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Sex Offender-Specific Treatment Outcome Research: Learning Objectives. Describe the general findings of sex offender-specific treatment outcome research Describe the financial costs and benefits of sex offender-specific treatment. Does Treatment Reduce Recidivism in Sex Offenders?.

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sex offender specific treatment outcome research learning objectives
Sex Offender-Specific Treatment Outcome Research: Learning Objectives
  • Describe the general findings of sex offender-specific treatment outcome research
  • Describe the financial costs and benefits of sex offender-specific treatment

Short Version: Section 2

does treatment reduce recidivism in sex offenders
Does Treatment Reduce Recidivism in Sex Offenders?

Goal: reduction in sexual recidivism in treated versus untreated sex offenders

Short Version: Section 2

barbaree marshall 1988
Barbaree & Marshall, 1988
  • 126 treated (cognitive-behavioral methods) and untreated child molesters in a community sample
  • 4 year follow-up
  • Recidivism (measured by official police records and unofficial police and child protective agency reports) rates quite different between the treated and untreated groups

Short Version: Section 2

barbaree marshall 1988 cont
Barbaree & Marshall, 1988(cont.)
  • Extra-familial female-target child molesters
    • Recidivism rates over four years for treated group: 18%; for untreated group: 43%
  • Extra-familial male-target child molesters
    • Recidivism rates for treated group: 13%; for untreated group: 43%
  • Incest female-target child molesters
    • Recidivism rates for treated group: 8%; for untreated group: 22%

Short Version: Section 2

barbaree marshall 1988 cont1
Barbaree & Marshall, 1988 (cont.)

Recidivism Rates

Short Version: Section 2

rice quinsey harris 1991
Rice, Quinsey, & Harris, 1991
  • Studied 136 extrafamilial child molesters from a maximum security psychiatric hospital over a 6 year follow-up period
  • Found no treatment effect

Short Version: Section 2

hall 1995
Hall, 1995
  • Performed meta-analysis on 12 sex offender treatment outcome studies
  • Total sample size of 1,313 sex offenders
  • Recidivism: formal legal charge for a new sex offense after the completion of treatment for the treatment group
  • Mean length of treatment 18.5 months

Short Version: Section 2

hall 1995 cont
Hall, 1995(cont.)
  • Mean follow-up period across studies was 6.85 years
  • Found small but significant recidivism-reducing treatment effect for treatment versus no treatment or comparison treatment conditions
    • Overall recidivism rate for treated sex offenders: 19%
    • Recidivism rate for untreated group: 27%

Short Version: Section 2

hall 1995 cont1
Hall, 1995(cont.)

Short Version: Section 2

hall 1995 cont2
Hall, 1995(cont.)
  • Greatest treatment effects were in studies with
    • Longer follow-up periods
    • Higher base rates of recidivism
    • Outpatient services
    • Cognitive-behavioral treatment or anti-androgen treatment

Short Version: Section 2

general accounting office 1996
General Accounting Office, 1996
  • Summarized 22 reviews of research on sex offender treatment covering 550 studies between 1977 and 1996
  • Report concluded that the results are promising but inconclusive

Short Version: Section 2

alexander 1999
Alexander, 1999
  • Examined data from 79 sex offender treatment outcome studies encompassing 10,988 subjects
  • Divided offenders and offenses into subtypes by age of offender, age of victim, offense type, type of treatment, location of treatment, years in which treatment occurred, and length of follow-up
  • Recidivism typically defined as subjects who were rearrested for a new sex offense

Short Version: Section 2

alexander 1999 cont
Alexander, 1999(cont.)
  • Offenders who participated in relapse prevention treatment programs had a rearrest rate of 7% compared to 18% for untreated offenders
  • 528 adult male rapists: 20% of the treated group reoffended; 24% of the untreated group

Short Version: Section 2

alexander 1999 cont1
Alexander, 1999(cont.)

Short Version: Section 2

alexander 1999 cont2
Alexander, 1999(cont.)

Recidivism Rates

Short Version: Section 2

alexander 1999 cont3
Alexander, 1999(cont.)
  • 2,137 child molesters: 14% of the treated group reoffended; 26% of the untreated group
  • Treatment effect was especially strong for the 331 exhibitionists: 20% of the treated group reoffended; 57% of the untreated group
  • For all 10,988 study subjects combined, 13% of the treated group reoffended; 18% of the untreated subjects reoffended

Short Version: Section 2

alexander 1999 cont4
Alexander, 1999 (cont.)

Recidivism Rates

Short Version: Section 2

hanson et al 2002
Hanson et al., 2002

The 2002 ATSA Report on the Effectiveness of Treatment for Sexual Offenders

  • Collaborative research project to:
  • Define standards for research on treatment outcomes for sex offenders
  • Summarize existing research
  • Promote high quality evaluations

Short Version: Section 2

hanson et al 2002 cont
Hanson et al., 2002(cont.)

Short Version: Section 2

seto barbaree 1999
Seto & Barbaree, 1999
  • Evaluated the relationship of clinical ratings of treatment behavior to recidivism (in-session behavior, homework quality, motivation, and change achieved)
  • Found good treatment behavior was unrelated to general recidivism but associated with higher serious violent or sexual recidivism
  • Men who scored higher in psychopathy and better in treatment behavior were the most likely to reoffend

Short Version: Section 2

serious sex offender recidivism related to treatment behavior and psychopathy
Serious Sex Offender Recidivism Related to Treatment Behavior and Psychopathy

Psychopathy

Seto & Barbaree, 1999

Short Version: Section 2

hanson morton bourgon 2004
Hanson & Morton-Bourgon, 2004
  • Update of 1998 meta-analytic review of sex offender recidivism studies
  • Analyzed 95 studies containing 31,216 sex offenders
  • This study examined primarily dynamic (changeable) risk factors, rather than the static (unchangeable) factors reviewed in the 1998 study
  • 5-6 year follow-up

Short Version: Section 2

hanson morton bourgon 20041
Hanson & Morton-Bourgon, 2004
  • Results showed that the sexual recidivism rate across all studies was 13.7%
  • General recidivism rate was 36.9%
  • All types of recidivism were predicted by offenders having an unstable, antisocial lifestyle, or lack of self-control
  • Those individuals with deviant sexual interests, particularly in children, were most likely to reoffend sexually
  • High rates of sexual preoccupation were significantly related to all forms of recidivism

Short Version: Section 2

l sel schmucker 2005
Lösel & Schmucker, 2005
  • First international meta-analysis of both published and unpublished sex offender biological and psychological treatment outcome studies
  • Included 69 studies with more than 22,000 subjects were analyzed—about one-third published since the year 2000 and one-third published outside North America
  • Recidivism was operationalized as broadly as possible, ranging from incarceration to lapses in behavior

Short Version: Section 2

l sel schmucker 20051
Lösel & Schmucker, 2005
  • 11% recidivism rate in treatment groups
  • 17.5% recidivism rate in control groups
  • Overall, treatment provides a 37% reduction in sexual recidivism
  • Cognitive-behavioral treatments had the most significant impact on sexual recidivism

Short Version: Section 2

l sel schmucker 20052
Lösel & Schmucker, 2005

Short Version: Section 2

marques et al 2005
Marques et al., 2005
  • Marques and colleagues employed an experimental design to evaluate the Sex Offender Treatment and Evaluation Project (SOTEP)
  • Stationed at Atascadero State Hospital in California, SOTEP operated from 1985 to June 1995
  • Randomized clinical trial
  • 704 participants
    • 259 = relapse prevention program
    • 225 = untreated volunteer control
    • 220 = untreated non-volunteer control
  • 8 year follow-up

Short Version: Section 2

marques et al 20051
Marques et al., 2005
  • Final results revealed no significant differences among the three groups in their rates of sexual or violent reoffending
  • 22% of the treatment group committed a subsequent sexual offense and 16.2% had a violent reoffense
  • 20% of the volunteer group reoffended sexually and 16.3% had a subsequent violent offense
  • 19.1% of the non-volunteer control group had a sexual reoffense and 15% had a violent reoffense
  • However, those who did well in treatment recidivated at lower rates than those who did not progress in treatment

Short Version: Section 2

marques et al 20052
Marques et al., 2005

Short Version: Section 2

mcgrath et al 2003
McGrath et al., 2003
  • Evaluation of a prison-based cognitive-behavioral, relapse prevention treatment program for adult sex offenders in the State of Vermont, which included a community aftercare component
  • 195 participants
    • 90 = no treatment
    • 56 = completed treatment
    • 49 = some treatment
  • 6 year follow-up

Short Version: Section 2

mcgrath et al 20031
McGrath et al., 2003
  • Results showed that almost one quarter of the total sample (23%) were found to have committed a new sex offense during the follow-up period
  • Sex offenders in the completed treatment group had a significantly lower sexual recidivism rate (5%) then both the some treatment group (31%) and the no treatment group (30%)
  • The completed treatment group also had a significantly lower rate of violent recidivism than the no-treatment group

Short Version: Section 2

mcgrath et al 20032
McGrath et al., 2003

Short Version: Section 2

seager et al 2004
Seager et al., 2004
  • Seager et al. examined men over the age of 18 who were convicted of a sex offense and were offered the opportunity to participate in a manualized treatment program, in which offender progress was clinically evaluated
  • 177 participants
    • 81 successfully completed the treatment program
    • 28 were unsuccessful
    • 17 offenders dropped out
    • 19 refused to participate

Short Version: Section 2

seager et al 20041
Seager et al., 2004
  • Overall, 12% of the offenders in this study were reconvicted for a sex or violent offense and 23% were charged with a new sex or violent offense
  • 4% of successful treatment completers and 7% of unsuccessful treatment completers were convicted for a new sexual or violent offense
  • 32% of those who dropped out, refused, or were terminated from treatment incurred a new conviction and 49% had new charges
  • Dropping out, refusing, or being terminated from treatment was related to higher risk for sexual and/or violent offending

Short Version: Section 2

seager et al 20042
Seager et al., 2004

Short Version: Section 2

financial costs benefits of treatment
Financial Costs/Benefits of Treatment
  • Any reduction in recidivism is significant in terms of reduction of harm to victims and costs to society
  • Prentky and Burgess (1990) estimated the costs per sex offense for offender-related and victim-related expenses totaled $183,333
  • Therefore, if there are eight fewer offenses for every 100 sex offenders, the tangible financial savings is $1,466,664
  • If we think treatment of sex offenders is expensive, compare it to the cost of not treating sex offenders

Short Version: Section 2

summary
Summary
  • When all studies are reviewed, sex offender treatment reduces sexual recidivism in adult males about 5 to 10%
  • Any reduction in reoffense rates can result in very significant cost savings and—more critically—a reduction in harm

Short Version: Section 2