Effectiveness of a risk–need–responsivity‐based treatment program for violent and sexual offenders: Results of a retrospective,quasi‐experimental study

Purpose

Relapse prevention is an important goal in correctional settings. Although there is strong evidence for the effectiveness of certain treatment programs for juvenile offenders, those for adults lack such evidence. This study evaluated the effectiveness of a risk–need–responsivity (RNR)‐based intervention.

Methods

A quasi‐experimental, observational study design and cox regression analysis were used to compare treated violent and sexual offenders (n = 171) with untreated offenders (n = 241).

Results

Both groups were observed for an average of 7.9 years. Recidivism rates of treated offenders (11.7%, n = 20) were similar to those of control offenders (15.8%, n = 38; p = .25). When controlling for confounding variables, the hazard of recidivism in the treatment group was 5.2% lower than that in the control group. Subdividing the treatment group resulted in lower hazard ratios for offenders still in therapy when released and offenders cancelling therapy. However, none of the group differences was statistically significant.

Conclusion

Our results show that control and RNR‐based treatment groups had comparable recidivism rates with a trend towards a positive treatment effect, especially for people in outpatient treatment. However, criminal history, age at the start of follow‐up, and actuarial risk of recidivism were significantly associated with recidivism. Future research needs to apply elaborate methodological approaches to detect robust treatment effects and consider different criteria of treatment effectiveness. Furthermore, the influence of prison climate, motivational factors, intervention quality, and factors supporting the success of outpatient treatment should be considered in future studies of larger offender samples.     

Utility of the Revised Level of Service Inventory (LSI-R) in Predicting Recidivism After Long-Term Incarceration

Assessing an inmate’s risk for recidivism may become more challenging as the length of incarceration increases. Although the population of Long-Term Inmates (LTIs) is burgeoning, no risk assessment tools have been specifically validated for this group. Based on a sample of 1,144 inmates released in a state without parole, we examine the utility of the Level of Service Inventory-Revised (LSI-R) in assessing risk of general and violent felony recidivism for LTIs (n = 555). Results indicate that (a) the LSI-R moderately predicts general, but not necessarily violent, recidivism, and (b) this predictive utility is not moderated by LTI status, and is based in part on ostensibly dynamic risk factors. Implications for informing parole decision-making and risk management for LTIs are discussed.

Cross-Validation and Extension of the Violence Risk Appraisal Guide for Child Molesters and Rapists

A cross-validation of the Violence Risk Appraisal Guide was performed on a sample of 159 child molesters and rapists followed for an average of 10 years at risk The performance of the instrument was also examined on a 10-yr followup of 288 sex offenders that included both those in the original construction sample for the VRAG and the validation sample. The instrument performed as well as it had in construction for predicting violent recidivism in both the cross-validation and extended followup samples, and moderately well in the prediction of sexual recidivism. Survival analyses showed that child molesters exhibited higher risk of sexual recidivism than rapists or offenders against both children and adults, whereas the opposite was true for violent recidivism. As predicted, psychopathy and phallometrically determined sexual deviance exhibited a multiplicative interaction effect on sexual recidivism. Proportional hazards event history analyses supported the use of the VRAG for the prediction of violent recidivism among sex offenders.     

Criminal recidivism in sexual homicide perpetrators

Forensic psychiatric reports on 166 sexual homicide perpetrators in Germany were retrospectively analyzed for criminal risk factors. Follow-up information about release and reconvictions from federal criminal records was available for 139 offenders; 90 (64.7%) had been released. The estimated recidivism rate (Kaplan-Meier analyses) for 20 years at risk was 23.1% for sexual and 18.3% for nonsexual violent reoffences. Three men (3.3%) were reconvicted for attempted or completed homicide. Only young age at the time of sexual homicide resulted in higher sexual recidivism, whereas increased nonsexual violent recidivism was related to previous sexual and nonsexual delinquency, psychopathic symptoms, and higher scores in risk assessment instruments. Increased recidivism with any violent reoffence was associated with age-related factors: young age at first sexual offence, at homicide, and at release and duration of detention. The impacts of the results for risk assessment, relapse prevention, and supervision are discussed.     

Prospective Replication of the Violence Risk Appraisal Guide in Predicting Violent Recidivism Among Forensic Patients

An exhaustive survey of a cohort of forensic patients provided an opportunity for a prospective replication of the predictive accuracy of the Violence Risk Appraisal Guide (VRAG). Data collected during the original survey also permitted a test of the predictive accuracy of clinical assessments of risk on the same cohort. The VRAG yielded a large effect size in predicting violent recidivism (ROC area = .80) over a constant 5-year follow-up and performed significantly better than averaged clinical opinions. The superiority of the VRAG was also observed at very short follow-up times and for very serious violence. Moreover, for 16 subsamples, observed rates of violent recidivism did not differ significantly from the expected rates. VRAG score was unrelated, and clinical judgments inversely related to violent recidivism in the small low-risk sample of female forensic patients. The authors conclude that, regardless of length of opportunity or severity of outcome, actuarial methods are more accurate than is clinical judgment.     

Predictive accuracy of static risk factors for Canadian Indigenous offenders compared to non-Indigenous offenders: implications for risk assessment scales

ABSTRACT

The over-representation of Indigenous offenders in Canadian prisons highlights the importance of research on the generalizability of potential static risk factors for this group. The current investigation examined whether 87 static indicators currently assessed in Canadian federal prisons were differentially present and related to outcomes (revocations, general recidivism, and violent recidivism) for Indigenous (n?=?1500) and non-Indigenous (n?=?6684) male federal offenders. The follow-up was eight months for revocations and five years for any/violent recidivism. Indigenous offenders scored significantly higher risk than non-Indigenous offenders on the majority of the indicators (particularly criminal history indicators). Generally, most criminal history indicators and some offence severity indicators predicted revocations, general, and violent recidivism for Indigenous offenders; however, several of the indicators had significantly lower accuracy for Indigenous offenders (particularly criminal history indicators). Overall, Indigenous offenders are a higher risk population and several static risk indicators do not perform as well for this group as for non-Indigenous offenders. Nonetheless, there were numerous static indicators that did predict outcomes for Indigenous offenders. The current findings suggest that it is possible to meaningfully assess static risk for recidivism among Indigenous offenders.     

The PCL-R and violent recidivism in a prospective follow-up of a nationwide sample of female offenders

Psychopathy has been linked to violent reoffending in men, but the findings in women have been contradictory. The aim of this study was to examine the predictive validity of the Psychopathy Checklist-Revised (PCL-R) for violent recidivism in a nationwide sample of female violent offenders. The offenders (n = 48) had been assessed by the PCL-R and were followed after their release from prison or a psychiatric hospital. The average follow-up period was 8 years. Of the offenders, 16 (33%) had been reconvicted of a violent crime. Current findings of the performance indicators did not support the use of the PCL-R as a predictive instrument assessing risk of violent recidivism in females. The findings indicate that impulsivity plays a crucial role in female violent recidivism and that the PCL-R should be used with caution in risk assessment with female populations.     

Long-term follow-up of criminal recidivism in young sex offenders: Temporal patterns and risk factors

Abstract

Recent studies indicate that risk for criminal re-offending in identified adult sex offenders may persist decades after the index offence, calling for inquiry into these issues also for younger sex offenders. The author studied temporal patterns for criminal reconvictions and the validity of 16 empirically motivated risk factors for recidivism among all young sex offenders (15–20 years of age) subjected to pre-sentence forensic psychiatric evaluations in Sweden during 1980–1995 (N = 126). The Ss were followed from release and for an average of 115 months. One-hundred-and-seventeen (115 male, 2 female) Ss were available for follow-up with a mean time-at-risk of 80 months. Base rates for sexual and violent non-sexual reconvictions were 30% and 42%, respectively. Using time-at-risk-adjusted hazard ratios derived from Cox regression, characteristics indicative of deviant sexual interest (any previous sex offending behaviour, an index sex offence in a public area, involving a stranger victim, offending on two or more offence occasions, and two or more victims) were found to increase the risk for sexual recidivism. Markers of antisocial lifestyle (early signs of DSM-IV Conduct Disorder and any prior violent conviction), sex offence-related characteristics indicating aggression proneness (use of threats or force and physical victim injury), and victim penetration, increased the risk for violent non-sexual reconvictions. Survival analyses indicated that the rate of sexual reconvictions as a function of time at risk decreased distinctly after 6–7 years whereas the rate for violent non-sexual reconvictions remained largely the same.     

The Relationship Between Gambling Severity and Risk of Criminal Recidivism

Individuals involved with the criminal justice system have the highest prevalence of gambling disorder. Yet, this is an understudied area, especially in relation to postrelease functioning and recidivism risk. Participants (N = 100) were recruited from a local nonprofit organization and a federal probation office. Participants completed both self‐report and interviewer‐administered questionnaires assessing past‐year and lifetime gambling behaviors and problems, legal history, health, and risk of recidivism. Past‐year (8%) and lifetime (18%) rates of gambling disorder among the current sample are significantly greater than those of the general population and similar to rates found in incarcerated populations. Furthermore, 13% of individuals reported a direct relationship between their gambling and crime, and analyses revealed that increased gambling severity was a significant predictor of increased recidivism risk. Results suggest the need for screening and intervention efforts and call for policy reform among incarcerated and ex‐offender populations.     

Predicting dropout from a residential programme for adolescent sexual abusers using pre-treatment variables and implications for recidivism

Abstract

This study addresses the prediction that dropout from a UK specialized residential treatment program for adolescent sexual abusers can be determined from pre-treatment variables. Participants were 49 adolescents aged 12–16?years, who had sexually abused children, peers/adults or both. Of the variables examined, 25 showed a significant association with treatment dropout. A scale, consisting of 20 items, was designed to predict treatment dropout. As a measure it showed internal consistency (alpha?=?0.84) and predictive validity. Treatment dropout was linked to a greater risk of recidivism: offences of a general; violent; and combined violent or sexual nature. Missing data confounded the overall small sample size; therefore, a brief checklist of factors associated with dropout was produced as a guide for treatment managers and clinicians.     

Criminal Recidivism After Forensic Psychiatric Treatment. A Multicenter Study on the Role of Pretreatment,Treatment-Related,and Follow-Up Variables

This study examined associations between criminal recidivism after discharge from forensic treatment and variables related to either the time before the current forensic treatment, or the current forensic treatment, or the follow-up after discharge. Participants were treated in 12 forensic clinics according to section 63 of the German penal code. A patient was classified as a criminal recidivist when the patient or the aftercare reported that the patient was delinquent at follow-up. Patients without criminal recidivism were patients for which both perspectives (patient and aftercare) reported no delinquency at follow-up. Mann–Whitney U-tests and Fisher's exact tests were performed. Data to classify patients were available for N = 249 patients. Fifteen patients (6%) were classified as criminal recidivists. The follow-up was M = 12.58 (SD = 1.84) months, and the criminal acts occurred M = 6.00 (SD = 5.55) months after discharge. Differences between patients with and without criminal recidivism were found in pretreatment (young age at first crime, early onset of mental disorder, previous forensic treatments), treatment-related (disorder due to psychoactive substance use, gradual release abuses, outbreaks, assaults against staff, criminal act during treatment, type of discharge, outcome ratings), as well as follow-up variables (no specified housing situation, not being abstinent from psychoactive substances, inpatient readmission, course of outpatient treatment, course of mental disorder) (all p < 0.05). To conclude, it is important to consider variables related to the time before the current treatment, treatment-related variables, and variables related to the follow-up to identify the patients at risk of criminal recidivism after discharge from forensic treatment.     

Associations between Dating Aggression Involvement and Subsequent Relationship Commitment

Little is known about how an individual’s commitment to their romantic partner evolves over the course of a relationship following involvement in dating aggression (DA). The present study explored longitudinal associations between both psychological and physical DA involvement and subsequent changes in commitment. We hypothesized that experiences of physical and psychological DA may be related to decreased feelings of commitment (including both dedication and constraint) in a relationship, and that gender may moderate the link between DA and changes in commitment. One-hundred and twenty (60 female) young adults (ages 18–25) in a romantic relationship completed electronic questionnaires each month for 6 months, (M age Wave 1?=?22.44, SD =?2.20). DA involvement and commitment were measured by the Revised Conflict Tactics Scale, and the Revised Commitment Inventory, respectively. Using multilevel modeling, the current study examined shifts in commitment (dedication and constraint) following DA involvement. As hypothesized, physical and psychological dating aggression involvement were both associated with declines in relationship commitment. Analyses also tested for potential gender interactions with physical and psychological dating aggression involvement for both constraint and dedication. No significant gender interactions emerged. These findings add to the accumulating evidence for the deleterious effects of dating aggression on relationships, including on relationship commitment, and illustrate important implications for interventions aimed at reducing dating aggression among young adults.

     

Identifying Three Types of Violent Offenders and Predicting Violent Recidivism While on Probation: A Classification Tree Analysis

This study employs classification tree analysis (CTA) to address whether 3 groups of violent offenders have similar or different risk factors for violent recidivism while on probation. A sample of 1344 violent offenders on probation was classified as generalized aggressors (N = 302), family only aggressors (N = 321), or nonfamily only aggressors (N = 717). The strongest predictor of violent recidivism while on probation was whether the offender was a generalized aggressor or not, with generalized aggressors more likely to be arrested for new violent crimes. Prior arrests for violent crimes predicted violent recidivism of generalized aggressors, but did not significantly predict violent recidivism of family only and nonfamily only aggressors. For generalized aggressors and family only batterers, treatment noncompliance was an important risk predictor of violent recidivism. CTA compared to logistic regression classified a higher percentage of cases into low-risk and high-risk groups, provided higher improvement in classification accuracy of violent recidivists beyond chance performance, and provided a better balance of false positives and false negatives. The implications for the risk assessment and domestic violence literature are discussed.     

Psychopathy (PCL-R) Predicts Violent Recidivism Among Criminal Offenders with Personality Disorders in Sweden

Psychopathy as conceptualized with Hare's Psychopathy Checklist Revised, PCL-R, has attracted much research during the 1990s. In the Scandinavian countries, few studies that empirically support the validity of North American risk assessment techniques in our regional context have been published. The purpose of this paper is to explore the predictive power of the PCL-R in a population of personality-disordered violent offenders subjected to forensic psychiatric evaluation in Sweden. Following release from prison (n = 172), discharge from forensic psychiatric treatment (n = 129), or probation (n = 51), a total of 352 individuals were followed for up to 8 years (mean = 3.7 years) with reconviction for violent crime as endpoint variable (base rate 34%). As the estimate of predictive power, the area under the curve of a receiver operating characteristic (AUC of ROC) analysis was calculated. For PCL-R scores to predict 2-year violent recidivism, AUC of ROC was .72 (95% CI: .66–.78). In addition, the personality dimension of psychopathy (Factor 1) and the behavioral component (Factor 2) both predicted 2-year recidivism significantly better than random: AUC of ROC .64 (95% CI: .57–.70) and .71 (95% CI: .65–.77), respectively. We conclude that psychopathy is probably as valid a predictor of violent recidivism in Swedish forensic settings as seen in previous North American studies.     

Violent Sex Offenses: How are They Best Measured from Official Records?

In the United States, sexually violent predator (SVP) commitment statutes generally require assessment of an offender's risk of subsequent sexual violence. Current actuarial methods for predicting sexual reoffending were actually designed to predict something else—charges or convictions for offenses deemed sexual based on information obtained from police “rapsheets” alone. This study examined the referral and past offenses of 177 sex offenders. Results showed that police rapsheets (and data based on them) underestimated the number and severity of sexually motivated violent offenses for which sex offenders were actually apprehended. Rapsheet violent offenses seemed a more accurate index of the conduct addressed by SVP legislation than were rapsheet sex offenses. We suggest that, when evaluating sex offenders for SVP status, actuarial instruments designed to predict violent recidivism (as measured by rapsheet violent reoffenses) might be preferable to those designed to predict sexual recidivism (as measured by rapsheet sexual reoffenses).

The impact of pre-treatment responsivity and treatment participation on violent recidivism in a violent offender sample

This study assessed whether pre-treatment responsivity (psychopathy, motivation to attend treatment, denial and minimisation of offending behaviour, and feelings of guilt or shame) predicted violent recidivism and/or moderated the effectiveness of a violence intervention programme. Participants were 114 male violent offenders who were referred to a structured violent offender group treatment programme; 84 offenders commenced the programme. Results showed that treatment completion did not have a significant main effect on recidivism but that psychopathy scores moderated the effects of treatment. Offenders with high scores on the Psychopathy Checklist: Screening Version (PCL:SV) who were rated as having good engagement with treatment, or who completed treatment, had similar violent recidivism rates compared to offenders with low PCL:SV scores. In contrast, offenders with high PCL:SV scores who dropped out of treatment or were poorly engaged had significantly higher rates of violent recidivism. These findings indicate that treatment effectiveness could be enhanced, and greater reductions in recidivism achieved, if programmes find ways to engage and maintain psychopathic offenders in treatment.     

A Time Series Modeling Approach in Risk Appraisal of Violent and Sexual Recidivism

For over half a century, various clinical and actuarial methods have been employed to assess the likelihood of violent recidivism. Yet there is a need for new methods that can improve the accuracy of recidivism predictions. This study proposes a new time series modeling approach that generates high levels of predictive accuracy over short and long periods of time. The proposed approach outperformed two widely used actuarial instruments (i.e., the Violence Risk Appraisal Guide and the Sex Offender Risk Appraisal Guide). Furthermore, analysis of temporal risk variations based on specific time series models can add valuable information into risk assessment and management of violent offenders.     

The criminal career of men convicted of rape: evidence from a Norwegian national cohort

The extent to which sexual offenders are a group separate from other types of offenders has been debated for many years and investigated from different perspectives. The present study investigated similarities and differences regarding socio-economic background, criminal history and recidivism involving new crimes between rape offenders and three other groups: other sexual offenders, non-sexual violent offenders and other offenders. Data came from Norwegian population registers containing information on all crimes investigated from 1992 to 2012. The sample consisted of all persons convicted in 2002 and 2003 (N = 36,951). Background characteristics and estimated recidivism risk was described using hazard models. Results indicated that men convicted of rape (n = 142) had lower levels of education and that a higher percentage of them were on social benefits compared to the other crime groups. A large majority (79%) of rape-convicted men had previous convictions. Rape offenders were considerably more criminally active and diverse than the other crime groups. Prior criminal record, irrespective of type, increased the risk of recidivism in general. Controlling for other background characteristics did not alter this outcome. Treatment of convicted rapists needs to take into consideration that this offender group has much in common with violent offenders in general.     

The long term recidivism risk of young sexual offenders in England and Wales– enduring risk or redemption?

PurposeTo examine the long-term sexual recidivism risk of juvenile sex offenders in England and Wales, and to compare the risk to that of a first time sexual offense for non-convicted juveniles. Additionally, the study explores the long term sexual recidivism risk of other types of juvenile offenders, and the long term violent recidivism risk of these groups.MethodsThe England and Wales Offenders Index was used to extract birth cohort data. Life table methods were used to estimate cumulative recidivism risk, and discrete time hazard models were used to compare hazard functions.ResultsAt the five year period, 7% of juvenile sexual offenders have been reconvicted of a sexual offense; reaching 13% by the end of the 35 year follow-up. When the reconviction hazard of the juvenile sexual offenders was compared with the first sexual conviction risk of a non-convicted comparison group, the hazards converged statistically after 17 years.ConclusionsThe study has implications for the registration periods of juvenile sex offenders. Indefinite registration for some juveniles needs to be considered, and a review of registration after a conviction free period would provide more balance between the protection of the public and the rights of the offender.     

Follow-up of a social skills training (SST) for juvenile delinquents: effects on reoffending

Objectives

To examine (1) the long-term effects on reoffending of an individual SST for juvenile delinquents in The Netherlands and (2) whether effects differ by demographic and offense history characteristics.

Methods

The present study is a follow-up of a matched control study comparing post-treatment effects of N?=?115 juveniles receiving Tools4U, an SST with a parental component, to N?=?108 control group juveniles receiving treatment as usual (TAU). Analyses were conducted separately for delinquents and truants. Effects in terms of recidivism were assessed using official delinquency data after 6 and 12 months and 1.46 years after SST termination. Percentage of recidivists, number of re-arrests, and violent recidivism were outcome variables.

Results

Overall, 39% of the juveniles reoffended, and there were no differences between Tools4U and TAU on any of the selected recidivism outcomes. Additionally, demographic and delinquency characteristics and post-treatment effects did not moderate effectiveness.

Conclusions

Tools4U was not more effective than TAU in preventing recidivism, which may be explained by a generally low percentage of recidivists. With established treatment integrity, and a lack of well-researched effective treatment alternatives, Tools4U could still be a reasonable treatment option for adolescent onset juvenile offenders, although more research is needed to confirm this.