The use of psychological interventions for adult male sex offenders with a learning disability: a systematic review†

ABSTRACT

There is a drive to attend to the specific treatment needs of sexual offenders with a learning disability (LD) and increasing recognition of treatment limitations in this group. Cognitive behavioural therapy (CBT)-based sex offender treatment programmes (SOTPs) are being increasingly adapted for the LD population. This review systematically considers the evidence base for LD adapted CBT-based SOTPs. Ten studies together comprising 358 participants were reviewed. LD adapted SOTPs were conducted in prisons, secure settings and in the community. Within-treatment findings generally indicated positive cognitive shift, improvements in victim empathy and increased sexual knowledge on psychometric measures. Whilst findings are encouraging, many of the studies have methodological limitations. In particular, all studies used pre-test post-test study designs lacking control groups therefore restricting the evaluation of treatment outcomes. The LD sex offender literature remains underdeveloped and there is a strong case for further research to establish a valid evidence base for treatment.     

Application of the clinical polygraph examination to the assessment,treatment and monitoring of sex offenders

Abstract

Post Conviction Clinical Polygraph Examination Testing (Lie Detector Testing) offers significant opportunities for assessing, treating and monitoring sex offenders. This article briefly reviews the historical development of polygraph techniques including the physiological measures employed, the administration of the polygraph and the interpretation of data collected. Criticisms of polygraphy are explored and information concerning the scientific acceptability of these procedures is given. The current influence of polygraphy in sex offender work is reviewed. Evidence is given of the utility of polygraphy in reducing denial, improving treatment outcomes and more effectively supervising sex offenders on probation or license. Cost benefit considerations are examined, as well as the need for further controlled research and future regulation of the polygraph, if it is to be introduced in Britain. Planned UK Trials are described.     

Sexual offenders’ parental and adult attachments and preferences for therapists’ interpersonal qualities

ABSTRACT

This study explored sex offenders' parental and adult attachment difficulties and assessed the extent to which these were associated with preferences for therapists' interpersonal qualities. One-hundred and twelve adult male child sexual offenders were invited to provide self-report data on their attachment histories, adult attachments and preferences for therapists' interpersonal qualities. A weak relationship between childhood and adulthood secure attachment was found, suggesting that attachment at the time of offending may be more relevant than childhood attachment to the aetiology of sexual offending. Participants valued a range of therapists' qualities previously identified as important for positive treatment change. Therapist trust and genuineness were perceived as particularly important by those with attachment difficulties, demonstrating the need for these qualities in offender programmes where attachment difficulties would be expected. There were some differences in the preferences for therapists' qualities between participants with different adult attachment types, highlighting the importance of responsivity factors in treatment.     

Using context and difference in sex offender treatment: An integrated systemic approach

Summary

The primary objective of this paper is to promote a re-examination of the current use of cognitive-behavioural programmes in work with men who have sexually offended against children or adults and to encourage the application of ideas from the systemic field. In order to support this objective, the paper puts forward and develops the following arguments:

1. That the current content of manualised programmes in this field has been distilled too far and left behind some of the most important principles of the cognitive approach. Returning to the work of Marshall et al (1999), the need for a thorough and broad-based assessment of each individual prior to deciding treatment goals is clearly recommended. Further, there is a need to pay much more attention to differences between, as well as similarities of those who sexually offend.

2. That ideas from within the systemic therapeutic field be integrated within existing approaches to attempt to address some of the limitations of cognitive-behaviour therapy as currently employed. Evidence for the potential benefits of this comes from a broad personal experience of working directly with offenders and consulting to group facilitators.

It is concluded that all therapeutic approaches reach a ‘moment of integration’ (Pinsof, 1994), when their failures are recognised and other approaches are drawn on. It is suggested that this moment may be upon us in this area.     

“A different world” exploring and understanding the climate of a recently re-rolled sexual offender prison

Understanding how sexual offenders experience prison and its environment is important because such experiences can impact on rehabilitation outcomes. The purpose of this research investigation was to explore the rehabilitative and therapeutic climate of a recently re-rolled sexual offender prison. The research took a mixed methods approach and consisted of quantitative and qualitative phases. There were differences between prisoners and staff on their perception of the prison climate and for prisoner and staff relationships. The qualitative results helped to explain the quantitative findings and added a more nuanced understanding of the experience of the prison, the nature of prisoner and staff relationships and the opportunities for personal growth within the prison. The study has important implications for prisons that co-locate sexual offenders and want to provide an environment conducive to rehabilitation.     

Sex offender laws in the United States: smart policy or disproportionate sanctions?

In the 1990s, the United States began enacting a series of laws to monitor and supervise sex offenders living in the community. These evolved to include Internet registries of sex offenders, sex offender residence restrictions, GPS monitoring, and even civil commitment of sex offenders at the conclusion of their criminal sentences. Though other countries have enacted legislation to monitor sex offenders, none have implemented laws impinging on the civil liberties of offenders to the extent of those in the United States. This article examines the basis of the US laws and their challenges, provides an overview of their efficacy, and compares the US approach to those of other countries.     

Female Sex Offenders: A Controlled Comparison of Offender and Victim/Crime Characteristics

The current study was a chart review of 31 female sex offenders (FSO), 31 male sex offenders (MSO), 31 female violent offenders (FO), and 31 male violent offenders (MO) using a 2 (female or male) by 2 (sex or violent offender) design. This is the first known study to employ three control groups when researching female sex offenders. Multiple variables appeared related to gender and crime. However, some variables emerged as FSO specific. They reported the least alcohol abuse history and had fewer admissions of guilt to the crime than the two violent offender samples. More FSOs knew their victim and were biologically related to their victim than MSOs. Lastly, the FSO sample was the least discriminating as to their victim’s gender and had the highest overall rate of sexual victimization.     

Utilizing Criminal History Information to Explore the Effect of Community Notification on Sex Offender Recidivism

While sex offender registration laws with notification provisions are now over a decade old, little is known about how these policies influence the prevention of sex offending. Very few studies have considered the impact of notification on sex offender recidivism or the effect of these laws on sex crimes, generally. This study considers the effectiveness of offender tracking and declaration at the state level through evaluation of current sex offender laws in Arkansas. Using a quasi‐experimental regression‐discontinuity design, this research evaluated the recidivism of the first three waves of sex offenders registered in the state (1997–1999) vs. a comparison group of sex offenders from a decade earlier (1987–1989). Findings indicate there is no statistically significant difference between the two groups in terms of recidivism. Policy implications are discussed.     

Evaluation of the assessment and treatment of a child sex offender: A case study

Abstract

There is indisputable necessity for engaging child sex offenders in effective therapy to reduce recidivist rates. However, it is becoming increasingly recognised that, to do this, more contemporary psychological methods of treatment are being utilised instead of, or as well as, imprisonment.

To establish what constitutes effective therapy requires the constant search for new and successful treatments. To achieve this, it is advantageous to follow preexisting successful methods of treatment but to acknowledge that therapy must be adapted according to an individual's unique presenting difficulties and therapeutic needs.

This paper details assessment techniques, evaluation of psychological dysfunctions, the therapy plan and treatment outcome of a convicted child sex offender. Specifically, Mr X's background history, psychological dysfunctions and progress, using a functional analysis approach, are examined in detail with critical review of the therapeutic intervention.     

Sexual recidivism: A review of static,dynamic and actuarial predictors

The need for accurate risk assessment of sexual offence recidivism has never been greater. It is widely accepted that actuarial risk instruments outperform clinical judgement and the literature has recently witnessed a surge of empirically derived actuarial measures. However, in spite of the increased levels of predictive accuracy, actuarial measures have been criticized as being unrepresentative, lacking specificity, and being heavily reliant on static risk factors without taking into account dynamic risk, psychological emotional states and treatment effects. Rather than offering a critique of the actuarial movement, this paper offers a summary of static and dynamic risk factors associated with sexual offence recidivism as identified from the literature. Implications of incorporating dynamic factors into risk assessments and actuarial measures are discussed.