A Longitudinal Outcome Evaluation of a Prison-Based Sex Offender Treatment Program

Moderators of Sexual Recidivism as Indicator of Treatment Effectiveness in Persons With Sexual Offense Histories: An Updated Meta-analysis

The present meta-analysis is an update of the meta-analysis by Schmucker and Lösel [Campbell Syst. Rev. 2017; 13: 1-75], which synthesized evidence on sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories. The updated meta-analysis includes 37 samples comprising a total of 30,394 individuals with sexual offense histories, which is nearly three times the sample size reported by Schmucker and Lösel (2017: 28 samples, N = 9781). In line with Schmucker and Lösel (2017), the mean treatment effect was small with an odds ratio of 1.54 [95% CI 1.22, 1.95] (p < .001). A moderator analysis suggested three predictors of importance, i.e., risk level, treatment specialization, and author confounding. Greater treatment effectiveness was suggested in high- and medium-compared to low-risk individuals and in specialized compared to non-specialized treatments. Authors affiliated with treatment programs reported larger effectiveness than independent authors. These findings were overall in line with Schmucker and Lösel (2017), though the effects of risk level and treatment specialization were stronger in the current meta-analysis. The findings of the updated meta-analysis reinforce the evidence for the first and second principle of the Risk-Need-Responsivity model. The results may support researchers and decision-makers in interpreting the current evidence on sexual recidivism as an indicator of treatment effectiveness, and, based on that, implement and carry out informative, methodologically sound evaluations of ongoing treatment programs in persons with sexual offense histories.

Learning From Consumers of Mandated Sex-Offending Programs: "It's Not Treatment, I Wish It Was."

The purpose of this qualitative study was to explore clients' perceptions of sex-offending treatment. The sample included 291 people required to register as sex offenders in the U.S. who answered an open-ended question in an online survey asking them to describe their positive and negative experiences in mandated treatment. Using qualitative analysis, three overarching themes (with several subthemes) were identified: (1) positive and (2) negative treatment experiences and (3) the affiliation between the criminal justice system and clinical services. Experiences in sex offending treatment were viewed as positive when clients had opportunities to learn about themselves, experience group cohesion, build a positive alliance with a caring therapist, learn tools and skills for emotional health, explore the roots of offense behavior, and create healthy life plans to reduce risk for re-offending. Negative themes emerged when treatments were viewed as coercive, confrontational, or demeaning; when therapists seemed inexperienced or unqualified; and when seemingly outdated or unscientific methods were emphasized without explanation or dialogue. The entanglement between court-mandated treatment providers and the criminal justice system led to concerns about confidentiality, conflicts of interest, and role ambiguity. Drawing upon literature related to therapeutic alliance, trauma-informed care, and Risk-Need-Responsivity models, we offer suggestions for integrating client feedback to improve treatment responsivity and prevent re-offending.

The efficacy of CBT based interventions to sexual offenders: A systematic review of the last decade literature

Sexual violence is a significant public health problem and a devastating issue for mental health throughout the world. Clinicians and researchers have worked, over the last decades, to develop effective strategies aimed at reducing sexual abuse rates. Multiple treatment approaches for sex offenders have been developed, with Cognitive Behavioral Therapy (CBT) been the most widely used therapy model with recognized effectiveness. In this sense, the present study aimed to analyze and evaluate the effectiveness of CBT based interventions in the treatment of individuals convicted of sexual crimes. For this purpose, a systematic review of articles published between 2012 and 2022 was carried out in the databases Pubmed, Science Direct, APA PsycNet and Scielo, with the keywords "cognitive behavioral therapy", "CBT", "sexual offender", "sexual crimes" and others. As a result, eight studies were selected that met the defined inclusion criteria. Cognitive-behavioral interventions have shown great promise in reducing sexual crime recidivism and improving self-control, emotional regulation, intra and interpersonal social skills, supporting the hypothesis that CBT may be a promising model of intervention in forensic settings with sex offenders.

Balancing Political and Criminogenic Needs: Evaluating the New Zealand Department of Corrections' Response to Men Assessed With a Below Average Risk for Sexual Recidivism

Current research provides little evidence for the effectiveness of treatment in reducing sexual offence recidivism amongst low-risk populations. However, in real-world correctional settings, program delivery rarely occurs in a vacuum, treatment may be politically mandated and unidimensional measures of program success may preclude recognition of broader benefits. The current study investigated the effectiveness of a low-intensity treatment program, both in terms of participants' recidivism outcomes and in terms of broader organizational/systems impacts. The results demonstrated low base rate recidivism across both program participants (n = 311) and a comparison group of men who were assessed as demonstrating similar static sexual offence recidivism risk (n = 391), and little evidence of reduced recidivism following treatment. However, program administration led to many potential participants being identified as demonstrating higher levels of dynamic risk and overridden to more intensive treatment options (n = 101). Given evidence that such options do effectively reduce recidivism in higher risk populations, these findings may suggest an overall positive net effect.

The Absence of Evidence-Based Practices (EBPs) in the Treatment of Sexual Abusers: Recommendations for Moving Toward the Use of a True EBP Model

Despite a continued evolution of the field of sexual abuser treatment toward a distinct professional discipline with clinicians using an increasing variety of treatment approaches, there is no consensus regarding the strength of our various clinical interventions as evidence-based practices (EBPs). This article provides a brief history of the development and goals of EBPs in medicine and mental health, and a review of the earnest efforts of researchers within the field to establish treatment approaches with sexual abusers as evidence-based. An appraisal of the current status of EBP's with sexual abusers is provided. Although there have been improvements in the methodological quality of treatment outcome research with sexual abusers, divergent opinions about treatment effectiveness remain, and the field has not yet agreed on a system or set of criteria for what constitutes "evidence." We contend that clinical practice has been influenced as much, or more, by new paradigms that are intuitively meaningful and perceived as needed than it has by what has been determined to be scientifically efficacious. This trend and other processes in our field that seem to be slowing the development of EBPs with sexual abusers are discussed. Recommendations for conducting evidence-based reviews and moving the field of sexual abuser treatment toward the use of a true EBP model are provided.

On the Effectiveness of Sexual Offender Treatment in Prisons: A Comparison of Two Different Evaluation Designs in Routine Practice

Although there is less continuity of sexual offending in the life course than stereotypes suggest, treatment should lead to a further reduction of reoffending. Contrary to this aim, a recent large British study using propensity score matching (PSM) showed some negative effects of the core sex offender treatment program (SOTP) in prisons. International meta-analyses on the effects of sex offender treatment revealed that there is considerable variety in the results, and methodological aspects and the context play a significant role. Therefore, this study compared different designs in the evaluation of sex offender treatment in German prisons. PSM was compared with an exact matching (EM) by the Static-99 in a sample of 693 sex offenders from Bavarian prisons. Most results were similar for both methods and not significant due to low base rates. There was a treatment effect at p < .05 on general recidivism in the EM and at p = .06 on serious reoffending in the PSM. For sexual recidivism, EM showed a negative trend, whereas PSM suggested the opposite. Overall, the study underlines the need for more replications of evaluations of routine practice, methodological comparisons, sensitive outcome criteria, and differentiated policy information.

State of the Art Treatment Options for Actual and Potential Sexual Offenders and New Prevention Strategies

Sexual violence is a significant and devastating issue for men and women throughout the world. Its consequences are not only disastrous for victims of sexual violence but are also extremely costly (estimated cost of $41,000 per rape) for society. Successful treatment of sexual offenders is therefore an important goal for society as well as for victims and offenders themselves. Over the years, multiple treatment approaches for sex offenders have been developed. Treatment programs range from the risk-need-responsivity (RNR) model, which focuses on providing tailored treatment for high-risk and low-risk offenders, to psychodynamic models. This article presents an overview for clinicians of state-of-the-art offender treatment, describing the most common treatment approaches, in particular the RNR model, cognitive-behavioral programs (relapse prevention programs, sexual offender treatment programs), psychodynamic approaches (transference-focused psychotherapy, mentalization-based therapy), the Good Lives Model, as well as pharmacological options. In addition, it provides an evaluation of the various treatment programs. However, given the fact that most acts of sexual violence will never be reported to the police, the question arises if treating convicted perpetrators is enough. Do we need rather-in terms of preventive work-a program for potential sexual offenders and men with delinquent sexual fantasies? Given the prevalence of sexual violence and its impact on victims, society, and the medical community, it would be remiss not to try to reach potential/unconvicted perpetrators. This article offers novel ideas and a project the goal of which is to prevent sexual offenses against women by introducing the "I CAN CHANGE" program from Hannover Medical School.

A Call for Research on Sex Offender Treatment Programs

The effects of sex offender treatment programs have been addressed in the literature, but there are opportunities to expand research and potentially improve existing sex offender treatment programs. The Federal Bureau of Prison's Sex Offender Treatment Program gives offenders the opportunity to change their behavior by reducing criminality and recidivism, and receive transition services as offenders exit the prison system and reenter society. This program is evidence-based and utilizes landmark research in sex offender treatment, however there are a few details that may present limitations to the effectiveness of the treatment program within the Federal Bureau of Prisons. Entry requirements, such as literacy, cognitive, and remaining sentence requirements, as well as the treatment program environment, present opportunities for research to evaluate the effects of these variables on the convicted sex offender population.

Beyond Circles of Support: "Fearless"-An Open Peer-to-Peer Mutual Support Group for Sex Offense Registrants and Their Family Members

The term sex offender carries expectations that include a continuous level of sexual criminal risk and untreatable mental health conditions that govern sex offending behaviors. These role expectations by the public can socially isolate individuals who have been convicted of a crime and the people who love them. This is likely to contribute to negative self-images that can result in loneliness, isolation, and depression, and, subsequently, contribute to discontinuing support for sex offender's loved ones and reoffending. This article highlights the creation and maintenance of a peer-to-peer social support group for registered sex offenders and their family members that helps combat the effects of "sex offender" labels. This group differs from formal organized circles of support model and traditional self-help groups such as Alcohol (AA) or Narcotic (NA) Anonymous. We review this group's creation, processes and procedures, and outcomes, including changes in cognition, mood, and affect over time for members in the group.

The utility of peer-support in enhancing the treatment of incarcerated sexual offenders

Purpose

In the quest to maximize treatment gains, recent research has shifted focus from treatment itself to the context in which treatment takes place. Such investigations have alluded to rehabilitative climate, therapeutic alliance, prison social climate, and the efficacy of group process. The purpose of this paper is to review peer-support as a mechanism via which these goals might be reached.

Design/methodology/approach

A review of the literature on peer-support in carceral settings was undertaken in February 2017.

Findings

While there is very little research exploring peer-support in the context of offender rehabilitation, there are some promising signs from many qualitative investigations that peer-led roles can bridge many gaps in support within the therapeutic context.

Research limitations/implications

More research on the potential negative impact of peer-support in carceral setting is needed.

Practical implications

This paper proposes that the implementation of peer-support programs that operate alongside treatment interventions represent an encouraging direction for the future. It is argued that prisoner-led peer-support initiatives that are characterized by shared problem solving and reciprocal emotional support can greatly reduce the anxiety prisoners face surrounding treatment. It is suggested that, through peer-support, treatment gains may be enhanced and better assimilated into program-completers’ lives.

Social implications

Peer-support may assist current treatment approaches with sexual offenders and could therefore potentially contribute to reductions in recidivism.

Originality/value

This paper is the first to review peer-support in the context of imprisonment and offender therapy. It therefore provides an important status update for future researchers wishing to investigate this topic, and outlines several priorities that such research might interrogate further.