of sex offenders, and forensic psychiatrists' expertise in the media. Whereas medical students knew about the term ‘forensic psychiatry’, they showed a lack of specific medico-legal knowledge. Multivariable models on predictor variables revealed statistically significant findings with, however, small estimates and variance explanation. Therefore, further research is required along with the development of a refined assessment instrument for medical students to explore both attitudes and knowledge in forensic psychiatry.

Demographic, mental health, and offending characteristics of online child exploitation material offenders: A comparison with contact‐only and dual sexual offenders

Technological advances have dramatically increased the ability to access, distribute and produce child exploitation material (CEM) online, resulting in increased numbers of individuals being charged with CEM offences. This study examined the demographic, mental health, and offending characteristics of CEM offenders (n = 456) in comparison to child contact sexual offenders (n = 493) and offenders with a history of both CEM and contact offences (dual offenders, n = 256). A robust data linkage methodology was employed to link records from statewide corrections services with policing and mental health records in Victoria, Australia. The results indicated that CEM offenders differed from both contact and dual offenders, and that the groups were primarily differentiated based on two factors: antisocial orientation and sexual deviance. CEM offenders demonstrated high rates of sexual deviance but low rates of antisociality, contact offenders exhibited the opposite pattern, and dual offenders had both high sexual deviance and antisociality. The findings suggest that existing sexual offender assessment and treatment frameworks are unlikely to be suitable for exclusive CEM offenders. The implications for future research are discussed.

Risk-Need-Responsivity applications of the MMPI-2 in sexual offender assessment

ABSTRACTThe present investigation examined the risk, need, and responsivity (RNR) correlates of MMPI-2 scores in a Canadian sample of 349 federally incarcerated sex offenders, followed up prospectively 19 years post-release. In terms of responsivity indicators, more serious profile patterns were associated with younger age, single marital status, lower education, and lower cognitive ability; the scales generally had weak associations with sex offender treatment completion or change. With respect to criminogenic risk and need, Scales F, 4, 6, 8, and 9 and combinations therein had significant associations with structured measures of sex offender risk, and in turn, consistently predicted sexual or violent recidivism over 5 and 10-year follow-ups. Several of these predictive associations were maintained even after controlling for static and dynamic risk factors. Finally, model based clustering of the MMPI-2 scales generated three clusters termed disordered, emotionally distressed, and predominantly antisocial (non-disordered) subtypes. Although comparatively higher rates of violent recidivism were found with the disordered subtype, this group did not have higher levels of risk and need, broadly speaking, than the other subtypes. The RNR implications of the results are discussed in terms of forensic applications of MMPI-2 with sex offender populations.

The impact of sex offender’s interpersonal style, treatment readiness and the therapeutic alliance on treatment gain

The impact of internal responsivity factors and therapeutic process variables on intra-individual within-treatment gain in sex offenders has received little empirical attention. This study examined how (1) internal responsivity factors, including treatment readiness and interpersonal style, and (2) therapy process variables, including the therapeutic alliance and the presence of ruptures in the therapeutic relationship, impacted intra-individual within-treatment gain. Participants comprised 71 sex offenders who participated in group-based sex offender treatment programmes in prison or the community. Results showed that offender hostile-dominance and the affective and interpersonal characteristics of psychopathy, as measured by the Psychopathy Checklist: Screening Version Factor 1 score, negatively impacted treatment gain. Pre-treatment readiness, client ratings of the therapeutic alliance and whether or not there were ruptures in the therapeutic relationship had no association with within-treatment gain. The strength of the therapeutic alliance later in treatment did not moderate the relationship between offender interpersonal style, or psychopathy, and treatment gain.

Sex Offenders: General Information and Treatment

Sex offenders are often neglected by psychiatrists due to a deficiency in training and a lack of knowledge in the area of sexual offenders. Many sex offenders have a comorbid psychiatric illness, including paraphilic disorders. Research has established that sex offenders can be treated with evidence-based principles. Psychiatrists can serve a pivotal role in the evaluation and biological treatment of sex offenders. Together, psychiatrists can work toward primary prevention of sexual violence by learning the requisite skills to identify and treat risk factors of sexual abuse. [ Psychiatr Ann. 2018;48(2):120–128.]

The predictive properties of dynamic sex offender risk assessment instruments: A meta-analysis.

This meta-analysis is the first to our knowledge to evaluate the predictive properties of dynamic sex offender risk assessment instruments, which are designed to assess factors associated with recidivism that are amenable to change. Based on 52 studies (N = 13,446), we found that dynamic risk assessment instruments have small-to-moderate predictive properties, with Cohen's d ranging between 0.71 for sexual recidivism (41 studies, 22 unique samples, N = 5,699) and 0.43 for violent (including sexual) recidivism (27 studies, 14 unique samples, N = 10,368). Incremental predictive validity of dynamic over static risk assessment instruments was significant but modest; Cox hazard ratios varied between 1.08 for sexual recidivism (19 studies, 13 unique samples, N = 3,747) and 1.05 for any recidivism (11 studies, 8 unique samples, N = 2,511). Cox hazard ratios for the predictive validity of change scores on dynamic risk assessment instruments, controlling for static and initial dynamic scores, varied between 0.91 for sexual recidivism (6 studies, 6 unique samples, n = 1,980) and 0.95 for any recidivism (3 studies, 3 unique samples, n = 1,172). These findings indicate that dynamic risk assessment instruments can, in terms of Andrews and Bonta's (2010) risk and need principles, be a useful tool for improving sex offender treatment. They have the potential to contribute to the selection of appropriate, more individually tailored treatment approaches (focusing on individually relevant criminogenic need factors) and can assist in the evaluation of treatment effects. Considering this, further development of dynamic risk assessment instruments is warranted. (PsycINFO Database Record

Public Perception of Sexual Offence: A Comparison

Studies show that, given the opportunity, most people would punish perpetrators of sexual assault more severely than those who commit other personal injury offences (Roberts, 1990). This study will attempt to explain why most people would prescribe harsher punishment to sexual offenders. Participants will take part in answering one of two questionnaires for the purpose of data collection, each with control variables. It is hypothesized that specific factors play a role in the belief that sexual offenders are a greater threat to individual and public safety than other offenders. These hypothesized factors include: risk to individual and public safety, lack of understanding with regard to sexual offences, belief that the offender has a greater likelihood to reoffend than non sexual offenders, and perception that treatment for sexual offending is not effective. Results from the study are anticipated to help explain why sexual offences are often thought to be more deserving of punishment than most other offences. It is anticipated that results will assist in providing a more complete understanding of sexual offences, both in public perception and in treatment.