The treatment of sexual offenders in Canada: An update.

Surveyed 22 Canadian programs for sex offenders by means of site visits and questionnaires issued to program directors. Collectively, these programs provided services to more than 1,500 sex offenders annually. Programs varied considerably in size (7–250 clients), duration (3–36 mo), and intensity (1–33 hrs per wk). Assessments were typically multimodel, involving interviews, file reviews, and psychological testing. Similarly, the treatment services provided by most settings included a variety of behavioral, cognitive-behavioral, and psychodynamic approaches. On average, each program targeted 17 different risk factors. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The sexual preferences of incest offenders.

Inclusive fitness theory suggests that discriminative solicitude and inbreeding avoidance are important mechanisms regulating parent–children interactions. From an inclusive fitness perspective, sex with one's biological children is paradoxical. The authors hypothesized that incest can occur when these mechanisms are not activated (e.g., if a father is uninvolved in child rearing) or are overwhelmed by another factor, such as pedophilic interest. They predicted that biological fathers, who presumably have been the most involved in the rearing of their victims, would show greater phallometrically measured pedophilic interest than would other incest offenders against children (e.g., grandfathers, uncles, stepfathers). The prediction was not supported. A testable alternative hypothesis to explain biological father incest is presented and the importance of assessing pedophilic interest among incest offenders is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating adolescent sexual offenders.

A significant number of sexual offenses are committed by adolescents. This article addresses clinical and ethical issues to be considered by the clinician in assessing adolescent sexual offenders. Issues in the treatment of adolescent sex offenders are discussed. A treatment program based on a cognitive behavioral model is described and follow-up data are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of mentally disordered offenders.

However narrowly defined, mentally disordered offenders (MDOs) are heterogeneous in demographics, diagnoses, offense characteristics, risk, and clinical needs. Treatment planning for MDOs should begin with an assessment of risk of future violent behavior in the community and risk of violence toward self or others inside an institution. Purposes of treatment among MDOs include treatments both to reduce risk of future violence and to alleviate the mental disorder. Relevant outcome measures include criminal and violent behavior, psychiatric symptomatology, admission to correctional or psychiatric facility, and quality of life. Clinical problems include aggression and problems of institutional management, criminal propensity, life skills deficits, substance abuse, active psychotic symptoms, social withdrawal, and depression. Because evidence relating them to risk of future violence is highest for the first 4 problems, it is argued that inpatient treatments should especially target them. Whenever risk levels and legal circumstances permit, community treatment is to be preferred. Sex offenders are discussed as a group for whom specialized services are indicated.… (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The treatment of juvenile homicide offenders.

This article describes psychodynamic treatment of juvenile homicide offenders whose lethal violence is the result of severe developmental deficits. The 3 major tasks of treatment are to reduce fear, to develop and strengthen ego functions, and to understand and accept the social, emotional, and legal consequences of homicide. The role of regression in treatment is discussed, as are the issues of grief and guilt. The child's family may also need assistance in dealing with the same issues, and the role of family therapy is discussed. Recommendations are made for assessing risk and termination and transition criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators of change for multisystemic therapy with juvenile sexual offenders.

The mediators of favorable multisystemic therapy (MST) outcomes achieved at 12 months postrecruitment were examined within the context of a randomized effectiveness trial with 127 juvenile sexual offenders and their caregivers. Outcome measures assessed youth delinquency, substance use, externalizing symptoms, and deviant sexual interest/risk behaviors; hypothesized mediators included measures of parenting and peer relations. Data were collected at pretreatment, 6 months postrecruitment, and 12 months postrecruitment. Consistent with the MST theory of change and the small extant literature in this area of research, analyses showed that favorable MST effects on youth antisocial behavior and deviant sexual interest/risk behaviors were mediated by increased caregiver follow-through on discipline practices as well as decreased caregiver disapproval of and concern about the youth’s bad friends during the follow-up. These findings have important implications for the community-based treatment of juvenile sexual offenders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relapse prevention, offense process models, and the treatment of sexual offenders.

Is the extraordinary popularity of relapse prevention with sex offender treatment providers justified? Introduced 20 years ago, relapse prevention dominates the field of sexual offending, despite its clear limitations. Two of its major legacies are scrutinized closely: the relapse model and the use of relapse prevention as a treatment framework. Despite its practical value, relapse prevention's widespread adoption has obscured its limitations as a model of the offense process and in treatment design. Recent research on sexual offense processes is reviewed, and the self-regulation model (Ward & Hudson, 2000) is examined for its ability to provide a more complete understanding of sex offenders' treatment needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating the therapeutic community and work release for drug-involved offenders. The CREST Program

As the nation's first therapeutic community (TC) and work release center for drug involved offenders, CREST combines the basic elements of both modalities into an effective agent for behavioral change. This article explores the ways in which these elements are integrated and applied, and the outcome of such treatment as determined by subsequent substance abuse and criminal activity. Clients entering the program from prison progress through several phases of counseling, group interaction, confrontation, and education before they enter the work release phase, where they gain realistic experience and can implement what they learned in the TC concerning living drug free. Follow-up data collected at 6 and 18 months after entry into the program indicate that CREST clients have significantly lower relapse and recidivism rates than a comparable comparison group. CREST has similar effects on relapse and recidivism across sexes, racial/ethnic groups, and different age categories, although length of time in treatment and whether clients graduated do impact outcome variables.     

The accuracy of recidivism risk assessments for sexual offenders: A meta-analysis of 118 prediction studies.

This review compared the accuracy of various approaches to the prediction of recidivism among sexual offenders. On the basis of a meta-analysis of 536 findings drawn from 118 distinct samples (45,398 sexual offenders, 16 countries), empirically derived actuarial measures were more accurate than unstructured professional judgment for all outcomes (sexual, violent, or any recidivism). The accuracy of structured professional judgment was intermediate between the accuracy found for the actuarial measures and for unstructured professional judgment. The effect sizes for the actuarial measures were moderate to large by conventional standards (average d values of 0.67–0.97); however, the utility of the actuarial measures will vary according to the referral question and samples assessed. Further research should identify the psychologically meaningfully factors that contribute to risk for reoffending. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing indicators of sexual sadism as predictors of recidivism among adult male sexual offenders.

Objective: In this longitudinal study, the predictive validity of a psychiatric diagnosis of sexual sadism was compared with three behavioral indicators of sadism: index sexual offense violence, sexual intrusiveness, and phallometrically assessed sexual arousal to depictions of sexual or nonsexual violence. Method: Five hundred and eighty six adult male sexual offenders were assessed between 1982 and 1992, and these offenders were followed for up to 20-years postrelease via official criminal records. Assessment information included the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis, offense characteristics, phallometric assessment results, and an actuarial risk measure (the Sex Offender Risk Appraisal Guide). Results: Predictive validity was demonstrated in univariate analyses for the behavioral indicators of sexual sadism (area under the curve [AUCs] from .58 to .62) but not psychiatric diagnosis (AUC = .54). Cox regression analyses revealed that phallometrically assessed sexual arousal to violence was still significantly associated with violent (including sexual) recidivism after actuarially estimated risk to reoffend was controlled. A psychiatric diagnosis of sexual sadism, in contrast, was unrelated to recidivism. Conclusions: The results support the use of more behaviorally operationalized indicators of sexual sadism, especially phallometric assessment of sexual arousal, and suggest the DSM criteria for sexual sadism require further work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative reanalysis of aggregate data on IQ in sexual offenders.

General intelligence has been the most commonly studied neuropsychological characteristic of sexual offenders for over 70 years. Results, however, have been highly inconsistent. To assess whether sexual offenders score lower in IQ than nonsexual offenders and to explore which sexual offense characteristics relate to IQ, the authors reanalyzed all reports providing sufficient information. Data spanned 236 samples, comprising 25,146 sexual offenders and controls. The literature contained sufficient information to permit comparison of adult versus juvenile sexual offenders, offenders targeting children versus adults, offenders targeting their own versus unrelated children, and offenders targeting boys versus girls. Results confirm the association between IQ and sexual offending and suggest that previous discrepancies are attributable to how many pedophilic individuals were in each sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary typology designed for treatment matching of driving-while-intoxicated offenders.

A typology of 156 convicted driving-while-intoxicated (DWI) offenders was developed using cluster analysis and external validation procedures. The typology was derived from 4 variables (alcohol dependence severity, psychiatric severity, bad-driving index, and social instability) selected to maximize the feasibility of performing treatment matching with DWI offenders. Five clusters that suggested specific treatment matching opportunities were identified. The largest, Cluster 4 (31% of cases), showed a low problem profile. However, a moderate-severity group (Cluster 1), a high-risk driver group (Cluster 2), and 2 high problem-severity groups (Clusters 3 and 5) were also found. Clusters 3 and 5 had high levels of alcohol dependence and psychiatric symptoms but differed significantly on social instability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of high-risk alcohol consumption in young offenders on community orders: Policy and treatment implications.

The present study examined the relationship between a set of individual and contextual variables and high-risk alcohol use among young offenders placed on community orders in New South Wales, Australia. Participants (n = 777) were compared on a set of factors known to be strong predictors of high-risk alcohol use among adolescents. The authors assessed the strength of the relationship between gender, age, ethnicity, geographical region of residence, school attendance, father absence, history of childhood trauma, and the presence of severe conduct disorder on weekly levels of alcohol use. Living in rural locations, not currently attending school, being female, and not having been raised with a biological father present were associated with significantly increased odds of alcohol abuse. Father absence was a more important risk factor for rural young offenders, but school dropout was associated with more hazardous drinking among young offenders in urban areas. Accordingly, the authors suggest family-focused intervention programs for young offenders living in rural areas and school-based programs for vulnerable young people living in urban areas, although programs should consider including both factors for both groups if feasible and warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The treatment of sex offenders: Risk management and good lives.

How would a good lives model of sex offender treatment differ from a risk-need model? In the good lives model, risk factors are viewed as obstacles that erode individuals' capacities to live more fulfilling lives. The therapeutic focus is thus on implementing offenders' good lives plans rather than simply managing risk. To develop our argument, we first outline the risk-need approach and briefly comment on its core assumptions. We then present the good lives model and discuss the clinical utility of an integrated approach by way of a case example. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of two community alternatives to incarceration for chronic juvenile offenders

The relative effectiveness of group care (GC) and multidimensional treatment foster care (MTFC) was compared in terms of their impact on criminal offending, incarceration rates, and program completion outcomes for 79 male adolescents who had histories of chronic and serious juvenile delinquency. Results show that boys who participated in MTFC had significantly fewer criminal referrals and returned to live with relatives more often. Multiple regression analyses showed that assignment to a treatment condition (i.e., GC or MTFC) predicted official and self-reported criminality in follow-up beyond other well-known predictors of chronic juvenile offending (i.e., age at 1st offense, number of previous offenses, age at referral).     

Group treatment for child sexual abuse.

Describes a 12-wk group therapy program used with more than 50 preadolescent children (aged 7–12 yrs) who have experienced intrafamilial sexual abuse. A cotherapy model is used. 90-min group sessions consist of 4 parts: circle time, focused activities, diary time, and snack. Activities are designed to highlight (1) development of trust, cohesiveness, and safety; (2) identification and labeling of feelings; (3) discussion of family relationships and family changes; and (4) exploration of issues associated with the offender. Sessions also examine legal issues and concerns and focus on self-esteem enhancement, social skills development, sex education, prevention of future abuse, and termination issues. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical fitness training and counseling as treatment for youthful offenders.

Two groups of 30 randomly selected males (15 yrs 5 mo to 18 yrs 6 mo) in a state industrial school for youthful offenders were administered pre- and posttreatment a battery of physiological and psychological measures by an exercise physiologist and a psychometrist. Measures included tests of cardiovascular fitness and muscle strength/endurance as well as the Self-Esteem Inventory, State-Trait Anxiety Inventory, and Beck Depression Inventory. The experimental group received a systematic physical fitness program delivered by counselors for 1.5 hrs/day, 3 days/wk, for 20 wks. Treatment included a counseling model previously used with delinquent adolescents. MANOVAs revealed significant differences between the groups on pretest measures in favor of controls. Significant differences on the posttest measures were found in favor of experimental Ss. Univariate analysis identified the areas of difference both physiologically and psychologically. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)