Eye movement desensitisation and reprocessing for offence-related trauma in a mentally disordered sexual offender

Abstract

Research demonstrates a high incidence of offence-related trauma in mentally disordered offenders convicted of violent and sexual offences. The adaptive information processing (AIP) model offers a theoretical framework for understanding the hypothesised relationship between offence-related trauma and reoffending. Evidence suggests that for a sub-population of offenders presenting with offence-related trauma: (1) therapy may retraumatise them, and (2) unresolved trauma severely blocks the positive benefits of talking therapies. Thus, it is postulated that traumatised violent and sexual offenders may be released into the community when they are still at risk of reoffending. A single case study is presented, which describes the application of eye movement desensitisation and reprocessing (EMDR) for a sexual offender presenting with offence-related trauma, whose offences occurred in the context of serious mental disorder. The identification of offence-related trauma and subsequent resolution of trauma symptomatology are discussed in regard to effective offender rehabilitation. Furthermore, the idiosyncratic nature of offence-related trauma and the application of the standard EMDR protocol for a single traumatic event are considered.     

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.     

Predictors of sex offender treatment dropout: psychopathy,sex offender risk,and responsivity implications

Abstract

We examined sex offender treatment dropout predictors, in particular, the relationship of psychopathy and sex offender risk to treatment dropout in a sample of 154 federally incarcerated sex offenders treated in a high intensity sex offender treatment program. Demographic, criminal history, mental health and treatment-related data as well as data on risk assessment measures including the Static 99, Violence Risk Scale – Sexual Offender version (VRS-SO), and Psychopathy Checklist – Revised (PCL-R) were collected. Logistic regression and discriminant function analyses were used to identify predictors that made significant and unique contributions to dropout among all the variables under study. The Emotional facet of Factor 1 of the PCL-R and never being married were found to be the most salient predictors of treatment dropout and correctly identified about 70% of the cases. The implications of the findings for managing treatment dropout and for the treatment of psychopathic offenders are discussed.     

Child sex tourism: extending the borders of sexual offender legislation

Child sex tourism, the act of traveling to engage in sexual acts with minors, plagues developing nations worldwide. Several laws have been passed internationally in recent years designed to curtail this practice. Government entities and human rights organizations have driven these efforts. United States citizens represent a significant proportion of participants in child sex tourism. The PROTECT Act of 2003 prohibits United States citizens from participating in sexual acts with minors while traveling, and establishes extraterritorial jurisdiction. The case of Michael Lewis Clark, the first United States citizen convicted under this legislation, is highlighted. Child sex tourism poses unique issues to courts that will require ongoing clarification as challenges arise. This article discusses potential future challenges, describes strategies to address this problem, and relates this issue to psychiatry. Mental health providers may have the role of evaluating both the victims and perpetrators of child sex tourism. The authors propose a classification system for offenses and an initial list of topics to discuss with victims. The authors also describe the proper mechanism for reporting United States citizens suspected of participating in child sex tourism.     

The predictive and convergent validity of a psychometric battery used to assess sexual offenders in a treatment programme: an 18-year follow-up

Abstract

This study examined sex offender risk and treatment change based on a battery of psychometric assessment measures administered to 267 treated adult Canadian federal sex offenders followed up an average 18 years post release. Several significant pre–post changes that were frequently moderate in magnitude (d>.50) were observed across these measures. A factor analysis of the psychometric battery generated three broad need domains consistent with the extant literature that were labelled Socioemotional Functioning, Anger/Hostility, and Misogynist Attitudes. The three need domains and a Need Total, created by their summation, converged with the Violence Risk Scale—Sexual Offender version (VRS-SO; Wong, Olver, Nicholaichuk, & Gordon, 2003) in conceptually meaningful ways and predicted sexual and violent recidivism to varying degrees. Raw measurements of change obtained from pre-to posttreatment frequently bore weak and non-significant relationships to outcome. However, after creating standardised residual change scores to control for pre-treatment score, treatment changes in the individual measures, need domains and Need Total improved significantly in their prediction of reductions in general and sexual violence.     

Factorial analysis of risk matrix 2000 on an Italian sample of sexual offenders

ABSTRACT

In order to assess the internal structure of Risk Matrix 2000 in an Italian sample of 308 adult males convicted for sex abuse, a principal component analysis with Promax rotation was performed. The results identified a structure with three factors that explained 53.8% of the total variance: the first factor concerned items referred to the criminal career of the offender; the second factor concerned the age of onset in committing crimes; the third factor was more strictly related to the offenders' attitude towards the sex crime/s, and reflects the aggravating items of the S scale. These results allows us to have the first validated tool on an Italian sample for assessing the level of risk for recidivism.     

A cognitive-based indicator of deviant sexual interest: Concurrent validation of the Stroop task

ABSTRACT

One of the strongest predictors of sexual recidivism is sexual deviance [Hanson, R. K., & Bussière, M. T. (1998). Predicting relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical Psychology, 66, 348–362. doi:10.1037/0022-006X.66.2.348]. Phallometric testing, the most commonly used method of assessing sexual deviance, has elicited methodological and ethical criticisms, while self-report is vulnerable to social desirability and poor insight. To overcome these limitations, researchers have utilised cognitive measures, including a modified Stroop task, to measure deviant sexual interests among sex offenders using victim selection as a comparison measure. However, the results have been inconclusive. The current study explored the validity of the modified Stroop task as a measure of deviant sexual interest among a non-offending sample of 570 females and 223 male participants, using self-report as the comparison measure. The results indicated a significant gender difference in concurrent validity; there was a significant relationship between self-reported deviance and deviant word Stroop performance for male but not for female respondents, suggesting the Stroop is a viable option for assessing sexual deviance among males. Implications of these findings are discussed relative to sexual recidivism risk assessment.     

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.     

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.     

Exploring the criminal histories of stranger sexual killers

Although sexual homicide is receiving increasing research attention, few studies have examined the criminal histories of sexual killers in any detail. This study examined the criminal histories of 81 British stranger sexual killers to determine whether they were generalist, specialists or both and whether their criminal histories reflected violent, sexual, marginality and over control pathways. Results found most stranger sexual killers were generalist offenders and sexual homicide was part of a varied criminal repertoire and non-sexual crimes predominate. This ‘antisocial orientation’ means future offending may not be limited to sexual violence. Criminal histories reflected the violent, sexual, marginality and over control pathways, but offenders in the violent pathway were more criminally orientated. The clinical and investigative implications of these findings were considered as they suggest knowledge of the criminal histories of stranger sexual killers is an important consideration for criminal justice professionals.     

The sex offender next door: deconstructing the United States' obsession with sex offender registries in an age of neoliberalism

In the 1990s, against the backdrop of an ascending Age of Neoliberalism, sex offender registration statutes were passed in the United States. These laws require law enforcement officials to utilize computer technologies in order to publicly identify individuals who have been convicted of sexual offenses. In this study, we conducted in-depth interviews with twenty-four respondents who were forced to register as sex offenders. All of these participants resided within Southeast Texas, which is arguably one of the most punitive regions within the United States. The vast majority of the sample reported moderate to severe forms of harassment as a result of being outed as sex offenders via computer technologies. We conclude that in the post-Keynesian United States, the Web-based monitoring of sex offenders will continue to remain a popular American pastime and may even expand to other industrialized democracies throughout the world.     

Some notes on the validation of VRS-SO static scores

ABSTRACT

The present study was a psychometric examination of Violence Risk Scale-Sexual Offender version (VRS-SO; Wong, S., Olver, M. E., Nicholaichuk, T. P., & Gordon, A. (2003 Wong, S., Olver, M. E., Nicholaichuk, T. P., & Gordon, A. (2003). The violence risk scale: Sexual offender version (VRS-SO). Saskatoon: Regional Psychiatric Centre and University of Saskatchewan. [Google Scholar]). The violence risk scale: Sexual offender version (VRS-SO). Saskatoon: Regional Psychiatric Centre and University of Saskatchewan) static item scores in a Canadian multisite sample of 668 treated adult male sexual offenders. Exploratory factor analysis (EFA) of 13 nonredundant Static-99R and VRS-SO static items generated three factors labelled Youthful Aggression, Sexual Criminality, and General Criminality. The factor and total scores converged with Static-99R and VRS-SO dynamic factor scores. Scores on the VRS-SO static items, EFA-derived factors, and total score each significantly predicted 5- and 10-year sexual, violent, and general recidivism through ROC analyses. Cox regression survival analyses showed all three factors uniquely predicted sexual recidivism to varying degrees in the overall sample; however, only Youthful Aggression and General Criminality uniquely significantly predicted violent and general recidivism in the overall sample and among sexual offender subgroups. Implications for theory, clinical practice, and instrument refinement are discussed.     

Actuarial risk assessment and recidivism in a sample of UK intellectually disabled sexual offenders

Abstract

This study examines the effectiveness of three risk assessment instruments: Static-99, Risk Matrix 2000 (RM2000) and the Rapid Risk of Sex Offender Recidivism (RRASOR), in predicting sexual recidivism among 27 intellectually disabled sex offenders. The overall sexual offence reconviction rate was 30%, while non-recidivists remained offence-free over 76 months of follow-up. Static-99 presented as performing as well as guided clinical judgements in mainstream population studies [area under the curve (AUC)=0.64] exceeding the performance of RM2000 (AUC=0.58) in predicting sexual recidivism. However, the results were not statistically significant. In contrast to previous findings, the RRASOR presented the worst level of prediction (AUC=0.42). These results highlight the need to investigate further with larger sample sizes and in conjunction with more dynamic measures of risk. Proposed relevant factors are discussed in detail.     

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.     

Exploring the role of locus of control in sex offender treatment

Abstract

This study aims to investigate the concept of Locus of Control (LoC) and its relationship to risk, personality disorder and treatment outcome in sexual offenders. The sample was taken from referrals to a community treatment service for sexual offenders in south-east London. One hundred and eighty-five men completed a measure of LoC at the time of assessment, of whom 74 entered the treatment programme and 39 completed a post-treatment LoC measure. At assessment, child molesters and non-contact offenders had a significantly more external LoC than rapists, and LoC was also significantly associated with cluster A and C personality disorder traits, as well as the presence of traits in two or more personality disorder clusters. LoC was not associated with risk measures or compliance with treatment. Once outliers were removed, a significant change was seen in post-treatment LoC scores, with most change occurring in an increasingly internal direction.     

Screening for mental disorder using the UK national offender assessment system

Probation officers have large caseloads with high levels of psychiatric morbidity but receive minimal training in recognising/managing mental health problems. In the UK, there is no national screening procedure for mental illness among offenders that is considered effective. This study’s aim was to develop a screening system for mental/personality disorders using the Offender Assessment System. Seven screens for mental disorder were developed using items from assessments on 574 prisoners: alcohol misuse, drug dependence, antisocial personality disorder, psychopathy, learning difficulties, psychosis and severe mood disturbance. Internal validation showed that the screens performed well across accuracy estimates. Prevalence of mental disorders identified with the screens in test and validation samples was similar. However, the psychopathy and severe mood disturbance screens may be more effective in screening for true negatives. The screens are an economical method for prioritising mental health needs of the UK prison and probation population using routinely collected data.