Sex offenders: Treatment & risk
assessment
Jill D. Stinson, PhD
ETSU, Psychology
Disclosure Statement of
Financial Interest
• I, Jill Stinson, PhD,
DO NOT have a financial
interest/arrangement or affiliation with
one or more organizations that could
be perceived as a real or apparent
conflict of interest in the context of the
subject of this presentation.
Disclosure Statement of
Unapproved/Investigative Use
I, Jill Stinson, PhD,
DO NOT anticipate discussing the
unapproved/investigative use of a
commercial product/device during this
activity or presentation.
Introduction
• About your presenter
• Outline for today
▫ Who are we talking about?
▫ Traditions & new approaches in sex offender
treatment
▫ Treatment effectiveness
▫ Thinking about risk
The sex offender…
…is not what you think.
• Heterogeneity of the population
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Contact vs. non-contact offenders
Adult vs. child victims
Male vs. female victims
Familial vs. non-familial victims
High vs. medium vs. low risk
Juvenile sex offenders
Sex offenders with:
Paraphilias
Mental illness
Intellectual / developmental disabilities
Psychopathic traits
Sex offender treatment
• In the early days
▫ Insight-oriented approaches
▫ Behavioral reconditioning
• Then later
▫ Cognitive behavioral therapy
▫ Pharmacological interventions
▫ Relapse prevention
Everyone wants treatment, right?
Sex offender treatment
• Treatment effectiveness research
▫ Measured by reduction in sex offense recidivism
▫ Comparisons made between treatment vs. no
treatment
▫ Follow-up generally 5-10 years
▫ Not a lot of standardization among treatment
protocols
Sex offender treatment
• Does treatment work? Um, not sure.
• Problems with treatment effectiveness research
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Short-term treatment approaches
Focus on one outcome
Low base rates of sex offending behavior
Underreporting of sex offending
Are we using the right treatment?
Sex offender treatment
• Special challenges in sex offender treatment
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Involuntary treatment participation
High social cost of participation
Personal discomfort
Lack of insight or distress
Blame, denial, & minimization
Sex offender treatment
• What doesn’t seem to work very well
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Highly aversive methods
Indiscriminate chemical castration
Victim empathy training
Avoidance strategies
Confrontation
Overcoming denial
General social skills training
Sex offender treatment
• Traditional goals
▫ Prevent sexual offending
▫ Control sexual behavior
▫ Eliminate deviant sexual interests, thoughts, &
fantasies
……But is sex all we care about?
Emerging treatment trends
• Good Lives Model
• Circles of Support & Accountability
• Safe Offender Strategies
Emerging treatments – New goals
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Developing appropriate boundaries
Normative relationships with others
Forming good social support networks
Having prosocial interests and goals
Treating mental illness
Treating substance abuse problems
Positive life skills & experiences (job, home, recreational
activities, religious or spiritual involvement, etc.)
Measuring Risk
• Sex offender recidivism
▫ Sex offense specific recidivism
Ranges from 10-15% over 5-10 year period postrelease
▫ General criminal recidivism
Ranges from 35-50% over 5-10 year period postrelease
• Special groups
▫ Juvenile sex offenders
▫ Sexually Violent Predators
About 5% of the sex offender population is
responsible for the majority of sexual crime
Measuring Risk
• Factors that increase risk (static)
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Youthful age
Multiple arrests or incidents of sexual offending
Offenses against males
Multiple offenses against children
Offenses against strangers or non-family members
Other criminal arrests
History of non-compliance with supervision
Arrests for sexual offending as a juvenile
Limited history of normative intimate
relationships
Measuring Risk
• Factors that increase risk (dynamic)
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Poor progress in treatment
Treatment dropout
Poor sexual self-regulation
Poor self-regulation
Limited insight into one’s own risk
Impulsivity
Paraphilias (deviant sexual interests)
Psychopathy, or diagnosis of ASPD
Offense-supportive beliefs
What now?
• Better understanding of treatment effectiveness
▫ What works, for whom, & when?
▫ Prevention practices
• More dynamic understanding of risk
▫ Risk is like the weather
▫ Mechanisms of risk
