1. CSOM Long Version: Section 41 Learning Objectives Participants will be able to: zSummarize research zOutline treatment components zIdentify reasonable expectations of treatment provider zIdentify treatment provider qualifications zOutline collaboration strategies

2. CSOM Long Version: Section 42 Effectiveness of Treatment zDifficult to study zPoor data zPrograms and definitions vary zDesign criteria difficult to meet BUT z“Good grounds for optimism” (Marshall and Pithers, 1994)

3. CSOM Long Version: Section 43 Review of the Research zIndividuals who had received treatment had consistently lower recidivism rates than untreated individuals. zBetter outcomes after 1980--perhaps better programs or better research. zTreatment over long periods of time is more effective. zCompleting treatment is important. (M.A. Alexander, 1994)

4. CSOM Long Version: Section 44 Review of the Research (cont.) zRecidivism rates of untreated offenders are approximately 60%. zRecidivism rates of offenders completing specialized treatment are between 15% and 20%. (U.S. Department of Justice, 1991)

5. CSOM Long Version: Section 45 Review of the Research (cont.) zGrossman et al (1999): reduction in recidivism of 30% over seven years zGallagher et al (1999): cognitive- behavioral approaches appear particularly promising zPolizzi et al (1999): prison and non-prison based programs show effective or promising results

6. CSOM Long Version: Section 46 Review of theResearch (cont.) z1995 meta-analysis found (Hall, 1995) ysmall but significant treatment effect y12 studies--all with control groups y8 percent reduction in recidivism in the treatment group

7. CSOM Long Version: Section 47 Summary of Research on Treatment Effectiveness zMany studies, many poorly designed. zWell-designed studies associate treatment with lower recidivism--some very significantly zOutcomes differ by type of offender zGreater reductions found in more recent studies zTreatment and/or evaluation methods are improving

8. CSOM Long Version: Section 48 Summary of Research on Treatment Effectiveness (cont.) zAnalytic or insight oriented therapies are not effective (Quinsey, 1990, 1994; Salter, 1988; Lanyon, 1986) zA combination of educational, cognitive- behavioral, and family system interventions is effective (Knopp and Stevenson, 1988, 1992) zWhen reviewing all studies; conclude that treatment reduces recidivism by 10%

9. CSOM Long Version: Section 49 Effectiveness of Treatment Plus Supervision zOnly a few studies done--they support effectiveness of combined treatment and supervision (some with the polygraph). (Romero and Williams, 1985, 1991) zCurrent study of Maricopa County program is revealing low rates of recidivism. (Maricopa County Adult Probation Department, 1999)

10. CSOM Long Version: Section 410 Traditional vs. Sex Offender Treatment zOffender-focused zTargets reduction in anxiety/inadequacy zIndividual counseling zUsually voluntary z Victim/community safety focused z Targets accountability and thinking errors z Primarily group setting z Often mandated Traditional Sex Offender Specific

11. CSOM Long Version: Section 411 Traditional vs. Sex Offender Treatment (cont.) zClient/patient confidentiality zProvider works as an individual practitioner zGeneralist” training for a variety of client types z Waivers of confidentiality z Provider is part of management team z Specialized training/ experience essential Traditional Sex Offender Specific

12. CSOM Long Version: Section 412 Means of Reducing Recidivism through Treatment zAccepting responsibility and modifying cognitive distortions zDeveloping victim empathy zControlling sexual arousal zImproving social competence zDeveloping relapse prevention skills zEstablishing supervision conditions and networks zClarification

13. CSOM Long Version: Section 413 Methods of Treatment zPsycho-educational groups zCognitive-behavioral groups zMedication zIndividual therapy zPsychological and physiological testing zReferrals to other necessary treatments

14. CSOM Long Version: Section 414 Components of Treatment zTo cause acceptance of responsibility: yEducation about denial ySupport for incremental steps yMaking responsibility a prerequisite for entry/completion yConfronting/challenging discrepancies, cognitive distortions

15. CSOM Long Version: Section 415 Components of Treatment zTo develop victim empathy: yPsychoeducation on effects of abuse yExercises to imagine victim experience yTeaching empathy skills yMeeting with victim(s)

16. CSOM Long Version: Section 416 Components of Treatment zTo control sexual arousal: yEducation about fantasy and behavior yCognitive-behavioral techniques for interrupting/reducing deviant urges, developing/increasing non-deviant urges yMethods for practice outside of therapy setting yMedication

17. CSOM Long Version: Section 417 Components of Treatment zTo improve social competence: yUsing group setting for practice yReferral to specialized treatment yInvolving significant others

18. CSOM Long Version: Section 418 Components of Treatment zTo develop relapse prevention skills: yEducation about relapse prevention yIdentifying individual’s cycle yTeaching strategies to avoid lapses yTeaching/practicing strategies to minimize lapses

19. CSOM Long Version: Section 419 Components of Treatment zTo establish supervision conditions and networks: yProvider collaborates with officer yAdvises on cycle and appropriate conditions yAssists with modifications yEducates network

20. CSOM Long Version: Section 420 Components of Treatment zTo Clarify: yVerbalize full responsibility yAcknowledge grooming, set up yState details of offense ySupport decision to report to police yAcknowledge ongoing problem

21. CSOM Long Version: Section 421 What to Expect from a Sex Offender Treatment Provider zTeam work zCommunity safety zLimited confidentiality zIncorporates evaluation zAlso: Experience and/or recent specialized training

22. CSOM Long Version: Section 422 Monitoring Treatment and Providers zWritten reports zCase conferences yNew cases ySpecific offender issues ySystem problems

23. CSOM Long Version: Section 423 Monitoring Treatment and Providers(cont.) zObservation yContent yProcess zEmergency case reviews zCommunity feedback zGraduation Criteria

24. CSOM Long Version: Section 424 Treatment Providers Must Deal With: zDomination zManipulation zAnger zAggressive outbursts zDepression zSelf-defeating behaviors z Variety of skill deficits z Family education z Victim issues z Ongoing risk assessment

25. CSOM Long Version: Section 425 Collaboration Between Treatment and Supervision zProbation/parole may offer classes zComplementary treatment and supervision plans zProbation/parole participate/observe in treatment sessions zWritten treatment plan exchanged with probation zJoint understanding of offense cycles

26. CSOM Long Version: Section 426 Primary Goal of Treatment -- Reduce Future Victimization The following are means to that end: zReducing cognitive distortions zAccepting responsibility zDeveloping victim empathy zControlling sexual arousal zImproving social competence zDeveloping relapse prevention skills zEstablishing supervision conditions and networks

27. CSOM Long Version: Section 427 Treatment Providers Must be Willing to... zWork as part of a team zShare information zProtect the community as a primary responsibility zEvaluate their work by these standards