1
Natasha: Good job. I am glad you wrote on a topic of interest to you. You have
addressed all my concerns. Final grade=A
...
2
A) Introduction
The purpose of this paper is to discuss the best treatments for male sexual offenders as
proven by empir...
3
regardless of the nature of their offense. Yet, they still believed that young sexual offenders
deserved more punishment...
4
limiting the freedom of sexual offenders. This increase reflects increased public pre-occupation
with controlling sexual...
5
2013, Wong et al., 2013). This means that both sexual and non-sexual offenders can potentially
benefit from programs and...
6
Though they fall into the two offenses defined above, the Federal Bureau of Investigation
does not define molestation an...
7
unable to consent. These statistics are likely understated, though, because only 16% of rapes are
reported to law enforc...
8
Like adults and children, strangers do not victimize most teenage sexual assault victims. Related
to this fact is the fi...
9
intensities of anti-social behavior that can be measured using the Hare Psychopathy Checklist
Revised, known as the PCL-...
10
to have sexual desires that are considered socially unacceptable and taboo (Gretton et al., 2001;
Hanson & Yates, 2013;...
11
dependents (wife, children) who will be impacted by their negative decisions or consequences
such as loss of income due...
12
Once an assessment tool is selected it should be used to determine the risk, or likelihood,
that the offender will reci...
13
Once an assessment is done, an understanding should have been developed regarding
whether an offender is low-risk, medi...
14
may last for a longer period of time. These are just examples but they illustrate that treatment for
high-risk offender...
15
al., 2013; Stalans, 2004). This does not, however, mean that risk-assessment is not useful and
should not be conducted....
16
2013). Treatment should last for at least 6 months for these offenders (Sperber et al, 2013).
Following this pattern is...
17
Many studies conducted on the impact of behavioral therapy have found that they can
lead to improvements in sexual offe...
18
Lipsey et al, 2001; Nunes & Jung, 2012; Schaffer et al, 2010). The latter attempts to accomplish
it by teaching appropr...
19
deficiencies in the thought processes of sexual offenders that contribute to their criminogenic
needs, desires and acti...
20
of many studies that have been conducted on and found support for Cognitive Behavioral
Therapy (Ho & Ross, 2012; Lipsey...
21
examples of tested treatments, but they show how relapse prevention therapy targets triggers that
sexual offenders sugg...
22
more likely to commit violent and sadistic crimes than those who are not psychopaths (Gretton et
al, 2001; Wong et al, ...
23
deviant desires. Some are of these treatments are similar to those provided to non-sexual
offenders in that they are ps...
24
recidivism rates of those who are being chemically castrated to those of offenders who aren’t.
Yet, it is criticized be...
25
Though more research needs to be done on the topic, existing evidence illustrates that these
sexual-offender specific p...
26
A 2009 survey revealed that the Good Lives Model is used in around 30% of treatment
programs for sexual offenders (Hans...
27
sufficient evidence, though, to generally support the contention that such therapies and services
can prevent sexual re...
28
Bibliography:
1. Justin S. Campbell, Paul Rogers , Lindsay Hirst & Michelle Davies (2011) An Investigation
Into the Eff...
29
17. Lovins, B., Lowenkamp, C. T., & Latessa, E. J. (2009). Applying The Risk Principle To Sex
Offenders: Can Treatment ...
of 29

NatashaMoses_RecommendedSexualOffenderTreatment-Final

Published on: Mar 3, 2016
Source: www.slideshare.net


Transcripts - NatashaMoses_RecommendedSexualOffenderTreatment-Final

  • 1. 1 Natasha: Good job. I am glad you wrote on a topic of interest to you. You have addressed all my concerns. Final grade=A Name: Natasha Moses Professor: Dr. Latessa Course: Demonstration Project Assignment: Demonstration Project Outline Date: November 9, 2013 Recommended General and Specific Treatments for Sexual Offenders as Demonstrated through Analysis of Empirical Evidence Abstract: The purpose of this research project is to explore and recommend general and specific treatment options for male sex offenders. The paper begins by describing the public and political attitudes that foster research on curing sex offenders. We then will discuss statistics concerning sexual offending within the United States. This is followed by exposure of the factors that are correlated to sexual offenders. Next, we delve into general and sex-offender specific treatments and expose the factors that cause them to be successes or failures. Lastly, we summarize our findings about our recommendations of the most promising programs. Limitations of our paper will be addressed, as well as proposals for needed research related to male sex offending.
  • 2. 2 A) Introduction The purpose of this paper is to discuss the best treatments for male sexual offenders as proven by empirical, scholarly evidence. Evidence suggests that society has a general pre- occupation with this particular subset of offenders (Meloy et al., 2013; Rogers et al., 2011; Rogers and Ferguson, 2011). Research conducted and laws passed over the last several decades suggest that this pre-occupation has been increasing. This increase in the amount and severity of legislation serves the purpose of exerting additional control over sexual offenders to prevent recidivism (Meloy et. al, 2013). Studies conducted on public perception towards this issue suggests that sexual offending is a pervasive issue in American society, typically considered one of the most serious offenses that one can commit. The public tends to view sexual offenders as a special class of criminal, one deserving of some of the harshest forms and longest duration of punishment. The reverse trend is true for non-sexual offenders, suggesting that sexual offenders might be considered a special class of criminal (Meloy et al., 2013; Rogers et al., 2013; Rogers and Ferguson, 2011). While there have not been many studies closely studying public perception of sexual offenders, the research that does exist suggests that the public holds harsher views of sexual offenders in relation to citizens and non-sexual offenders. The public prefers that sexual offenders receive sentences that offer more punishment than rehabilitation or treatment. This is in opposition to their views about non-sexual offenders who they believe should receive sentences comprised more of rehabilitation than punishment. These trends were true regardless of the offender’s age, race and ethnicity. However, society appears to have a belief that juvenile sexual offenders are generally more deserving of rehabilitation than adult sexual offenders
  • 3. 3 regardless of the nature of their offense. Yet, they still believed that young sexual offenders deserved more punishment over more rehabilitation than non-sexual offenders of the same age. Occupation was also correlated to the extent of these beliefs as those in law enforcement felt similarly, while those in more liberal professions like nursing and human services believed to a lesser extent that sex offenders should receive more punishment than rehabilitation (Rogers et al., 2013; Rogers and Ferguson, 2011). Moreover, the evidence also implies that this may be a long-standing view about sexual offenders. These beliefs persist despite evidence that sexual offenders who recidivate are more likely to commit non-sexual offenses than sexual one. The few studies conducted on public perception of sex offenders span the course of several decades. This enabled them to measure and compare the views of individuals of different ages, mindsets and generations (Meloy et al., 2013; Rogers et al., 2013; Rogers and Ferguson, 2011). Studies conducted recently had results that were extremely similar to those discovered during a study conducted in the 1960s. Other studies have found similar results, with one proclaiming that this viewpoint has existed from at least the 1960’s until the 1990s (Rogers and Ferguson, 2011). However, as is true of the social sciences there were differences in the extent to which these viewpoints were observed. Given that they believe in more punishment and less rehabilitation, this paper examines the impact of different punitive and rehabilitative sanctions on sex offender recidivism. Doing so will enable us to determine the level of support, if any, for the public’s opinion on the most appropriate distribution of punishment for sexual offenders (Meloy et al., 2013; Rogers et al., 2013; Rogers and Ferguson, 2011). The increase in legislation concerning sexual offenders also contributes to this paper’s focus on sexual offenders. Over the last several decades, there has been increasing legislation
  • 4. 4 limiting the freedom of sexual offenders. This increase reflects increased public pre-occupation with controlling sexual offenders. One example is the sex offender registry that requires sex offenders to register the addresses at which they live so that citizens can be aware of their residency in a particular neighborhood (Meloy, 2013; Worrall, 2007). Some laws may require a sex offender to remain imprisoned even after they have completed their term if they are determined to still be a threat to the community (Meloy, 2013). Others make it more difficult for sexual offenders to contact children via the Internet. There are also laws restricting where they can live and their opportunities to be in the presence of children (Worrall, 2008). Some states allow for the chemical castration of sexual offenders. On one extreme, the state of California gives offenders the choice of whether to be physically castrated to remove the sexual urges that contribute to their deviant behavior (Stalans, 2004; Worrall, 2008). It is this public and political preoccupation with sexual offenders that has caused them to be the focus of this and many other studies concerning sexual offenders. Over the last several decades, many research and scholarly efforts have been conducted to better ascertain what – if anything - triggers, treats and cures sexual offenders. The conclusions gathered from these studies imply that sexual offenders are not a completely separate and unique class of criminal. Some of the factors and treatments that are correlated to sexual offending are also correlated to non-sexual offending (Gretton et al., 2001; Hanson & Yates, 2013; Illescas & Genoves, 2008; Sperber, 2013; Stalans 2004). Behavioral therapy, for example, could be used to lessen the anti- social personality traits that contribute to criminal behavior in both sexual and non-sexual offenders (Gretton et al., 2001; Hanson & Yates, 2013; Illescas & Genoves, 2008; Sperber et al., 2013; Stalans 2004). Sexual offender’s likelihood of sexual re-offending should be assessed to determine the intensity, amount and length of such services (Lovins et al., 2009; Sperber et al.,
  • 5. 5 2013, Wong et al., 2013). This means that both sexual and non-sexual offenders can potentially benefit from programs and services aimed towards these factors. It would be remiss, though, to ignore evidence suggesting that sexual offenders may need some customized treatments as they may fail to respond to certain treatments provided to non- sexual offenders. One example of such a treatment that is recommended specifically for sexual offenders is treatment that addresses their tendency to deny committing the offense (Stalans, 2004). Biochemical and pharmacological treatments are specific sexual offender treatments that attempt to remove their intrinsic, deviant sexual desires (Worrall, 2008). Both of these treatments are recommended due to multiple studies illustrating their successful impact on factors correlated specifically to sexual offending. This is unsurprising, however, in that there are no sanctions that will universally punish, deter and rehabilitate every offender – sexual or not. Ultimately, this paper explores the best general and specific programs that target factors associated with sexual offending (Stalans, 2004; Worrall, 2008). B) Sex Offending Statistics Before recommending proven treatments for sex offenders it is first necessary to assess the extent of the problem within the United States. Sex Offenders can generally be divided by the acts that they commit and the age of the their victims. According to the Federal Bureau of Investigation (FBI), Sex Offenses (except forcible rape, prostitution, and commercialized vice) are offenses against chastity, common decency, morals, and the like. Incest, indecent exposure, and statutory rape are included. Attempts are included.” Forcible Rape is defined as “The carnal knowledge of a female forcibly and against her will. Rapes by force and attempts or assaults to rape, regardless of the age of the victim, are included. Statutory offenses (no force used ― victim under age of consent) are excluded” (Federal Bureau of Investigation, 2012).
  • 6. 6 Though they fall into the two offenses defined above, the Federal Bureau of Investigation does not define molestation and pedophilia specifically (Federal Bureau of Investigation, 2012). Molestation can refer to penetrative or non-penetrative acts against children by an adult who is at least five years older than the child while the latter refers to penetrative or non-penetrative acts against pre-pubescent children (Child Molestation Research & Prevention Institute, 2013; University of California, Davis Department of Psychology, 2013). While both terms may be used interchangeably, it is noted that child molesters and pedophilia are two separate, but not mutually exclusive, sexual offenders. Pedophiles are regarded as having a psychological defect that partially explains their sexual preference for pre-pubescent children. A child molester who is not actually sexually attracted to children may not be a pedophile. A child molester who molests a child past pre-pubescent age also does not meet the definition of a pedophile. Though it seems all pedophiles are automatically child molesters, this is not the case because not all pedophiles act upon their urges and sexual thoughts of molesting children. Other sex offenders include exhibitionism, voyeurism and forcing others to participate in non-penetrative acts such as masturbation. Official U.S. statistics reveal that rape is a pervasive issue in American society. Unsurprisingly, the vast majority of rape victims are women. According to a study commissioned by the U.S. Department of Justice (DOJ) in 2007, at least 112 million – of 18% - of American women have been raped in their lifetime. One quarter of female sexual assault victims reported that their assailants were strangers in 2010. For forcible rape, the figure totaled 81,280 in 2009 alone. However, the number of forcible rapes that were committed has remained relatively stable over the past decade, ranging between 79,000 and 82,000 per year. Forcible rape includes rape with force, rapes using drugs and those where the person was incapacitation or
  • 7. 7 unable to consent. These statistics are likely understated, though, because only 16% of rapes are reported to law enforcement. Research reveals that sexual offending is also a prevalent occurrence against adolescents and children. Like adults, the vast majority of adolescent victims are female. At least 1.8 million children have been victims of sexual assault according to a study conducted in 1998. It is estimated that approximately 33% of girls and 14% of boys will be abused during their childhood. The DOJ reveals that there were 63,000 cases of child sexual abuse reported to various U.S. monitoring agencies in 2010 alone. In 2010 9.2% of children who were being monitored for maltreated were determined to be victims of sexual abuse. Many of the victims knew their offenders because most are acquaintances, immediate family members or extended relatives (Department of Justice, 2013; Meloy et al, 2013). This is changing, though, as social media and the Internet are being increasingly used to commit sexual offenses against children such as sending obscene materials. One example is a survey conducted between October 2001 and July 2002 that revealed that three-fourths of child sexual abuse victims were not initially familiar with their assailant because they met them on an Internet chat room (Department of Justice, 2013). Statistics also reveal that teenagers comprise a substantial proportion of sexual assault victims. In 2010 alone, there were 188,380 reported rapes or sexual assaults of a person at least 12 years of age. Young adults appear to be particularly vulnerable to assault. One-third of sexual assaults happens when the victims is between the ages of 12 and 17. More specifically for those under the age of 18, children between the ages of 12-15 have the highest percentage of sexual abuse. Young adults aged 16 to 19 year olds also have rates of rape, attempted rape and sexual assault that 3 ½ times more likely than the general population (Department of Justice, 2013).
  • 8. 8 Like adults and children, strangers do not victimize most teenage sexual assault victims. Related to this fact is the finding that more than two-thirds of teen sexual assaults occur in their residence or in the residence of their assailant. Moreover, this group also reports high rates of inappropriate sexual exposure and solicitation from adults while browsing online and in chat rooms. The figures for both children and adolescents are also likely to be understated since only 30% of these overall crimes are reported to authorities. Regardless, available statistics illustrate that sexual offending is troubling, undeniable issue that must be prevented to the benefit of the children, adolescents and young offenders whose lives are permanently destroyed and altered by the acts of these offenders (Department of Justice, 2013). C) Characteristics and Traits of Sex Offenders Before discussing and assessing the best treatments for offenders, it is first necessary to describe the criminogeic factors that may contribute to their offending. Evidence suggests that having an antisocial personality is one of the strongest predictors of sexual offending for adults, juveniles and adolescents. This is unsurprising since it is also a strong predictor of whether an individual commits any type of crime, including those that are non-sexual. The United States National Institutes of Health (NIH) defines antisocial personality disorder as a “mental health condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights of others. This behavior is often criminal” (National Institutes of Health, 2013). Anti- social Personality Disorder is also sometimes referred to as Psychopathy, or being a Psychopath. There is dissention, however, over whether the conditions are the same. Nevertheless, anti-social individuals exhibit traits such as superficiality, glibness, lying, compulsive behavior, manipulative actions and callousness (National Institutes of Health, 2013). Anti-social individuals are commonly and disproportionately represented in prison. There are varying
  • 9. 9 intensities of anti-social behavior that can be measured using the Hare Psychopathy Checklist Revised, known as the PCL-R. Evidence shows that anti-social sexual offenders recidivate more quickly, frequently and more violently than other offenders once they are released from prison. PCL-R exams reveal that psychopathy is a frequent occurrence for various types of sex offenders, including rapists, child molesters and those who commit various types of sexual offenses (Gretton et al., 2001; Harkins et al., 2012). Testing of general samples of rapists revealed that 40% to 50% suffer from psychopathy. For child molesters, it was determined that 10% to 15% are psychopathic (Gretton et al., 2001). Moreover, psychopathic sexual offenders are more likely to recidivate with violent and sadistic offenses (Gretton et al., 2001; Harkins et al., 2012). Research indicates that the more psychopathic an individual is (as determined by the PCL-R), the more likely they are to recidivate violently (Harkins et al., 2012). Quinsey et. al’s study found that 80% high psychopathy rapists and child molesters recidivated violently in comparison to only 20% of their low psychopathy rapists and child molesters. Adolescent and juvenile sex offenders are also frequently psychopathic (Greton et al., 2001; Hanson et al., 2005; Hart-Kerkhoffs et al., 2009). This is true not only because psychopathy appears in childhood, but also because many adult sex offenders committed their first sex offenses when they were children (Greton et al., 2001; Hanson et al., 2005). Like anti-social personality, having sexually deviant thoughts is also a strong predictor of offending (Gretton et al., 2001; Hanson & Yates, 2013; Scalora & Garbin, 2003 Stalans, 2004; Wong et al., 2013). Sexually deviant thoughts include, but are not limited to thoughts involving children, rape and fetishism (Hanson and Morton-Bourgon, 2005; Scalora & Garbin, 2003). Several studies have found that it is common for adolescent, juvenile and adult sexual offenders
  • 10. 10 to have sexual desires that are considered socially unacceptable and taboo (Gretton et al., 2001; Hanson & Yates, 2013; Stalans, 2004; Wong et al., 2013). Many commit sexual offenses after acting on these urges. In fact, one such study reported that a large percentage of child molesters who recidivated had sexually deviant fantasies shortly before committing their new offense (Stalans, 2004). Some believe that sex offenders who act upon engrained sexual desires and fantasies, such as pedophilic and psychopathic sexual offenders, cannot be cured. This is because these urges and desires are static and unchangeable (Harkins et. al, 2012; Rogers & Ferguson, 2011). Anti-social personality is also correlated to sexual offending in adolescents and juveniles. Adolescents, adults and juveniles with both psychopathy and anti-social personality are extremely more likely to commit violent sexual and non-sexual offenses, and to offend in general (Gretton et al., 2001; Hanson & Morton-Bourgon, 2005; Harkins et al., 2012; Illescas & Genoves, 2008). Other factors linked to sexual offending are related to the individual’s upbringing, current status in society and cognitive deficiencies. Contrary to popular belief, only certain factors related to an individual’s childhood are correlated to sexual offending. Having strained relationships with parents and feelings of isolation, for example, are highly correlated to sexual offending (Kim et. al, 2012). Being sexual abused as a child, however, is neither highly correlated to sexual offending nor sexual recidivism. Another factor that is weakly correlated is the overall childhood upbringing of the offender. Rather, it appears that the individual’s current state that is a stronger predictor. Individuals who have less to lose are more likely to recidivate and resist treatment. Examples of individuals who are stereotypically considered as having less to lose are those who are unemployed, low-income, single, childless and who already have criminal records (Stalans, 2004). These individuals have lower status, ties to the community and
  • 11. 11 dependents (wife, children) who will be impacted by their negative decisions or consequences such as loss of income due to incarceration or lowered employment prospects after incarceration. Cognitive dynamic factors include difficulty in managing anger and emotions, denial and minimization of the impact of the crime and inability to obtain pro-social intimate relationships (Gretton et al., 2001; Hanson & Bourgon, 2005; Harkins et al, 2013; Kim et al, 2012; Schaffer et al, 2010; Stalans, 2004; Wong et al, 2013). D) The Role of Risk Assessment Though sex offenders are usually considered a unique type of criminal, evidence suggests that they may benefit from treatments that work for non-sexual criminals. Firstly, sex offenders are similar to other offenders in that their propensity to re-offend should be assessed (Harkins et al, 2012; Lovins et al., 2009; Sperber et al, 2013; Wong et al., 2009). Like other offenders, sex offenders can generally be classified as low-risk, moderate-risk and high-risk using diagnostic tools. The Level of Service Inventory–Revised (LSI-R) is a primary, validated risk-assessment tool for offenders (Sperber et al, 2013). The Violence Risk Scale – Sexual Offender Version (VRS-SO) is another tool and is used to determine the likelihood of and level of treatment needed to prevent violent offenses. There are many other diagnostic tools (Wong et al., 2009). However, there is no risk-assessment that can definitively determine whether an offender will re- offend. This is because neither the absence nor presence of risk factors guarantees whether an offender will commit further offenses. Nevertheless, evidence still implies that they should be a required precursor to assigning offenders to treatment. Assessment is critical to determining the type, frequency and duration of the treatments that will be provided to each individual offender (Hanson & Yates, 2013; Harkins et al., 2013; Lovins et al., 2009; Sperber et al, 2013; Wong et al., 2009).
  • 12. 12 Once an assessment tool is selected it should be used to determine the risk, or likelihood, that the offender will recidivate. This can be accomplished by measuring the extent to which the offender has exposure to factors that are empirically correlated to criminality. Factors are either static or dynamic, with the former being fixed and the latter being changeable (Harkins et al., 2012; Sperber et al, 2013; Wong et al, 2013). An example of a static factor that is correlated to criminality is being a man since men are more likely to participate in criminal activities. Being unemployed, on the other end, is a dynamic factor that is linked to criminality and can be changed by obtaining employment. Dynamic factors are sometimes called causal factors. Unsurprisingly, treatment programs should generally be directed at these dynamic, causal factors since they can actually be changed (Sperber et al, 2013; Wong et al, 2013). The differences between low-risk and high-risk treatment are the amount, frequency and intensity of treatment (Hart-Kerkhoffs et al, 2009; Hanson & Yates, 2013; Wong et al, 2013). Some of the treatments that are given to offenders are individual psychoanalysis and group counseling. They are usually given to offenders to address the underlying issues that are contributing to the criminal activity, such as emotional disturbance, lack of developmental support and poor self-control. For example, treatment might be given to an individual who identifies that they molest children because they were molested as children. Therapy might seek to acknowledge, minimize and heal the pain and impact of such child molestation, the hope being that this will prevent recidivism in the future. Treatment can also refer to the type of services that an offender receives once they are released from prison since treatments like counseling can be given outside of prison walls (Hanson et al., 2009; Illescas & Genoves, 2008; Stalans, 2004).
  • 13. 13 Once an assessment is done, an understanding should have been developed regarding whether an offender is low-risk, medium-risk or high-risk. Like general offenders, an offender’s risk level should influence the intensity of the services they should receive (Harkins et al., 2012; Sperber et al, 2013; Wong et al, 2013). Evidence suggests that low-risk offenders should receive less-intensive services. This is for several reasons. Firstly, that a person is designated as a low- risk offender means that they are not likely to re-offend regardless of whether they are given treatment. Moreover, evidence implies that low-risk offenders may be more likely to re-offend when they receive treatments for high-risk offenders (Hanson & Yates, 2013; Sperber et al, 2013; Wong et al., 2013). This is backed by several studies examining the most appropriate treatment members for general and sexual offenders. Giving low-risk offenders the same treatment as high-risk offenders means, then, that resources within the criminal justice system are being used ineffectively and unsuccessfully to address a problem. Similarly, high-risk sexual offenders should receive the highest level and most intensive level of treatment like general high-risk offenders. Evidence implies that the highest-risk offenders may need the most intensive and frequent treatment because they may be influenced by a greater number of criminogenic features. Like lower-risk offenders, they can also be successfully treated using various types of therapy (Hanson & Yates, 2013; Sperber et al, 2013; Wong et al., 2013). However, they might need therapy several times more per week or month than their lower-risk counterparts. Though the purpose and design of the treatment might be the same, the number of and depth with which issues that are targeted might vary substantially. Therapy aiming to address the impact of childhood sexual abuse on the decision to molest children might address not only how it impacts the offender now, but how it influenced them throughout their entire life. This therapy may occur 3 times per week or as frequently as that given to low-risk offenders but
  • 14. 14 may last for a longer period of time. These are just examples but they illustrate that treatment for high-risk offenders should ideally be more intensive than that given to low-risk. Ultimately, meta-analytical research implies that risk assessment is a required precursor to any sexual offender treatment. However, risk assessment has its limitations and criticisms. One limitation is that even the most effective, empirically based risk assessments are not definitive (Hart-Kerkhoffs et al, 2009; Hanson & Yates, 2013; Wong et al, 2013). Though they should measure criminogenic factors, neither the presence nor absence of a factor guarantees whether a person will or will not engage in criminal activity. There have been examples of low-risk offenders recidivating, as well as of high-risk offenders not recidivating after release from prisons. Other limitations are that certain offenders - such as psychopaths – possess traits that may lie about historical or present circumstances so that they can falsely convince assessors that they are a lower risk level than they actually are (Harkins et al, 2012; Illescas & Genoves, 2008). Additional limitations abound concerning the ability to implement such assessment programs since they and the treatments they prescribe can be resource intensive. Resources include everything from funding, labor that administers the assessments and programs, rooms in which to administer assessments and adoption of appropriate risk assessment tools. Unfortunately, the criminal justice system constantly has insufficient resources. Though there have been increases in some resources in recent years, they have been accompanied by increases in the overall prison population (Worrall, 2008). This calls into questions the utility and practicality of risk assessment measures - especially since they are not guaranteed to be accurate. Other limitations and criticisms of risk assessment must also be acknowledged. Regardless of the type of offender, research implies that it is generally difficult to determine what offenders will be high-risk and the correct mixture of treatment for them (Hanson et al., 2009; Sperber et
  • 15. 15 al., 2013; Stalans, 2004). This does not, however, mean that risk-assessment is not useful and should not be conducted. Actually, evidence suggests that risk-assessment is required for treatment programs to be successful. Successfully completing a risk-assessment requires assessment of the existence and extent of factors correlated to criminality and re-offending. Examples of such factors include upbringing, educational attainment, anti-social behavior, income and low self-control (Hanson et al., 2009; Hanson & Yates, 2013; Harkins et al, 2012; Hart-Kerkhoffs et al, 2009; Illescas & Genoves, 2008; Sperber et al., 2013; Stalans, 2004; Wong et al, 2013). There is also criticism that risk assessment might unfairly be used to target disadvantaged persons who are, have been or remain more predisposed to criminogenic risk factors. One example is that persons who reside in a low income area might be substantially more likely to be viewed as high-risk and thus to review harsher sentenced or lower chance of parole. There is some evidence of discriminatory assessment and treatment that target at-risk families when children are young, with minority and impoverished families receiving most of these treatments (Worrall, 2008). Despite these limitations risk-assessment is crucial because its classifications determines the type, frequency and duration of the treatment provided to an offender. Empirical studies have found that the high-risk offenders should have the longest, most frequent and intensive treatment services (Hanson & Yates, 2013; Sperber et al, 2013). Some studies measuring the number of hours required for recidivism determined that these offenders require between 200 and 300 hours (Sperber et al, 2013). The most severe high-risk offenders may require more than 300 hours of treatment. High-risk offenders who have high needs require more than 300 hours (Hanson & Yates, 2013). They also need to meet for frequently (Hanson & Yates, 2013; Sperber et al,
  • 16. 16 2013). Treatment should last for at least 6 months for these offenders (Sperber et al, 2013). Following this pattern is the finding that low and moderate risk offenders should receive moderate to low level treatment, respectively (Hanson & Yates, 2013; Sperber et al., 2013; Wong et al., 2013). In other words, low-risk offenders should receive the shortest, least frequent and intense treatment. In fact, there is some evidence to suggest that they should not be given treatment at all because an inappropriate amount of treatment might increase or have no impact on recidivism (Hanson & Yates, 2013). Naturally, moderate risk offenders fall and should receive treatment with an intensity, frequency and duration that falls between that given to low and high-risk offenders. The amount of hours that should be devoted to low and moderate risk offenders to optimize impact on recidivism is between 0 and 200 hours (Sperber et al., 2013). E) Evaluation and Recommendation SuggestedGeneral Programs Overall, studies conducted on sexual offenders reveal that they may benefit from treatment programs that are also provided to non-sexual offenders. There are many types of therapy from which they can benefit (Hanson et al., 2009; Hanson & Yates, 2013; Illescas & Genoves, 2008; Scalora & Garbin, 2003; Stalans, 2004) One example of such therapy is that which targets behavior, otherwise known as behavioral therapy. These behavioral therapies attempt to teach offenders to control the behaviors that are correlated to their offending. Examples of behaviors that are targeted by these treatments are poor impulses and irrational, illogical thinking. During these therapy sessions, offenders are taught to control the factors that contribute to their decision to commit sexual offenses. They can occur in both individual and group sessions. They can also be successful in both a prison or community setting (Hanson et al., 2009; Hanson & Yates, 2013; Harkins et al., 2012; Illecas and Genoves, 2008; Stalans, 2004).
  • 17. 17 Many studies conducted on the impact of behavioral therapy have found that they can lead to improvements in sexual offenders that reduce their rate of sexual recidivism (Illecas and Genoves, 2008). One study compared the sexual (and non-sexual) recidivism rates of sexual offenders who were treated with behavioral therapy to those who do not. It found that after four years only 4.1% of the former recidivated sexually compared to 18.2% of the latter whom recidivated after 3.5 years. These different recidivism rates were statistically significant. Since the control group was monitored for a shorter time, it is possible that they had higher recidivism rates after 4 years (Illecas and Genoves, 2008). Similar studies have found that the level of effectiveness of behavioral therapy depends on the type of sexual offenses they commit. Rapists, for example, have better rates of rehabilitation through behavioral therapy than child molesters. However, there is evidence against behavioral therapy (Hanson et al., 2009; Hanson & Yates, 2013; Harkins et al., 2012; Illecas and Genoves, 2008; Stalans, 2004). Several studies have found that behavioral therapy is ineffective at rehabilitating and preventing recidivism for sexual offenders (Hanson et. al, 2009). Other studies and academics imply that the majority of evaluations of behavioral therapy programs cannot be used to determine their effectiveness because there designs are either weak or insufficiently sophisticated (Stalans, 2004). Ultimately, though, the preponderance of evidence suggests that behavioral therapy can be effective. Additionally, evidence suggests that Cognitive Behavioral Therapy is an effective treatment for lowering sexual recidivism in sexual offenders. Cognitive Behavioral Therapy is similar to behavioral therapy in that it attempts to correct and prevent future behaviors that are antisocial and contribute to the offender’s decision to re-offend. There are different means to their common ends, however. The former attempts to accomplish this end by improving the offender’s thinking processes, patterns and distortions (Jeglic, 2010; (Illecas and Genoves, 2008;
  • 18. 18 Lipsey et al, 2001; Nunes & Jung, 2012; Schaffer et al, 2010). The latter attempts to accomplish it by teaching appropriate behaviors that are conductive to pro-social behaviors and lifestyles. As such, Cognitive Behavioral Therapy will be discussed independently from non-cognitive behavioral therapy despite the similar missions between the two. Like behavioral therapy, the preponderance of evidence supports the use of cognitive behavioral therapy for treatment in sexual offenders. Numerous individual and meta-analytical studies have been conducted to assess the overall impact and effect of cognitive behavioral therapy on sexual offenders. These studies have concluded that cognitive behavioral programs can produce statistically significant decreases in sexual re-offending for sexual offenders. The studies assessed the impact of cognitive behavioral therapy across a diverse population of offenders (Jeglic, 2010; Lipsey et al., 2001; Nunes & Jung, 2012; Schaffer et al, 2010). One meta-analysis of 14 of the most rigorous and sophisticated studies (as of 2001) found that the ratio of non-recidivism to recidivism for treated sexual offenders was half of that for sexual offenders who were not treated. Other studies have found similar results, though the extent of the impact varies. Some research in support of these treatments has determined that its impact depends on the reason why the treatment was implemented. Cognitive Behavioral Treatment programs that were provided for research purposes tend to result in much lower – and sometimes significantly lower – levels of sexual recidivism than programs that are naturally offered in prisons for non-academic purposes (Lipsey et al., 2001). In other words, programs conducted for research purposes perform better. Nonetheless, most studies remain in support of Cognitive Behavioral Therapy. That the majority of studies have revealed that Cognitive Behavioral Therapy is successful is unsurprising. Cognitive Behavioral Therapy essentially works by correcting
  • 19. 19 deficiencies in the thought processes of sexual offenders that contribute to their criminogenic needs, desires and activities (Lipsey et al, 2001; Nunes & Jung, 2012; Schaffer et al, 2010; Ward, 2000). These thoughts may include the thoughts about their future actions, themselves and others. Research indicates that sexual offenders generally suffer from deficiencies of interpersonal skills, empathy and acceptance. Studies throughout the last several decades have noted that sexual offenders tend to lack social skills necessary to cope with stress, make informed decisions and form crucial intimate relationships. They also lack empathy towards the victim that may contribute to their tendency to devalue the extent of the harm they inflict on their victims. Similarly, they have high rates of denial of the crime and the pain that it inflicts on victims. Beliefs that the victim deserved or wanted to the assault, devaluation of women and children and outright denial of the offense are common (Lipsey et al, 2001; Schaffer, 2010; Stalans, 2004; Ward, 2000; Wong et al., 2013). Therefore, it is not surprising that Cognitive Behavioral Therapy can be successful given that it attempts to address and correct these very deficiencies (Lipsey et al, 2001; Nunes & Jung, 2012; Schaffer et al, 2010). During sessions of Cognitive Behavioral Therapy therapists can utilize different techniques such as individual therapy, group counseling and role-playing to lessen the extent and impact of these deficiencies. The goal of the sessions is to increase the extent to which the offender thinks more rationally and pro-socially about future decisions. Rather than simply teaching a child molester to avoid playgrounds and schools to reduce the likelihood of sexual re-offending, sessions may teach offenders the skills necessary to logically and rationally conclude for themselves that they should avoid these locations. Yet, there is also evidence against Cognitive Behavioral Therapy (Ho & Ross, 2012; Lipsey et al, 2001; Marques et al., 1994) Some scholars have questioned the overall rigidity, thoroughness and sophistication
  • 20. 20 of many studies that have been conducted on and found support for Cognitive Behavioral Therapy (Ho & Ross, 2012; Lipsey et al., 2001). Others have yielded inconclusive results as to whether Cognitive Behavioral Therapy is effective for sexual offenders or for certain subsets thereof (Ho & Ross, 2013; Marques et al., 1994). Ultimately, the majority of evidence favors the usage of Cognitive Behavioral Therapy in the treatment of sexual offenders. Another form of therapy that is successful is relapse prevention therapy (Hanson et al., 2009; Meloy et al., 2013). It is similar to behavioral therapy in that it attempts to prevent sexual recidivism by targeting dynamic factors that lead to it. However, relapse prevention therapy for sexual offenders involves preventing the occurrence of avoidable triggers that can lead to recidivism (Hanson et al., 2009; Meloy et al., 2013). In this way, it may differ from behavioral therapy that can target static factors that are unchangeable. An example can illustrate the differences between the two. Relapse therapy may seek to prevent sexual recidivism by preventing sexual offenders from purchasing alcohol – two actions which evidence suggests can be pre-cursors to re-offending. Behavioral therapy, conversely, may seek to teach rational thinking and long-term planning skills that will cause them to correctly decide that they should not purchase alcohol because it can lead to re-offending that is not worth the risk of jail time for committing future sexual offenses. Some relapse therapies aim to increase supervision, decrease access to sexual content and to lessen ability to obtain inhibitors such as alcohol and drugs. One such program teaches sexual offenders to avoid sexual content – such as pornographic images, movies and sounds – because it can possibly trigger thoughts, desires and arousal that may lead to recidivism. Others seek to lessen opportunities to re-offend by using family, friends, acquaintances, neighbors and others to monitor the behavior the offender who is under treatment (Stalans, 2004). There are just
  • 21. 21 examples of tested treatments, but they show how relapse prevention therapy targets triggers that sexual offenders suggest might have contributed to their re-offending. Several studies on sexual offenders have found that many re-offended shortly after encountering or succumbing to triggers such as sexual content, stress, intoxication and being in the presence of children (Stalans, 2004). As is typical of the social sciences, there is mixed evidence on the impact of relapse prevention therapy (Hanson et al., 2009; Hanson & Yates, 2013; Meloy et al, 2013; Stalans, 2004). Some studies have found that it is has no impact at all. But, the majority of evidence seems to imply that relapse therapy can be successful in preventing sexual re-offending. One study found that relapse prevention therapy can lower recidivism rates to less than 11% for juveniles, rapists, child molesters and exhibitionists. The amount of success can depend largely on what the therapy comprises. Those that comprise avoidance of sexual media are more successful, for example, than those which increase supervision by using family, friends and neighbors as watchmen to lower the extent of re-offending (Stalans, 2004). As discussed in the section about risk assessments, these therapy sessions should vary in length, duration and frequency according to whether the offender is a low, medium or high-risk offender. They can occur in both individual and group sessions. They can also be successful in either a prison or community setting. Another treatment that is successful both sexual and non-sexual offenders are those that target psychopathic traits. As previously mentioned, a considerable percentage of both sexual and non-sexual offenders are antisocial (Gretton et al., 2001; Hanson & Bourgon, 2005; Harkins et al, 2013; Kim et al, 2012; Wong et al, 2013). This suggests that treatment can be successful if it targets psychopathic traits, many of which contribute to their tendency to commit sexual offenses – especially those of a violent or sadistic nature. Psychopathic sexual offenders are
  • 22. 22 more likely to commit violent and sadistic crimes than those who are not psychopaths (Gretton et al, 2001; Wong et al, 2013). However, treating psychopathic offenders can be particularly challenging. Psychopaths possess traits such as lying, manipulativeness, charm, callousness and arrogance that enable them to more easily commit crimes against others. Moreover, evidence suggests these traits may also enable them to commit more serious offenses (Gretton et al., 2001; Hanson & Bourgon, 2005; Harkins et al, 2012; Kim et al, 2012; Wong et al, 2013). As such, it is critical to provide training that targets these traits. Unfortunately, these same traits that enable them to more easily commit crime against others also enables them to falsely convince others that they have been successfully treated or rehabilitated (Gretton et al, 2001; Harkins et al., 2012; Illescas & Genoves, 2008; Stalans, 2004;). Moreover, psychopathic offenders are also more likely to recidivate, to resist treatment and to violate the conditions of their treatment or sentence, such as committing crimes while in prison. This makes offenders who are psychopaths generally more difficult to successfully treat and rehabilitate than offenders who are not. Yet, research implies that psychopathic sexual offenders can benefit from treatment when it is completed. Psychopathic offenders need more intensive services to circumvent their ability to manipulate the results of certain tests and tools used to diagnose the likelihood of re-offending (Gretton et al., 2001; Hanson & Bourgon, 2005; Harkins et al, 2012; Kim et al, 2012; Wong et al, 2013). However, like non-sexual offenders, they may also need more services to encourage and require them to continue with treatment (Illescas & Genoves, 2008; Stalans, 2004). F) Evaluation and Recommendation of Specific Programs Though there are few quality studies assessing programs specifically for sexual offenders, those that exist suggest that sexual offenders can benefit from specific treatment that targets their
  • 23. 23 deviant desires. Some are of these treatments are similar to those provided to non-sexual offenders in that they are psychological, behavioral or mental. One example of a treatment specific to juvenile sexual offenders is intensive therapy that targets and attempts to lessen or remove their sexual desires. To be fair, some are convinced that certain offenders – such as child molesters and pedophiles – may not be curable. This is because these sexual preferences and desires, especially for the former, may be static and engrained. However, evidence suggests others and that they still benefit from treatment that attempts to lessen their ability to act upon those urges, or teach them that their sexually deviant behaviors and desires are inappropriate and socially unacceptable (Ghezzi & Kimball, 1998; Gretton et al, 2001; Hanson & Yates, 2013; Scalora & Garbin, 2003). Biochemical and pharmacological treatments are also examples of specific programs for sexual offender’s deviant desires (Stalans, 2004; Worrall 2008). These treatments primarily target the physical aspect of sexual arousal. They attempt to prevent sexual recidivism by lowering or preventing the sexual arousal that fuels such acts. Chemical castration and physical castration are two options that fall under the category of biochemical and pharmacological treatment. These options are not widely available in the United States as it is only legal in a total of 4 states, California, Florida, Georgia and Louisiana. Chemical castration requires that an offender take medication in regular intervals to lower their libido and their ability to become sexually aroused. It is mostly voluntary. The exception is in the state of California where it is mandatory for sexual offenders convicted twice of molesting 1 child under the age of 13 (Worrall, 2008). Evidence shows that chemical castration can successfully lower recidivism. In fact, this successful impact on recidivism has been found in numerous studies, some of which compare
  • 24. 24 recidivism rates of those who are being chemically castrated to those of offenders who aren’t. Yet, it is criticized because its effect is not permanent. The effect of the pill on libido can be reversed if the offender stops taking the pill for a certain amount of time (Stalans, 2004; Worrall, 2008). Alternatively, the state of California allows for physical castration. Studies on the effectiveness of the methods have determined that they can be successful in lowering sexual recidivism. Some categories of sexual offenders, such as child molesters, are less resistant to the impact of these pills (Worrall, 2008). However, more research does need to be done since chemical castration is not widely available, studied or used. Specialized sex-offender probation programs also show promise in successfully lowering recidivism in sexual offenders by reducing their ability to act on their sexually deviant desires. Before these specialized probation programs were created sexual offenders could be sentenced to the same standard probation as non-sexual offenders. However, analysis thereof revealed that these programs are insufficient and ineffective at preventing recidivism in sexual offenders. This was due largely to the inadequate supervision and monitoring that these offenders received under these traditional probation programs. The sex-offender probation programs address these issues by using multiple methods of monitoring sex offenders and assuring their compliance with various aspects of the programs. It contains three separate components that involve various agents with the Criminal Justice System. The first component is intensive supervision through actions such as house visits, random searches and polygraph testing. The next phase is requiring completion of treatments that target behaviors and other factors correlated to relapse. The third phase involves verification of information provided by the offenders to ensure they are being compliant. Some programs might contain additional, more intensive provisions (Stalans, 2004).
  • 25. 25 Though more research needs to be done on the topic, existing evidence illustrates that these sexual-offender specific probation programs can lower recidivism in sexual offenders. One study conducted in Arizona found that sexual offenders on lifetime specialized sexual offender probation had a recidivism rate of only 1.5%. However, it was not a truly experimental design because there was not a comparison group. In Canada, offenders who were under specialized sexual offender probation had a lower recidivism rate of 3.7% over a period of three years. It should be noted that Canada’s probation requires additional monitoring by an intensive supervisory unit, as well as individual and group behavioral counseling. This means that these additional components may be causing the success of Canada’s programs, rather than the standard three components. Yet, the general evidence suggests that standard specialized sexual- offender probation is successful (Stalans, 2004). Lastly, evidence implies that the Good Lives Model (GLM) may be an important tool in indirectly lowering sexual reoffending in sexual offenders. The Good Lives Model is a recent development that aims to prevent sexual and non-sexual recidivism by cultivating and implanting the desire for a positive life within offenders (Cullen, 2012; Hanson & Yates, 2013; Schaffer et al., 2010; Ward et al., 2007). It focuses not only on the criminal aspect of the offender’s life, but on other areas such as employment, marriage, education, and other pro-social goals and aspirations. It focuses on the using the offender’s strengths, competencies, and resources to help them reach their goals and fulfill their innate human needs in a positive, non-criminal manner. While it does acknowledge the offense, the offense is discussed as an obstacle with consequences that the offender can overcome by bettering their lives and planning for a positive future. Avoidance of future criminal activity is just one component of a holistic plan towards a better life (Cullen, 2012; Hanson & Yates, 2013; Schaffer et al., 2010; Ward et al., 2007).
  • 26. 26 A 2009 survey revealed that the Good Lives Model is used in around 30% of treatment programs for sexual offenders (Hanson & Yates, 2013). While evidence implies that the Good Lives Model may not directly impact recidivism, it may have an indirect impact on measures that may be related thereto. More specifically, studies have found treatments that were or based on the Good Lives Model Evidence positively increase motivation, enhance engagement with treatment, lower attrition and promote progress towards completion of treatment goals (Hanson & Yates, 2013; Schaffer et al., 2010). Good Lives Model, then, might be a useful tool in indirectly lowering recidivism by increasing the completion rates of treatment initiatives linked to lower recidivism. This evidence is preliminary, however, so additional research should be done to confirm these findings and determine whether it has any direct impact on recidivism. Conclusion Ultimately, this paper concludes that sexual offenders can benefit from general and specific treatments aimed at preventing recidivism in sexual and non-sexual offenders. Generally, sexual offenders can benefit from non-sexual behavior treatments that target and prevent the occurrence of behaviors, relapses and psychopathic traits correlated to sexual offending. Evidence points to larger reductions in recidivism for sexual offenders who receive these services than those observed for sexual offenders who do not receive or complete these services. Some of these programs appear to be successful because they are able to target and control criminogenic factors, behaviors, triggers and personality characteristics that are correlated to and facilitate personalities that are more comfortable with offending. Others may be successful because they allow the usage of pro-social tools and outlets to satisfy certain innate human needs, wants and desires. Not all evidence points conclusively to these treatments being successful. There remains
  • 27. 27 sufficient evidence, though, to generally support the contention that such therapies and services can prevent sexual recidivism for sexual offenders. However, sex offenders may also require specific treatments that target their deviant sexual desires to be successfully rehabilitated. Sexual offenders are more likely to have deviant sexual fantasies, lack of empathy and the feeling that they are alone and isolated from other individuals. Consistent with this, research has found that programs that target these deficiencies can be successful at rehabilitation. As is typical of the social sciences, research concerning these recommended treatments did not always yield conclusive results that were in favor of the program. The studies conducted also vary in their level of rigor and sophistication. They also have limitations in their ability to truly test the hypothesis and questions that they were created to study. These weaknesses are the reality of conducting and evaluating studies concerning phenomenon in the social world. Nevertheless, these general and specific treatments were recommended because they were shown to be successful in the preponderance of studies that evaluated them. A greater number of rigorous, sophisticated and generalizable studies should be done on these and other treatments to gain an enhanced understanding of the best, most effective treatments in preventing recidivism amongst sex offenders.
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