1. Sex offenders: Treatment & risk assessment
Jill D. Stinson, PhD
ETSU, Psychology

2. 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.

3. 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.

4. Introduction About your presenter Outline for today
Who are we talking about?
Traditions & new approaches in sex offender treatment
Treatment effectiveness
Thinking about risk

5. The sex offender…

6. …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

7. Sex offender treatment
In the early days
Insight-oriented approaches
Behavioral reconditioning
Then later
Cognitive behavioral therapy
Pharmacological interventions
Relapse prevention

8. Everyone wants treatment, right?

9. 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

10. 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?

11. 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

12. 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

13. Sex offender treatment
Traditional goals
Prevent sexual offending
Control sexual behavior
Eliminate deviant sexual interests, thoughts, & fantasies
……But is sex all we care about?

14. Emerging treatment trends
Good Lives Model
Circles of Support & Accountability
Safe Offender Strategies

15. 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.)

16. 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

17. 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

18. 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

19. 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