Treatment programmes for adolescents who commit sexual offences: Dropout and recidivism

This paper reviews the state of research into treatment programmes for adolescent sexual offenders, focusing first on treatment dropout, then on recidivism studies. Pre-treatment variables, which may predict dropout from programmes for these adolescents, have hardly been considered, despite obvious financial and ethical implications. In relation to recidivism studies, these have been carried out quite consistently since the mid 1980s, yet, as is discussed, they still suffer from many methodological problems. The authors also note that research into treatment programmes comes almost exclusively from North America. Thus, such research needs replicating with UK samples in order to assure the applicability of any research findings to this population.     

A human rights-based practice framework for sexual offenders

Abstract

Human rights create a protective zone around people and allow them the opportunity to further their own valued personal projects without interference from others. In our view, the emphasis on community rights and protection may, paradoxically, reduce the effectiveness of sex offender rehabilitation by ignoring or failing to ensure that offenders’ core human interests are met. In this paper we consider how rights-based values and ideas can be integrated into therapeutic work with sex offenders in a way that safeguards the interests of offenders and the community. To this end we develop a rights-based normative framework (the Offender Practice Framework: OPF) that is orientated around the three strands of justice and accountability, offender needs and risk, and the utilization of empirically supported interventions and strength-based approaches. We examine the utility of this framework for the different phases of sex offender practice.     

Using wilderness therapy in treating adolescent sexual offenders

Abstract

This article describes a follow-up study of 14 adolescent sexual offenders who had attended a community treatment programme. A core component of their treatment included outdoor wilderness group therapy. Interviews were conducted with adolescents and parents and tapped several areas including social skills and peer relationships, victim empathy, cognitive distortions, safety plans and coping with high risk situations, sexual offending cycle, perceived level of risk, intimacy and sexuality. The study also examined the child protection service records of the It adolescents. Data from child protection service computer records showed that none of the adolescents had reoffended. Interviews with adolescents and families focusing particularly on the wilderness component of the programme showed positive changes.     

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.     

The big 5 dimensional personality approach to understanding sex offenders

Abstract

Although previous research has reported that the incarceration of sex offenders does not significantly reduce re-offending, there is no adequate theory guiding remedial programs for this population. The aim of the present study was to examine whether normal personality variation provides useful theoretical insight into the nature of sex offences against children. The Revised NEO Personality Inventory (NEO PI-R), a measure of the five-factor model (FFM) of personality, was administered to 64 males incarcerated for child sex offences. Sex offenders were categorised into different offender groups comprising incest within the immediate family, incest within step-family and extra familial offence. A comparison group of 33 non-offender males also completed the NEO PI-R. Results indicated that the sex offender groups were significantly higher in Neuroticism and significantly lower in Extraversion and Conscientiousness compared to the non-offender group. Significant differences between the sex offender groups and comparison groups for NEO PI-R facets were also found. The implications of these findings in terms of early identification and treatment are discussed.     

Sexual offenders with learning disabilities: risk,recidivism and treatment

Abstract

While the literature on the assessment, treatment and management of non-learning disabled sexual offenders is well established, it is only in recent years that researchers and clinicians have focused on sexual offenders with learning disabilities. In contrast to mainstream sex offender treatment programmes, there are few evaluated community-based treatment programmes for sexual offenders with learning disabilities, and of the small number of published studies that describe treatment programmes, most are based on small samples and few have been validated empirically. Sexual offenders with learning disabilities differ from their non-disabled counterparts in several important ways, having implications for management and treatment. Due to methodological differences between studies, the prevalence of sexual offending by men with learning disabilities is not clear. However, in some studies, the sexual recidivism rate of offenders with learning disabilities is 6.8 times and 3.5 times that of non-disabled sexual offenders at 2- and 4-years’ follow-up, respectively. Sexual offenders with learning disabilities are also at greater risk of re-offending in a shorter time period. There remains an urgent need for further research into the assessment of risk and whether components from mainstream treatment programmes can be adapted to meet the needs of learning disabled sexual offenders. Approaches to working with sexual offenders with learning disabilities and programme development are discussed.     

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.     

Hope in the treatment of sexual offenders: the potential application of hope theory

Abstract

The present paper attempts to demonstrate how hope theory is conceptually consistent with current positive approaches to sexual offender treatment. Hope theory and its components of goals, pathways thinking, and agentic thinking is reviewed as defined by Snyder and his colleagues. A theoretical relationship exists between the role of hope and many aspects of sexual offending and treatment. Developmental course, attachment style, and the formation and maintenance of coping styles are reviewed as they relate to hope and sexual offending. A framework by which to apply hope theory to pre-treatment, treatment, and more specifically, self-management or relapse prevention for sexual offenders is proposed. Emphasis is placed on the use of techniques that target hope components, particularly in pre-treatment programs.     

Arbitrary decision making in the absence of evidence: an examination of factors related to treatment selection and recidivism for female sexual offenders

ABSTRACT

As criminal justice professionals are asked to assign risk levels and treat females who sexually offend, identifying risk factors for recidivism prediction and treatment targets is important. Although the majority of risk and treatment studies have focused on males, general female offender research and developing research with female sex offenders both provide some evidence for possible factors related to sexual offending behaviour in women. The purpose of this study was to explore what possible factors were related to treatment selection in a sample of 506 females serving prison sentences for a sexual offense, and, in turn, to examine which factors predicted non-sexual and sexual recidivism. Results demonstrated that exploratory variables were significantly related to treatment selection, as opposed to variables previously supported in research. Furthermore, living with a significant other for more than two years, and prior sexual offending arrests predicted sexual recidivism, while decreased age and treatment participation predicted non-sexual recidivism. These findings indicate that while similarities between male and female sexual offenders exist, females still demonstrate gender-specific risk factors.     

The effectiveness of relapse prevention training in a group of incarcerated child molesters

Abstract

A sample of child molesters participating in the U.K. prison sex offender treatment programme (SOTP) were required to complete a relapse prevention questionnaire before and after treatment. Results indicated that there were significant improvements in both awareness of risk situations and coping strategies, as measured by this instrument, through treatment. Nine months after the end of treatment most agreed to complete the questionnaire again. Those who had shown significant changes in terms of reduction of pro-offending attitudes through treatment maintained their RP skills. Men whose attitudes had not changed, although evidencing good RP skills at the end of treatment, were found to have lost these. This was most noticeable among men who had been released into the community and who had undergone a relatively short amount of therapy on the original SOTP (80 hours). These results indicate that RP training is only really useful where individuals have genuinely changed through treatment; and that the RP training should only be undertaken as part of an extensive treatment programme covering all areas of offending behaviour.     

Experiences of engaging in psychotherapeutic interventions for sexual offending behaviours: A meta-synthesis

Abstract

This meta-synthesis explores individuals' experiences of engaging in psychotherapeutic interventions for sexual offending. The findings of ten qualitative studies were integrated and five over-arching concepts emerged: (1) incentives and inhibitions: to engage or not to engage?; (2) help or hindrance: the impact of others in therapy; (3) the abused and the abuser: perspectives for transformation; (4) struggling and striving: dealing with distress and difficulties and (5) what works: inside and outside. A line of argument derived from these concepts is proposed as a framework for understanding sex offenders' experiences of therapy and highlights aspects of treatment programmes that need further exploration or emphasis. Using qualitative accounts can improve the responsiveness of treatment programmes, but such research is currently limited. Future qualitative studies and reviews could help further improve the effectiveness of treatment programmes, and thereby reduce the rate of sexual reoffending.     

A qualitative investigation of treatment components for families of youth who have sexually offended

ABSTRACT

Traditional treatment approaches for youth who commit sexual crimes are generally understudied and lack consideration for youths’ evolving context and development. A holistic model is important in service delivery, whereby multiple socio-ecological risk and protective factors are targeted in treatment. Family treatment, a key component of holistic practices, has not been well-defined for families of youth who have committed sexual crimes. Better understanding of the practical techniques used in service agencies can inform family services for youth. Using an inductive grounded theory approach, this qualitative study interviews service providers (N?=?19) to understand components of family treatment. Findings suggest components including problem solving, communication skills, and working through the pain meet certain goals of restructuring and uniting families. The therapeutic relationship was a component that meets all goals of family treatment and helps families and youth overcome stigma of sexual offending. Findings have implications for developing and testing models of family treatment for sexually abusive youth.     

Issues in the treatment of asian sexual offenders

Abstract

This aper considers the scant literature in the field of child sexual abuse in Asian families, and reports the authors' involvement with four male Asian sexual offenders. The therapeutic approach used with the offenders is described, and clinical themes arising from their treatment are identified. Issues and difficulties in therapy are discussed, in particular personal issues arising for the therapists. It is concluded that Asian sexual offenders are a group who have been neglected in the literature and in treatment, partly, perhaps, because they are infrequently referred to treatment services in comparison with non-Asian sexual offenders. Particular therapeutic issues relating to the treatment of immigrant Asians who do not speak English are raised and further research needs are identified in relation to this patient group.     

The relationship between risk,deviance, treatment outcome and sexual reconviction in a sample of child sexual abusers completing residential treatment for their offending

Abstract

The study investigated the relationship between static and dynamic risk and reconviction in a sample of child sexual abusers who had completed a long-term residential treatment programme for their sexual behaviour problems. Results found that only High/Very High risk men as measured by a static risk assessment schedule (Risk Matrix 2000) were reconvicted for sexual offences (17% over a 2-year period, 42% over a 5-year period). Results also showed that it was generally men who were rated as a high level of dynamic risk that were reconvicted for a sexual offence (13% versus 5% over a 2-year period; 44% versus 10% over a 5-year period). The study also indicated the benefits of residential treatment for such High risk/High Deviance men in that no men who left the programme having responded to treatment had been reconvicted for sexual offences at either follow-up period.     

Geographical access to treatment for sex offenders under community supervision in Kentucky

Abstract

As sex offenders are probated or paroled into the community, sex offender treatment and monitoring is often a condition of their release. In Kentucky, sex offenders are required to participate in community-based treatment for two years or more. However, some sex offenders are disadvantaged in accessing mandated treatment. This is a result of decisions concerning the placement of treatment programmes, the sex offenders' preference to return to communities where they can rely on family and other indigenous support networks, and some statutes (e.g. sex offender registration and residency restriction laws). This study utilises spatial methodologies, including an origin–destination (OD) matrix, to determine the time, in minutes, that sex offenders travel to sex offender treatment providers and non-spatial ordinary least squares (OLS) regression techniques to determine the association between family, neighbourhood and community characteristics on sex offenders’ travel time to treatment. Findings suggest that there is substantial disadvantage in treatment access, measured by travel time, for sex offenders who live in impoverished rural communities.     

How to train your dragon: an introduction to the special issue on treatment programmes for high-risk offenders

The plot of the popular movie How to Train Your Dragon includes several features that are paralleled in the efforts of programme designers and treatment providers who work with the highest risk offenders in criminal justice systems. This introduction to the special feature on programmes for high-risk offenders notes that there are important differences in how treatments are provided for offenders with varying levels of risk, need, and responsivity. It asks if what is known about effective offender intervention – much of it derived from moderately risky offenders – applies to those who are thought to be at high risk of new criminal activity. It observes that the relative lack of intervention theory for these offenders provides an important justification for a feature that focuses primarily on describing a range of these interventions and their theoretical underpinnings. The papers that follow are then introduced.     

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.     

Sleep apnea as a possible factor contributing to aggression in sex offenders

Sleep disorders, such as obstructive sleep apnea (OSA), are often unrecognized and undertreated. A disruption in normal sleep may be associated with increased irritability and aggression. To elucidate further the impact of OSA on hostility of forensic patients, we performed a retrospective chart review of 10 consecutive outpatient sex offenders who were diagnosed with OSA and treated with continuous positive airway pressure (CPAP). The Buss-Perry Aggression Questionnaire was compared pre- and posttreatment. Following treatment, the total Buss-Perry score was significantly lower, with lower scores on the anger, physical aggression, hostility, and verbal aggression subscales. These results suggest that in sex offenders suffering from OSA, aggression and hostility may be significantly reduced through CPAP treatment. Further investigation is required to investigate if reducing aggression and hostility in this manner impacts recidivism and overall functioning.     

Therapist characteristics in the treatment of sexual offenders: Tentative data on their relationship with indices of behaviour change

The present study examined the relationship between reliably identified therapist characteristics and treatment-induced changes in sexual offender treatment programmes in English prisons. The results indicated that 10 therapist features predicted beneficial changes in coping skills, perspective-taking, and relationship difficulties. A confrontational style, on the other hand, was negatively related to increased competence in coping. The results are discussed in terms of their research and clinical implications.