Transcript Module Three – Treatment and Supervision of Sex Offenders

Treatment and Supervision of
Sex Offenders
Learning Objectives
• Name the commonly used model of
treatment for adult sex offenders;
• Identify three targets of treatment
designed to reduce recidivism among sex
offenders; and
• Discuss the current controversies that
lead to differing opinions regarding
treatment of sex offenders;
Learning Objectives (cont.)
• Name three areas in which
“specialization” applies to supervising sex
offenders; and
• List three examples of specialized
supervision conditions that may be
relevant for sex offenders.
Research Strengths and
Weaknesses
What Sex Offender Treatment Looks
Like
Treatment and Supervision
Professionals
OVERVIEW
Two Overarching Goals of Sex
Offender Treatment
• Prevent further harm, victimization
• Promote offender stability, success
COMPARISON OF SEX
OFFENDER TREATMENT
WITH OTHER “BEHAVIORAL
HEALTH” TREATMENTS
How is Sex Offender Treatment . . .
• Similar to other types of psychological
treatment?
• Different from other types of
psychological treatment?
Treatment Comparisons
Sex OffenderSpecific Treatment
Other Mental
or Behavioral
Health Treatment
Clients generally involuntary,
mandated
Often voluntary, self-selected
clients
Limited confidentiality,
waivers common
Strict confidentiality, few
exceptions
Therapeutic climate is vital
Therapeutic climate is vital
Blend of client-determined
and pre-determined goals
Primarily client-determined
goals
Treatment Comparisons (cont.)
Sex OffenderSpecific Treatment
Other Mental
or Behavioral
Health Treatment
Assessment-driven
interventions
Assessment-driven
interventions
Group therapy modality most
common
Individual therapy sessions
most common
Success or “failure” impacts
public safety
Success or failure primarily
impacts the client
Different Approaches to
Sex Offender Treatment:
Which Seem Most Likely to Work?
• Psychoanalysis
• Insight-oriented therapy
Different Approaches to
Sex Offender Treatment:
Which Seem Most Likely to Work?
(cont.)
• Behavioral techniques
• Medical, pharmacological
interventions
• Cognitive-behavioral treatment
RESEARCH STRENGTHS
AND WEAKNESSES
Understanding the Controversy
• What do we need to understand
about treatment research to know if it
validly informs us as to whether
treatment works?
• A little background on research
design
General: How Do We Know if a
Treatment Works?
• Test it scientifically for risks and
benefits
• Standard: scientific studies
– Adequate sample of subjects
– Randomized
– Controlled
• Measure outcomes with
accuracy
After the Research
• Findings of safety and efficacy allow
for treating within guidelines of “dose”
and duration
• Findings apply to a certain population
with extreme care for extrapolation
• “Off-label use” – new applications of
treatment
Experimental vs.
Quasi-Experimental Studies
WHAT SEX OFFENDER
TREATMENT LOOKS LIKE
Commonly Used Approach to Sex
Offender-Specific Treatment
• Cognitive-behavioral model
• Multiple modalities
– Group, individual, marital/family
– Pharmacological
What Does Cognitive Behavioral
Treatment Look Like?
• Individual and/or group sessions
• Focus on past offenses and the pattern
of thoughts, feelings, and behaviors that
led up to the offense
– e.g., substance use, viewing
pornography, fantasies
• Challenges old patterns, introduces
alternative thought and behavior patterns
Primary Targets of Sex Offender
Treatment (Static and Dynamic)
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•
•
•
•
•
Sexual deviance, sexual preoccupations
Intimacy deficits, conflicts in relationships
Pro-offending attitudes
Hostility, pervasive anger
Lifestyle instability
Research data does not show that
treatment of specific risk factors works.
Assessment-Driven Treatment
• Individualized dose and duration of
treatment and supervision
• Target known risk factors
• Measurement of progress
– e.g., Treatment needs and progress cale
every six months
Medication Approaches
• Decrease testosterone  decrease
sex drive
• Does not change sexual interests
• Time-limited effect
• Side effects: bones, liver
Medications
• Antiandrogens
– Provera™
– Lupron™
• SSRI Antidepressants
Research on
Treatment Effectiveness
• Increasing body of research
• Several meta-analyses
• Treatment associated with lower
recidivism rates in non-randomized
studies
• However, randomized study found higher
rate of recidivism in treatment group
“Balanced Approach” to
Sex Offender Management
Risk
Management
through
Specialized
Supervision
Maximized
Public
Safety
Risk
Reduction
through
Sex
Offender
Treatment
TREATMENT AND
SUPERVISION PROFESSIONALS
Treatment Provider Expertise
• Relevant advanced degree
• Forensic training, experience
• Specialized training, clinical
supervision
• Licensure, professional affiliations
• Continuing education
Elements of Sex
Offender Supervision
• Specialized officers
• Specialized conditions
• Specialized technology
Specialized Officers
•
•
•
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Internal expertise
Focused efforts
Awareness of resources
Collaboration emphasis
Areas Addressed by
Specialized Conditions
• Treatment
• Victim contact
Areas Addressed by
Specialized Conditions (cont.)
• Employment, leisure activities
• Surveillance
• Monitoring
Supervision – Query
• What types of specialized conditions
do you believe are most important for
sex offenders under community
supervision?
• To what extent are specialized
conditions for sex offenders used in
your jurisdiction?
• Who is responsible for imposing these
conditions?
Supervision Orientations and
Philosophies
Surveillance,
Monitoring,
Enforcement
Social
Casework
Surveillance and Monitoring
• GPS
• Polygraph
• UDS
Applying Risk Principles to Sex
Offenders Supervision
• Target higher risk offenders for more
intensive supervision strategies
• Provide longer periods of supervision for
higher risk offenders than for lower risk
offenders
• Focus programming referrals on higher risk
offenders
• Ensure that more risk factors, rather than
non-risk factors, are the focus of intervention
Summary and Implications
• Cognitive-behavioral sex offender
treatment reduces recidivism in nonrandomized studies.
• Supervising sex offenders involves
specialization
• Balancing treatment and supervision may
increase public safety
• Risk reduction and risk management can
be targeted through sentencing orders