SEX OFFENDER DENIAL: What really is the evidence?

Transcription

1 SEX OFFENDER DENIAL: What really is the evidence? Prof Todd Hogue & Laura Brand Division of Forensic Psychology Annual Conference, Belfast, June 26 th 2013

2 Sex Offender Denial A substantial proportion of sex offenders deny some aspect of their offence: Complicates assessment/treatment processes Exclusion from treatment Denial is used to support and justify sexual offending behaviour and serves to attribute responsibility and causality of the behaviour (Gannon, 2009) Function of denial Reasons for denial/minimization: threats to self-esteem and selfimage; fear of negative extrinsic consequences; adverse effects on convictions and sentencing; deficits in perspective taking; low motivation to stop offending (Lord & Willmot, 2004; Marshall, et al., 2009)

3 Literature Review Denial/minimization: Treatment target in sex offender treatment programmes Few widely-accepted conclusions amongst researchers and practitioners about the impact of denial on treatment programmes and sexual offence recidivism Impact on treatment Limited clinical benefits to focusing on accepting responsibility for past behaviour (Maruna & Mann (2006) Successful treatment completion significantly related to lower denial/minimisation Barbaree, 1991; Maletzky, 1993; Hunter & Figueredo, 1999; Geer, Becker, Gray & Kraussm 2001; Levenson & Macgowan, 2004) Denial significantly related to lower motivation to fully engage in treatment (Simkins, Ward, Bowman & Rinck, 1989; Matthews, 1991; Gibbons, De Volder & Casey, 2003; Jung & Nunes, 2012).

4 Impact on Sexual Recidivism Reduction of future recidivism is generally the ultimate objective in sex offender treatment (Harkins, Beech & Goodwill, 2010). The relevance of denial as a risk factor unclear Numerous studies and meta-analyses demonstrate no relationship (Hanson & Bussière, 1998; Hanson & Morton-Bourgon, 2005) Inconsistent definitions of denial, varying lengths in follow-up periods and small samples that were not homogenous in terms of populations or settings Lund (2000): Denial also potentially interacts with other factors (Harkins et al. 2010; Langton, et al. 2008; Nunes et al. 2007)

5 There is a lack of consistent evidence indicating that denial and minimization leads to increased recidivism Ware and Mann (2012)

6 Aims of Study Comprehensive review: Examine the existing evidence base related to denial/minimization Critically analyse existing sample-based studies relating to sex offender denial/minimization Identify the extent of clear and consistent definitions The evidence across differing sample populations

7 Method Selection Criteria: a) Empirical study b) Sample of offenders accused or convicted of a sexual offence c) Classification/assessment of offence-related denial or minimization Systematic search of the following electronic databases conducted in EBSCO: PsychINFO, Academic Search Complete, MEDLINE, ERIC and PsychARTICLES Wide range of key terms used for denial and sex offenders entered in the search Sex offenders: child molesters*, paedophiles*, rapists*, sexual abuse*, sexual offence*

8 Method Google scholar, reference lists, previous reviews and meta-analyses, contacted authors for articles and conference papers More comprehensive than the initial instructive systematic review Search Results: 57 research papers, 64 independent sex offender samples

9 The Studies Study Location US 26 46% Canada 14 24% UK 14 24% The rest 3 6% Study Type Treatment engagement 14% Treatment target 14% Assessment tool 2% Sexual recidivism 12% Mixed 28% Other 30% Study Setting Community 31% Prison 31% Health 4% Mixed 3% Unknown 30% Focus of the study Adults 84% Juvenile 11% Mixed 5% Status Accused 22% Convicted 33% Incarcerated 20% Unknown 25%

10 Study summaries Each study was compiled into a summary table with the following information: Study Research Purpose N Control Offence Type Setting Country Denial Definition Assessment Results Summary Barbaree (1991) Denial as treatment target 41 male adults None Child Molest 37% Adult Rape 63% Prison Canada Categorical denial/minimization of responsibility, offence history, victim harm DMCL -Denial 59% -Minimization 39% -Admits 2% First stage of treatment should target denial and minimization as both appear to decrease with intervention. Highlighted the amount of missing information across different studies, particularly regarding the sample, eg. Sex offence type, age group, pre-/post-conviction, denial statistics

11 Denial: How defined? Wide ranging definitions 50% dichotomous Categorical denial of offence charges Categorical denial of child-sex related history Denial of paraphilic behaviour Total denial of offence Acceptance of responsibility and treatment readiness Denial of deviant arousal and child molestation Denial of guilt Minimizing or excusing Range of multifaceted measures / conceptualizations 11

12 Results and Analyses Denial Assessment/Classification: For 50% of the samples, denial was assessed using an assessment tool with a scale or structure Tool No. Author Comprehensive Inventory of Denial (Sex Offender 4 Jung (2004) Version) Facets of Sex Offender Denial 3 Schneider & Wright (2001) Sex Offender Acceptance of Responsibility Scales 4 Peacock (2000) Denial and Minimization Checklist/-III 3 Barbaree (1991); Langton, et al. (2003) Sex Offence Information Questionnaire 4 Hogue (1993; 1998) Sex Offence Attitudes Questionnaire 2 Proctor (1994) Denial Scale for Male Incest Offenders 1 Guthrie et al. (1998) Denial Scales and Ratings 2 Kennedy & Grubin (1992) Mulitphasic Sex Inventory sub-scales 3 Nichols & Molinder (1984; 1996) Sexual Violence Risk measure sub-scales 4 Boer et al. (1997) Adolescent Sexual Offender Assessment Packet 1 Gray & Wallace (1992) Response to Treatment scale 1 Langton (2003)j

13 Number of Denial Sub-types Results and Analysis 67% - Categorical: For almost half of these studies denial was absolute (present or absent), More than half did not explain how they came to the decision of denial classification Few had any information on reliability of classification 33% - Dimensional: Almost all of these used a clinical assessment tool Sample Size (n) Relationship between study year and number of denial sub-types measured Study Year

14 Results and Analysis only 6 published studies identified, with sufficient information to calculate odds ratios (OR). OR>1 = odds of sexual recidivism significantly higher for admitter group For 2 studies the odds of sexually recidivating were higher for the denier groups For 4 studies the odds were higher for the admitter groups Study Sexually Recidivated N % Odds ratio 95% CI

15 Conclusions Lack of clarity and consistency in terms of definitions, conceptualization, classification and treatment of denial Relevant and sufficient data recurrently found to be missing from studies Limited information of reliability of classification Poor quality and design of studies There is not sufficient information to provide clear understanding of the evidence Currently undertaking a quality rating of the studies Challenges the extent to which the position of denial can be understood in the sex offender population

16 References Barbaree, H.E. (1991). Denial and minimization among sex offenders: Assessment and Treatment outcome. Forum on Corrections Research, 3, Gannon, T.A. (2009). The cognitive distortions of child molesters are in need of treatment. Journal of Sexual Aggression: An International, interdisciplinary forum for research, theory and practice, 17(2), Geer, T.M., Becker, J.V., Gray, S.R., & Krauss, D. (2001). Predictors of Treatment Completion in a Correctional Sex Offenders Treatment Programme. International Journal of Offender Therapy and Comparative Criminology, 45(3), Gibbons, P., de Volder, J., & Casey, P. (2003). Patterns of Denial in Sex Offenders: A Replication Study. The Journal of the America Academy of Psychiatry and the Law, 31(3), Hanson, R.K., & Bussière, M.T. (1998). Predicting relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical Psychology, 66, Hanson, R.K., & Morton-Bourgon, K.E. (2005). The Characteristics of Persistent Sexual Offenders: A Meta-Analysis of Recidivism Studies. Journal of Consulting and Clinical Psychology, 73(6), Harkins, L., Beech, A.R., Goodwill, A.M. (2010). Examining the Influence of Denial, Motivation, and Risk on Sexual Recidivism. Sexual Abuse: A Journal of Research and Treatment, 22(1) Hunter, J.A., & Figueredo A.J. (1999). Factors Associated With Treatment Compliance in a Population of Juvenile Sexual Offenders. Sexual Abuse: A Journal of Research and Treatment, 11(1), Jung, S., and Nunes, K.L. (2012). Denial and its relationship with treatment perceptions among sex offenders. The Journal of Forensic Psychiatry and Psychology, 23(4),

17 References Langton, C.M., Barbaree, H.E., Harkins, L., Arenovich, T., McNamee, J., Peacock, E.J., et al. (2008). Denial and Minimization Among Sexual Offenders: Post-treatment Presentation and Association With Sexual Recidivism. Criminal Justice and Behaviour, 35(1), Levenson, J.S., & Macgowan, M.J. (2004). Engagement, Denial and Treatment Progress Among Sex Offenders in Group Therapy. Sexual Abuse: A Journal of Research and Treatment, 16(1), Lord, A., and Willmot, P. (2004).The process of overcoming denial in sexual offenders. Journal of Sexual Aggression, 10(1), Lund, C.A. (2000). Predictors of Sexual Recidivism: Did Meta-Analysis Clarify the Role and Relevance of Denial. Sexual Abuse: A Journal of Research and Treatment, 12(4), Maletzky, B.M. (1993). Factors associated with success and failure in the behavioural and cognitive treatment of sexual offenders. Annals of Sex Research, 6, Marshall, W.L., Marshall, L.E., Serran, G.A., & O Brien, M.D. (2009). Self-esteem, shame, cognitive distortions and empathy in sexual offenders: their integration and treatment implications. Psychology, Crime & Law, 15(2&3), Matthews, R. (1991). Variations of sex offender patterns of denial. In S. Boddis (Ed.). Prison Service Psychology Conference: Conference Proceedings (pp ). Scarbourgh, Yorkshire, England: HMSO. Nunes, K.L., Hanson, R.K., Firestone, P., Moulden, H.M., Greenberg, D.M., & Bradford, J.M. (2007). Denial Predicts Recidivism for Some Sexual Offenders. Sexual Abuse: A Journal of Research and Treatment, 19, Simkins, L., Ward, W., Bowman, S., & Rinck, C.M. (1989). The Multiphasic Sex Inventory: Diagnosis and prediction of treatment response in child sexual abusers. Sexual Abuse: A Journal of Research and Treatment, 2(3),