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1
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2
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- Goal: reduction in sexual
recidivism in treated versus untreated sex offenders
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3
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- 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
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4
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- 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%
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5
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6
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- Studied 136 extrafamilial child molesters from a maximum security
psychiatric hospital over a 6 year follow-up period
- Found no treatment effect
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7
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- 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
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8
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- 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%
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9
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10
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- 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
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11
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- 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
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12
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- 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
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13
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- 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
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14
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15
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16
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- 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
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17
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18
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19
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20
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- 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
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21
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22
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- 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
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23
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- 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
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24
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- 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
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25
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- 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
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26
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27
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- 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
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28
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- 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
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29
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30
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- 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
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31
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- 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
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32
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33
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- 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
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34
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- 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
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35
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36
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- 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
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37
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- 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
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Notes
