Sex offenders: Treatment & risk assessment Jill D. Stinson, PhD ETSU, 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 Special groups 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