Correctional treatment for co-occurring disorders: results of a national survey

The significant expansion of correctional populations in the last decade, coupled with the gradual erosion of community treatment infrastructure and health insurance, have brought greater attention to the needs of offenders who have co-occurring mental health and substance use disorders. Individuals with co-occurring disorders frequently cycle through acute care facilities in the community and increasingly are placed in jails or prisons. Approximately 16% of inmates in correctional facilities have major mental health disorders (Bureau of Justice Statistics, 1999), and a large majority of these inmates have co-occurring substance use disorders. Few studies have examined the effectiveness of correctional treatment for co-occurring disorders, and there is little information available regarding clinical and programmatic approaches used with this population. The current study provides findings from a comprehensive national survey of co-occurring disorder treatment programs in correctional settings. A total of 20 co-occurring disorder treatment programs from 13 state correctional systems were identified and surveyed. Many of the programs featured modified therapeutic communities, but there was significant diversity in the duration of treatment and type of services provided. Several unique structural and clinical modifications to treatment have been developed in these settings. Implementation of co-occurring disorder treatment programs has led to enhanced collaboration with prison health services and community supervision and treatment agencies, and greater use of interdisciplinary staff to provide outreach and case management services. Research is now being conducted to examine outcomes in several of these correctional treatment programs.     

Innovative Community Services for Rape Victims: An Application of Multiple Case Study Methodology

A qualitative multiple case study design was used to examine communities across the United States that have developed coordinated community-based programs to assist rape victims. Previous studies have suggested that coordinated community programs help victims obtain needed resources and services. This study provided a follow-up examination of how and why these programs are helpful to rape victims. In-depth interviews were conducted with rape victim advocates, rape crisis center directors, police officers, prosecutors, doctors, nurses, and rape survivors from 22 communities with coordinated programs. A comparison sample of 22 communities with fewer coordinated programs was also obtained. Results indicated that the high coordination communities had three types of programs to address sexual assault: coordinated service programs, interagency training programs, and community-level reform groups. Although not all of these programs directly address service delivery for rape victims, they help create a community culture that is more responsive to victims' needs. The research team and participants developed an explanatory model of why these program are effective in addressing rape victims' needs. This model hypothesizes that coordinated programs reflect an understanding of the multiple contexts of service delivery and embody that knowledge in services that are consistent with victims' needs. Narrative data from the interviews with service providers and rape survivors are used to develop and support this model.     

Leugnen bei inhaftierten Sexualstraftätern

Many sex offenders deny the charges which is often considered as a barrier to treatment and an indicator of an elevated risk for re-offending. Both expectations, however, are controversial in the literature. In the context of Andrews’ and Bonta’s risk-need-responsivity (RNR) model it seems appropriate to understand denial not as a risk factor but as a responsivity issue. A study of 1,381 sex offenders released from prison in Bavaria since 2004 showed that deniers seldom participated in treatment programs and were rarely granted a temporary licence or early release from prison, compared to those who admitted the offenses. The proportion of deniers was higher in immigrants, married and older persons. For 833 offenders released up to the end of 2008 reconviction records were available, with a time at risk of between 5 and 9 years. No correlations were found between denial and violent, sexual, serious or general recidivism. The implications of these findings relate to the correctional treatment of sex offenders and the need for programs that are adapted to the needs of deniers.     

COD services in community correctional settings: an examination of organizational factors that affect service delivery

Little is known about service delivery for those in the correctional system with co-occurring mental health and substance abuse disorders (COD). Using data from the National Criminal Justice Treatment Practices survey (NCJTP) on community corrections and jail agencies, this study found that correctional organizations that offer COD services differ from agencies that do not. Organizations that respond to the needs of COD offenders tend to be more "service friendly," rank higher on measures of various dimensions of organizational climate that embrace learning and goal achievement, and tend to adopt more innovations, particularly those classified as evidence-based practices. These survey findings indicate that correctional agencies who serve COD offenders are in a better position to be responsive to the changing service needs of the populations, and are more likely to be able to balance public safety and treatment goals. Future steps to develop support environments for COD assessment and treatment services are discussed in light of these findings.     

Sex offender community notification: managing high risk criminals or exacting further vengeance?

The current trend in dealing with convicted sex offenders is to impose long prison sentences followed by stringent release conditions. Added to this practice has been the policy of making such offenders who have been returned to society more visible to the public. In state after state, sex offender community notification laws have been passed, enabling communities to be put on notice that a convicted sex offender has become a resident. To date there has been little empirical evidence regarding the impact of these laws on managing sex offenders in the community. This study focuses on the social and psychological effects of community notification on sex offender reintegration within those communities where notification has occurred. Data are derived from face-to-face interviews with 30 convicted sex offenders, residing in various locations throughout Wisconsin, who were the subjects of community notification. The findings indicate that community notification can have a critical impact on the minimum essentials needed for the reintegration of offenders within the community. What is proposed is a reintegrative approach which suggests that stable housing and employment would mitigate the disruptive and antitherapeutic effects of community notification.     

Megan's Law and its impact on community re-entry for sex offenders

Community notification, known as "Megan's Law," provides the public with information about known sex offenders in an effort to assist parents and potential victims to protect themselves from dangerous predators. The purpose of this study was to explore the impact of community notification on the lives of registered sex offenders. Two hundred and thirty-nine sex offenders in Connecticut and Indiana were surveyed. The negative consequences that occurred with the greatest frequency included job loss, threats and harassment, property damage, and suffering of household members. A minority of sex offenders reported housing disruption or physical violence following community notification. The majority experienced psychosocial distress such as depression, shame, and hopelessness. Recommendations are made for community notification policies that rely on empirically derived risk assessment classification systems in order to better inform the public about sex offenders' danger while minimizing the obstacles that interfere with successful community reintegration.     

Have Mental Health Education Programs Influenced the Mental Health Literacy of Those with Major Depression and Suicidal Ideation? A Comparison between 1998 and 2008 in South Australia

Mental health literacy is the knowledge and beliefs about mental disorders that aid their recognition, management, or prevention and is considered to be an important determinant of help‐seeking. This has relevance in suicide prevention, as depression, the clinical condition most frequently associated with suicidality, has been the target of community and professional education programs designed to enhance mental health literacy. In this study, whether such programs have influenced help‐seeking attitudes and behavior in those who are depressed and suicidal was considered. The results indicate that despite intensive community education programs over the last two decades, there has been little change in those who are depressed and suicidal in terms of their attitudes toward treatment seeking and, more importantly, their treatment‐seeking behavior. These results draw into question the value of current community education programs for those most vulnerable to suicidal behavior.     

MISUNDERSTOOD IN THE DIASPORA: THE EXPERIENCE OF ORTHODOX SIKHS IN VANCOUVER

Heroism and martyrdom are central values in contemporary Sikh historiography and primary symbols in their collective memory. Both are replete with the stories of numerous heroes and martyrs who faced death, unflinchingly fighting in defense of the Sikh faith and its believers (constituting the Panth or community) against overwhelming odds. Conversely, it is considered shameful for Sikhs to become mere victims, succumbing to attacks against faith and community without fighting to the death. It is also insisted that true Sikhs do not themselves attack those who are weak or harmless; on the contrary true Sikhs come to the defense of such persons even if they are not of the same faith. However, during the last half century, Sikhs have many times become victims, as well as perpetrators of violence, being unable to act in a way consistent with their central values. The consequence has been an inability to integrate their modern history successfully into a narrative consistent with those values and to find appropriate ways of memorializing what has been done to many Sikhs and what many Sikhs have done to others.     

Bullying behaviors in female and male adolescent offenders: prevalence,types, and association with psychosocial adjustment

Despite the surge of research on bullying, few studies have examined bullying in young offenders, particularly female young offenders. This study investigated the prevalence, types, and correlates of bullying behaviors in 193 male and 50 female incarcerated adolescents from nine young offender facilities. Overall, 37% of participants identified themselves as bully‐victims, 32% as pure bullies, 23% as not involved, and 8% as pure victims. In comparison to males, females were more likely to report being involved with bullying in some capacity, particularly as pure victims, and being bullied by sexual touching and comments. Pure victims reported higher rates of psychological distress and suicidal behaviors than those youth not involved in bullying, and pure bullies were more likely to have been previously incarcerated and affiliated with a gang. Bully‐victims reported the highest rates of previous abuse, peer victimization in the community, drug use, and suicide attempts while in custody. All groups, including pure victims, reported high rates of bullying others in the community. Treatment providers should recognize that offenders who are victims are often bullies as well, and be alert to broad mental health needs among victims and bully‐victims. Given the prevalence and potential serious consequences of bullying, the development of anti‐bullying policies appears to be an important step in recognizing and reducing bullying. Aggr. Behav. 00:1–16, 2005. © 2005 Wiley‐Liss, Inc.     

Empathy deficits and sexual offending: A model of obstacles to empathy

Theoretical models of the role of empathy in sexual offending agree on five components relevant to the experience of empathy: a respectful and compassionate orientation to others, perspective taking, affective responding, the ability to manage personal distress, and situational factors. We identify overlap between these components of the empathic process and established risk factors for sexual offending and create a model detailing potential blocks to the empathic process during sexual offending. The model has external consistency and useful implications for interventions with sex offenders. Viewed in the light of this model, we argue that current sex offender treatment programs spend a disproportionate amount of time examining empathy for past victims. We recommend, instead, that treatment aims to enhance offenders' abilities in relation to the components of the empathic process more generally, using creative and engaging techniques akin to those used to develop “victim empathy”.     

Repairing the rupture: Restorative justice and the rehabilitation of offenders

Restorative justice is a social justice movement that aims to deal with consequences of crime through repairing and restoring relationships of three key stakeholders: victims, offenders, and communities. Unfortunately, it is often unclear where offender rehabilitation fits within the constructs of repair and reintegration that drive this justice paradigm. An analysis of the relationship between restorative justice theory and offender rehabilitation principles reveals tensions between the two normative frameworks and a lack of appreciation that correctional treatment programs have a legitimate role alongside restorative practices. First, we outline the basic tenets of the Risk–Need–Responsivity Model and the Good Lives Model in order to provide a brief overview of two recent models of offender rehabilitation. We then consider the claims made by restorative justice proponents about correctional rehabilitation programs and their role in the criminal justice system. We conclude that restorative justice and rehabilitation models are distinct, although overlapping, normative frameworks and have different domains of application in the criminal justice system, and that it is a mistake to attempt to blend them in any robust sense.     

Bullies, Victims, and Antipathy: The Feeling is Mutual

In this study we consider whether bullies and victims are disliked by most of their classmates, or whether antipathy is concentrated among the occupants of these roles. Antipathy nominations were collected from a community sample of 699 Finnish adolescents (14 to 17 years of age), who described their own bullying and victimization, as well as problem behaviors and school engagement. Victimization was associated with antipathy, but the strength of the association differed according to characteristics of the nominator. Victimization was related to antipathy when the nominator was high on bullying but not low. Similarly, bullying was related to antipathy when the nominator was high on victimization, but not low. The findings indicate that although bullies and victims have elevated mean levels of rejection, they are not disliked by most peers but rather by those who report themselves to be high on these attributes.     

Therapeutisches Gruppenprogramm für Stalking-Opfer

Stalking victims show a high level of psychological disturbance and frequently need professional help. Thus, stalking must be considered as a serious issue in the field of psychosocial care. However, specific intervention programs to support stalking victims are not available. This paper reports on a pilot project that offers therapeutic help to stalking victims via a structured outpatient group therapy approach. The program aims at setting up appropriate behavior patterns concerning contact with the stalker, strengthening the victims’ self-efficacy and developing coping strategies for stalking-related stress situations. To investigate the effectiveness of the group program, an evaluation study has been conducted using self-report inventories, interview data and biological parameters. Preliminary results from 4 completed groups with 13 participants, indicating that the approach is highly effective, are reported. The potential of the group approach to improve psychosocial care provision for stalking victims is discussed. The need to integrate psychotherapeutic approaches into a multi-professional support system for stalking victims, comprising legal counsel, police measures and psychosocial interventions, is emphasized.     

Psychological Resources in Australasian Correctional Departments

The past and present delivery of psychological services to correctional departments in Australia and New Zealand was surveyed via questionnaires. Responses were received from six of the eight Australian jurisdictions surveyed and the one New Zealand department. Considerable variation in size and range of service was evident. Clinical work, particularly treatment, was the central activity in all cases. Recent developments, such as larger-scale treatment programs for special groups (e.g., sex offenders) and contributions to overall correctional management were repotted by some respondents. The restructuring of psychology sections in some departments had produced problems in relations between psychologists and their employing departments. Similarities in developments and issues in correctional psychology in the United States, England, and Wales were noted.     

More Alike than Different? Comparison of Formerly Incarcerated Youth with and Without Disabilities

We describe and compare the demographic characteristics of incarcerated youth with and without disabilities. These data were gathered as part of a 5-year longitudinal study that examined the experiences of 531 incarcerated youth from Oregons juvenile justice system as they left the correctional system on parole and returned to the community. Data on the demographic characteristics of the sample were gathered from files and through interviews conducted while the sample was still in state custody. We compared the two groups on 22 selected variables. Statistical comparisons indicated that the two groups were similar on most variables. The final statistical model indicated that participants with disabilities were more likely to have flunked a grade while in school, been committed to the juvenile correctional system for a person-related crime, and to have been last adjudicated for a felony in an urban setting. The implications of these findings for research and practice are discussed.     

Juvenile sex offenders: similar to, or different from, other incarcerated delinquent offenders?

The purpose of the present study was to compare incarcerated juvenile sex offenders to incarcerated youth who committed confrontational but nonsex offenses, and to those youth who committed only nonconfrontational, nonsex offenses. Furthermore, comparisons were made between two subtypes of sex offenders: those youth convicted for rape or sodomy vs those convicted for child molestation. Eighty-three male juvenile delinquents served as participants. Teachers within the correctional facility completed an instrument which allowed the examination of the two areas of interest: externalizing problems and internalizing problems. The results indicated that sex offenders generally, and particularly those who had committed only sex offenses, were perceived as having fewer externalizing and internalizing problems. No differences emerged between the two subtypes of sex offenders. Implications, as well as limitations, of the findings are discussed.     

A narrative review of research on clinical responses to the problem of sexual offenses in the last decade

Research on the treatment and programs for people who have committed sexual offenses has greatly increased in the past decade. The aim of this review is to discuss research that has been published over that period (2010–2019) that is relevant for treatment providers. The articles included in this review were found through PsycINFO and PubMed (Medline) using the keywords “treatment or therapy” and “sex offen*”. The inclusion criteria were publications that discuss treatment of persons who have committed sexual offenses (written in the English language only). Any articles that examined only special populations were excluded, such as those that examined persons who committed sexual offenses who were female, had intellectual disabilities, deafness, juveniles, etc., because these groups will likely have needs and responsivity factors that differ from the “average” natal-born male sex offender. Results showed that several meta-analyses indicate that treatment is effective in reducing sexual recidivism. The most frequently used treatment for sex offenders is cognitive behavioral therapy, which is often provided in conjunction with pharmacological treatment to reduce sexual impulsivity and/or sex drive. This review is limited to the specific key search terms. The findings of this review support the use of treatment and a community reintegration approach when treating persons who have committed sexual crimes to prevent sexual recidivism.