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Official websites use. Share sensitive information only on official, secure websites. Sex offenders have received considerable attention in recent years from both policymakers and the public. This is due at least in part to the profound impact that sex crimes have on victims and the larger community.

Perpetrators of sex crimes have come to be viewed by policymakers, practitioners and, arguably, the public as a unique group of offenders in need of special management practices. Indeed, therapeutic interventions aimed at reducing the likelihood of reoffending have become a staple of contemporary sex offender management practice.

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According to a recent Safer Society survey McGrath et al. Sex offender treatment programs in the United States in provided therapeutic services to more than 53, individuals who had committed sex crimes. While there is strong scientific evidence that therapeutic interventions work for criminal offenders overall, the effectiveness of treatment for sex offenders remains subject to debate. Inconsistent research findings and the fact that those studies that have found a positive treatment effect have not been randomized controlled trials are two primary factors contributing to the uncertainty about treatment effectiveness.

The mechanisms that lead to sexually abusive behavior vary by offender. Treatment needs vary by offender as well, and treatment effectiveness is likely to vary depending on various individual and contextual factors. Like therapeutic interventions for other criminal offenders, sex offender treatment at its broadest level is a tool for promoting offender ability, reducing recidivism and enhancing public safety. While there is growing interest in crime control strategies that are based on scientific evidence, determining what works is not an easy task.

It is not uncommon for studies of the same phenomena to produce ambiguous or even conflictingand there are many examples of empirical evidence misleading crime control policy and practice because shortcomings in the quality of the research were overlooked and inaccurate conclusions about an intervention's effectiveness were made see Sherman, ; McCord, ; Boruch, The importance of basing conclusions about what works on highly trustworthy and credible evidence cannot be overstated, and both the quality and consistency of the research evidence always have to be considered.

Because the quality of research studies may vary and it can be difficult for policymakers and practitioners to understand how one study differs from another, brief descriptions of the types of studies discussed in this review are provided below. In the fields of criminology and criminal justice, there is general agreement that certain types of single studies — namely, well deed and executed experiments or randomized controlled trials — provide the most trustworthy evidence about an intervention's effectiveness see, e.

Modeled on laboratory experiments, randomized controlled trials have several key features, most notably the use of random asment. In random asment, the researcher randomly decides which study subjects receive the intervention under examination treatment and which study subjects do not control. In randomized controlled trials, subjects in the treatment group and subjects in the control group are compared on outcomes of interest, such as recidivism.

A comparatively and statistically ificant lower rate of recidivism for the subjects in the treatment group would indicate that the treatment being tested worked.

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The random asment of subjects creates the optimal study conditions for making causal inferences about the effectiveness of an intervention. In other words, the researcher can reasonably conclude that an observed program result — such as a lower recidivism rate for treated subjects — is due to treatment and not some other factor.

While randomized controlled trials are an important method for determining the effectiveness of an intervention, they can be difficult to implement in real-life settings. Randomized controlled trials are expensive and require a level of organizational and, at times, community cooperation that can be difficult to obtain. In addition, there may be resistance to the use of random asment on the grounds that withholding potentially beneficial treatment from some study subjects for the sake of research is unethical. In practice, various constraints can preclude an evaluator from using a randomized controlled trial, and few of these studies have been employed in the assessment of sex offender treatment.

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When a randomized controlled trial cannot be used, researchers examining the effectiveness of an intervention typically employ the next best approach, a quasi-experiment. Many quasi-experiments are similar to randomized controlled trials; however, they do not employ random asment.

In this approach, researchers try to ensure that the treatment and comparison subjects are similar in all ways but one: participation in the treatment program. This is often accomplished by matching the treatment and comparison offenders on demographics, criminal history, risk level and other factors that are related to the outcome of interest. Sometimes statistical techniques are employed retrospectively to create equivalence between the treated and comparison subjects.

When treatment and comparison subjects are closely matched, the study can be capable of producing highly trustworthy findings. But in practice, equivalence between the groups can be hard to achieve, which may result in difficulties in reducing bias and inferring causality. As a result, quasi-experiments are typically less adept at reducing bias and inferring causality than randomized controlled trials Boruch, ; Cook, Researchers typically accomplish this by conducting a narrative or systematic review of a large body of research concerning an intervention's effectiveness.

A narrative review is a qualitative synthesis of findings from many different individual studies. Narrative reviews have been criticized for their subjectivity and lack of transparency, but they provide a rudimentary mechanism for assessing the general quality and consistency of the research evidence to arrive at a conclusion about whether an intervention works. Narrative reviews were the most common form of synthesis research in the past.

Today, researchers primarily rely on a more objective and quantitative process called a systematic review. This helps enhance the trustworthiness of the review findings. A well-deed and executed systematic review produces a comprehensive summary of the scientific evidence on a particular topic, such as whether or not an intervention is effective in reducing recidivism.

Systematic reviews are increasingly incorporating a statistical procedure called meta-analysis to synthesize findings from multiple studies. Meta-analysis enhances the quantitative nature of the review and helps to reduce bias and the potential for erroneous conclusions. In practice, meta-analysis combines the of many evaluations into one large study with many subjects. This is important, because single studies based on a small of subjects can produce misleading findings about a program's effectiveness Lipsey, Determining effect sizes is important because, as Lipseyp.

When systematic reviews and meta-analyses are done well, however, they provide the most trustworthy and credible evidence about an intervention's effectiveness. One of the few studies to use a randomized controlled trial de to evaluate the effectiveness of treatment for adult sex offenders was conducted by Marques and colleagues The research is widely referenced in the literature because of its use of random asment.

Marques and her colleagues compared the recidivism rates of sex offenders treated in an intensive treatment program with the recidivism rates of sex offenders in two untreated control groups. The other control group consisted of incarcerated sex offenders who did not want treatment. The outcome measures of interest were sexual and nonsexual violent recidivism. No ificant differences were found among the three groups in their rates of sexual or violent recidivism.

Based on a mean follow-up period of approximately eight years, the observed sexual recidivism rates were Marques and her colleaguesp. In discussing their findings, the researchers explored possible explanations for the study's overall. Marques and her colleagues suggested that, despite the use of random asment, the treatment and control groups likely differed in some important ways. For example, the treated subjects tended to be higher risk, and may have been less motivated or more sexually deviant than control group subjects.

In addition, the screening procedures used in the research likely eliminated some of the highest risk offenders from the study. As a result, the intervention may have been too intensive for the offenders in the treatment group.

Finally, the treatment program itself did not reflect "state-of the-art" treatment in several ways Marques et al.

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For example, the program did not fully adhere to the risk-need-responsivity model of effective intervention because it did not focus on high-risk offenders and treatment targets included only some dynamic risk factors. See the discussion of risk-need-responsivity in the section "Findings From Synthesis Research. The researchers emphasized the importance of including appropriate comparison groups in future treatment outcome studies, and they urged researchers who assess the effects of treatment "to control for prior risk by using an appropriate actuarial measure for both treatment and comparison groups" p.

It is worth noting that some of the subgroup analyses performed in the California Sex Offender Treatment and Evaluation Project study did find a treatment effect.

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Specifically, high-risk offenders who participated in treatment and demonstrated they "got it " — meaning that they derived benefit from the program, or basically met specified treatment goals — recidivated at a ificantly lower rate than offenders who "did not get it. Individuals with child victims who "got it" recidivated at a ificantly lower rate than similar offenders who "did not get it" — 9.

Another study that did not find overall evidence of a positive treatment effect was conducted by Hanson, Broom and Stephenson Recidivism rates for sex offenders released from prison into mandated community-based treatment and a comparison group of untreated sex offenders released from prison in earlier years were examined. Based on an average follow-up period of 12 years, no ificant differences were found between the treated and untreated sex offenders in terms of their sexual, violent or overall recidivism rates.

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The comparison group members were matched to the treatment sample on year of discharge and risk level. While no ificant differences in the two-year sexual reconviction rates were found between the treatment and comparison groups, there was a ificant difference between the treatment and comparison group reconviction rates for sexual and violent crimes combined.

Treated offenders had a combined sexual and violent two-year reconviction rate of 4. ificant differences were also found for the medium-low-risk and medium-high-risk offender groups. Overall, the treatment effects found in the analysis persisted when factors linked to recidivism such as risk level and prior criminal history were statistically controlled. Based on their findings, the researchers cautiously concluded that the treatment program had an impact on reconvictions for sexual and violent offenses combined. Friendship, Mann and Beech point out that treatment should not be expected to have the same effect on all sexual offenders, as success can depend on various factors, including the treatment climate, program delivery and how the participant responds to treatment.

With this in mind, researchers are increasingly examining whether a positive treatment effect is found for a particular subgroup of treated offenders, even if positive treatment effects are not observed for program participants overall.

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Beech and colleagues reported a somewhat similar finding in their study that examined sexual reconviction rates for 53 sex offenders six years after participating in community-based treatment. Offenders who were responsive to treatment based on a positive change in pro-offending attitudes were less likely to sexually recidivate than offenders who were not.

Offenders who were responsive to treatment — based on a positive change in pro-offending attitudes — were less likely to sexually recidivate than offenders who were not. Olver, Wong and Nicholaichuk conducted a treatment outcome study that examined the effects of a high-intensity sex offender treatment program in a Canadian prison.

The program employed a cognitive-behavioral approach and it subscribed to the risk-need-responsivity model of effective correctional intervention. The study was an extension of an earlier evaluation that found that sex offender treatment worked for both first-time and repeat sex offenders. In this study, Treatment, however, did not appear to affect the rate at which new nonsexual crimes were committed.

The study was more rigorous than the original study. It was based on a larger sample size treated and untreated sex offenders and a longer follow-up period. It also incorporated survival analysis, statistical controls of several factors that have been empirically linked to sexual recidivism such as time at risk, age at release and sexual offending historyand an intent-to-treat de. ificant differences between the recidivism rates of treated and untreated offenders were found at each follow-up period see table 1. Source: Olver, Wong and Nicholaichuk Positive treatment effects persisted after controlling for age and sexual offending history.

In addition, survival analysis indicated that positive treatment effects persisted over time. Olver, Wong and Nicholaichukp. In conclusion, the present study provides empirical support to indicate that a high-intensity treatment program for moderate- to high-risk sex offenders that follows the "what works" principles can yield reductions in sexual recidivism in both the shorter- and longer-term, even after potentially confounding variables were controlled for.

In short, treatment appeared to "work" for this group of sex offenders. A recent study of prison-based sex offender treatment in Minnesota also found positive. This study used propensity score matching to create the study's comparison group — a sophisticated statistical technique for achieving greater equivalence between the treatment and comparison offenders.

The researchers examined recidivism outcomes for 1, sex offenders who received treatment while incarcerated and 1, matched comparison sex offender inmates who had not received treatment.

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Chapter 7: Effectiveness of Treatment for Adult Sex Offenders