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CSOM Long Version: Section 4 1
Learning Objectives
Participants will be able to: Summarize researchOutline treatment componentsIdentify reasonable expectations of
treatment providerIdentify treatment provider qualificationsOutline collaboration strategies
CSOM Long Version: Section 4 2
Effectiveness of Treatment
Difficult to studyPoor dataPrograms and definitions varyDesign criteria difficult to meet
BUT“Good grounds for optimism”
(Marshall and Pithers, 1994)
CSOM Long Version: Section 4 3
Review of the Research
Individuals who had received treatment had consistently lower recidivism rates than untreated individuals.
Better outcomes after 1980--perhaps better programs or better research.
Treatment over long periods of time is more effective.
Completing treatment is important.(M.A. Alexander, 1994)
CSOM Long Version: Section 4 4
Review of the Research (cont.)
Recidivism rates of untreated offenders are approximately 60%.
Recidivism rates of offenders completing specialized treatment are between 15% and 20%.
(U.S. Department of Justice, 1991)
CSOM Long Version: Section 4 5
Review of the Research (cont.)
Grossman et al (1999): reduction in recidivism of 30% over seven years
Gallagher et al (1999): cognitive-behavioral approaches appear particularly promising
Polizzi et al (1999): prison and non-prison based programs show effective or promising results
CSOM Long Version: Section 4 6
Review of theResearch (cont.)
1995 meta-analysis found (Hall, 1995) small but significant treatment effect 12 studies--all with control groups 8 percent reduction in recidivism in the
treatment group
CSOM Long Version: Section 4 7
Summary of Research on Treatment Effectiveness
Many studies, many poorly designed.Well-designed studies associate treatment
with lower recidivism--some very significantly
Outcomes differ by type of offenderGreater reductions found in more recent
studiesTreatment and/or evaluation methods are
improving
CSOM Long Version: Section 4 8
Summary of Research on Treatment Effectiveness (cont.)
Analytic or insight oriented therapies are not effective (Quinsey, 1990, 1994; Salter, 1988; Lanyon, 1986)
A combination of educational, cognitive-behavioral, and family system interventions is effective (Knopp and Stevenson, 1988, 1992)
When reviewing all studies; conclude that treatment reduces recidivism by 10%
CSOM Long Version: Section 4 9
Effectiveness of Treatment Plus Supervision
Only a few studies done--they support effectiveness of combined treatment and supervision (some with the polygraph). (Romero and Williams, 1985 , 1991)
Current study of Maricopa County program is revealing low rates of recidivism.(Maricopa County Adult Probation Department, 1999)
CSOM Long Version: Section 4 10
Traditional vs. Sex Offender Treatment
Offender-focused Targets reduction
in anxiety/inadequacy
Individual counseling
Usually voluntary
Victim/community safety focused
Targets accountability and thinking errors
Primarily group settingOften mandated
Traditional Sex Offender Specific
CSOM Long Version: Section 4 11
Traditional vs. Sex Offender Treatment (cont.)
Client/patient confidentiality
Provider works as an individual practitioner
Generalist” training for a variety of client types
Waivers of confidentiality
Provider is part of management team
Specialized training/ experience essential
Traditional Sex Offender Specific
CSOM Long Version: Section 4 12
Means of Reducing Recidivism through Treatment
Accepting responsibility and modifying cognitive distortions
Developing victim empathyControlling sexual arousalImproving social competenceDeveloping relapse prevention skillsEstablishing supervision conditions
and networksClarification
CSOM Long Version: Section 4 13
Methods of Treatment
Psycho-educational groups
Cognitive-behavioral groups
Medication
Individual therapy
Psychological and physiological testing
Referrals to other necessary treatments
CSOM Long Version: Section 4 14
Components of Treatment
To cause acceptance of responsibility: Education about denial Support for incremental steps Making responsibility a prerequisite for
entry/completion Confronting/challenging discrepancies,
cognitive distortions
CSOM Long Version: Section 4 15
Components of Treatment
To develop victim empathy: Psychoeducation on effects of abuse Exercises to imagine victim experience Teaching empathy skills Meeting with victim(s)
CSOM Long Version: Section 4 16
Components of Treatment
To control sexual arousal: Education about fantasy and behavior Cognitive-behavioral techniques for
interrupting/reducing deviant urges, developing/increasing non-deviant urges
Methods for practice outside of therapy setting
Medication
CSOM Long Version: Section 4 17
Components of Treatment
To improve social competence: Using group setting for practice Referral to specialized treatment Involving significant others
CSOM Long Version: Section 4 18
Components of Treatment
To develop relapse prevention skills: Education about relapse prevention Identifying individual’s cycle Teaching strategies to avoid lapses Teaching/practicing strategies to
minimize lapses
CSOM Long Version: Section 4 19
Components of Treatment
To establish supervision conditions and networks: Provider collaborates with officer Advises on cycle and appropriate
conditions Assists with modifications Educates network
CSOM Long Version: Section 4 20
Components of Treatment
To Clarify: Verbalize full responsibility Acknowledge grooming, set up State details of offense Support decision to report to police Acknowledge ongoing problem
CSOM Long Version: Section 4 21
What to Expect from a Sex Offender Treatment Provider
Team workCommunity safetyLimited confidentialityIncorporates evaluationAlso: Experience and/or recent
specialized training
CSOM Long Version: Section 4 22
Monitoring Treatment and Providers
Written reportsCase conferences
New cases Specific offender issues System problems
CSOM Long Version: Section 4 23
Monitoring Treatment and Providers (cont.)
Observation Content Process
Emergency case reviewsCommunity feedbackGraduation Criteria
CSOM Long Version: Section 4 24
Treatment Providers Must Deal With:
DominationManipulationAngerAggressive
outburstsDepressionSelf-defeating
behaviors
Variety of skill deficits
Family educationVictim issuesOngoing risk
assessment
CSOM Long Version: Section 4 25
Collaboration Between Treatment and Supervision
Probation/parole may offer classesComplementary treatment and
supervision plansProbation/parole participate/observe
in treatment sessionsWritten treatment plan exchanged
with probation Joint understanding of offense cycles
CSOM Long Version: Section 4 26
Primary Goal of Treatment -- Reduce Future VictimizationThe following are means to that end:Reducing cognitive distortionsAccepting responsibilityDeveloping victim empathyControlling sexual arousalImproving social competenceDeveloping relapse prevention skillsEstablishing supervision conditions
and networks
CSOM Long Version: Section 4 27
Treatment Providers Must be Willing to...
Work as part of a team
Share information
Protect the community as a primary
responsibility
Evaluate their work by these
standards