The Use of Leuprolide Acetate in the Management of High-Risk Sex Offenders

Sexual Abuse ◽  
2018 ◽  
Vol 31 (8) ◽  
pp. 930-951 ◽  
Author(s):  
Alessandra Gallo ◽  
Jeffrey Abracen ◽  
Jan Looman ◽  
Elizabeth Jeglic ◽  
Robert Dickey
Keyword(s):  
Sex Offenders ◽  
Sexual Offenders ◽  
Sex Offender ◽  
Behavioral Therapy ◽  
A Priori ◽  
Dependent Measure ◽  
Leuprolide Acetate ◽  
Offender Treatment ◽  
Term Outcome ◽  
Long Term Outcome

The present study investigates whether leuprolide acetate (Lupron) adds to the efficacy of traditional sex offender treatment. A group of sex offenders receiving both Lupron and cognitive behavioral therapy (CBT; n = 25) were compared with a group of sex offenders receiving only CBT ( n = 22). Treated subjects were compared with norms available with reference to the Static-99R, as well as compared with a sample of untreated, nonsexual violent offenders ( n = 81), to provide baseline data regarding risk of violent recidivism. Results indicated that subjects receiving Lupron were at significantly higher risk of recidivism and significantly more likely to be diagnosed with a paraphilia than subjects receiving only CBT, a priori. Both treated groups of sexual offenders recidivated at substantially lower rates than predicted by the Static-99R. Currently, this study represents the only, long-term outcome study on Lupron administration using officially recorded recidivism as the primary dependent measure.

A Long-Term Outcome Assessment of the Effects on Subsequent Reoffense Rates of a Prison-Based CBT/RNR Sex Offender Treatment Program With Strength-Based Elements

Sexual Abuse ◽  
2018 ◽  
Vol 32 (2) ◽  
pp. 127-153 ◽  
Author(s):  
M. E. Olver ◽  
L. E. Marshall ◽  
W. L. Marshall ◽  
T. P. Nicholaichuk
Keyword(s):  
Sex Offender ◽  
Behavioral Therapy ◽  
Specific Treatment ◽  
Outcome Data ◽  
Baseline Risk ◽  
Offender Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Strength Based

This article describes an evaluation of the effects of an early version (1991-2001) of Rockwood’s prison-based Cognitive Behavioral Therapy/Risk–Needs–Responsivity (CBT/RNR) sex offender program that had emerging elements of a strength-based approach. This program was implemented under contract to Correctional Service of Canada (CSC) and continued to evolve in response to emerging evidence until it closed in 2013. Thus, the program as evaluated here did not involve a fixed approach as did the comparison CSC program (hereafter referred to as SOTP). Long-term reoffense data, from Rockwood’s program ( n = 579), were compared with SOTP ( n = 625) and with a group of untreated men ( n = 107) sentenced for sex offenses. A modified brief actuarial risk scale (BARS-M) was used to control for baseline risk among the three groups, along with additional controls for age at release, victim type, and individual differences in the length of long-term follow-up period. Both treatment groups displayed lower rates of both sexual and violent reoffending when compared with the no-treatment offenders. Overall, the Rockwood program generated the lowest recidivism rates. The results demonstrate that prison-based sex offense–specific treatment can be effective. We discuss the strengths and limitations of the current design through the Collaborative Outcome Data Committee’s guidelines.

The Impact of Interpersonal Style on Ruptures and Repairs in the Therapeutic Alliance Between Offenders and Therapists in Sex Offender Treatment

Sexual Abuse ◽  
2015 ◽  
Vol 29 (7) ◽  
pp. 709-728 ◽  
Author(s):  
Rachael Watson ◽  
Stuart Thomas ◽  
Michael Daffern
Keyword(s):  
Sex Offenders ◽  
Therapeutic Alliance ◽  
Therapeutic Relationship ◽  
Sexual Offenders ◽  
Group Treatment ◽  
Sex Offender ◽  
Psychological Treatment ◽  
Offender Treatment ◽  
Interpersonal Style ◽  
The Impact

The therapeutic relationship is a critical component of psychological treatment. Strain can occur in the relationship, particularly when working with offenders, and more specifically, those offenders with interpersonal difficulties; strain can lead to a rupture, which may affect treatment participation and performance. This study examined ruptures in the therapeutic relationship in sexual offenders participating in offense-focused group treatment. Fifty-four sex offenders rated the therapeutic alliance at the commencement and completion of treatment; at the completion of treatment, they also reported on the occurrence of ruptures and whether they believed these ruptures were repaired. Ruptures were separated by type, according to severity—Each relationship was therefore characterized as experiencing no rupture, a minor rupture, or a major rupture. Offender characteristics including interpersonal style (IPS) and psychopathy were assessed at the commencement of treatment; their relationship with ruptures was examined. Results revealed that more than half of the offenders (approximately 55%) experienced a rupture in the therapeutic alliance, with one in four of these ruptures remaining unresolved. Offenders who did not report a rupture rated the therapeutic alliance significantly higher at the end of treatment compared with those offenders who reported a rupture that was not repaired. Offenders who reported a major rupture in the therapeutic relationship were higher in interpersonal hostility and hostile-dominance. No interpersonal or offense-specific factors affected the likelihood of a rupture repair.

Cognitive-Behavioral Therapy in the Treatment and Management of Sex Offenders

2010 ◽  
Vol 24 (2) ◽  
pp. 92-103 ◽  
Author(s):  
Megan Schaffer ◽  
Elizabeth L. Jeglic ◽  
Aviva Moster ◽  
Dorota Wnuk
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Sex Offenders ◽  
Sex Offender ◽  
Behavioral Therapy ◽  
Sexual Offending ◽  
Cognitive Behavioral ◽  
Offender Treatment ◽  
Sex Offending ◽  
Sex Offender Treatment ◽  
Adult Sexual Offending

In this article, current methods of conceptualizing and treating adult sexual offending are reviewed. First, the Risk-Needs-Responsivity (RNR) approach to sex offender management is presented and critiqued. Then, the newer Good Lives Model is discussed and contrasted with the aforementioned RNR approach. The discussion of these approaches to sex offender management and rehabilitation is followed by a review of those cognitive-behavioral therapy (CBT) techniques used to treat risk factors associated with sex offending, as such techniques are employed in both paradigms. Finally, research regarding the efficacy of using CBT techniques to treat sex offending behavior is presented, and future directions for sex offender treatment and management are discussed.

Evaluation of New Jersey's Sex Offender Treatment Program at the Adult Diagnostic and Treatment Center: Preliminary Results

2003 ◽  
Vol 31 (2) ◽  
pp. 133-164 ◽  
Author(s):  
Kristen M. Zgoba ◽  
Wayne R. Sager ◽  
Philip H. Witt
Keyword(s):  
Sex Offenders ◽  
Sexual Offenders ◽  
Sex Offender ◽  
Prison Population ◽  
Correctional Facility ◽  
Treatment Center ◽  
Offender Treatment ◽  
Sexual Offense ◽  
Sex Offender Treatment ◽  
Sexual Offenses

This study examined 10-year sexual and non-sexual offense recidivism for sex offenders released from New Jersey's general prison system and from the Adult Diagnostic and Treatment Center (ADTC), New Jersey's correctional facility and treatment center for repetitive-compulsive sexual offenders. The study found that sexual offenders released from the ADTC had significantly lower rates of committing both non-sexual offenses and any offense, compared with the general prison population of sex offenders. For both groups, the 10-year sexual offense reconviction rates were relatively low, 8.6% for the ADTC offenders and 12.7% for the general prison sexual offenders, while reoffense rates for non-sexual offenses were 25.8% and 44.1% for ADTC and general prison sex offenders, respectively.

scholarly journals Volunteering With Sex Offenders: The Attitudes of Volunteers Toward Sex Offenders, Their Treatment, and Rehabilitation

Sexual Abuse ◽  
2017 ◽  
Vol 30 (6) ◽  
pp. 659-675 ◽  
Author(s):  
Nathan Kerr ◽  
Ruth J. Tully ◽  
Birgit Völlm
Keyword(s):  
Sex Offenders ◽  
Sexual Offenders ◽  
General Public ◽  
Sex Offender ◽  
Management Strategies ◽  
Future Research ◽  
Offender Treatment ◽  
Offender Rehabilitation ◽  
Sex Offender Treatment ◽  
Attitudes Toward Sex

The general public has been shown to hold negative attitudes toward sexual offenders, sex offender treatment, and the rehabilitation of sexual offenders. It appears pertinent to the success of sex offender management strategies that utilise volunteers that selected volunteers do not share these attitudes. Here, volunteers for Circles of Support and Accountability (CoSA), a community-based initiative supporting the reintegration of sex offenders, completed three validated psychometric measures assessing attitudes toward sex offenders in general and toward their treatment and rehabilitation. Responses were compared with a U.K. general public sample. The results showed that volunteers held more positive attitudes toward sex offenders, sex offender treatment, and sex offender rehabilitation than the U.K. general public sample. The significance of these findings is discussed alongside directions for future research.

scholarly journals Functional Long-Term Outcome after Left- versus Right-Sided Intracerebral Hemorrhage

2017 ◽  
Vol 43 (3-4) ◽  
pp. 117-123 ◽  
Author(s):  
Vanessa D. Beuscher ◽  
Joji B. Kuramatsu ◽  
Stefan T. Gerner ◽  
Julia Köhn ◽  
Hannes Lücking ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Outcome Measures ◽  
A Priori ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Excellent Outcome ◽  
Confounding Variables ◽  
Baseline Characteristics

Background and Purpose: Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings. Methods: Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014. Data were retrieved from institutional databases. Outcome was assessed using the modified Rankin Scale (mRS) score. Outcome measures (long-term mortality and functional outcome at 12 months) were correlated with ICH location and hemisphere, and the imbalances of baseline characteristics were addressed by propensity score matching. Results: A total of 831 patients with supratentorial ICH (429 left and 402 right) were analyzed. Regarding clinical baseline characteristics in the unadjusted overall cohort, there were differences in disfavor of right-sided ICH (antiplatelets: 25.2% in left ICH vs. 34.3% in right ICH; p < 0.01; previous ischemic stroke: 14.7% in left ICH vs. 19.7% in right ICH; p = 0.057; and presence/extent of intraventricular hemorrhage: 45.0% in left ICH vs. 53.0% in right ICH; p = 0.021; Graeb-score: 0 [0-4] in left ICH vs. 1 [0-5] in right ICH; p = 0.017). While there were no differences in mortality and in the proportion of patients with favorable vs. unfavorable outcome (mRS 0-3: 142/375 [37.9%] in left ICH vs. 117/362 [32.3%] in right ICH; p = 0.115), patients with left-sided ICH showed excellent outcome more frequently (mRS 0-1: 64/375 [17.1%] in left ICH vs. 43/362 [11.9%] in right ICH; p = 0.046) in the unadjusted analysis. After adjusting for confounding variables, a well-balanced group of patients (n = 360/hemisphere) was compared showing no differences in long-term functional outcome (mRS 0-3: 36.4% in left ICH vs. 33.9% in right ICH; p = 0.51). Sub-analyses of patients with deep vs. lobar ICH revealed also no differences in outcome measures (mRS 0-3: 53/151 [35.1%] in left deep ICH vs. 53/165 [32.1%] in right deep ICH; p = 0.58). Conclusion: Previously described differences in clinical end points among patients with left- vs. right-hemispheric ICH may be driven by different baseline characteristics rather than by functional deficits emerging from different hemispheric functions affected. After statistical corrections for confounding variables, there was no impact of hemispheric location on functional outcome after ICH.

Sex Offender Registration: Implications and Difficulties for Ireland

2000 ◽  
Vol 10 (1) ◽  
pp. 75-102 ◽  
Author(s):  
Anne-Marie McAlinden
Keyword(s):  
Sex Offenders ◽  
Sexual Offenders ◽  
Sex Offender ◽  
Sexual Offending ◽  
Social Constructionist ◽  
Sex Offender Registration ◽  
Socially Constructed ◽  
Justice Process ◽  
Criminal Justice Process ◽  
The Media

This paper explores the implications and difficulties of a system of sex offender registration for the two jurisdictions of Ireland. From the orthodox perspective, registration appears justified. Sexual offending has increase and this is used by the media to generate a ‘moral panic’. However, in terms of Blumer's (1971) developmental perspective, sexual offenders in the community have been socially constructed in Ireland, as a problem requiring specific action. This perspective most adequately explains the formulation of legislation. Arguments expounded in favour of registration include the supposedly high recidivism among sex offenders, the inadequacy of supervision provisions and the resulting need to ‘track’ the offender for public protection. Yet a plethora of obstacles which were not considered at the time the legislation was being formulated, such as cost and inadequate policing resources, may impede its effectiveness in aiding law enforcement and reduce it to symbolic significance only. Given these difficulties, I argue that registration is not an appropriate response to the problem of released sexual offenders in Ireland. Rather, from the social constructionist perspective, I suggest that it is better to ‘treat’ the sex offender through less formal and stringent means in the community, away from the criminal justice process.

scholarly journals “Mr S, you do have sexual fantasies?” The Parole Hearing and Treatment of a Sex Offender at the Turn of the 21st Century

2013 ◽  
Vol 38 (1) ◽  
pp. 33-64 ◽  
Author(s):  
Dany Lacombe
Keyword(s):  
Sex Offenders ◽  
Treatment Program ◽  
Sex Offender ◽  
Offender Treatment ◽  
Sex Offender Treatment ◽  
Sexual Fantasies ◽  
Parole Board ◽  
Clear Sign ◽  
Prevention Plan

How does the Parole Board decide a sex offender is rehabilitated and can be released into the community? This case study of a parole hearing reveals the significance the Parole Board gives to a sex offender’s management of his arousal as a clear sign of his rehabilitation. To explain the Board’s preoccupation with a sex offender’s sexual fantasies and arousal, I draw on a prison ethnography of a sex offender treatment program. Rehabilitation as risk management relies on the development of a crime cycle and relapse prevention plan designed to grasp the connection between fantasies, arousal and offending. I argue the parole hearing and treatment program exist in a symbiotic relationship that fabricates the sex offender into a species larger than life, one at risk of offending all the time. Key words: rehabilitation, sex offenders, parole, sexual fantasies, ethnography, prison.

Relationships Between Treatment Delivery, Program Attrition, and Reoffending Outcomes in an Intensive Custodial Sex Offender Program

Sexual Abuse ◽  
2018 ◽  
Vol 31 (4) ◽  
pp. 477-499 ◽  
Author(s):  
Mark V. A. Howard ◽  
Abilio C. de Almeida Neto ◽  
Jennifer J. Galouzis
Keyword(s):  
Sex Offenders ◽  
Sex Offender ◽  
Treatment Effectiveness ◽  
Potential Interaction ◽  
Program Completion ◽  
Offender Treatment ◽  
Therapist Characteristics ◽  
Treatment Delivery ◽  
Program Adherence ◽  
Program Attrition

Retention of sex offenders to the completion of treatment is critical to program adherence to risk need responsivity (RNR) principles; however, it is also important to consider the potential interaction between attrition and treatment outcomes such as reoffending. The first aim of this study was to evaluate the influence of changes to treatment delivery in a residential sex offender treatment program (SOTP), including introduction of rolling groups and systematic emphasis on positive therapist characteristics, on likelihood of program noncompletion ( n = 652). Pooled regression modeling indicated that these operational interventions were associated with a significantly increased likelihood of program completion. We also examined whether variance in rates of participant attrition was related to reoffending outcomes for program completers ( n = 494). Incidence of attrition within completing participants’ treatment cohorts had a significant negative association with hazard of sexual reoffending that was not accounted for by pretreatment risk. Results are discussed in terms of their implications for treatment delivery processes that aim to optimize both participant retention and treatment effectiveness.

Sign in / Sign up

Export Citation Format

Share Document