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What Works: Effective Interventions with Sex Offenders. R. Karl Hanson Public Safety Canada Presentation at the 13 th Annual Conference of the NYS Chapter of the Association for the Treatment of Sexual Abusers, May 14 th , 2008, Saratoga Springs, NY.

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What Works: Effective Interventions with Sex Offenders

R. Karl Hanson

Public Safety Canada

Presentation at the 13th Annual Conference of the NYS Chapter of the Association for the Treatment of Sexual Abusers, May 14th, 2008, Saratoga Springs, NY

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History of Offender Rehabilitation Research

  • Many studies; lots of variability

  • Martinson (1974) “Nothing works”

  • “What Works”

    • Lipsey (1989)

    • Andrews, Zinger et al. (1990)

    • Andrews, Bonta, Gendreau, Dowden

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Sanctions or Service?


2003: r = -.03

(k = 101)


2003: r = +.12

(k = 273)

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Effective Correctional Interventions

  • Risk

    • Treat only offenders who are likely to reoffend (moderate risk or higher)

  • Need

    • Target criminogenic needs

  • Responsivity

    • Match treatment to offenders’ learning styles and culture

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Results Stable Across Studies

  • Same results found in randomized clinical trials and non-random assignment studies (except those with obvious biases)

  • Meta-analytic findings replicated by independent groups

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Risk – Self-Evaluation for sex offenders

  • Does your program select offenders based on risk?

    • Which measure? Sexual or general risk?

    • Average risk score is moderate or higher (e.g., Static-99 4+)

    • Are low risk offenders separated from high risk offenders?

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Needs Self-Evaluation I for sex offenders

  • What are the major criminogenic needs targeted in your program?

    • (i.e., what intermediate changes would you like to see in order to reduce the risk of recidivism?)

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Criminogenic Needs for sex offenders(general recidivism)

  • Antisocial Personality

    • Impulsive, adventurous pleasure seeking, restlessly aggressive, callous disregard for others

  • Grievance/hostility

  • Antisocial associates

  • Antisocial cognitions

  • Low attachment to Family/Lovers

  • Low engagement in School/Work

  • Aimless use of leisure time

  • Substance Abuse

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Non-criminogenic needs for sex offenders(general recidivism)

  • Personal distress

  • Major mental disorder

  • Low self-esteem

  • Low physical activity

  • Poor physical living conditions

  • Low conventional ambition

  • Insufficient fear of official punishment

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Criminogenic Needs for Sexual Recidivism for sex offendersA-list (3+ Prediction Studies)

  • Deviant sexual interests

    • Children

    • Sexualized Violence

    • Multiple Paraphilias

  • Sexual preoccupations

  • Antisocial orientation

    • Lifestyle instability

    • Unstable employment

    • Resistance to rules and supervision

    • Antisocial Personality Disorder

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Criminogenic Needs for Sexual Recidivism for sex offendersA-list (3+ Studies)

  • Offence-Supportive Attitudes

  • Intimacy deficits

    • Emotional congruence with children

    • Lack of stable love relationships

    • Conflicts in intimate relationships

  • Negative Social Influences

  • Poor Cognitive Problem-Solving

  • Grievance/Hostility

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Criminogenic Needs for Sexual Recidivism for sex offendersB-list (at least one prediction study)

  • Sexualized coping

  • Callousness/Lack of concern for others

  • Poor emotional control

  • Hostile beliefs about women

  • Adversarial sexual orientation

  • Machiavellianism

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Possible Criminogenic Needs for Sexual Recidivism (some evidence)

  • General and sexual entitlement

  • Fragile narcissism

  • Delinquent pride

  • Loneliness

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Factors Unrelated to evidence) Sexual Recidivism

  • Victim empathy

  • Denial/minimization of sexual offence

  • Lack of motivation for treatment

  • Internalizing psychological problems

    • Anxiety, depression, low self-esteem*

  • Sexually abused as a child

  • Low sex knowledge

  • Poor dating skills/Social skills deficits

  • Hallucinations/delusions

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Needs Self-Evaluation II evidence)

  • Is there empirical evidence demonstrating that the factor predicts recidivism?

    • (yes/no for each treatment target)

  • Does your program predominantly target empirically supported criminogenic needs?

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Responsivity evidence)

  • Cognitive-behavioural

  • Therapist style – firm but fair

  • Flexibility to address special needs

  • Culturally specific elements

  • Do offenders actually engage in treatment?

    • Low drop-out rates

    • Change on intermediate targets

    • Working with you, not against you

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Hanson, Bourgon, Helmus & Hodgson, 2008 evidence)

  • 24 studies

    • Examined sexual recidivism as outcome criteria

    • Examined adult or adolescent sexual offenders

    • Compared offender assigned to a treatment program to offenders who received no treatment (or treatment that was expected to be inferior)

    • Met minimum criteria for study quality (CODC Guidelines)

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24 Studies evidence)

  • 50% published (1983 – 2006)

  • 23 English; 1 French

  • Canada (13), US (5), England (3), New Zealand (2), Netherlands (1)

  • Institution (12); Community (11); Both (1)

  • Treatments delivered: 1966 - 2004

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Adherence to R/N/R evidence)

  • Risk Rarely (3/24)

  • Need Sometimes (12/24)

  • Responsivity Most programs (18/24)

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Keys to Effective Implementation evidence)

  • Select staff for relationship skills

  • Print/tape manuals

  • Train staff

  • Start small

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Characteristics of Effective Therapists with Offenders evidence)

  • Able to form meaningful relationships with offenders

    • Warm, accurate empathy, rewarding

  • Provide prosocial direction

    • Skills, problem-solving, values

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How it goes wrong evidence)

  • Risk

    • Same program for all, regardless of risk/need

    • Low risk offenders introduced to high risk offenders

    • High risk cases excluded from treatment (by self and program)

  • Focus on non-criminogenic needs

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How it goes wrong evidence)

  • Offender feels judged/rejected

  • Criminal thinking rewarded

    • Blind acceptance of “alternative” subcultures

    • Rewarding candour

    • Procriminal attitudes of staff

    • Bonding/collusion with offenders

  • Punishing Prosocial Acts

    • Prosocial incompetence

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Directions for Sexual Offender Treatment evidence)

  • Risk

    • Treat only sex offenders who are likely to reoffend (moderate risk or higher)

  • Need

    • Target criminogenic needs

  • Responsivity

    • Match treatment to offenders’ learning styles and culture

  • Use Skilled Therapists

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Suggested Readings evidence)

Andrews, D.A. (2006). Enhancing adherence to Risk-Need-Responsivity: Making quality a matter of policy. Criminology and Public Policy, 5, 595-602.

Andrews, D.A., & Bonta, J. (2006). The psychology of criminal conduct (4th ed.). Cincinnati: Anderson.

Bonta, J., & Andrews, D.A. (2007). Risk-need-responsivity model for offender assessment and rehabilitation. Corrections User Report 2007-06. Ottawa: Public Safety Canada.

Curtis, N.M., Ronan, K.R., & Borduin, C.M. (2004). Multisystemic treatment: A meta-analysis of outcome studies. Journal of Family Psychology, 18(3), 411-419.

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Suggested Readings evidence)

Hanson, R.K., & Bourgon, G. (2008). A psychologically informed meta-analysis of sexual offender treatment outcome studies. In G. Bourgon et al. (Eds). Proceedings of the First North American Correctional and Criminal Justice Psychology Conference. Ottawa: Public Safety Canada.

Landenberger, N.A., & Lipsey, M.W. (2005). The positive effects of cognitive-behavioral programs for offenders: A meta-analysis of factors associated with effective treatment. Journal of Experimental Criminology, 1, 451-476.

Tong, L.S.J., & Farrington, D.P. (2006). How effective is the “Reasoning and Rehabilitation” programme in reducing reoffending? A meta-analysis of evaluations in four countries. Psychology, Crime & Law, 12(1), 3-24.

Wilson, D.B., Bouffard, L.A., & Mackenzie, D.L. (2005). A quantitative review of structured, group-oriented, cognitive-behavioral programs for offenders. Criminal Justice and Behavior, 32 (2), 172-204.

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Copies/Questions evidence)

[email protected]

www.publicsafety.gc.caLook under “publications” “corrections reports and manuals”