Sex offenders: Treatment & risk assessmentJill D. Stinson, PhDETSU, Psychology

Disclosure Statement of Financial Interest

• I, Jill Stinson, PhD,

DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent

conflict of interest in the context of the subject of this presentation.

Disclosure Statement of Unapproved/Investigative Use

I, Jill Stinson, PhD, DO NOT anticipate discussing the unapproved/investigative use of a

commercial product/device during this activity or presentation.

Introduction

•About your presenter

•Outline for today▫Who are we talking about?▫Traditions & new approaches in sex

offender treatment▫Treatment effectiveness▫Thinking about risk

The sex offender…

…is not what you think.

•Heterogeneity of the population▫ Contact vs. non-contact offenders▫ Adult vs. child victims▫ Male vs. female victims▫ Familial vs. non-familial victims▫ High vs. medium vs. low risk▫ Juvenile sex offenders▫ Sex offenders with:

Paraphilias Mental illness Intellectual / developmental disabilities Psychopathic traits

Sex offender treatment

•In the early days▫Insight-oriented approaches▫Behavioral reconditioning

•Then later▫Cognitive behavioral therapy▫Pharmacological interventions▫Relapse prevention

Everyone wants treatment, right?

Sex offender treatment

•Treatment effectiveness research

▫Measured by reduction in sex offense recidivism

▫Comparisons made between treatment vs. no treatment

▫Follow-up generally 5-10 years▫Not a lot of standardization among

treatment protocols

Sex offender treatment

• Does treatment work? Um, not sure.

• Problems with treatment effectiveness research▫Short-term treatment approaches▫Focus on one outcome▫Low base rates of sex offending behavior▫Underreporting of sex offending▫Are we using the right treatment?

Sex offender treatment

•Special challenges in sex offender treatment▫Involuntary treatment participation▫High social cost of participation▫Personal discomfort▫Lack of insight or distress▫Blame, denial, & minimization

Sex offender treatment

•What doesn’t seem to work very well▫Highly aversive methods▫Indiscriminate chemical castration▫Victim empathy training▫Avoidance strategies▫Confrontation▫Overcoming denial▫General social skills training

Sex offender treatment

•Traditional goals▫Prevent sexual offending▫Control sexual behavior▫Eliminate deviant sexual interests,

thoughts, & fantasies

……But is sex all we care about?

Emerging treatment trends

•Good Lives Model•Circles of Support & Accountability•Safe Offender Strategies

Emerging treatments – New goals• Developing appropriate boundaries• Normative relationships with others• Forming good social support networks• Having prosocial interests and goals• Treating mental illness• Treating substance abuse problems• Positive life skills & experiences (job, home,

recreational activities, religious or spiritual involvement, etc.)

Measuring Risk• Sex offender recidivism

▫Sex offense specific recidivism Ranges from 10-15% over 5-10 year period post-

release▫General criminal recidivism

Ranges from 35-50% over 5-10 year period post-release

• Special groups▫ Juvenile sex offenders▫Sexually Violent Predators

About 5% of the sex offender population is responsible for the majority of sexual crime

Measuring Risk•Factors that increase risk (static)

▫ Youthful age▫ Multiple arrests or incidents of sexual offending▫ Offenses against males▫ Multiple offenses against children▫ Offenses against strangers or non-family

members▫ Other criminal arrests▫ History of non-compliance with supervision▫ Arrests for sexual offending as a juvenile▫ Limited history of normative intimate

relationships

Measuring Risk•Factors that increase risk (dynamic)

▫ Poor progress in treatment▫ Treatment dropout▫ Poor sexual self-regulation▫ Poor self-regulation▫ Limited insight into one’s own risk▫ Impulsivity▫ Paraphilias (deviant sexual interests)▫ Psychopathy, or diagnosis of ASPD▫ Offense-supportive beliefs

What now?

•Better understanding of treatment effectiveness▫What works, for whom, & when?▫Prevention practices

•More dynamic understanding of risk▫Risk is like the weather▫Mechanisms of risk