Sex Offender Treatment Intervention

Over the past few decades, sexual offences have become the focus of the public eye, prompting eval¬uation of current treatment interventions and the consideration of new treatment interventions with the aim of preventing and/or reducing future sexual offences (Belcher, 2008). This paper well aim to evaluate current literature examining the effectiveness of sex offender treatment interventions. It looks at which approaches appear to be most effective and why. Furthermore the paper attempts to identify if the treatment interventions are equally as effective with youth and adult offenders or not.
The success of sexual offender treatment interventions is a notable focus for many countries throughout the world (Lösel & Schmucker, 2005). This is
due to significant focus on the serious nature of sexual based offences within the Media, therefore creating a strong public concern base. As a result, politicians and policy makers have responded to public outcry with punishments containing both incarceration and treatment programs (Lösel & Schmucker, 2005). Incarceration is successful at reducing immediate risk for the community, although, most sex offenders are released back into the community, hence the importance of treatment interventions to be utilised (Lösel & Schmucker, 2005). Several sex offender treatment interventions have been developed and implemented to rehabilitate sex offenders (Ackerman & Furman, 2012). Though various treatment interventions were developed purposely to be utilised with sex offenders, most have been adopted from treatment intervention that are utilised for other psychological and criminological aspects (Ackerman & Furman, 2012). Furthermore, it is important to note that most sex offender specialised treatment interventions have achieved at least a reasonable base of empirical validation, though, others have minimal validation or have not completed any empirical research to date (Lösel & Schmucker, 2005). Undeniably, there is extreme difficulty in evaluating treatment results within sex offender populations due to the nature of the crimes and the difficulty in being able to identify sexual deviance. As a result it is noted that further research is required to determine the effect of treatment interventions with sex offenders in reducing recidivism and sexual deviancy (Polizzi, Mackenzie & Hickman, 1999).
The basis of many intervention treatment programs for sex offenders is cognitive behavioural therapy (CBT) and relapse prevention therapy (RPT) (Kim, Benekos, & Merlo, 2015). McGrath et al (2009) reported that out of 1,379 programs within the USA and Canada, that the CBT model was utilised within 85% of all programs and that relapse prevention was utilised for 50% of all programs. CBT utilises psychotherapies to support the offender in critically examining the connection between thoughts and emotions and behaviours (Moster, Wnuk, & Jeglic, 2008). The cognitive emphasis is on changing the thought patterns in order to change subsequent behaviour’s and ultimately alter the emotions (Moster, Wnuk, & Jeglic, 2008). This approach helps sex offenders through cognitive restructuring by challenging rationalisations, minimisation and other offence supporting beliefs that may be occurring (Moster, Wnuk, & Jeglic, 2008). Ultimately the premise behind CBT is to lead to providing new skills to control sexual impulses for sex offenders (Kim, Benekos, & Merlo, 2015). Polizzi, Mackenzie & Hickman (1999) evaluation of sex offender treatment programs found that CBT approaches showed a positive treatment effect and therefore effectively provided outcome in decreasing recidivism rates amongst sex offenders. CBT treatment interventions for sexual offending has found to be effective for both adult and youth offenders, although there is far more evidence of it success of adult offenders than youth offenders (Redondo, Sanchez-meca,& Garrido,1999). It is important to note that CBT approaches are found to the most effective due to the larger amount of empirical support then the preceding treatment interventions in this paper.
Relapse prevention therapy (RPT) as previously mentioned is an effective treatment intervention for sexual offenders. RPT initiated as an intervention for the treatment of alcohol abuse and was subsequently modified to be implemented for the treatment of sexual offenders (Hanson, 1996). Most intervention programs include some aspect of RPT (Hanson, 1996). RPT is a multimodal and rigid intervention aimed at supporting offenders to maintain behavioural changes by anticipating and managing problems of possible relapse (Law, 2003). RPT delivers an inclusive framework within which CBT and educational approaches are utilised to educate a sex offender how to identify and interrupt the sequence of events leading to a relapse (Law, 2003). RPT is intended to enhance self-control (Hanson, 1996). RPT is rarely utilised as a standalone treatment intervention, although is effective when utilised with other methods (Hanson, 1996). Letourneau & Borduin, (2008) identified that RPT treatment approaches do not represent the most effective care for youth sex offenders due to not being focused for youth offending and youth development. Although, as RPT is developed for adult offenders, it stands to reason that RPT has more applicability to reducing recidivism rates with adult offenders than youth offenders.
Another favourable treatment intervention is multisystemic therapy (MST) (Dopp, Borduin, & Brown, 2015).
MST was initially established for anti-social and pro-criminal youth offenders. MST is a family based treatment intervention that works with families to improve and develop the supervision, discipline and monitoring of young people (Kim, Benekos, & Merlo, 2015). The MST was adapted for the treatment of youth sex offenders and is identified as multisystamic therapy- problem sexual behaviour (MST-PSB) (Dopp, Borduin, & Brown, 2015). MST-PSB focuses on the aspects of a youth sex offenders ecology that are associated to the problem sexual behaviour, including, addressing family and youth repudiation about the sexual offence, views and attitudes that may have been a contributing factor to the offending behaviour and age appropriate sexual behaviours (Dopp, Borduin, & Brown, 2015). MST-PSB intervention overall attempts to interfere and disrupt the sexual assault cycle by engaging the young person to work with family members in order to create a safety plan and empower the family with the skills and resources to effectively manage the young person and the behaviours. Dopp, Borduin and Brown (2015) identified through their study of three clinical trials that MST-PSB is an effective treatment intervention with young people providing promising
outcomes.
Further to the MST and CBT treatments other sex offender treatment interventions can include medical interventions that are either physical or chemical (Kim, Benekos, & Merlo, 2015. Androgen deprivation therapy (ADT) is an intervention that can be accomplished both surgically and pharmacologically (Kim, Benekos, & Merlo, 2015). Ultimately ADT is the pharmacological or chemical castration which consists of administration of anti-androgens (Rice & Harris, 2011). The idea behind ADT is that the anti-androgens decrease the levels of testosterone and therefore, sexual urges (Rice & Harris, 2011). Due to the invasive and altering nature of the treatment, ADT is a treatment intervention directed specifically at adult sex offenders (Rice & Harris, 2011). Furthermore, there is significant legal and moral implications of the treatment that limit its application to adult sex offenders (Rice & Harris, 2011). Results of a German study by Will and Beier in 1989 found that ADT was successful in decreasing recidivism, although all offenders were volunteers for the procedure and this may have skewed the results (Kim, Benekos, & Merlo, 2015). Additionally, Kim, Benekois & Merlo (2015) noted in their review that ADT shows significantly superior effects in comparison to the psychological treatments (MST-PSB and CBT). This result was highlighted as being consistent with previous research in the area, though; it was also noted by Kim, Benekois & Merlo (2015) that these results should be interpreted cautiously. This is further supported by Rice and Harris (2011) that identified ADT as a treatment intervention that may be effective though requiring further scientific basis.
As discussed above CBT, RPT, MST and ADT are treatment interventions found to be effective in reducing recidivism and sexualised behaviours. Though, it is important to explore if the interventions can be utilised for both adult and youth offenders. Historically, significant concerns evolved because interventions for young people primarily based on the treatment interventions for adult offenders (Chaffin & Bonner, 1998). Many intervention treatments characteristically fail to address the numerous elements of youth sexual offending and could result in harm to the offender. It is important to note that adult sexual offenders are significantly different from youth sex offenders in several ways. Most youth sex offenders do not display deviant sexual arousal, nor do they have significant deviant sexual fantasies as their adult counterparts do (Longo, 2006). Further to this, youth sex offenders generally do not have tendencies to commit sexual offenses, nor do they have a high rate of recidivism (Longo, 2006). Therefore, young people are more likely to be more responsive to treatment interventions than adult sex offenders (Longo, 2006). Interventions for youth sex offenders are required to modified and appropriate for youth (Hunter & Longo, 2004). For instance, the language, style, and approach to the intervention and treatment are customised for youth sex offenders (Hunter & Longo, 2004). Youth sexual offending is far more complex than that of adults. To date there has been little research into the effectiveness of the treatment interventions for youth sex offenders, than that of their adult counterparts.
Effective sex offender treatment interventions are required to minimise or cease the risk recidivism.
This paper aimed to briefly examine current literature in efforts to outline the most effective treatment interventions including CBT, RPT, MST and ADT. Although, these four treatment interventions have been found to be effective it is important to mention that CBT has quite a significant empirical support basis as possibly the most effective treatment in the reduction of sexual recidivism (Moster, Wnuk, & Jeglic, 2008). CBT interventions are an all-inclusive and effectual treatment for sex offenders and are considered to be the best practice for treatment of both youth and adult sexual offenders (Moster, Wnuk, & Jeglic, 2008). CBT has found to be significantly effective with adults, although is still able to be applied to youth sex offenders (Redondo, Sanchez-meca,& Garrido,1999). It has been highlighted that CBT is most effective when utilising other treatment interventions like that of relapse prevention therapy (RPT) (Redondo, Sanchez-meca,& Garrido,1999). Furthermore, CBT if utilised in conjunction with MST achieves more effective treatment outcomes (Kim, Benekois & Merlo, 2015). Kim, Benekois & Merlo (2015) identified that utilising both CBT and MST allows focus on sexual self-regulation and therefore lowering the risk of recidivism for youth sex offender than that of MST alone. In summary, CBT based treatment interventions are the most utilised and effective method
for adult sex offenders and MST is the most utilised and effective method for youth sex offenders. Additionally both methods are even more effective when utilising other interventions including RPT and ADT. It is important to note that ADT has also been found to have significant effectiveness in reducing recidivism in adult sexual offender, although there is limited empirical basis and further research is required.