Transcript Sexual Deviance
Dynamic Supervision of Sexual Abusers
Robin J. Wilson, PhD, ABPP
Clinical Director The GEO Group / Florida Civil Commitment Center
Part 1
Defining the Problem Assessment Dynamic Supervision STATIC
Defining the Problem
Risk Management Philosophy
Sex offending results from a complex interaction of offender specific and environmental factors which require competent assessment and, ultimately, long-term treatment and follow-up.
Stakeholders
victims citizens law enforcement legal and correctional personnel mental health personnel the media offenders
Sexual Offending
The past 15-20 years has been witness to a flurry of research into the nature and consequences of sexually offensive behavior. Isn’t it odd that the focus has come so late in the game? There is no doubt that there has been sexual offending since there were people to be offenders and others to be victims —thousands and thousands of years. Why has the attention shifted only recently?
Victims
As many as 90% of reporting victims know their offender 2/3 or more of known offenses occur in the victim’s own home As many as 90% of victims fail to report their abuse to authorities or others in a position to help
Offensive Sexual Behavior
One of the greatest hurdles to defining sexual deviance is a lack of clarity as to what actually constitutes offensive sexual behavior. What do you consider to be sexually offensive?
Assessment
Dangerousness
BAD: GOOD: “This person is dangerous.” “If
the following risk factors are present
, then there is a
high/medium/ low
probability that the person will engage in
some specific
behavior within
specify period of time
that may place specific victims at risk for a specific type and severity of harm.”
Assessment
assessment forms the foundation upon which all subsequent intervention is built
poor assessment = trouble
comprehensive assessment should take demand characteristics into consideration assessment is
dynamic
Why Assess Risk?
Promoting public safety Routine interventions Targeting scarce resources Officer time Treatment Exceptional measures
Risk Assessment Tools
General and violent recidivism:
Psychopathy Checklist-Revised (PCL-R) Level of Service Inventory-Revised (LSI-R) Violence Risk Appraisal Guide (VRAG) HCR-20 Spousal Assault Risk Assessment Guide (SARA)
Risk Assessment Tools
Sexual recidivism:
Sex Offender Risk Appraisal Guide (SORAG) Sexual Violence Risk-20 (SVR-20) MnSOST-R Rapid Risk Assessment for Sex Offender Recidivism (RRASOR) STATIC-99 STABLE-2007 / ACUTE-2007
Strengths
Valid risk factors Explicit rules for combining factors Explicit probability estimates Robust across settings & samples Easily scored
Weaknesses
Only moderate predictive accuracy We always want to do better!
Tend to neglect important factors Sexual Deviance (Phallometrics) Dynamic Factors
Dynamic Supervision of Sexual Offenders
Static, Stable, & Acute Risk Factors
Definitions
Static – Non-changeable life factors that relate to risk for sexual recidivism, generally historical in nature Stable – Personality characteristics, skill deficits, and learned behaviours that relate to risk for sexual recidivism that may be changed through intervention Acute – Risk factors of short or unstable temporal duration that can change rapidly, generally as a result of environmental or intra personal conditions
Three Generations of Risk Assessment
Bonta (1996)
First Generation = “Clinical Judgment” Unstructured, Non-replicable, Personal Discretion Based on experience and level of knowledge of the literature Non-standard (even within same institution) Level of prediction little better than chance Second Generation = “Actuarial Assessment” Static, Actuarial, Structured, Replicable, Less open to Interpretation Based on factors empirically related to recidivism Standardized assessment, “Static” - Can not measure change “Moderate” Levels of prediction, ROC’s upper 60s to lower 70s Third Generation = “Dynamic Assessment” Based on factors empirically related to recidivism Standardized assessment, Measures change Actuarial measure with dynamic factors
Prediction of sexual recidivism
Measures Designed for Sexual Recidivism Empirical Actuarial d (95% CI) .67 (.63-.72) N (k) 24,089 (81) Mechanical .66 (.58-.74) 5,838 (29) Structured Judgement .46 (.29-.62) 1,131 (6) Unstructured .42 (.32-.51) 6,456 (11)
General Recommendations for Risk Assessment
Use an explicit list of empirically validated risk factors determined in advance Use an empirically validated method of combining the risk factors into an overall evaluation Estimate the risk for an individual offender based on the group he or she most closely resembles
General Recommendations for Risk Assessment
Build-in methods for quality control At least one year is needed before re evaluating stable factors (pending deliberate interventions) Use offence history, enduring psychological characteristics, and current behaviour to evaluate risk
STATIC
Static Risk Factors
Don’t change (on the whole) Allow you to gauge the long-term level of risk for sexual recidivism Allows you to determine an appropriate level of supervision and treatment for the individual (Andrews & Bonta, 2006)
JÄSENTYNYT RISKIARVIO – 99.02
JRA/STAATTINEN 99 Riskitekijä
1) Aikaisemmat seksuaalirikokset 2) Tuntematon 3) Ei-sukslainen 4) Miespuolinen uhri 5) Ilman kosketusta 6) Yksinäinen/naimaton 7) 18-24 vuoden ikäinen vapautuessa 8) Ei-seksuaalinen väkivalta laskentatuomiossa 9) Ei-seksuaalinen väkivalta aiemmissa 10) Yli neljä tuomiota 0 0 0 0 0 0 0 0
Pisteet
1 2 0 0 1 1 1 1 1 1 1 1 1 3
Risk Factor Young Single Index non-sexual violence Prior non-sexual violence Prior Sex Offences Prior sentencing dates Convictions for non contact sex offences Any Unrelated Victims Any Stranger Victims Any Male Victims
Total Score
Codes Aged 25 or older Aged 18 – 24.99 Ever lived with lover for at least two years? Yes No No Yes No Yes Charges Convictions None None 1-2 1 3-5 2-3 6 + 4+ 3 or less 4 or more No Yes No Yes No Yes No Yes
Add up scores from individual risk factors
0 1 0 1 0 1 0 1 0 1 2 3 0 1 0 1 Score 0 1 0 1 0 1
50 20 15 10 5 0 45 40 35 30 25 New Norms: 10-year Sexual Survival Analysis, initial
n
= 6,406 Original 2008 results 0 1 2 3 4* STATIC-99 score 5 6+
60 50 40 30 20 10 0 New Norms: 10 year Violent Survival Analysis, initial
n
= 6,096 Original 2008 results 0 1 2 3 4 STATIC-99 score 5 6+
10 Year Sexual Recidivism Rates (from logistic regression estimates)
70 60 50 40 30 20 10 0 0 1 2 3 4 5 6 7 STATIC-99 score 8 9 10 High Risk CSC Original
Presenting STATIC-99 Scores
STATIC-99 as part of a
complete
assessment Consideration of factors external to STATIC-99 Advanced age/ill health Criminogenic needs/stable dynamic risk factors Completion of credible treatment program Stated intentions to reoffend
Years offence-free in the community
If offenders are able to remain in the community two to ten years without another serious offence, their chances of sexual recidivism decrease substantially Offence free: no new sexual or non-sexual violent offences no offences that result in long periods of incarceration
Part 2
STABLE
STABLE - 2000
Developed from: SONAR (Hanson & Harris, 2000) STEP (Beech et al., 2002) SRA (Thornton, 2002) Explicit, structured risk assessment tool 16 Items Combined with STATIC-99 into overall risk Empirically Informed, but needed validation
SONAR Hanson & Harris
STABLE Intimacy Deficits Social Influences Attitudes Sexual Self-Regulation General Self-Regulation ACUTE Substance Abuse Negative Mood Anger/Hostility Victim Access
STABLE – 2007 5 sections for a total of 13 Items
Significant Social Influences Intimacy Deficits General Self-regulation Sexual Self-regulation Co-operation with Supervision
Refer to tally sheet provided.
STABLE - 2007 Scoring
All available information Historical and recent STABLE - typical or base line functioning past year and next year
Will the change endure?
50 40 30 20 90 80 70 60 10 0 1995 1997 1999 2001 Karl Andrew
Exceptional circumstances?
Major life change?
Opportunity?
External pressure?
Quality of evidence New base line?
Return to Base Line
50 40 30 20 90 80 70 60 10 0 1995 1997 1999 2001 Karl Andrew
50 40 30 20 90 80 70 60 10 0 1995 1997 1999 2001
New Base Line
Karl Andrew
Significant Social Influences Things to consider
Does this person provide material support?
Does this person undermine the offenders controls? If the offender went to that person for advice would that person be likely to give pro-social or anti-social advice?
Circles of Support and Similar – if the formal structure dissolved would that (positive) person still go for coffee with the offender?
The magic question: If you had a magic wand and could “zap” that person out of the offender’s life – would the offender be more or less likely to reoffend?
More likely to reoffend – they are a positive influence Less likely to reoffend – they are a negative influence
Intimacy Deficits
Capacity for relationship stability Emotional identification with children Hostility toward women Social rejection/loneliness Lack of concern for others
Capacity for Relationship Stability
A two-part question
“A” Part:
Has this offender ever had a two-year intimate (sexual & “live-in”) relationship with an appropriate adult partner (STATIC-99, Q#2)
“B” Part:
Is the offender currently living with an intimate partner in a relationship without obvious problems? This relationship can be short, but should be expected to be reasonably STABLE.
Emotional Identification with Children
Note: Only score for those with child victims age 13 or less
Does the offender feel emotionally close to or intimate with children?
Sees children as peers or equals Relates more easily to children than to adults Not parent-child relationship Consider not only attitudes and values, but also leisure and work activities suggestive of a child-oriented lifestyle Involved in children’s activities Boy-victim child molesters tend to be childlike themselves Offender ascribes adult qualities to children (Incest)
Scoring Example 1 - John
Convicted of “Demand Sexual Touch – Child”, John, age 35, lives alone and has no adult friends. He works as a janitor at the recreation facility. He generally keeps to himself, but he does talk with some of the regulars, including a couple of the pre-teens who come for the children’s programs. When asked, he says that he likes children, and that he would rather play ball with the kids than watch TV on his own. John has never been in a steady heterosexual relationship. He says that he would like to date more often, but fears rejection (he is not physically attractive).
Scoring Example 2 - Fred
Fred was a school principle and was caught surreptitiously masturbating in the school library. has been convicted of exhibitionism. He is married and has two children, ages 8 and 10. His relationship with his wife is distant, and he has no close friends outside his family. Fred appears to live through his children. All of his free time is spent supporting his son’s hockey and his daughter’s competitive country dancing. Most of his conversation centres on the special talents of his children. His emotional highs and lows follow their successes or failures .
Hostility Toward Women
A prejudice, making women into a different class unworthy of trust or respect Unable to form warm, constructive relationships with women Believes or endorses sexist attitudes Does not consider women as people worthy of trust and respect May have sexual or personal relationships with women, but these relationships are adversarial and conflicted
Scoring Example 3 - Richard
Richard has been convicted of Forcible Confinement. He is 28 years old and works on and off as a night-club bouncer. He likes to party, dance, drink, and socialise with his male friends from high school. He is out on a date almost every week, although rarely does he see the same women for more than a month. He divides women into those that are “fun” and those that are “boring”. Fun women drink, flirt and are open to casual sex. Boring women either don’t pay attention to him, or want a long term commitment. He does not get into conflicts with women. When problems arise, he simply ignores them or ends the relationship.
Social Rejection/Loneliness
Is the offender able to make friends and feel close to others (demonstrating secure adult attachment)? Is he lonely, prone to feeling socially rejected?
Is he emotionally close to friends and family?
How does he feel over the intermediate term – his impression of the world
Lack of Concern for Others
This item does not reflect solely their treatment of their victims Little consideration for the feelings of others Acts according to their own self-interest Feigns shallow displays of regret, little or no remorse Unfeeling, ruthless, or indifferent Not just towards their victims or adversaries, but also towards their in-group Possibly has friends, associates and acquaintances, but no stable, caring relationships Quite significant pathology must be present, this condition is fairly unusual
Scoring Example 5 - Jim
Jim, age 33, works as a construction labourer. He says he has a few friends, but has not known any for more than 6 months. He was living with his mother, but she recently evicted him after she caught him pawning small household articles. He says it was all a big misunderstanding; he was going to pay her back but now that she kicked him out he isn’t going to bother. He has had a number of short-term sexual relationships, including living with a women for almost a year. Once she became pregnant, he left and he has had no further contact with her or the child.
Scoring Example 6 - Ian
Ian lives with his brother. They work together and they often socialise with other men from the factory. Ian is generally well liked by his friends and family, but they describe him as having a mean streak. All of his intimate female partners have left following beatings. He says he is glad they are gone. On at least two occasions, he has been in bar fights in which strangers were left badly beaten. He shows no remorse for the victims of these or other crimes, and typically implies that the victims deserved what they got.
General Self-Regulation
Impulsive Acts Poor Cognitive Problem Solving Skills Negative Emotionality/Hostility
Impulsive Acts
Easily swayed by opportunistic circumstances Behavior that has a high likelihood of negative consequences Easily bored, seeks thrills and has little regard for personal safety or the safety of others Impulsive across several settings – not just represented by his history of sexual offending
Impulsive Acts
reckless driving substance abuse “getting into” partying accepting bets and dares quitting jobs with no other job in sight changing residences unsafe work practices starting fights with men much bigger than himself
Poor Cognitive Problem Solving
Difficulty accurately identifying and solving problems Proposes unrealistic solutions – (or none at all) Unable to choose appropriately between competing possible options (Always takes the easiest or the one with the most immediate “pay off” Lacks long-term plans Fails to recognize the consequences of their actions
Poor Cognitive Problem Solving
Problem identification
Generating alternatives
Evaluating alternatives
Negative Emotionality/Hostility
A feeling of almost constant grievance is key to this item This is not the “blue” guy – this is the guy with “A chip on his shoulder” – a grudge against the world Prone to feeling hostile, victimized, and resentful Vulnerable to emotional collapse when stressed Although possibly linked to real grievances, the offender’s emotional response is excessive Rather than attempting to cope constructively, the offender ruminates on the negative events and feelings and may appear to be “getting into it” Your helpful suggestions are dismissed or belittled Explosive expressions of emotion, quickly over
Sexual Self-regulation
Sex drive/Pre-occupations Sex as coping Deviant sexual interests
Sex Drive/Pre-occupations
Recurrent sexual thoughts and behaviour ( not directed to a current romantic partner) Casual or impersonal sexual activity Interference with other pro-social goals Perceived as intrusive or excessive by the offender Or just plain excessive
Sex Drive/Pre-occupations
Masturbation most days (15+ times a month) Regular use of prostitutes, strip bars, massage parlours, phone-sex and phone sex bills Sex-oriented internet use, such as sexually explicit sites, chat rooms - Large amounts of time “surfing the web” for pornography sites Pornography collection (videos, magazines) (or, parent/baby magazines) Cruising for impersonal sex A history of multiple sexual partners (e.g., 30 or more) Excessive sexual content in typical conversations Pre-occupation with own/other’s sex crimes Self-report of difficulty controlling sexual impulses Any disturbing sexual thoughts
Sex as Coping
Life stress and negative emotions trigger sexual thoughts or behaviour Content may be normal or deviant This coping behaviour will be seen in multiple life domains (in response to work stress, family stress, interpersonal stress) Sexual expression to dissipate anger, humiliation, or frustration
Deviant Sexual Interests
Sexual interest in people, objects, or activities that are illegal, inappropriate or highly unusual. children, non-consenting adults, voyeurism, exhibitionism, cross-dressing, coprophilia, and fetishism Assessed by number of sex offence victims, number of deviant preference victims, self-report of deviant history or preferences, or the results of specialised testing (e.g., phallometrics)
Deviant Sexual Interests “Behavioural History”
You must consider both frequency and the unusualness of the behavior Sex with pre-pub boy (X1) = 1 Masturbation in car: caught once = 1 caught more than once = 2
Deviant Sexual Interests
(Please see Table – page 35 Tab 08) Domain
Number of Sex Offence Victims Number of Deviant Preference Victims/Activities •Pre-pubescent child victims etc.
Self-report of deviant history or preferences (or observed behaviour) Results of specialized testing
Count/Criteria
0 = Only one victim 1 = 2 to 7 victims 2 = 8+ victims 0 = No deviant victims 1 = One deviant victim 2 = Two or more deviant victims 0 = Endorses only normal fant/prefs 1 = You suspect deviant fant/prefs 2 = Describes or admits to dev. fant/prefs Not Scored = No evidence testing ever offered 0 = Testing – results show no dev. Prefs 1 = Mixed Results – Possible deviance 2 = Deviant preference shown in testing and nothing done about it
Score
Deviant Sexual Interests
Scoring Notes:
At the time of Static-99 construction, the age of consent in Canada for sexual activity was 14 years old. People who have reached their 14th birthday are not considered “child” victims. Physically developed (mature) 12 and 13 year olds are not considered “deviant” sexual victims (sub-section two) – they are simply victims. If the victims have a “mature”, “developed” or “adult” body shape they are not considered “child” victims.
Scoring Deviant Sexual Interests
Of the four sections – the highest score in any section is the score for the whole item
Domain
Number of Sex Offence Victims Number of Deviant Preference Victims/Activities •Pre-pubescent child victims etc.
Self-report of deviant history or preferences (Or observed behaviour) Results of specialized testing
Count/Criteria
0 = only one victim 1 = 2 to 7 victims 2 = 8+ victims 0 = No deviant victims 1 = One deviant victim 2 = Two or more deviant victims 0 = Endorses only normal fant/prefs 1 = you suspect deviant fant/prefs 2 = Describes or admits to dev. fant/prefs Pass = No evidence testing ever offered 0 = Testing – results show no dev. Prefs 1 = Mixed Results – Possible deviance 2 = Deviant preference shown in testing and nothing done about it
Score
Deviant Sexual Interests
Deviant Sexual Interests in Possible Remission
An offender who has scored a “1” or a “2” based upon historical facts can have their Deviant Sexual Interest score reduced by one point if the following is present: The offender is involved in an age appropriate, consensual, satisfying sexual relationship of at least one years duration while “at risk” in the community with the absence of behavioural indicators of Deviant Sexual Interests for 2 years Presence of this relationship requires credible, independent, collateral confirmation of the relationship
Scoring Example 7 - Bob
Bob, now age 43, had 15-20 sex partners before marrying when he was age 24. Bob wanted her to do the things Susan he saw in porno videos, but she lost interest and left three years later. By that time, Bob was already involved with another women. He never remarried, but has almost continuously pursued casual encounters. He says that he likes the chase and that he can pull himself out of a funk by thinking about his past or future conquests. He describes his current offence of sex with a 15 year old neighbour as a novelty that he does not want to repeat. When in prison, he masturbates three times a week.
Scoring Example 8 - Mike
Mike, age 22, has had 4 female and 3 male sexual partners. He considers himself bisexual. He masturbates 1-2 week, usually thinking about anal sex with consenting partners of vague (and changing) genders. His current offence involved tying up a female acquaintance, forcibly removing her clothes, sexually assaulting her for several hours, then falling asleep. In the morning he released her, drove her home and asked what she was doing next weekend. Once free, she went directly to the police. He denies any interest in sado masochistic sex, claims it was all her idea and that it was the only time he tried it.
Scoring Example 9 - Norman
Born in 1976, Norman was found guilty of sexual assault of a minor child (boy) in 1997 – he served 30 months incarceration and was then released to a 10-year intensive supervision order. Phallometric testing done pre-trial indicated preference for pre pubescent boys over adult males and females. During the course of treatment he admitted to sexual involvement with another male child (never charged) and stated that at the time of the crimes he had no idea why he was interested is sex with young boys. He now believes that this was part of his personal struggle with being homosexual. While in prison he met a male church volunteer. Upon release this quickly developed into a relationship and the men have been living together for five years now. Both indicate considerable commitment to and satisfaction with the relationship. Phallometric assessment done in 2008 showed significant arousal to adult males, no other categories were significant.
Cooperation with Supervision
Do you feel that the offender is working with you or working against you? Does he see himself as at no risk to reoffend and place himself in high-risk situations?
Does not take seriously the conditions of supervision?
Non-cooperation
Disengagement: just going through the motions, silent/non-disclosing, keeping secrets, not invested in treatment Manipulation: trying to “play the system”, trying to be “buddy-buddy” with you, trying to lie to you and deceive you, asking for special favours, engaging in the manipulation of helpers (e.g., playing one off against another) No Show: often shows up late or at the wrong times, fails to attend scheduled appointments with you and others
Think of your normal interview
Significant Social Influences* Who do you hang around with?
What do you do with Joe?
Intimacy Deficits* Anybody special in your life?
How do you get along with women? Children?
Would you say you are a loner?
Who do you care most about in the world?
General Self-regulation* Ever play sports? How often in Emerg? Money problems? Housing problems? Quit jobs a lot?
What sort of things cause you problems in your life? What do you do about them?
What do you think of (the guy who caused the problem)? And do you meet people like that a lot?
Think of your normal interview
Sexual Self-regulation Sexual outlets? Habits? How often? Pressure? Relationship to self-esteem and self-perception Ever use sexual outlets to change your mood or make yourself feel better?
You mentioned a child in your list of friends. You seem to have a history of people making allegations against you Co-operation with Supervision* (Your call) (You can re-order the STABLE interview to suit yourself)
Combining STATIC and STABLE Empirical Rules STATIC-99 Risk Category STABLE-2007 Need Category Overall Supervision Priority
Low Moderate-Low Moderate-High High
Low Moderate High Low Moderate High Low Moderate High Low Moderate High Low Low Moderate-Low Low Moderate-Low Moderate-High Moderate-Low Moderate-High High High High Very High
Treatment What does all this mean?
STABLE factors are your best treatment targets Use STABLE assessment to inform your treatment and supervision efforts STABLE assessment represents the beginning of “diagnostic” treatment assessment for sexual offenders Does it make sense? - Is it a good use of money to put everybody through everything
Analysis of Stable Change
Little change over the 6 month period Amount of change unrelated to recidivism Only weak evidence that most recent assessment more accurate the prior assessment Few offenders would have received effective treatment Recommend Stable re-assessment every year Results of the STABLE-2000 were used to refine the measure to create STATIC-2007
STABLE-2007 adds predictive power
Sexual Sexual plus breaches Violent Any Crime Any Crime plus breaches Recidivism Rate 7.2% (57/793) 9.7% (77/793) 13.7% (109/793) 19.3% (153/793) 29.2% (232/793) Test STATIC-99 S-99 & STABLE-07 STATIC-99 S-99 & STABLE-07 STATIC-99 S-99 & STABLE-07 STATIC-99 S-99 & STABLE-07 STATIC-99 S-99 & STABLE-07 ROC .74
.76
.69
.73
.71
.72
.70
.70
.69
.70
Part 3
ACUTE Treatment Risk Management
Acute Risk Factors
Short term risk Timing of reoffense These factors represent current expressions of problematic (risky) of risky behaviours Note: Research data shows that an average rating over time (4 mos) performs better than any individual assessment Hence, do ACUTES often and regularly for best prediction
ACUTE PREDICTORS – Two Factors
Sex/Violence Score (Four Items) Victim Access Hostility Sexual pre-occupation Rejection of Supervision General Recidivism Score (All seven items) Victim Access Hostility Sexual pre-occupation Rejection of Supervision Emotional Collapse Collapse of Social Supports Substance Abuse [predicts all types of relapse]
Same Behavior – Different Scoring
In the community the same behaviour can result in scoring differences depending on the characteristics of the offender.
1.
2.
3.
4.
Rapist riding a city bus to work with school children most likely a manageable risk Child Molester riding a city bus to work with school children may or may not be a manageable risk Frotteur riding a city bus to work with school children most likely an unassumable risk Rapist working the “late shift” at a courier company where they hire an evening shift of university students possibly a manageable risk, if he is “part of the crew” most likely an unassumable risk if he’s made the “shift chief”
Scoring Chronic Conditions
Is it serious enough to be a supervision target?
To score a “2” there has to be some evidence of a problem and this problem has to be a supervision target If you have suspicion of a problem you can score a “1” as a place-holder for one supervision. You can score “1” repeatedly if there is some documented evidence that the problem remains and it is a topic of supervision.
ACUTE PREDICTORS – Two Factors
Sex/Violence Score (Sum of four factors) Score General Recidivism Score (Sum of all seven factors) Score
• Victim Access • Hostility • Sexual Pre-occupation Copy Score Over Copy Score Over Copy Score Over • Rejection of Supervision Copy Score Over
Sex/Violence Total
• Emotional Collapse • Collapse of Social Supports • Substance Abuse
General Recidivism Total
Acute Rating System
0 - No problem 1 - Maybe a problem, not sure 2 - Yes, a concern IN - Intervene now
Victim Access
0 - no problem 1 - incidental contact, not repeated/regular incidental contact that can not be avoided but no indications of victim approach 2 - repeated opportunity, hints of planning – several different paths, he mostly/always chooses the most risky one IN - clear planning, grooming, stalking, hiding deliberate contact
Hostility
0 - no problems 1 - some resentment; harsh words 2 - heated confrontations; any physical aggression, veiled threats, angry rumination, something is bugging him and you are aware there is a problem IN - direct threats, open plans of retribution
Sexual Preoccupations
0 - no problem 1 - slight concerns, increased masturbation 2 - rumination on sexual issues, sexual tension, deviant urges, porno/strip clubs, sex urges when angry or upset IN - out of control of sexual urges, lots of impersonal sex
Rejection of Supervision
0 - regular reporting, appropriate responses 1 - reluctant, missed appointments with others, you are unsure of what is going on 2 - breaching conditions, missed 2 consecutive appointments, manipulative lying, treatment dropout IN - brings weapon, attends drunk, new offences, driving while suspended, he disappears
Emotional Collapse
0 - common misery 1 - stressed, but coping (strained) 2 - hopeless, helpless, negative emotional rumination, self-pity, not coping, paranoia IN - suicide risk, acting on paranoid impulses, not caring what happens to them
Collapse of Social Supports
0 - no major changes 1 - threats to important relationships, loss of minor relationships 2 - loss of significant social relationship or social group, gain negative peer group, initiates or re joins a dysfunctional relationship IN - loss of essential supports, complete community rejection, pro-paedophilic clubs Note: In most cases, the loss of a paid therapist does not count - unless it was a particularly close and important relationship for the offender.
Substance Abuse
0 - no use 1 - some drinking, but not problematic and not prohibited 2 - problem use; any prohibited use IN - out of control, interference in daily functioning
Are Acute Factors Acute?
Most recent acute ratings predicted recidivism Average of acute ratings predicted better than most recent acute rating Average of acute ratings over the 4 th to 6 th month prior predicted as well as average for first to 3 rd month Average of last 6 months predicted slightly better than average of months 7-12
Relative Priority of ACUTE Ratings Implications for Supervision
“Basically”, as a heuristic, men who score “Moderate” on this “three level” assessment should receive twice the supervisory priority as those who score “Low” and those who score “High” should receive four times (X4) the supervisory priority as those who score “Low”.
Combining STATIC and STABLE - Empirical Rules
Low
STATIC-99 Category
Moderate-Low Moderate-High High
Low Moderate High Low Moderate High Low Moderate High Low Moderate High STABLE-2007 Category Overall Priority Low Low Moderate-Low Low Moderate-Low Moderate-High Moderate-Low Moderate-High High High High Very High
Combining STATIC/STABLE and ACUTE Factors
STATIC- STABLE-2007 Combined Category ACUTE SCORE CURRENT PRIORITY
Low Moderate-low or Moderate-high High or Very-high
Low Moderate High Low Moderate High Low Moderate High
Low Low Moderate Low Moderate High Moderate High High
Dynamic Supervision Project Suggested Methods
Static factors are typically assessed once – at the beginning of the risk assessment process Stable factors can be assessed every six to nine months, with changes over a year likely being most useful Acute factors can be assessed at every supervision opportunity, but changes are most likely to be pertinent over three to four months
Treatment
Nothing Works?
Martinson (1974)
Large-scale study of correctional treatment outcomes Could find no clear evidence that efforts to rehabilitate offenders were “working” Led to considerable research into aspects of treatment/counseling/interventions that would lead to lower recidivism
Effective Programs
Based on meta-analytic research, Don Andrews and his colleagues have suggested principles of effective correctional interventions.
Known as RNR model
Effective Programs
RISK principle
effective programs match the level of treatment intensity to the level of risk posed by the offender high risk = high intensity mismatching can result in increased risk
Effective Programs
NEED principle
effective programs target identified criminogenic needs sex offenders require sex offender specific treatment programming other programs may result in some ancillary gain, but risk for sexual recidivism likely will not be reduced
Effective Programs
RESPONSIVITY principle
effective programs are those which are responsive to offender characteristics cognitive abilities maturity motivation mode of intervention scheduling concerns
Is Treatment Effective?
In the USA, costs of sexual assault are enormous. This situation is certainly paralleled in other western nations. The cost associated with each sexual offender has been estimated as being in excess of $1.5 million. Therefore, a reduction in recidivism of merely 1%, which may or may not be statistically significant, may be viewed as socially significant in terms of cost and harm reduction.
Nothing Works?
One review of studies relating to the effectiveness of treatment found that far more studies reported positive results (treated group with significantly lower recidivist rates than untreated) than inconclusive results.
Another more recent review found that 19% of the treated offenders re-offended during an average follow-up period of 6.85 years compared with 27% of the untreated group.
California Sex Offender Treatment & Evaluation Project
The results of the SOTEP study showed no differences in sexual reoffending between treatment participants, volunteer controls, and non-volunteer controls. Follow-up was just over eight years and rates of sexual reoffending were in the 20% range for all groups.
Effective Programs
The consistency of the outcome studies accentuates the need to move beyond simple questions as to whether treatment works (Abracen & Looman, 2004).
There are a number of significant questions which have yet to be answered with reference to sex offender treatment.
For example, do higher risk clients receive more treatment programs than lower risk clients?
Assessment of In-Treatment Change with Sexual Offenders
We need to ...
Make sure that the treatment targets are actually related to recidivism Need to make sure that targets are actually being addressed
Risk Management
Today’s Situation
Upon release, many sex offenders are subject to public notification, vilification and, sometimes, vigilantism.
As a result, some are eventually driven out of one community into another and, often, go “underground”.
This does not help.
Sexual Assault is a Community Issue
The community lives in fear of sex offenders and responses to dealing with this fear are varied throughout history.
At the end of the day, reduced recidivism is everyone’s business— offender, victim, and community.
Stakeholders
victims citizens law enforcement legal and correctional personnel mental health personnel the media offenders
Risk Management
team work is critical effective risk management involves the collaboration of many different service providers offenders must be apprised of the limits of confidentiality varying the mode of contact allows for greater monitoring of activities and attitudes greater contact and monitoring increases the reliability of information leading to case management and treatment decisions and initiatives
Closing Thoughts
Research has clearly shown that a collaborative approach which includes representation from all stakeholders can assist considerably in enhancing public safety and offender accountability. Working together, we can manage the risk.
Teamwork is the key!!
Contact Information
Robin J. Wilson, PhD, ABPP
Clinical Director The GEO Group, Inc.
Florida Civil Commitment Center 13619 SE Highway 70 Arcadia, FL 34266 863 491 4805