Interventions for High Risk Sexual Offenders Franca Cortoni, Ph.D., C.Psych. Prepared for the Ottawa Forum on Change in High Risk Sexual Offenders March 14, 2011
Question? How to apply knowledge of risk factors to design intervention strategies for high risk sexual offenders?
Who is the high risk sexual offender?
The prototypical sexual recidivist is not upset or lonely; instead he leads an unstable, antisocial lifestyle and ruminates on sexually deviant themes (p.1158; Hanson & Morton-Bourgon, 2005)
Pathways to Sexual Offending - Highlights Nisbet: Developmental similarities between versatile & specialized sexual offenders But more conduct problems in versatile offenders No specific psychopathology in either group Lussier: Antisocial tendencies related to sexual offending behavior Antisocial tendencies were common developmental precursors to sexual offending as opposed to 2 distinct pathways (antisocial vs. sexualized) Criminogenic models & deviant sexual models highly inter-related
Pathways to Sexual Offending Indications that criminogenic models at the root of both versatile & specialized sexual offending patterns - similar findings by Knight & Guay, 2003 Their research shows that Impulsivity, Callousness/Unemotionality, & Sexualization are all important etiological factors in sexual offending
Established Risk Factors for Sexual Recidivism Sexual criminal history Prior sexual offences Victim characteristics Unrelated Strangers Males Early onset Diverse sex crimes Non-contact sex offences Hanson (2005)
Established Risk Factors (cont.) Sexual deviance Any deviant sexual interest Children Paraphilias Sexual preoccupations Attitudes tolerant of sexual assault Lifestyle instability/general criminality History of rule violation Antisocial traits Impulsivity, hostility Hanson (2005)
Established Risk Factors for Violent Recidivism Antisocial orientation History of rule violation History of violent crime Lifestyle instability Substance abuse Cluster B Personality Disorders (antisocial, narcissistic, borderline) Hanson (2005)
These risk factors for sexual recidivism fall into 2 broad domains: Antisociality Sexual Interests Hanson & Morton-Bourgon (2005)
Distribution of risk factors in Antisocial vs. Sexual Domains Antisocial Antisocial orientation (includes antisocial peers/traits) History of rule violation/violent crime Lifestyle instability Impulsivity/hostility Substance abuse Cluster B Personality Disorders (antisocial, narcissistic, borderline) Poor Cooperation with Supervision Sexual Diverse History of Sexual Crimes Deviant Sexual Preference Attitudes Tolerant of Sex Crimes Sexual Preoccupation Poor interpersonal relationships Emotional Identification with Children
Current Established Treatment Targets for Sexual Offenders Intimacy Deficits confusion between needs for relatedness & sexual satisfaction Emotional Regulation Lack of emotional control / disinhibition / use of sex to manage emotional states Deviant Sexual Arousal deviant sexual interests Cognitive Distortions misleading understanding of the abusive situation Self-Esteem Disturbances fragile or unstable not necessarily low Social/Cultural Factors maladaptive models of masculinity and sexual functioning Ward & Marshall, 2004
Convergence of Current Treatment Targets to Sexual Risk Factors Treatment Targets Sexual Dynamic Risk Factors Intimacy Deficits Emotional Regulation Deviant Sexual Arousal Poor Interpersonal Relationships Emotional Identification with Children Deviant Sexual Preference Cognitive Distortions Attitudes Supportive of Sexual Abuse Self-Esteem Disturbances??? Social/Cultural Factors Negative Social Influences
Convergence of Current Treatment Targets to Antisocial Risk Factors Treatment Targets Intimacy Deficits Antisocial Dyn. Risk Factors Poor interpersonal relationships Emotional Regulation Deviant Sexual Arousal Cognitive Distortions????????? Self-Esteem Disturbances??? Social/Cultural Factors???
Sexual Dynamic Risk Factors Not Addressed in Treatment for Sexual Offenders None the sexual dynamic risk factors are the current established treatment factors.
Antisocial Risk Factors Not Addressed in Standard Treatment for Sexual Offender Procriminal Attitudes Antisocial Peers Antisocial Traits Lifestyle Instability Poor Cooperation with Supervision *** Essentially current specialized treatment practices tend not to focus on the more general criminogenic needs of sexual offenders.
Implications Overall, current specialized treatment practices do not focus on the more general criminogenic needs of sexual offenders Antisocial factors tend to be viewed as responsivity issues rather than specifically being targeted by the intervention As a result, antisocial risk factors and corresponding specialized treatment interventions mostly likely found for the high risk /versatile sexual offender are virtually non-existent. There s a need to consider that sexual offending has at its root in general antisocial tendencies.
How to apply knowledge of risk factors? Treatment approach should cover the following aspects: In addition to current established treatment that targets the sexual risk factors there should be a specific targeted focus on the antisocial risk factors Treatment should specifically be build to deal with cognitive patterns & behavioral habits (e.g., impulsivity; low self-control) related to the antisocial domain of risk factors Treatment should also attend to the interactions between the antisocial & sexual risk factors their combination is related to the highest risk of sexual recidivism
Food for Thought Helping offenders lead more meaningful prosocial lives in a manner that makes sense to them will be linked to reduced recidivism If the balance of costs & rewards has shifted to favour non-offending & prosocial behaviour (Andrews & Bonta, 2010) But no intervention will achieve this if the offender himself does not see the benefits of doing so consequently, a large portion of this work may need to focus on the offender s general motivation to change For some offenders addressing antisocial issues a priori may be necessary before dealing with sexual factors but research is required to verify this hypothesis!
Thank you!