Part II: Risk Assessment Instruments June 2-4, 2015 Assessment of Juvenile Sexual Risk Part II: Risk Assessment Instruments Phil Rich, Ed.D., LICSW Specialized Consultation and Training www.philrich.net phil@philrich.net 413-687-7098 Notes 1

Assessment Instruments Juvenile Sexual Risk Assessment Instruments

Sexual Risk Assessment Instruments for Adolescents There are a number of juvenile risk assessment instruments in use. However, the three currently most commonly used instruments in North America are: The J-SOAP-II (Juvenile Sex Offender Assessment Protocol-II) The ERASOR (Estimate of Risk of Adolescent Sexual Offence Recidivism) -These are both structured and empirically-based instruments designed for clinical assessment. The JSORRAT-II, (Juvenile Sexual Offense Recidivism Risk Assessment Tool-II), currently the only available actuarial assessment for juvenile sexual offenders

Sexual Risk Assessment Instruments for Adolescents Recently added is the MEGA (Multiplex Empirically Guided Inventory of Ecological Aggregates for Assessing Sexually Abusive Adolescents), also a clinical risk assessment instrument. We will also discuss the J-RAT, as it will be used in the training. However, even though there are differences between each instrument, they are more similar than they are different. The main exception is the JSORRAT-II, with respect to its inclusion of static items only.

Remaining Well-Informed: Weak Empirical Support for Sexual Risk Instruments Of these instruments, the J-SOAP has received the most attention and been subject to the most empirical scrutiny in terms of validation studies. Nevertheless, among the studies of each instrument completed thus far, overall the literature is scattered and inconsistent and does not offer a great deal of statistical support for any of the risk assessment instruments.

Remaining Well-Informed: Weak Empirical Support for Sexual Risk Instruments Research has yielded mixed and inconsistent, and hence, contradictory, results. The literature instead largely describes risk assessment instruments as failing to show high, consistent, or universal levels of reliability or predictive validity.

The Juvenile Sexual Offender Assessment Protocol (J-SOAP-II)

The Juvenile Sexual Offender Assessment Protocol (J-SOAP-II) The J-SOAP-II is an empirically-guided checklist used to aid in the systematic review of risk factors that have been identified in the professional literature as being associated with sexual and criminal offending. The J-SOAP-II is designed to be used with 12-18 year old males who have been adjudicated for sexual offenses, as well as non-adjudicated youths with a history of sexually coercive behavior. Decisions about re-offense risk should not be based exclusively on the results from J-SOAP-II. The J-SOAP-II should always be used as part of a comprehensive risk assessment.

The Juvenile Sexual Offender Assessment Protocol (J-SOAP-II) The J-SOAP-II is composed of four scales that include 28 Risk Factors: Scale One. Sexual Drive/Preoccupation (Static) Scale Two. Impulsive/Antisocial Behavior (Static) Scale Three. Intervention (Dynamic) Scale Four. Community Stability/Adjustment (Dynamic) The J-SOAP-II does not assign risk ratings.

J-SOAP II Static Risk Assessment Scale One. Sexual Drive/Preoccupation Points assigned based on scoring rules Static Risk Assessment Scale One. Sexual Drive/Preoccupation Risk Factor 1. Prior Charged Sexual Offenses Risk Factor 2. Number of Sexual Abuse Victims Risk Factor 3. Male Child Victim Risk Factor 4. Duration of Sexual Offense History Risk Factor 5. Degree of Planning in Sexual Offenses Risk Factor 6. Sexualized Aggression Risk Factor 7. Sexual Drive and Preoccupation Risk Factor 8. Sexual Victimization History

J-SOAP II Static Risk Assessment Points assigned based on scoring rules Static Risk Assessment Scale Two. Impulsive/Antisocial Behavior Risk Factor 9. Caregiver Consistency Risk Factor 10. Pervasive Anger Risk Factor 11. School Behavior Problems Risk Factor 12. Conduct Disorder Before Age 10 Risk Factor 13. Juvenile Antisocial Behavior (10-17) Risk Factor 14. Charged or Arrested Before age 16 Risk Factor 15. Multiple Types of Offenses Risk Factor 16. History of Physical Assault/Exposure to Family Violence

J-SOAP II Dynamic Risk Assessment Scale Three. Intervention Points assigned based on scoring rules Dynamic Risk Assessment Scale Three. Intervention Risk Factor 17. Accepting Responsibility for Offenses Risk Factor 18. Internal Motivation for Change Risk Factor 19. Understands Risk Factors/ Applies Risk Management Risk Factor 20. Empathy Risk Factor 21. Remorse and Guilt Risk Factor 22. Cognitive Distortions Risk Factor 23. Quality of Peer Relations

J-SOAP II Dynamic Risk Assessment Points assigned based on scoring rules Dynamic Risk Assessment Scale Four. Community Stability/Adjustment Risk Factor 24. Management of Sexual Urges and Desires Risk Factor 25. Management of Anger Risk Factor 26. Stability of Current Living Situation Risk Factor 27. Stability in School Risk Factor 28. Evidence of Positive Support System

The Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR)

The Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR) The ERASOR is a structured professional judgment instrument used for the assessment of sexual re-offense in juvenile sexual offenders, ages 12-18. The ERASOR is composed of 25 risk factors falling into five categories: Sexual Interests, Attitudes, and Behaviors Historical Sexual Assaults Psychosocial Functioning Family/Environmental Functioning Treatment The ERASOR provides an overall risk assessment rating of Low, Moderate, or High.

Scored as Not Present, Partially/Possibly Present, Present, Unknown ERASOR Scored as Not Present, Partially/Possibly Present, Present, Unknown 1. Sexual Interests, Attitudes, and Behaviors Risk Factor 1. Deviant Sexual Interests Risk Factor 2. Obsessive Sexual Interests Risk Factor 3. Attitudes Support Sexual Offending Risk Factor 4. Unwilling to Alter Deviant Sexual Interests

Scored as Not Present, Partially/Possibly Present, Present, Unknown ERASOR Scored as Not Present, Partially/Possibly Present, Present, Unknown 2. Historical Sexual Assaults Risk Factor 5. Assaulted 2 or More Victims Risk Factor 6. Sexually Assaulted Same Victim 2+ times Risk Factor 7. Prior Adult Sanctions for Sexual Assaults Risk Factor 8. Threats or Use of Violence/Weapons Risk Factor 9. Sexually Assaulted Child Risk Factor 10. Sexually Assaulted Stranger Risk Factor 11. Indiscriminate Choice of Victim Risk Factor 12. Sexually Assaulted Male Victim Risk Factor 13. Diverse Sexually Assault Behaviors

Scored as Not Present, Partially/Possibly Present, Present, Unknown ERASOR Scored as Not Present, Partially/Possibly Present, Present, Unknown 3. Psychosocial Functioning Risk Factor 14. Antisocial Interpersonal Orientation Risk Factor 15. Lack of Intimate Peer Relationships Risk Factor 16. Negative Peer Associations Risk Factor 17. Interpersonal Aggression Risk Factor 18. Recent Escalation in Negative Affect Risk Factor 19. Poor Self-Regulation/Impulsive

Scored as Not Present, Partially/Possibly Present, Present, Unknown ERASOR Scored as Not Present, Partially/Possibly Present, Present, Unknown 4. Family/Environmental Functioning Risk Factor 20. High Stress Family Environment Risk Factor 21. Problematic Parent-Offender Relationship Risk Factor 22. Parents Don’t Support SOS Treatment Risk Factor 23. Re-Offense Opportunities in Environment 5. Treatment Risk Factor 24. No Development of Relapse Prevention Plan Risk Factor 25. Incomplete Sex Offense Specific Treatment 6. Other Risk Factor 26. Other

The Juvenile Risk Assessment Tool J-RAT

The Juvenile Risk Assessment Tool J-RAT The J-RAT is a structured, empirically-guided clinical instrument designed to assess the risk for a sexual re-offense in adolescent males, ages 12-18 (19th birthday). It is not an empirically validated instrument. It corresponds closely to the ERASOR and J-SOAP. It is comprised of 12 risk domains, each of which represents an overarching risk factor. Each risk domain represents an area of behavior, capacity or skill, psychosocial functioning, cognition, relationships, or environmental conditions, and each domain contains individual risk elements. There are a total of 97 individual risk elements, each of which is assessed independently of one another.

The Juvenile Risk Assessment Tool J-RAT Risk elements are assessed by the evaluator in terms of the significance of each element as a concern. Each level of significance is assigned a numerical value. The assessed value given to each risk element yields an overall numerical score, which leads to an assessed level of risk for each domain in terms of its possible contribution to a sexual re-offense. The J-RAT has three risk scales: Sexual Risk Non-Sexual Risk Non-Abusive Sexual Risk

The Juvenile Risk Assessment Tool J-RAT Each domain within the J-RAT contains a protective factors screen, allowing the evaluator to note the presence of an identified protective factor. The final/global assessment of risk for sexual recidivism is the outcome of a series of assessments in each individual risk domain, combined into a final numerical score that translates into a global level of risk. Risk is assessed as high, moderate-high, moderate, low- moderate, or low. Risk may also be assessed as no risk, not applicable, or cannot assess in the event that there is no known history of sexually abusive behavior or there is insufficient evidence or applicability.

J-RAT Domains Domain 1. History of Sexually Abusive Behavior………... 19 elements Domain 2. History of Non-Sexual Antisocial Behaviors... 13 elements Domain 3. Responsibility………………………………........... 6 elements Domain 4. Relationships……………………………………..... 8 elements Domain 5. Cognitive Capacity and Ability………………..... 5 elements Domain 6. Social Skills.......................................................... 7 elements Domain 7. Developmental Adversity/Trauma…………...… 6 elements Domain 8. Personal Characteristics and Qualities…........ 8 elements Domain 9. Psychiatric Comorbidity and Treatment……… 5 elements Domain 10. Substance Abuse………………………………….. 4 elements Domain11. Family Factors…………………………………...... 12 elements Domain 12. Environmental Conditions………………………. 4 elements Total elements………….……………………………………. 97 elements

Interim Re-Assessment J-RAT/IR The J-RAT can be used for re-assessment over time. However, the J-RAT/IR (Juvenile Risk Assessment Tool/Interim Re-Assessment ) is designed for that purpose.

J-RAT Variants CI/J-RAT Juvenile Risk Assessment Tool (Cognitively Impaired) LA-SAAT Latency Age-Sexual Adjustment and Assessment Tool Both instruments have interim assessment counterparts

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II )

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II ) The JSORRAT-II is the first actuarial assessment in which risk factors are truly founded in empirical evidence, and thus statistically derived. It is an actuarial assessment instrument, designed to statistically assess the likelihood of a sexual re-offense prior to age 18 in male adolescents aged 12-18, with a history of at least one prior adjudicated sexual offense committed between the ages of 12-17.

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II ) In most locales, the JSORRAT-II is presently a research tool and is continuing to undergoing development and further validation with other independent samples, and may change in construction and content. It is currently available for use only in Utah, Iowa, California, and Georgia. In other locales, the JSORRAT-II may be used only a research instrument.

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II ) In California, although not yet validated, the JSORRAT has been selected by the State Authorized Risk Assessment Tool for Sex Offenders Committee (SARATSO) as the required instrument to be used in the assessment of male juvenile sexual offenders (California Penal Code, §§ 290.03-290.08).

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II ) The JSORRAT-II assesses 12 items, or risk factors, each of which can be evaluated from record review alone. Each item, or risk factor, scores between 0-3 points depending on the item, in which a total score of 8 or more is considered moderate-high risk in Utah and California, and 7 or more is considered “risk level 3" (the highest risk level) in Iowa.

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II ) Number of actual adjudications for sex offenses Number of different victims in charged sex offenses Length of sex offending history Under supervision when any sex offenses occurred Felony level sex offense committed in public Use of deception/grooming in sex offenses.

Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II ) Prior sex offender treatment status Number of incidents of hands-on sexual offenses in which the offender was the victim Number of incidents of physical abuse in which the offender was the victim Any placement in special education Number of educational time periods with discipline problems (elementary through high school) Number of adjudications for non-sexual offenses

The Limitations of Actuarial Assessment However, a major difficulty with any actuarial assessment is that it overlooks dynamic risk factors… … and is a static instrument that fails to recognize or take into consideration situational, relational, or environmental risks. Actuarial assessments necessarily see the individual as a member of a class, rather than as an individual.

The Limitations of Actuarial Assessment Despite all we have learned about the developmental fluidity of the adolescent experience, the need to include a focus on protective factors as well as risk, and the short-term nature of risk estimates… … actuarial assessments are unable to recognize or respond to change in clients. Additionally, actuarial assessments are not able to tell us anything about the individual being assessed… … or help set priorities for case management and treatment planning.

Protective Factors

Desistence for Adolescents Who Sexually Harm Protective Factors DASH-13 Desistence for Adolescents Who Sexually Harm Prosocial sexual interests Prosocial sexual attitudes Prosocial sexual environment Awareness of the consequences of sexual reoffending Compassion for others Positive problem-solving skills Positive affect-regulation skills Emotional intimacy with peers Close relationship with a positive and supportive adult Adequate environmental controls Active involvement in prosocial structured activity with peers Hope Successful treatment completion

Protective Factors J-RAT Protective Factors Scale Recognizes sexually abusive behavior as harmful to others Accepts responsibility for sexually abusive behavior No significant history of non-sexual behavioral problems Accepts personal responsibility Expresses remorse for personal behavior Motivated for treatment Expresses concern for victims of personal behavior Prosocial peer relationships Meaningful and satisfying peer relationships Average or higher IQ Communicates well Manages conflict well

Protective Factors J-RAT Protective Factors Scale Effective self-regulation No history of significant developmental trauma or loss No significantly problematic personality traits No extensive treatment history Responded well to prior general treatment No history of substance abuse Stable family environment Family support for juvenile Positive/strong family relationships Strong community support system Strong community monitoring/supervision Stable community living environment

The Choice of Risk Assessment Instrument In the choice of assessment tools, the evaluator should be aware of different orientations and approaches in the underlying model, and even in the design, focus, and scope of the assessment instrument. However, the differences between instruments within the same class (that is, actuarial or clinical) can be difficult to fully discern. Differences often seem more a matter of degree than substance with respect to selected risk factors, scope, design, and wording.

The Evaluation Process Overall Hart el al. (2003) suggest that 10 points are important in the selection of a risk assessment instrument. These 10 points reflect the role of the risk assessment instrument as part of a larger process. Does the evaluation gather information concerning multiple domains of the individual’s functioning? Does the evaluation use multiple methods to gather information? Does the evaluation gather information from multiple sources? Does the evaluation allow users to evaluate the accuracy of relevant information? Does the evaluation involve both static and dynamic risk factors?

The Evaluation Process Overall Does the evaluation allow re-assessment, to evaluate change in risk over time? Is the evaluation comprehensive? Is the evaluation comprehensible and acceptable to those who will use its results? Can evaluators be trained to use the evaluation in a consistent manner? Does the evaluation process result in information, ideas, and recommendations that can reduce sexual risk?