Danielle Matsuo, Corrective Services NSW: Myths or Fact? The Nature of Sexual Offending and Treatment Effectiveness
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Danielle Matsuo, Corrective Services NSW: Myths or Fact? The Nature of Sexual Offending and Treatment Effectiveness

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Danielle Matsuo, College of Forensic Psychologists A/Director, Sex and Violent Offender Therapeutic Programs, Corrective Services NSW delivered this presentation at the 2013 National Forensic Nursing ...

Danielle Matsuo, College of Forensic Psychologists A/Director, Sex and Violent Offender Therapeutic Programs, Corrective Services NSW delivered this presentation at the 2013 National Forensic Nursing conference. The annual event promotes research and leadership for Australia’s forensic nursing community. For more information about the conference and to register, please visit the website: http://www.healthcareconferences.com.au/forensicnursing

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Danielle Matsuo, Corrective Services NSW: Myths or Fact? The Nature of Sexual Offending and Treatment Effectiveness Danielle Matsuo, Corrective Services NSW: Myths or Fact? The Nature of Sexual Offending and Treatment Effectiveness Presentation Transcript

  • Myths or fact? The nature of sexual offending and treatment effectiveness Danielle Matsuo M.Psych. (Forensic) A/Director, Sex & Violent Offender Therapeutic Programs Corrective Services NSW
  • OVERVIEW       Key messages about sexual offending What does the research tell us? (unpacking some misconceptions) Theories of sexual offending Recidivism rates Risk factors for sexual offending Treatment - do therapeutic programs for sexual offenders work?
  • KEY MESSAGES ABOUT SEXUAL OFFENDING  Sexual offenders are not a homogenous group  Individualised risk assessment is imperative – and it is important to look for changes in acute risk factors when considering an individual's “live” risk  Consistency and communication between and within agencies is central to effective risk management of sex offenders
  • ATTITUDES TOWARDS SEX OFFENDERS    Sexual offenders are often viewed negatively - these views are due to observed behaviour under supervision e.g. manipulation, hostility, distorted beliefs; but also attitudes towards these individuals and their offences (Ware & Mann, 2012) Greater contact with sex offenders appears to result in more positive views (Willis, Levenson & Ward, 2010) Positive engagement with these offenders improves treatment effectiveness (Marshall et al., 2003)
  • THEORIES OF SEXUAL OFFENDING BEHAVIOUR   Analysis of literature around theories of sexual offending suggests a number of associated causes These include:  Genetic predisposition (Siegert & Ward, 2003)  Developmental experiences (Beech & Ward, 2004)  Psychological disposition (Thornton, 2002; Ward & Beech, 2004)  Contextual factors (Hanson & Harris, 2000, 2001)
  • Four Preconditions of Sexual Abuse Finkelhor (1984) Sexual Arousal Emotional Needs 3 Internal Barriers External 4 Victim Resistance Barriers Victim’s Resistance Blockage Normal Sexual Outlets Motivation 2 Lack of Opportunity 1 Force Guilt Bribe Sexual Abuse
  • CASE STUDY - Mr. X    No sexual or criminal history Lifestyle characterised by negative selfevaluation and sexual pre-occupation Increased levels of stress; negative mood      Use of sexual fantasy; sex as coping Children were “safe” “I‟m not hurting anyone” Created opportunities Feelings of inadequacy; escalated to a contact offence
  • CASE STUDY – Mr. Y    No sexual or criminal history Lifestyle characterised by low self-worth; “unlovable” Long term intimate relationship; inadequacy & lack of intimacy     Increased levels of stress; negative mood Felt disgust and excitement; “It will only be once”; “She won‟t remember”; “She„ll love me more” Created opportunities Used emotional blackmail
  • MARSHALL AND BARBAREE‟S INTEGRATED THEORY (1990)    Developed as a general theory of sexual offending Explains the development, onset and maintenance of sexual offending Has been subject to several evaluations
  • MARSHALL AND BARBAREE‟S INTEGRATED THEORY (1990) Biological Influences Developmental Influences Situational Factors Environmental Influences Individual Vulnerabilities Cultural Influences
  • MARSHALL AND BARBAREE‟S INTEGRATED THEORY (1990) Developmental Influences •Neglect and physical abuse •Exposure misogynist behaviour •Sexual abuse
  • MARSHALL AND BARBAREE‟S INTERGRATED THEORY (1990) Developmental Influences Individual Vulnerabilities •Intimacy/social – insecure attachment, trust, rejection, hostile attitudes etc. •Self-regulation – coping, impaired problem-solving, impulsivity
  • MARSHALL AND BARBAREE‟S INTERGRATED THEORY (1990) Developmental Influences Individual Vulnerabilities Cultural Influences •Beliefs that confirm perceived superior status as males
  • MARSHALL AND BARBAREE‟S INTEGRATED THEORY (1990) •Distinguishing between sexual and aggressive urges •Using masturbation to cope Biological Influences Developmental Influences Individual Vulnerabilities Cultural Influences
  • MARSHALL AND BARBAREE‟S INTEGRATED THEORY (1990) Biological Influences Developmental Influences Environmental Influences Individual Vulnerabilities Cultural Influences •Social challenges in puberty unlikely to be resolved effectively, leading to rejection, anger, hostile attitudes etc.
  • MARSHALL AND BARBAREE‟S INTEGRATED THEORY (1990) Biological Influences Developmental Influences Situational Factors •Substance abuse, emotional states, victim access, loss of a relationship Individual Vulnerabilities Environmental Influences Cultural Influences
  • CASE STUDY – Mr. Z    History of general / violent criminality Rejection and mistreatment by parents lead to mistrust and belief people are hurtful Anger a response to stressful events; entitlement; “women will use you”     Poor coping e.g. substance use; isolating, promiscuous sex Wife unfaithful; felt powerless; wanted to hurt someone Went to sister‟s grave; intensified emotional experience Displaced aggression towards victim of sexual assault
  • UNIFIED THEORY OF SEX OFFENDING (WARD & BEECH, 2005)
  • WHO ARE THE VICTIMS?   ABS Personal Safety Survey (2005): Breakdown of perpetrator type (child sexual abuse) • • • • • • 11.1% stranger 30.2% male relative 16.3% family friend 15.6% acquaintance or neighbour 15.3% other known person 13.5% father or step-father
  • WHO ARE THE VICTIMS?   ABS Personal Safety Survey (2005): Breakdown of perpetrator type (adult sexual assault) • • • • • 22.1% stranger 21.1% previous partner 49.7% family member or friend 27.5% other known person 2.1% current partner
  • WHO ARE THE VICTIMS?    Generally sexual recidivists specialise in their choice of victims and behaviours Mixed evidence regarding crossover across domains of age, gender and relationship (Abel et al. 1988; Heil, Ahlmeyer & Simons, 2003 vs. Bradford et al., 1988, 1992; Marshall et al., 1991; Cann, Friendship & Gozna, 2007; Friendship & Thornton, 2002). Sim & Proeve (2010) found there was considerable stability with regard to gender and relationship
  • FACTORS PREDICTIVE OF CROSSOVER (Ahlmeyer & Simons, 2002; Cann et al, 2007)   Significantly more convictions for sexual offences and for any offence overall (including sexual) Significantly riskier in terms of sexual and violent recidivism (Static-99 score)   Younger when first convicted of a sexual offence and older when discharged from custody for their index offence Multiple paraphilias, prostitution procurement, substance abuse
  • DIMENSIONS OF SEXUAL REOFFENDING  Two main dimensions predicting recidivism for sex offenders in the items on risk assessment tools: ◦ 1) sexual deviance and repeat sexual offences and; ◦ 2) criminality/anti-sociality and violence (Hanson & Bussière, 1998; Hanson, Morton, & Harris, 2003; Hanson & Morton-Bourgon, 2005; Parent, Guay & Knight, 2012)
  • RECIDIVISM RATES FOR SEXUAL OFFENDING Estimated re-offence rates for a routine sample of sexual offenders:  Assessed as low risk - 1.2-2.8% over a period of five years  Assessed as high risk - 14.7-29.5% over a period of five years  (Phenix, Helmus & Hanson, 2012) 
  • RECIDIVISM RATES FOR SEXUAL OFFENDING Sexual recidivism (%) across time and samples Sub-group 5 years 10 years 15 years All sex offenders 14 20 24 Rapists 14 21 24 Extended incest child molesters 6 9 13 ‘Girl victim’ child molesters 9 13 16 ‘Boy victim’ child molesters 23 28 35 Offenders without prior sexual conviction 10 15 19 Offenders with conviction prior sexual 25 32 37 Offenders release age 50 at 7 11 12 Offenders less than age 50 at release 15 21 26 over
  • STATIC RISK FACTORS Prior sex offences  Prior sentencing episodes or criminal appearances  Prior non-sexual violence  Age „at risk‟  Victim gender (male)  Stranger victim  Relationship history 
  • DYNAMIC RISK FACTORS FOR SEXUAL OFFENDING  STABLE RISK FACTORS   Significant social influences Capacity for relationship stability Emotional identification with children Hostility towards women General social rejection           Lack of concern for others Poor problem solving skills Negative emotionality Sexual preoccupation Sex as coping Deviant sexual preference Co-operation with supervision
  • DYNAMIC RISK FACTORS FOR SEXUAL OFFENDING ACUTE RISK FACTORS  Victim access  Emotional collapse  Collapse of social support  Hostility  Substance abuse  Sexual preoccupation  Rejection of supervision 
  • MENTAL ILLNESS AS A RISK FACTOR    Major mental illness is accounted for as a risk factor in several widely used structured professional judgment tools Presence of mental illness should not prevent the assessor from considering empirically derived risk factors for sexual offending (Smith, 2000) Hostility has been identified as a salient risk factor in a sample of sexual offenders found NGMI (Koetting, 2003)
  • TREATMENT EFFECTIVENESS    Not all sex offender treatment works – what we do know is that CBT based approaches using the risk-needs-responsivity (RNR) model are effective RNR (Andrews & Bonta, 1998; 2003) – the who, what and how Recently developed treatment programs more effective than older programs
  • TREATMENT EFFECTIVENESS   Meta-analyses have demonstrated that sexual offender treatment appears to reduce recidivism (Losel & Schmucker, 2005; Hanson et al., 2002, 2009) Recidivism rates for treated sex offenders were lower than recidivism rates for untreated sex offenders (Hanson et al., 2009) • Sexual recidivism: 19.2% (untreated) – 10.9% (treated) • General recidivism: 48.3% (untreated) – 31.8% (treated)
  • TREATMENT EFFECTIVENESS CSNSW outcomes (Woodrow & Bright, 2010)    117 offenders who completed the CUBIT/CORE programs; in the community between 6 months and 6 years Collapsing the data across all Static 99 (Hanson & Thornton, 1999) risk bands the expected rates of recidivism of these offenders was 26% 8.5% of the 117 treated offenders had been reincarcerated for a sexual offence. This is a 17 percentage point reduction in re-offending.
  • TREATMENT EFFECTIVENESS (Woodrow & Bright, 2010) Sexual recidivism Violent recidivism Static 99 estimates Expected Observed Static 99 estimates Expected Observed Low 5.58 0.0 8.92 0.0 Lowmoderate 10.50 3.3 19.51 6.7 Moderatehigh 28.4 8.7 38.07 13.4 High 39.0 21.7 44.0 30.4
  • TREATMENT EFFECTIVENESS    Ware & Allnutt (2009) suggest a small proportion of sex offenders who offend because of sexual preoccupation and high levels of sexual deviance may be suitable for anti-libidinal medication Evidence of effectiveness of these medications in reducing sexual offending (Maletzky et al , 2006) – however many caveats and cautions around their use General agreement that anti-libidinal medication should be administered in conjunction with psychological treatment (Harrison, 2007)
  • SUMMARY    Sexual offenders are a heterogeneous group; the etiology and maintaining factors for their behaviour are varied – therefore individualised attention is required when developing a treatment and management plan There is now an extensive evidence base identifying risk factors for sexual recidivism & what works in sex offender treatment programs While the recidivism rates for sexual offending are low, there is a small proportion of high risk offenders that deserve the majority of resources in the interests of community safety
  • Danielle Matsuo A/Director Sex & Violent Offender Therapeutic Programs m. 0407695817 p. 92198104 Danielle.Matsuo@dcs.nsw.gov.au