International overview of phallometric testing for sexual offending behaviour and sexual risk

Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted of sexual offences, the evaluation of those with suspected paraphilias not subject to the criminal justice system, risk assessment and measurement of response to sex offender treatment. In some jurisdictions, phallometry is incorporated into legal decisions about release from custody or discharge from secure hospitals. This paper provides a brief overview of the international development of phallometry, considers challenges to its broader adoption and discusses future directions for research and clinical practice.

A Delicate Dance: Ethical and Systemic Issues in Providing Community-Based Sex Offender Treatment

Sex offender treatment providers are ethically responsible for their client’s treatment; yet they are morally bound to protect society. Those who treat court-mandated clients are required to violate client confidentiality and report to authorities any disclosures made by clients during the treatment process. Using in-depth interviews ( n = 22), this study focused on the perceptions of community-based sex offender treatment providers to explore ethical issues stemming from balancing a duty of care to the client with the mandated reporting requirements of the criminal justice system, and the difficulties of working within two bureaucratic systems (i.e., correctional and health systems). Results are discussed, followed by study limitations, suggestions for future research, and policy recommendations.

Sex Offender Treatment Program in Prison and Rehabilitation

The chapter seeks to demonstrate and describe, from a critical perspective, the most widespread treatment models and programs for sex offenders in prison, opting for integrated approach based on risk assessment and the evaluation of their psychological and social characteristics. Furthermore, specifying factors that can affect the success of the treatment leads to the conclusion that sex offenders require the implementation of differentiated programs focused on their personal characteristics and needs. The reduction of recidivism is indicated as a criterion with which to assess the effectiveness of the programs, although the results achieved in research on the matter do not always agree and do not always confirm a reduction in repeat offenses in the subjects undergoing treatment. The chapter concludes by calling for greater program development and more precise methodological accuracy in verifying the results.

On the Effectiveness of Sexual Offender Treatment in Prisons: A Comparison of Two Different Evaluation Designs in Routine Practice

Although there is less continuity of sexual offending in the life course than stereotypes suggest, treatment should lead to a further reduction of reoffending. Contrary to this aim, a recent large British study using propensity score matching (PSM) showed some negative effects of the core sex offender treatment program (SOTP) in prisons. International meta-analyses on the effects of sex offender treatment revealed that there is considerable variety in the results, and methodological aspects and the context play a significant role. Therefore, this study compared different designs in the evaluation of sex offender treatment in German prisons. PSM was compared with an exact matching (EM) by the Static-99 in a sample of 693 sex offenders from Bavarian prisons. Most results were similar for both methods and not significant due to low base rates. There was a treatment effect at p < .05 on general recidivism in the EM and at p = .06 on serious reoffending in the PSM. For sexual recidivism, EM showed a negative trend, whereas PSM suggested the opposite. Overall, the study underlines the need for more replications of evaluations of routine practice, methodological comparisons, sensitive outcome criteria, and differentiated policy information.