Chapter 11 The Role of Assessment Thorough assessment of offenders include information concerning their social history psychological ad social problems sexual development and sexual patterns of offending Info gained through assessments should also address issues such as o The degree of dangerousness of the offender to others o The offender s suitability for treatment o The degree to which the behavior and attitudes of the offender have changed in response to treatment These assessments provide useful information for o Research into the cessation of sexual offending o Helping police identify potential offenders o Guiding treatment strategies Problems in Assessment Research on sex offenders frequently fails to confirm the existence of traits of characteristics unique to the offender Many sexual offender assessments provide no connection between the measures they recommend and the type of treatment that would be most effective or the outcome to be expected from the treatment Sexual offenders may lie about their histories and attempt to deceive the staff about their psychological state Sex Offender Classification Displaced Aggression sexual assault is an expression of anger originally felt toward a wife mother or other close female Sexually Motivated Compensatory sexual assault is expression of the man s desire to find a girlfriend but using force to do so Sadistic Type sexual assault in which the fighting and resistance of the victim combined with the offender s own aggression is sexually exciting Treatment Approaches The major objective in treatment is the cessation of offending Traditionally it was assumed that all sex offenders suffered from the same problems as a result treatment for this offender population was one dimensional and singular in nature Physiological Strategies o Castration stereotactic brain surgery antiangrogens psychotropic and antiepileptic medications Behavioral Strategies o Aversion therapy covert sensitization masturbatory conditioning Cognitive Strategies o Empathy training role playing social skills training Relapse Prevention Relapse prevention is designed to teach clients strategies that are useful in dealing with interpersonal conflict negative emotions and other high risk situations that lead to relapse Primary goal of relapse prevention o Help the offender maintain and enhance the changes produced by the o Ensure that offenders continue to use the skills they learned after completion treatment strategies of the treatment Other Program Components In the 1980s and 1990s more multifaceted and comprehensive treatment programs were devised which incorporate several treatment strategies focus on a number of problem areas that may be relevant to sex offenders Additional concerns include o The increasing number of sex offenders in prison o The importance of treating adolescent sex offenders to prevent adult sexual offending o The effectiveness of group therapy and open groups over individual therapy and closed groups o The use of male and female co therapists Recent Trends in Research Assessment The increase in the scope of offending ex the Internet o Contact with potential victims o The downloading of child pornography The focus on special needs offenders o Schizophrenic sex offenders in comparison to schizophrenic non sex offenders are more likely to be married employed and homosexual or bisexual o Schizophrenic sex offenders are also less likely to have an antisocial personality substance abuse issues or very severe physical illnesses Victimology Improved tools for assessing risk factors and predicting recidivism Effectiveness of Treatment Programs Meta analyses have identifies several elements that contribute to successful intervention o High base rates of recidivism o Length of follow up after program o Outpatient status o Use of cognitive behavioral strategies and hormonal treatments o Targeting characteristics related to recidivism the needs principle o Matching programs to offender learning styles and removing barriers to treatment the responsivity principle o The present treatment methods are more effective than those used prior to 1980 o Overall the conclusion is that some treatment programs are successful in rehabilitating at least some sex offenders Chapter 12 Models of Substance Abuse Treatment Miller and Hester distinguish among 11 models of substance interventions o Moral Model o Temperance model o Disease model o Characterological model o Conditioning model o Social learning cognitive behavioral model o Biological model o General family systems model o Sociocultural model o Public health model Psychodynamic Approaches These approaches focuses on developmental and structural deficits o Ex limited ego control use of defense mechanism affective difficulties such as depression Therapists will target client s denial of abuse try to uncover sources of dependence and examine the developmental influences on ego and superego development This approach works best with more verbal highly motivated clients who are tolerant of insight oriented approaches and who will actively participate Radical Behavioral Approaches These therapies seek to reverse processes that encourage and maintain addiction by controlling the stimuli that encourage substance abuse and by reinforcing controlled drinking abstinence and other prosocial substitute behaviors Classical and Operant Conditioning strategies include o Aversion therapies o Contingency contracting o Token economies o Covert sensitization o Stimulus controls o Community reinforcement Social Learning and Cognitive Behavioral Approaches The fundamental tool for change within these models is the role model The sponsors in AA and Narcotics Anonymous are examples of role models in treatment programs Therapeutic Communities TC s residential setting TC s are inpatient forms of treatment in which clients spend 3 months to 1 year in a The goals of TC s are to change negative pattern of behavior thinking and feeling that act as predispositions to substance abuse and re socialize addicted offenders The TC environment should be characterized by consistency empathy and firm but With the exception of overly confrontive programs TC s have shown favorable non punitive confrontation results in recent meta analyses Coping and Social Skills These programs target skill deficiencies including problem solving self efficacy and skills pertinent to social competence and emotional control These skills are taught through these steps o