Understanding Sex Offenders: An Overview for Direct Care Staff and Case Managers Jackson Tay Bosley, Psy.D. Specialized Sex Offender Treatment Services Rutgers University Behavioral Health Care rev 6/2014 Numbers Between 15,600 and 16,000 Registered Sex Offenders in New Jersey 5,600 under supervision with the State Parole Board (Community or Parole Supervision for Life). Newly convicted offenders are all under supervision. Nationwide – about 9% of parolees are sex offenders. In New Jersey – 30%. Sex Offenders Who are sex offenders? What does “Sex Offender” mean? Where do they live? Heterogeniety Statutory-type offender Incest offender Female offender Exhibitionist Date rapist/stranger rapist Male-target pedophiles Sadistic rape-murderer Internet offender Juveniles with sexual behavior problems Commonalities Broke a Municipal, State or Federal Law Problems with sexual arousal (some) Problems obeying the law (some) Problems with social interactions (some) Problems making a living (some) Problems with drugs (some) Problems with societal norms (some) next section: Semantics Sexual Offender Legal term (2C:14-2-4) Broke a municipal, state or federal law Aggravated Sexual Assault/Sexual Assault Aggravated Criminal Sexual Contact/Criminal Sexual Contact Endangering the Welfare of a Child Kidnapping, Enticing or Luring, etc. CSL/PSL (2C:43-6.4) Sentencing provision Statutory Age of Consent in New Jersey In New Jersey, 16 is the age of consent: But, 13, 14 and 15 year olds can consent to sexual behavior with someone up to 4 years older than themselves (to the day). Teachers/coaches/ministers (in loco parentis) are prohibited from being sexual with minors under their supervision. New Proviso – Endangering Statute Sexually Violent Predator Legal term (C.30:4-27.24) Civil commitment for sex offenders Prior offense Mental abnormality or personality disorder High risk Volitional impairment 460 (or so) currently committed by court order, released when risk no longer reaches a statutorily- defined point. Pedophilia Pedophilic Disorder (302.2) Medical term (one of the paraphilias) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Over a period of at lest 6 months, recurrent, intense sexually arousing fantasies, sexual urges or behaviors involving sexual activity with a prepubescent child or children (generally age 13 and under). The individual has acted on the urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. Person is at least 16 and at least 5 years older than the child or children in criterion A. Rapist/Child Molester Colloquial terms Forcing someone to have sex Engaging in sexual contact with someone too young to give legal consent These terms do not appear in NJ state laws Not all child molesters are pedophiles Not all pedophiles are child molesters Exhibitionistic Disorder (302.4) Medical term (paraphilia) Legal term – Indecent Exposure/Lewdness DSM-5 …recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person as manifested by fantasies, urges or behaviors. The individual has acted on these sexual urges with a non-consenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational or other areas… Voyeuristic Disorder (302.82) Medical term (paraphilia) DSM-5 Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing or engaging in sexual activity as manifested by fantasies, urges or behaviors. Person has acted on these urges or the urges or fantasies cause marked distress or interpersonal difficulty. The individual is at least 18 years of age. Where do Sex Offenders live/work? Short answer: everywhere If under supervision, where they live/work is determined by their Parole Officer. Supervision stipulation: can’t live in a home with children unless approved. Supervision stipulation: employment must be approved. But, many are low-SES, live in urban areas and depend on public transport. Why do Sex Offenders Commit Sex Crimes? Variety of theories Personal factors Finkelhor’s 4 factors: Sexual arousal (deviant) Disinhibitors Biological contributors (sexual arousal) Contextual factors Blockages Emotional congruence “Rape culture” (socialized norms) Factors are unique to the individual Why do Sex Offenders Commit Sex Crimes? (cont.) Individual etiology Ascertained through individual assessment Empirical factors (Stable/Acute -2007) ACE (Adverse Childhood Experiences) Criminal/social/sexual history Treatment is (should be) based on assessment Legal Consequences of Sexual Offending on the Offender Criminal sanctions Megan’s Law Charges, trial, probation, incarceration Registration Community Notification Community/Parole Supervision for Life Supervision Conditions Mandated treatment Emotional/Social Consequences on the Offender The label “sex offender” Self-esteem Family shame Community scorn Problems/limitations obtaining Employment Housing Problems forming new relationships Take home messages Sex offenders are a wide variety of people. Sex offenders have a wide variety of problems. Sex offenders have a wide variety of recidivism rates (next section). Sex offenses have serious consequences. The topic is interesting and complicated. Who is Likely to “Do It Again”? What Science says about Recidivism Factor Analysis (what the science says) Sexual Deviance Sexual preference for pre-pubertal sexual partners (pedophilia) Sexual preference for cues of pain/fear Strength of sexual urges (hypersexuality) Antisociality Enjoyment of illegal activity Impulsive Criminal value system Actuarials Rapid Risk Assessment for Sexual Offense Recidivism (1997) Minnesota Sex Offender Screening Tool – Revised (1998) STATIC-99 and STATIC-99R Sex Offender Needs Assessment Rating -SONAR (Stable and Acute-2007) Others Sexual Reoffense CARAT, SORAG, JSORRAT-II, VASOR, SVR-20 (Risk for Sexual Violence Protocol), Risk Matrix-2000, RSVP Violent Reoffense VRAG, LSI-R, PCL-R, SAVRY Actuarial Item Analysis Actuarial items are chosen based on their empirical link to recidivism (atheoretical) Static Factors - Fixed, easy to code, most researched - priors, age/gender of victim Dynamic Factors – Changeable, harder to code (constructs: empathy, stability, psychopathy), what we target in treatment – indicators of imminent sexual recidivism Static Risk Items Age (youth) Prior criminal behavior Non-sexual crimes Sexual crimes Number of sentencing occasions Supervision violations Sexual offense victim choice Unrelated, Stranger, Male, Indiscriminate Static Risk Items Relationship history Treatment history (cont.) Completion Failure/termination Substance abuse history Adverse childhood environment Psychological factors/Dx ASPD, psychosis, DD/MR, pedophilia Factors Associated With Recidivism (Hanson & Morton-Bourgon, 2004): Specific interest in boys measured by ppg r = .30 Deviant sexual preference dx of any paraphilia .40 Sexual Preoccupations .51 Emotional identification with children .63 Dynamic Risk Items Stable (from Stable-2007) (score 0, 1, or 2) Significant social influences Capacity for relationship stability Emotional identification with children (<13) Hostility toward women General social rejection Lack of concern for others Impulsive Dynamic Risk Items Stable (cont.) Poor problem-solving skills Negative emotionality Sex Drive/Preoccupation Sex as coping Deviant sexual preference Cooperation with supervision (from Stable-2007) Dynamic Risk Items (from Acute-2007) type of recidivism Acute Victim access Hostility Sexual preoccupation Rejection of supervision Emotional collapse Collapse of social supports Substance abuse sexual x x x x general x x x x x x x Other Potential Risk Indicators Plethysmograph results Abel Assessment of Sexual Interest Polygraph results Treatment response Categorical denial (In)ability to empathize Psychosis Percentage Rates of Sex Offender Recidivism (Harris & Hanson, 2004): Type All Rapists Incest Female target CM Male target CM w/out prior offense w/ prior offense Offender over 50yrs 5yr 14 14 6 9 23 10 25 7 10yr 20 21 9 13 28 15 32 11 k=95 15yr 24 24 13 16 35 19 37 13 n=31,000 Criminal Recidivism Rates US Dept. of Justice (Bureau of Justice Statistics, 2002) 3 year follow-up Burglary Larceny Auto theft DUI Sex offenses 74% 75% 70% 51% 5.3% n=9691 Megan’s Law Tiering Registrant Risk Assessment Scale (adults) Juvenile Risk Assessment Scale (juveniles) These are not purely risk (recidivism) scales, but factor in seriousness of the offense if reoffense occurs. These scales have shown moderate concurrent validity with actuarials. Scores based on all credible information. Tiers and Notification Tier 1. Low risk Tier 2. Moderate risk Police notified (with registration) Police and community groups notified Internet notification (except incest) Tier 3. High risk Police, community groups and general public Internet notification GPS tracking Take Home Message: Adults: Baseline risk is determined by actuarials. Dynamic factors determine ongoing risk, imminence of reoffense and targets of treatment interventions. Juveniles: The research is less definite, but structured empirically-based instruments are essential. Contextual issues are of major importance in determining ongoing risk. What Can We Do About It? Characteristics of Effective Sexual Offender Treatment Basic Elements Community safety is an overarching goal Not voluntary – Motivation is a major issue Group-based Challenging Directed towards specific problems of sex offenders – Criminogenic needs Developmental/Contextual model This is NOT standard counseling (but has many aspects of general counseling) Treatment Models Legacy models One size fits all Harsh and confrontational Relapse Prevention (still used) Modern understanding Based on Risk/Need/Responsivity More risk – more (intensive & lengthy) treatment Address treatment to specific problem areas Provide treatment in a way that client can understand Specific Problems of Sexual Offenders Deviant sexual arousal Distorted cognitions/attitudes Antisocial value system Poor interpersonal functioning Poor problem-solving skills Poor coping mechanisms Denial Protective Factors Pro-social attitudes Lifestyle stability Respect for the law Desire to live a law-abiding lifestyle Steady, safe, affordable housing Living wage job Community supports Reasonable legal supervision Family/colleagues (non-criminal) Intervention Philosophy Collaborative effort (client onboard?) Accountability Limited confidentiality Skill building (work & social relationships) Risk/Need/Responsivity principle Accurate feedback Reinforce positive behaviors Challenge antisocial thinking/lifestyle Intervention Techniques Explicit CBT Ancillary techniques Examine distorted cognitions Enhance positive behavioral repertoire Polygraph Collaborative surveillance Medications (SSRIs and antiandrogens) Relapse Prevention Good Lives Model (strengths based) Relapse Prevention Offending behavior does not just “happen.” Offenders make a series of choices. Treatment teaches offenders to recognize those choices. Intervention: Offenders learn about their offense cycles. Offenders learn to identify risk factors. Offenders learn to respond appropriately. CSOM Long Version: Section 3 42 Modern Sexual Offender Treatment Approaches Treatment based on assessment Treatment that teaches new skills Treatment targets vary with individual Teach better coping skills Teach new social-interactional skills Time in treatment varies Short for some (statutory-type offenders) Long time/forever for some (psychopaths and pedophiles) Treatment Effectiveness Treatment has a positive effect for reducing recidivism (40% reduction). Failing treatment is a very poor prognosticator (200% increase in recid.). Treatment “works” for those who are invested in the process and “work the program”. Treatment has less effect for those who attend, but are not invested. Other Treatment Effectiveness Studies Furby, L., Weinrott, M.R., & Blackshaw, L. (1989) Hanson, R. K., Gordon, A., Harris, A. J. R., Marques, J. K., Murphy, W., Quinsey, V. L., & Seto, M. C. (2002) SOTEP study “…there is as yet, no evidence that that clinical treatment reduces rates of sexual reoffenses.” 10% Treated 17% Untreated n = 9454 Hanson, R. K., Bourgnon, G., Helmus, L., & Hodgson, S. (2009) 10.9% Treated 19.2% Untreated n = 6746 Take Home Message Treatment works (most of the time). Treatment is lengthy and difficult. The early stages are particularly difficult. Denial is an important issue. Treatment is usually based on Cognitive/Behavioral Principles. Risk/Need/Responsivity (triage) is an abiding principle. Honor the efforts you make to reduce suffering in the world. Contact Information: Jackson Tay Bosley, Psy.D. (609) 984-6280 Cell (201) 259-5228 bosleyjt@ubhc.rutgers.edu