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Sex Offender Evaluation . Donya L. Adkerson, MA, LCPC Alternatives Counseling, Inc. What an Evaluation can do:. Clarify recidivism risk level Identify problem areas and complications to the offending problem Identify treatment needs Identify supervision needs

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Sex offender evaluation l.jpg

Sex Offender Evaluation

Donya L. Adkerson, MA, LCPC

Alternatives Counseling, Inc.

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What an Evaluation can do:

  • Clarify recidivism risk level

  • Identify problem areas and complications to the offending problem

  • Identify treatment needs

  • Identify supervision needs

  • Lay groundwork for treatment

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What an evaluation can NOT do

  • Determine guilt or innocence regarding a specific crime

  • Give a 100% complete picture of the person

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Components of the Evaluation

  • Review of History

  • Collateral interviews

  • Client interview

  • Client testing

  • Actuarial assessment

  • Written report

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Review of History Information

  • Possible sources include

    • Police records & interviews

    • Child welfare investigations & interviews

    • Prior mental health records

    • Prior criminal history records

    • Trial transcripts

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Collateral Interviews

  • Consider interviewing

    • Spouse or partner

    • Former spouse or partner

    • Parents

    • Usually NOT the victim

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Client Interview

  • Broad topics to cover include

    • Family of Origin

    • Education & employment

    • Relationships and parenting

    • Health, substance use, treatment history

    • Sexual history

    • Criminal history

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Client Testing

  • Physiological

  • Clinical

  • Self-report

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Actuarial Assessment

  • Assessment based on research statistical analysis of factors strongly correlated with recidivism risk. This type of assessment is currently only available for adult male sexual offenders. Continuing research is needed before such tools will be available for minors and for females.

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Written report

  • The product from the evaluation process. The report serves to document, educate and guide decisions regarding the client’s containment and treatment. It should be detailed and specific.

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Relevant Standards for sexual offender assessment

  • Association for the Treatment of Sexual Abusers (ATSA)

  • Illinois Sex Offender Management Board (SOMB)

  • SOMB Standards include ATSA Ethics Code by reference

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Some relevant ATSA Ethics Guidelines

  • “…there is no know psychological test, profile, evaluation procedure, of combination of such tools that prove or disprove whether an individual has committed a specific sexual act.”

  • Follow all applicable reporting laws, including duty to warn or protect.

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ATSA Evaluation Standards:

  • Apply to work with Adult Male offenders; there may be variations from these standards in work with juveniles or females

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Overview of ATSA Standards specific to Evaluations:

2005 Edition (Note that Standards are revised regularly)

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Strive for Objective, fair, and impartial evaluations

  • Informed consent (or at least assent)

    • Right to refuse

    • Nature & purpose of eval

    • Who gets the results

  • Understand how legal status impacts eval

  • Don’t overstate your information/findings

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Obtain comprehensive information, including:

  • Community support

  • Criminal and other antisocial behavior,

  • Access to potential victims,

  • Developmental history and family background,

  • Deviant sexual interests and arousal.

  • Education and employment histories,

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Gather information about

  • History of aggression or violence,

  • History of sexually abusive behavior, including details about victims, tactics used in the commission of the offense, and the circumstances in which the sexual abuse occurred,

  • Level of cognitive functioning,

  • Medical and mental health histories,

  • Official and unreported history of sexual and nonsexual crimes,

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Gather information about

  • Peer and romantic relationship histories,

  • Substance use/abuse

  • Relevant personality traits such as, but not limited to suspiciousness, hostility, risk-taking, impulsivity, and psychopathy,

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Gather information about

  • Sexual history, including sexual fantasies, urges, and behavior, early sexual experiences; number and duration of sexual relationships; gender identity and sexual orientation; masturbation and intercourse frequency; sexual functioning; unusual sexual interests or behavior that are not sexually deviant

  • Use of sexually arousing materials (e.g., magazines, videos, computer porn, internet sites, phone sex)

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Use multiple sources of information, NOT client self report alone!

  • Review of official documents, including criminal justice records, witness statements, previous assessment and treatment reports, medical records, and victim impact statements.

  • Collateral interviews, as applicable (family members, romantic partner/spouse, employer, previous service providers, probation/parole officer),

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Use multiple sources of information alone!

  • Sexual preference measures

  • Relevant psychometric testing

  • Risk assessment

  • Client interview

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Use multiple sources of information alone!

  • Note significant discrepancies between client self-report and collateral information in the evaluation report.

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Do not base conclusions on Client self report alone alone!

  • Describe the sources of information

  • Identify any significant missing information in the report and note the impact this information could have on results/recommendations

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ATSA Evaluation Guidelines alone!

  • Use extreme caution if interviewing the victim, due to potential to add to victim harm.

  • Use caution to avoid conflict of interest if evaluating both the offender and his/her victim(s).

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ATSA Evaluation Guidelines alone!

  • Physiological testing

    • Get informed consent

    • Do not use physiological testing as a as sole criteria for findings.

    • Use appropriately trained examiners who follow their profession’s standards and guidelines

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ATSA Eval - Special considerations alone!

  • Be trained for any special populations you evaluate

  • Address any biases/assumptions based on age, cultural differences, socioeconomic differences, education, language, level of intellectual functioning, and mental or physical disability

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Evaluation Guidelines alone!

  • compared to the literature on adult male sexual abusers, less is known about the risk factors and prognosis for clients with developmental disability, offenders with major mental illnesses and female sexual abusers.

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ATSA Evaluation Guidelines alone!

  • If you don’t speak the client’s language, refer to someone who does.

  • If no native language evaluator is available, use a PROFESSINAL interpreter and document the use.

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ATSA Evaluation Guidelines alone!

  • Clients who cannot read at a level sufficient for completing written measures can often be tested using an auditory (taped or read) version of the instrument where such versions exist. Meet the special needs of clients with mental or physical disabilities during evaluations (e.g., using taped versions of questionnaires for vision-impaired clients).

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ATSA Evaluation Guidelines alone!

  • Select tests and instruments appropriate for that client.

  • Adapt for special needs (such as taped questionnaires for vision impaired or illiterate clients)

  • Note that modifications of testing might affect validity or reliability of testing

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ATSA Evaluation Guidelines alone!

  • Screen for mental or physical disabilities, major psychiatric disorders, substance abuse, and suicide potential. These conditions may have to be dealt with before evaluation or treatment for sexually abusive behavior begins

  • Recognize that treatment for a concurrent disorder or condition is, in most cases, not a substitute for sex offense specific treatment.

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ATSA Evaluation Guidelines alone!

  • Make recommendations for treatment, case management or supervision in clear and specific language.

  • Consider community safety and clients’ ability & willingness to manage their sexual offending when making recommendations.

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ATSA Evaluation Guidelines alone!

  • Release evaluation results to others only with written consent from the clients, unless legally obligated to do so.

  • Securely retain notes, raw test scores, and other documentation (including a copy of the evaluation report) for a minimum of five years after completing an evaluation.

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Illinois Sex Offender Management Board alone!

Practice Standards for Evaluation

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Illinois SOMB Evaluation Standards alone!

Public Act 093-0616 mandated use of the SOMB Standards and pre-sentencing eval for sex offenders considered for release to the community. It became effective January 1, 2004.

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P.A. 093-0616 On Evaluations alone!

  • Evals must be done by an SOMB approved evaluator

  • Done according to SOMB standards

  • Must be considered by the judge at sentencing

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Finding SOMB Evaluators & Treatment Providers alone!

  • A list of approved evaluators and Treatment providers is available on the Illinois Attorney General’s Website. The Standards are also available on the website.

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SOMB Eval Standards alone!

  • Overlaps with ATSA Standards –

  • Get informed consent & waivers of confidentiality

  • Be sensitive to diversity issues

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SOMB: Purpose of Evaluation alone!

  • Document treatment needs (offense specific and other)

  • Re-offense risk & amenability to treatment

  • Help determine setting, intensity, and level of supervision

  • Identify needs for supervision & support for community safety

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SOMB: Areas to Assess alone!

  • Mental & Organic disorders

    • IQ

    • Organic Brain Syndrome

    • Mental Illness

  • Drug & Alcohol use

    • Use/abuse history

    • Number of relapses

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SOMB: Areas to Assess alone!

  • Degree of Psychopathology

  • Stability of Functioning

    • Marital/Family stability

    • Employment & Education

    • Social skills, including dating history

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SOMB: Areas to Assess alone!

  • Developmental History

  • Self-image & self-esteem

  • Medical screening

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SOMB: Areas to Assess alone!

  • Sexual Evaluation

    • Sexual history

    • Reinforcement of deviant behavior

      • Culture, environment, cults, gangs

    • Arousal pattern

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SOMB: Areas to Assess alone!

  • Specifics of sexual crimes

  • Sexual deviance patterns

  • Sexual dysfunction

  • Sexual preferences

  • Sexual practices

  • Attitudes and cognitions (thoughts) about sexuality & offending

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SOMB: Areas to Assess alone!

  • Level of denial and deception

  • Level of violence and coercion

  • Evaluation of risk

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Factors Evaluator Must Consider in Making Recommendations alone!

  • Admission of offenses

  • Accountability

  • Cooperation

  • Offense history & victim choice

  • Escalation patterns; violence & dangerous behaviors

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Factors Evaluator Must Consider in Making Recommendations alone!

  • Sexual deviance, arousal, interest patterns

  • Social interest

  • Lifestyle characteristics & Psychopathology

  • Developmental markers

  • History of criminal behavior

  • Substance abuse

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Factors Evaluator Must Consider in Making Recommendations alone!

  • Social support systems

  • Overall control and interventions

  • Motivations of treatment and recovery

  • Previous treatment

  • Victim impact and victim access

  • Availability of treatment & supervision in the community

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Recommendations Must Address: alone!

  • Level & intensity of offense specific treatment needs

  • Assessment or treatment needs for co-existing conditions

  • Methods to lessen victim impact

  • Appropriateness of community based placement

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Recommendations Must Address: alone!

  • Appropriateness of community placement with emphasis on the risks associated with the home, neighborhood, school or community

  • Level and intensity of behavioral monitoring needed

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Recommendations Must Address: alone!

  • External controls that should be considered specifically for that sex offender (e.g., controls of work environment, access to children, leisure time, or transportation; life stresses; or other issues that might increase risk and require increased supervision)

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Preparing alone!yourself for the evaluation

The right preparation makes all the difference

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Structuring the Evaluation alone!

  • Safe and comfortable setting

  • Full days vs. multiple short sessions

  • Collateral before client interviews

  • Start with low defense areas, move to difficulty subjects later

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As the Evaluator, you should: alone!

  • Know your subject – sexual offenders – before doing any S.O. evaluation

  • Get education, training, supervision and experience

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As the Evaluator, you should: alone!

  • Do your homework. There is no substitute for thorough background research before your client interview

  • Think Kojak/Columbo/C.S.I. – NOT Carl Rogers!

  • Understand your client’s agenda; it will not be the same as yours

  • Respect the client as a person capable of positive change

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Evaluation Interview skills alone!

  • Take thorough notes. Get the name, age, gender of every person the client mentions

  • Don’t give away what you know.

  • Rephrase and re-ask questions at different points in the interview.

  • Bring your poker face. Smile pleasantly at appropriate opportunities to help put the client at ease.

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Evaluation Interview skills alone!

  • Use education to facilitate comfort and honesty; beware of over-educating in the evaluation – don’t teach them how to ‘fake good’

  • Keep a time line in mind – ask age, grade, place of residence or other markers to help the client provide a time frame. Be aware that low functioning clients will be poor at this even when honest

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Watch the NONVERBAL language alone!

Words are not the only way people communicate, and nonverbal communication becomes very important when working with people who may be motivated to be dishonest.

No matter how good you are at reading nonverbals, you still won’t catch every lie.

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Watch the NONVERBAL language alone!

  • Eye contact/changes noted

  • Voice tone/changes noted

  • Tearfulness

  • Power/control behaviors (i.e., walks around office during interview, handles objects from desk, tries to direct interview, silence)

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Watch the NONVERBAL language alone!

  • Nervous behaviors (i.e., leg shaking, tapping)

  • Defensive/evasive posturing (arms tightly closed, refuses to remove coat, gaze fixed to side or ceiling)

  • Destructive (to body, clothing, furniture, office objects, other)

  • Intimidation (i.e., invades space, covert threats, finger shaking, yells/curses at examiner, unwarranted touch, hostile stare)

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Watch the NONVERBAL language alone!

  • Aggressive (breaks objects, makes overt threats, assaults examiner)

  • Sexually suggestive/seductive behaviors or comments

  • Overt/covert exposure

  • Erection during interview

  • Observed or suspected masturbation

  • “Accidental" rubbing against examiner/staff

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Creating Comfort with the Client alone!

  • Assure the client of your knowledge, experience, comfort with the issues to help decrease embarrassment.

  • Choose language appropriate for the client’s developmental age and functioning. Be sure terms are understood.

  • Use the client’s terms whenever possible.

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Using Discomfort in the Interview alone!

  • Use silence to your advantage when you want the client to tell more. Don’t rush to speak.

  • Use hints of your information without details to elicit information in areas the client first omits.

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Questioning Styles alone!

  • Open–ended vs. closed-ended

    • Open: “Tell me about your marriage.”

    • Closed: “Do you have a good marriage?”

  • Forced choice questions

    • “Is your marriage good or bad?”

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Helpful Interview Techniques alone!

  • Mind-reading

  • Prediction

  • Leading

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Mind-reading alone!

Using info you know about the person/problem to tell the client what he is thinking/feeling.

This can help the client feel you understand, and feel that pretenses and denial won’t work with you.

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Mind-reading examples alone!

  • “I’m sure you don’t want to be here right now. I imagine you are worried about whether you will say and do the right things to make a good impression in this evaluation.”

  • “You’ve been thinking if you can just get through this it will never happen again; that you’ll find a way to make it up to (the victim).”

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Prediction alone!

Laying groundwork for positive movement in the evaluation and treatment.

This can create hope for recovery. It is most effective when coupled with mind-reading.

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Prediction Examples alone!

  • “You will find yourself feeling increasing anxiety and discomfort as we start talking about the sexual offenses today. What you will find is, as you begin to talk honestly about the problem here with someone who understands, you will become more comfortable as you talk more openly.”

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Prediction Examples alone!

  • (for offenders claiming memory loss) “I know you don’t want to remember and that is why it is hard for you right now. But as we talk, bits and pieces will of your memory will return, triggered by my questions. Those bits & pieces will come faster as we go along.”

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Leading alone!

Leading presupposes a given direction for the answer. This technique often goes against the therapist’s training.

In SO evals, it models the acceptability of talking about specifics and communicates the therapist expects and will not be shocked by even the most extreme answers.

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Leading Examples alone!

  • “Which of your children did you touch most often?”

  • “How long before the incident had you been spending time in the park?”

  • “Which part was more exciting to you – when you had your mouth on his penis or when you were rubbing his penis with your hand?”

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Use Caution with Leading ! alone!

Low functioning individuals may be led into admitting erroneous information. Leading should be used very cautiously with such people. Double check information obtained by trying to lead the client in the opposite direction and see if they remain consistent or simply follow the lead.

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Additional cautions with low functioning clients alone!

  • Expect poor time frames

  • Expect inconsistent estimations of frequency or number of occurrences

  • Inconsistent information may be a function of the person trying to be compliant rather than being misleading.

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Testing which may be used in evaluations alone!

  • Physiological

  • Clinical

  • Collateral completed inventories

  • Self- Report tests and inventories

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Physiological alone!Testing types

  • Visual Reaction Time (Abel Screen)

  • Plethysmograph

  • Polygraph

    • History

    • Maintenance

    • Specific issue

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Clinical alone! Testing examples

  • Personality testing

    • Examples: MMPI-2, MMPI-A, Millon

  • IQ testing

    • Examples: Wechsler (WAIS, WISC), Kaufman (KBIT)

  • Projective Testing

    • Examples: TAT, Rorschach (Ink Blot)

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Collateral alone!Testing examples

  • For parents of minors:

    • Behavior System Assessment for Children

    • Child Sexual Behavior Inventory

    • Adkerson Information & Beliefs Questionnaire for Parents

  • For partners:

    • Adkerson Partner Information & Beliefs Questionnaire

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Self- Report alone! Testing examples

  • Attitudes/beliefs about offending

    • Multiphasic Sex Inventory

    • Abel & Becker Cognitions Scale

    • Bumby Sexual Attitudes Scales

    • Burt Rape Myth Acceptance Inventory

  • Remorse or empathy measures

    • Carich-Adkerson Victim Empathy Scale

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Self- Report alone! Testing examples

  • Depression, anxiety or trauma

    • Beck Depression Scale

  • Sexual fantasies

    • Wilson Sexual Fantasy Questionnaire

  • Hostility or violence

    • Buss-Durkee Hostility Inventory

  • Other

    • Sex Offender Incomplete Sentence Blank

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Actuarial Risk Assessment alone!

  • Think insurance tables – taking aggregate data about risk is how insurance companies know to charge more for car insurance for a 18 year old male, single, D-student living on Elm St. than a 34 year old married female college graduate living on Maple St.

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Clinical vs. Actuarial alone!Risk Assessment

  • Actuarial Risk assessments are based on aggregate data, as obtained through meta-analysis studies. Their overall accuracy is better than clinical judgment alone.

  • Current SO-specific actuarial tools use STATIC (unchangeable) data to determine risk level

  • They do not give info on treatment needs

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Clinical vs. Actuarial alone!

  • Clinical risk assessment is the judgment of a clinician, based on training and experience, of the risk presented

    • This judgment can include DYNAMIC (changeable) factors as well as static factors

  • Clinically-Adjusted Actuarial Assessment combines both techniques and allows for individuation with a solid research base

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Important Points about Actuarial Assessment in 2005 alone!

  • Current tools are validated only with ADULT MALES

  • Although there are currently no true actuarial tools for juvenile sex offenders, there are guided clinical tools

  • Additional instruments continue to be researched

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Actuarial Assessment Tools alone!

  • Some of the most common actuarial assessment instruments currently in use are:

    • RRASOR

    • Static-99

    • VRAG & SORAG

    • LSI- Revised

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RRASOR: Rapid Risk Assessment for Sexual Offense Recidivism alone!

  • 4 items, all static factors

  • Easily scored

  • Moderately accurate predictor of sex offense recidivism, little relationship to general or non-sexual recidivism

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Static- 99 (revised scoring 2003) alone!

  • Incorporates and expands on the RRASOR

  • Uses only static risk factors

  • Greater predictive validity than RRASOR alone for sexual recidivism

  • Moderate accuracy for predicting any violent recidivism

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Sex Offender Risk Appraisal Guide alone!(modified from Violence RAG)

  • VRAG is one of best measures for general violence recidivism, but not designed to assess sexual recidivism

  • SORAG is also a good predictor of violence recidivism

  • SORAG only moderate predictor of sexual recidivism

  • Requires sophisticated administration (includes the PCL-R)

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Level of Service Inventory- Revised alone!

  • Designed to measure general criminal recidivism

  • Includes dynamic as well as static factors

  • NOT designed for sex offense specific use; omits important factors with strong correlation to sexual recidivism (e.g., relationship to the victim)

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Static Factors Associated with Increased Recidivism alone!

  • Prior charges or convictions for sex offense (higher # = higher risk)

  • Violence in current or past offense

  • Young age (under 25)

  • Never had a live-in partner (for at least 2 years)

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Static Factors Associated with Increased Recidivism alone!

  • Victim Characteristics

    • Male

    • Non-family

    • Stranger

  • Hand-off (non contact) offenses

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Static Factors Associated with Increased Recidivism alone!

  • Physiological assessment shows deviant arousal

  • Personality disorder (esp. Antisocial)

  • History of anger problems

  • Diverse sex crimes

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Static Factors Associated with Increased Recidivism alone!

  • Early onset of offending

  • Failure to complete treatment

  • Prior non-sexual offenses

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Some Dynamic Factors Associated with Increased Recidivism alone!

  • Intimacy deficits

  • Negative peer influences

  • Noncompliant with treatment/supervision

  • Attitudes tolerant of sexual assault

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Pitfalls to watch out for in evaluation interviews alone!

  • Interviewing without background info

  • Revealing what you know prematurely

  • Talking over the client’s head

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Pitfalls to watch out for alone!

  • Allowing parent or other collateral to set tone of denial in front of client

  • Engaging in power struggles

  • Addressing the offense history too early

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Pitfalls to watch out for alone!

  • Accepting vagueness or generalities

  • Showing embarrassment, discomfort or disgust

  • Giving up too soon