Offender engagement in group programs and associations with offender characteristics and treatment factors: A review

The aim of this review is to establish how offender engagement within group programs has been conceptualized, defined or assessed, and the factors that are associated with it. Existing models describe determinants of engagement and the process of behavioral change, but there is little in the way of theory explaining the process of engagement in treatment and change. Forty-seven studies were reviewed and revealed inconsistent definitions and assessments of engagement as well as inconsistent use of measures which contributes to confusion about the scope of engagement and reflects the lack of theory. Attendance, completion or dropout rates were frequently relied upon, but may not reliably infer engagement. Participation and out of session behaviors in conjunction with one another, reflecting a series of active responses to treatment, may more reliably reflect engagement in treatment and change. A model for offender engagement is presented which might help clarify the role of engagement variables. Offender demographics appeared to be of little value in predicting engagement, with only a small number of psychosocial factors (hostility, impulsivity) predicting low levels of engagement and most others (anger, anxiety) having little influence. Treatment factors (therapeutic relationship, program objectives) were more consistently related to engagement, but are under-researched.     

Pornography use and sexual aggression: the impact of frequency and type of pornography use on recidivism among sexual offenders

In this study, we examined the unique contribution of pornography consumption to the longitudinal prediction of criminal recidivism in a sample of 341 child molesters. We specifically tested the hypothesis, based on predictions informed by the confluence model of sexual aggression that pornography will be a risk factor for recidivism only for those individuals classified as relatively high risk for re-offending. Pornography use (frequency and type) was assessed through self-report and recidivism was measured using data from a national database from the Royal Canadian Mounted Police. Indices of recidivism, which were assessed up to 15 years after release, included an overall criminal recidivism index, as well as subcategories focusing on violent (including sexual) recidivism and sexual recidivism alone. Results for both frequency and type of pornography use were generally consistent with our predictions. Most importantly, after controlling for general and specific risk factors for sexual aggression, pornography added significantly to the prediction of recidivism. Statistical interactions indicated that frequency of pornography use was primarily a risk factor for higher-risk offenders, when compared with lower-risk offenders, and that content of pornography (i.e., pornography containing deviant content) was a risk factor for all groups. The importance of conceptualizing particular risk factors (e.g., pornography), within the context of other individual characteristics is discussed.     

A theoretically informed meta-analysis of the risk for general and violent recidivism for mentally disordered offenders

Mentally disordered offenders (MDOs) pose a significant challenge for forensic and correctional staff charged with managing them in a safe and humane manner. As with non-disordered offenders, it is important to identify the factors that are predictive of recidivism and can serve as treatment targets for MDOs. The present meta-analysis evaluated the relative predictive validity of the risk/need domains from the General Personality and Cognitive Social Learning (GPCSL) perspective and variables taken from the clinical perspective. The search yielded a total of 126 studies reporting on 96 unique samples (N = 23,900). Results indicated that all risk/need domains under the GPCSL perspective were significantly related to both general and violent recidivism. In contrast, the majority of clinical variables (with the exception of antisocial personality/psychopathy) were not predictive of either outcome. These findings emphasize the importance of identifying appropriate risk factors for MDOs.     

A dynamic assessment of offender risk, needs, and strengths in a sample of pre-release general offenders

Static, dynamic, and protective factors have been identified as three focal domains significantly related to offender recidivism. However, few measures include comprehensive and inclusive assessment of these variables. The Inventory of Offender Risk, Needs, and Strengths (IORNS) was developed to fill a void in the assessment of risk and needs for offenders. The current study examines the reliability and initial validity of the IORNS in a sample of pre-release offenders assessed for risk and treatment need. Results indicate moderate to high levels of internal consistency and identical IORNS scale results across race, and that the IORNS indexes, scales, and subscales display good convergent validity with self-report and interview measures of static risk, dynamic risk, antisocial behavior, psychopathy, personality pathology, substance abuse, depression, and anxiety. Initial predictive validity examination of the IORNS indicates that several of the indexes, scales, and subscales were able to differentiate offenders who were sent back to prison for half-way house rule violations from those who did not violate rules.     

Sensationalising sex offenders and sexual recidivism: Impact of the Serious Sex Offender Monitoring Act 2005 on media reportage

Differences in extent and nature of newspaper media reporting before and after the introduction of the Serious Sex Offender Monitoring Act 2005 in Victoria were investigated, critically exploring the interface between psychological, media and criminological disciplines. Forty‐three news items before the Act and 90 after the Act were analysed using a thematic and discursive framework. A significant increase in the number of items was found after the Act but other discursive and thematic findings were mixed. Several indicators of sensationalism such as headline size, tone, and theme did not differ between time frames, while there was a significant increase in the incidence of case‐based and high‐profile case reporting after the introduction of the Act. Hence, although the discourse and frames within which serious sex offenders are reported has remained similar over time, the introduction of the Act has dramatically impacted on the frequency of reporting in such cases. The findings are congruent with the extant literature on the newsworthiness of child sexual offending, indicating a need for media outlets to be more responsible in their reporting, and for legislators to enact legislation based upon empirical evidence.     

Effective interventions and the Good Lives Model: Maximizing treatment gains for sexual offenders

The effective risk management of sexual offenders is arguably one of the most contentious social issues of our day. The community is justifiably outraged by what it perceives to be a failure of correctional and mental health practitioners to demonstrate that rehabilitative and supervisory methods promote public safety. Those who treat offenders and attempt to manage risk are often frustrated by what appear, at times, to be emotion-based reactions to low base-rate incidents. The literature on effective correctional programming has produced a workable model—Risk/Needs/Responsivity (RNR)—in which interventions match intensity of treatment to level of risk, specifically target criminogenic needs, and tailor treatment to the personal and interpersonal needs and capacities of participants. However, this model has been criticized regarding an apparent failure to appreciate the totality of client needs, specifically with respect to offender responsivity concerns. The Good Lives Model (GLM) suggests that treatment for sexual offenders must regard participants as whole beings in need of focus in many principal life areas (e.g., family, employment, leisure, community, personal well-being). This article proposes that RNR and GLM are complementary and that, by emphasizing the merits of each, offender management and general well-being can be maximized while community safety is increased.     

Child sexual abuse: offenders,disclosure, and school-based initiatives

Children are being sexually abused at an alarming rate. Prevalence estimates suggest that one out of four girls and one out of ten boys experience sexual abuse. This paper examines the devastating impact of child sexual abuse and explores the contributions of school-based interventions to remedy the problem.     

Diagnostic issues,multiple paraphilias,and comorbid disorders in sexual offenders: Their incidence and treatment

This paper critically appraises the criteria for DSM diagnoses of the paraphilias relevant to sexual offenders. It is concluded that these criteria leave a lot to be desired and that a more helpful approach would be to rate the features of each type of sexual offender along dimensions ranging from normal to seriously problematic. Next consideration is given to the evidence on the incidence of multiple paraphilias and comorbid disorders. It is not yet completely clear from this evidence that sexual offenders typically have multiple sexual outlets although some obviously do. What is clear is that incidence of comorbid disorders is sufficiently high to warrant concerns about how to effectively address these additional disordered aspects of sexual offenders in treatment. Finally, suggestions are offered about how to address in treatment both multiple paraphilic offenders and those with associated comorbid disorders.     

From child pornography offending to child sexual abuse: A review of child pornography offender characteristics and risks for cross-over

In this review, concrete directions are provided for individual risk assessment, treatment planning, and future research on child pornography offending. First, based on reviewing offender characteristics, including demographics, socio-affective difficulties, cognitive distortions and psychosexual issues, it is concluded that despite individual differences, many child pornography offenders have psychological difficulties in multiple areas of functioning. Based on earlier child pornography offender typologies, it is proposed that risk factors of individual offenders can be viewed along the lines of two continua: (1) features related to criminal behavior, and (2) sexual deviance/fantasy. These continua not only give insight into psychological differences between offender types, but also allow for variation in the severity of psychological difficulties within offender types and therefore may enhance individual risk assessment and treatment planning. Moreover, risk factors for cross-over are discussed, including individual characteristics, factors related to engagement with the internet, and the offline environment. Future research should focus on the integration of risk domains within particular offending types. Specifically, research is needed on non-offending pedophiles in order to gain more insight into the relationship between pedophilia and child pornography offending in general.     

Understanding cognitive,affective, and intimacy deficits in sexual offenders: A developmental perspective

Factors, such as intimacy deficits, problems empathizing with victims, and cognitive distortions, have all been associated with the genesis of sexual abuse. Importantly, they all point to a lack of awareness of other peoples' beliefs, desires, perspectives, and needs. We argue that sexual offenders' problems in these domains can be viewed as partially arising from deficits in one central mechanism: the ability to infer mental states. Following a review of the above three areas, we discuss the developmental literature on children's theory of mind and develop a model informed by this work. We apply this model to sexual offenders and discuss its research and clinical implications.     

A review of the factors that can influence the effectiveness of sexual offender treatment: Risk,need, responsivity,and process issues

The aim of this paper is to review various factors that may affect the effectiveness of sex offender treatment. First, attention to risk level is discussed as an important factor in terms of ensuring that treatment is administered according to the level of an offender's problems and that treatment addresses criminogenic needs. Second, a number of responsivity/intra-individual characteristics (e.g., psychopathy, motivation, and locus of control), which may influence treatment outcome, are examined. Third, the importance of considering process issues, such as the therapeutic climate of the group, the composition of the group, and therapist characteristics is discussed. Finally, suggestions for future research and for optimizing the effectiveness of sex offender treatment are provided.     

Sex offenders, sentencing laws and pharmaceutical treatment: a prescription for failure

The phenomenon of adults who have sexual interests involving children as partners, or pedophiles, is considered among the most sociopathological of human conditions. Considerable literature is devoted to issues and problems associated with or related to pedophilia, including prevalence, etiology, treatment, and outcome studies. The sexual victimization of children, based upon data gathered from a number of sources, suggests an intractable problem that is national in scope. Recent manifestations of society's efforts to deal with the sexual victimization of children include the enactment of criminal sentencing laws that mandate the treatment of offenders with certain pharmaceutical agents, such as medroxy-progesterone acetate ("MPA"). Because sentencing laws as a rule vary widely from state to state, there is considerable variation as to who is subject to MPA treatment laws, and how such laws-including specific provisions, such as clinical criteria, if any, required for treatment; type and period of treatment plans; informed consent; etc-are implemented. Most important, these sentencing laws may have remarkably little relation to what is widely considered effective treatment for pedophilia disorders. We examine in detail the most recent sentencing laws pertaining to treatment of persons who have been convicted of sex offenses involving children as victims. Our critique may offer insight and suggestions as to how such sentencing laws can be more suitably tailored to the treatment needs of persons with pedophilia disorders.     

Empathic deficits in sexual offenders: An integration of affective,social, and cognitive constructs

A number of researchers have suggested that lack of empathy is a critical feature in the assessment and treatment of sex offenders. However, difficulties with definitions of empathy and corresponding measures of that construct have led to limited and disparate empirical findings supporting this claim. Such findings may be due to a definition of empathy that fails to incorporate other key factors related to sexual offending. Factors such as inaccurate social perceptions, cognitive distortions, deficits in interpersonal intimacy, maladaptive emotional regulation abilities, and other socio-cognitive deficiencies thought to contribute to sexually assaultive behavior also share a number of core developmental features with affect and emotional responding. As socio-cognitive abilities tend to develop simultaneously at times as humans mature, it is suspected that social, cognitive, and affective skills impact one another's development and ultimately dictate the expression of empathy in adulthood. Accordingly, deficits in social skills, interpersonal intimacy, and cognitive processes necessary to emotional stability and appropriate social interaction may be critical to the development and expression of empathic deficits and subsequent efforts to treat or reduce such deficits in sexual offenders. This paper will review and integrate literature examining the relationship of various socio-cognitive factors to empathic deficits in sexual offenders.     

The validity and reliability of the Violence Risk Scale-Sexual Offender version: assessing sex offender risk and evaluating therapeutic change

The Violence Risk Scale-Sexual Offender version (VRS-SO) is a rating scale designed to assess risk and predict sexual recidivism, to measure and link treatment changes to sexual recidivism, and to inform the delivery of sexual offender treatment. The VRS-SO comprises 7 static and 17 dynamic items empirically or conceptually linked to sexual recidivism. Dynamic items with higher ratings identify treatment targets linked to sexual offending. A modified stages of change model assesses the offender's treatment readiness and change. File-based VRS-SO ratings were completed on 321 sex offenders followed up an average of 10 years post-release. VRS-SO scores predicted sexual and nonsexual violent recidivism post-release and demonstrated acceptable interrater reliability and concurrent validity. A factor analysis of the dynamic items generated 3 factors labeled Sexual Deviance, Criminality, and Treatment Responsivity, all of which predicted sexual recidivism and were differentially associated with different sex offender types. The dynamic items together made incremental contributions to sexual recidivism prediction after static risk was controlled for. Positive changes in the dynamic items, measured at pre- and posttreatment, were significantly related to reductions in sexual recidivism after risk and follow-up time were controlled for, suggesting that dynamic items are indeed dynamic or changeable in nature.     

Men's media use, sexual cognitions, and sexual risk behavior: testing a mediational model

Efforts to link media use to adolescents' sexual initiation have produced somewhat inconsistent results, perhaps as a result of the limited framing of the question. This study sought to expand current approaches by sampling college students instead of high school students, by investigating a range of sexual behaviors and media formats, and by testing a model that featured sexual cognitions as mediators. We tested our model with a sample of 796 heterosexual, male college students who reported on their regular consumption of 4 media (prime-time TV programs, music videos, movies, and men's magazines); their attitudes toward abstinence, the male sexual role, and nonrelational sex; their perceptions of peer sexual behavior; and several aspects of their sexual behavior (e.g., number of sexual partners). Findings revealed strong support for our mediated model, with exposure to men's magazines and movies contributing most strongly to their sexual cognitions, and with men's cognitions, in turn, contributing heavily to their sexual behavior. Some direct connections from media use to sexual behavior also emerged. Together, the findings provide insight into both potential mechanisms for and new approaches to addressing this issue.     

The biological treatment of dangerous sexual offenders: A review and preliminary report of the Oregon pilot depo-Provera program

Despite advances in the cognitive and behavioral treatment of sexual offenders made over the past 10 years, a number of such individuals released from custody and on parole in their communities remain dangerous to be at large. Even if such men are currently undergoing treatment, psychological approaches by themselves cannot be expected to immediately reduce risk. Therefore, interest has been expressed in medical approaches to making such individuals safer to be at large while undergoing more traditional treatment techniques. While surgical castration has been endorsed by some European countries in the past, it continues to be considered a capital punishment beyond the scope of judicial mandate in the US. Instead, medications to reduce sexual drive have been promoted as adjuncts in the treatment of dangerous sexual offenders. The present review examines the body of literature investigating three classes of medications currently employed to achieve this goal: (1) hormonal agents acting peripherally, predominantly medroxyprogesterone acetate (MPA) (depo-Provera), (2) hormonal agents acting centrally, predominantly leuprolide (Leupron), and (3) serotonin-active antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil). Finally, preliminary results are presented from a pilot program in Oregon in which potentially dangerous sexual offenders are identified in state institutions prior to release and recommendations made for depo-Provera once they reach their communities. Initial follow-up results are presented along with recommendations for similar programs to enhance safety in this select group of offenders.     

Parricides: Characteristics of offenders and victims,legal factors,and treatment issues

Parricides account for about 2% of all homicides. Perpetrators are typically White middle-class males without a history of prior criminal convictions. Most parricides involve single-victim, single-offender situations, with firearms more likely to be used against fathers than mothers. The popular literature as well as much of the professional literature have presented youths who killed a parent as prosocial individuals who feared for their lives. Adults who killed a parent have typically been presented as suffering from a severe mental disorder. These two scenarios describe many parricides. However, major mental disorders among youthful parricidal offenders, conduct disorder and antisocial personality disorder as well as other psychiatric comorbidities also occur in a significant proportion of parricides. Youthful and adult offenders experience different legal outcomes and receive mental health services in differing contexts. We review offender and victim characteristics, as well as legal and treatment issues, and outline needs for future research.     

Co-occurring mental health and substance use problems in offenders: implications for risk assessment

We undertook a secondary data analysis to study issues relevant to co-occurring mental health and substance disorder in a combined sample of offenders (N = 3,197). Using the Personality Assessment Inventory, we compared the frequency of depressive, traumatic stress, and personality disorder symptom elevations across offenders with and without substance problems, identified the extent to which co-occurring problems were accompanied by risk factors for suicide and aggression, and tested for gender differences. Offenders with substance problems were more likely than others to have increased mental health problems and risk factors for suicide or aggression. Women with substance problems, compared with men, had higher depression, traumatic stress, and borderline features, in addition to lower antisocial features. The frequency with which suicide and aggression risk factors were associated with mental health problems was generally similar across men and women. Measurement issues relevant to co-occurring disorder and risk assessment are discussed.