If you are a seller for this product, would you like to suggest updates through seller support? Learn more about Amazon Prime. How can a psychological framework improve the success of risk management? The management of sex offenders in the community is of paramount concern to the general public, and this is reflected in the numberous recent changes to public protection procedures. Managing High Risk Sex Offenders in the Community covers both the assessment and management of high risk sex offenders in the community, with an emphasis on evidence-based approaches.
The reader will be able to access the most widely used actuarial approaches to risk assessment and understand the clinical themes that underpin such variables. The book answers questions including: This book links psychologically-based theoretical principles with practical considerations for professionals in the field. By demystifying the current state of knowledge on risk posed by sex offenders, practitioners will be well placed to engage in defensible decision-making and strive for best practice in the community. Read more Read less. Routledge August 15, Language: Be the first to review this item Amazon Best Sellers Rank: Related Video Shorts 0 Upload your video.
Try the Kindle edition and experience these great reading features: Customer reviews There are no customer reviews yet. Share your thoughts with other customers. Write a customer review. Amazon Giveaway allows you to run promotional giveaways in order to create buzz, reward your audience, and attract new followers and customers. Learn more about Amazon Giveaway. Set up a giveaway. When constructing a risk management plan it is important to prioritise and put in place the necessary key measures. This is particularly important in complex high-risk cases in which there may be an overwhelming number of risk factors, few if any protective factors, a complex formulation and where future scenarios point to a dreadful outcome.
A common mistake in such cases is to put in place far too many risk management strategies.
What are the crucial things to monitor, what is absolutely necessary in terms of restrictions, what are the treatment interventions that are likely to lead to gains, and do particular potential victims need to be protected? Monitoring Box 2 involves repeated assessment of acute dynamic, stable dynamic and protective factors and compliance with restrictive measures.
Considering the risk scenarios in a case can help in deciding whether things are going in the right direction. These are behaviours that are functionally similar in terms of their antecedents, meaning and function to an individual's offending behaviour Daffern Polygraph interviews are controversial, but there is evidence that they can enhance community management and there is legislation permitting their mandatory use in England and Wales Grubin When monitoring an individual, particularly in the community, it is important that it is clear who will be monitoring what, when and how, and what will happen if there is cause for concern.
Offenders and their families should be actively involved and engaged in the monitoring process where possible. Supervision involves placing restrictions on the offender Box 3. The type and level of restrictions required will depend on the risk scenarios, the ability to self-manage and the level of external support. Overly restrictive supervision may be counterproductive, and in some cases may increase the risk posed by the individual. For example, although some men who have committed sexual offences against children should not be allowed contact with any child, this should not automatically be a recommendation with all child sex offenders.
A long list of restrictions may be more about dealing with staff or organisational anxiety than about decreasing the likelihood of offending. Where there are too many restrictions, inevitably they will not be applied consistently, and offenders and staff often lose track of them. Having lots of restrictions can be particularly counterproductive where offenders have narcissistic, paranoid or antisocial personalities. The ultimate restriction that can be imposed is detention in an institution e. Although some sexual offenders will abide by voluntarily imposed restrictions, a legal framework such as probation, parole, notification requirements, mental health legislation or civil prevention order is required to impose such restrictions.
Electronic tags are used to monitor some sex offenders in the community, usually to ensure that a curfew is being adhered to. There is limited evidence that such tagging reduces offending Button In the USA, sex offenders are denied access to certain areas, so-called exclusion zones Council of State Governments The confluence of exclusion zones in neighbouring areas may mean the only places they can live are in swamps and under freeways. Such restrictions can lead to instability and limited access to employment, Social Services and social support Levenson , can lead to sex offenders going missing, and may ultimately increase the risk of recidivism.
Some states in the USA have adopted community notification, with websites giving details of sex offenders living in an area. Mobile telephone applications and three-dimensional computer maps are available to the public. In the UK there is no such public notification, but disclosure to certain individuals e. A trial scheme to allow parents to seek information from the police regarding individuals they are concerned about e.
However, most new sexual offences are not committed by individuals with a conviction for sexual offending. Blanket notification like restriction zones can alienate sexual offenders and even increase risk. Although blanket or limited notification may reassure the public, there is no evidence that it contributes to reducing the risk of sexual violence. Best practice would suggest that any notifications or disclosures should be reserved for the most risky cases based on an individualised assessment where other risk management strategies are insufficient.
Treatment includes all interventions which aim to improve psychosocial functioning by alleviating symptoms, changing problematic areas of functioning and improving skills which will allow more prosocial functioning. Treatment aims to ameliorate stable dynamic factors, develop intrinsic strengths, increase extrinsic supports, prevent the occurrence of acute states or circumstances, and promote prosocial self-management. Although specific treatment programmes and medications such as antilibidinals are important in the treatment of sexual offenders Box 4 , it is important to think of treatment more broadly.
Other mental health interventions psychological treatments, occupational therapy, medication for psychiatric disorder , the development of working relationships with staff, the mustering of personal support and broader rehabilitative measures e. Here we will give an overview of specific treatment approaches for sexual offenders. Psychological treatment for sexual offenders was primarily psychodynamic until the s, when behavioural treatments were introduced behavioural modification of sexual deviance and social skills training.
More recently, there has been emphasis on evidence-based dynamic factors such as sexual deviance, poor coping, impulsivity, intimacy deficits , responding to individual needs and a more positive goal-oriented approach, with fewer punitive, confrontational and confessional aspects. As with most psychological interventions, the process of therapy is probably more important than the specific tasks or modules Marshall b. Group-based cognitive—behavioural therapy group CBT for sex offending is regarded as the treatment of choice Hanson, In the UK, these programmes are available in prisons, some secure hospitals, and through probation in the community.
Hanson , although some experts still doubt whether there is evidence that treatment is effective Rice There is evidence Hanson that sex offender treatment is more effective when it follows the Risk, Needs, Responsivity approach known to be successful in general offending behaviour programmes Andrews That is, treatment should be delivered to more rather than less risky individuals Risk , should target factors criminogenic needs or stable dynamic factors associated with recidivism Need and should be delivered in a way matched to the learning style of individuals Responsivity.
The Good Lives model Ward has been increasingly influential on sex offender treatment. The model encourages us to see sex offenders as people who want the same things in life as everyone else e. Therefore, treatment should focus on helping the person achieve their needs and goals in prosocial ways. The Good Lives model is not a treatment as such, but a philosophy to guide treatment. We find it a useful framework not just for treatment but for wider aspects of risk management, helping to focus not just on risk and restrictions, but on achieving positive prosocial outcomes which reduces risk.
As most sexual offenders with mental disorder have similar psychosexual problems to those without mental disorder, and risk factors are the same in both groups, psychological treatment to address sexual offending should be available for higher-risk sexual offenders with mental disorders. Programmes are available in high and some medium secure units. There is no specific research on programmes for mentally ill sex offenders but programmes for sexual offenders with intellectual disability have been evaluated Craig Before patients take part in these programmes, their mental states should be stable and the programmes should be adapted to their interpersonal, cognitive, emotional and perceptual deficits.
Many of the areas targeted in treatment i. Adaptations for individuals with high levels of personality dysfunction and psychopathy have been made Dowsett , including: Whether such approaches for sex offenders reduce recidivism awaits evaluation. Some offending behaviour programmes exclude individuals with psychopathy, as they are considered unresponsive and disruptive.
Some programmes accept individuals with psychopathy, but limit groups to no more than one or two such individuals. Other programmes have been developed, for example in England and North America, primarily for offenders with severe personality disorders, including psychopathy.
Whichever programme is followed, the most important issue is having the right approach, in terms of the competence, qualifications, experience, supervision and training of staff; the way treatment is delivered; proper resourcing and support for any treatment programme; and integration of treatment with other aspects of risk management. Antilibidinals and SSRIs may be prescribed alongside psychological interventions to treat individuals who have problems with sexual regulation sexual preoccupation, sex as coping or sexual deviation that are not adequately addressed by other interventions Grubin, Psychiatrists have an important role to play in assessing and treating sexual offenders who may benefit from medication, in prison and in the community.
Medication should be given on a voluntary basis and the decision to prescribe should be based on the individual's clinical presentation. Selective serotonin reuptake inhibitors may be more beneficial where there are intrusive fantasies or urges or an element of obsession, or where sexual fantasy or behaviour is associated with low mood or anxiety. Antilibidinals are more appropriate where there is hypersexual arousal or deviant sexual urges which are subjectively difficult to control. Newer gonadotrophin-releasing hormone agonists are potent antilibidinals, which can be given by long-acting injection and may have less troubling side-effects than drugs such as cyproterone acetate Briken Victim safety planning may involve restricting access to specific named victims or a group of potential victims e.
Disclosure to schools, families, partners, employers and staff can also be used to minimise the risk that an offender may pose. The decision to disclose should be carefully considered in each case and based on an individualised risk assessment.
Depending on the level of risk posed and the complexity of multi-agency risk management, a case is allocated to one of three levels of risk management. The MAPPA framework is primarily about ensuring good communication and multi-agency working, especially where sexual offenders are assessed as posing a risk of serious harm to others. It can provide a valuable framework for clinical input for sexual offenders with personality disorders and paraphilias within a primarily criminal justice context Russell In such cases, clinicians can focus on assessment, consultation and treatment, whereas other agencies deliver other aspects of risk management supervision, monitoring, support, victim safety planning.
Circles of Support and Accountability was established in Canada to provide social support and monitoring for very-high risk sexual offenders released at the end of a prison sentence with no statutory community supervision. A group of trained and supported volunteers provides a network of support for the individual, helping the person to establish themselves in the community, to achieve goals in prosocial ways and to manage the risk they pose.
There is evidence that this approach reduces recidivism. Similar projects have been established in parts of the UK Harvey Whether sexual offenders have a mental disorder or not, they should undergo an assessment of risk using appropriate instruments that cover evidence-based risk factors.
Assessment involves gathering sufficient information from interviews, third parties and records, so that risk and protective factors can be identified. In complex cases it is important to undertake a thorough assessment of personality disorder and sexual deviance. The clinician should aim to produce a formulation which ties together the relevant risk and protective factors, helps in understanding why the person has offended in the way that they have, and looks to the future by setting out narrative risk scenarios.
Risk management plans should flow from the risk formulation and scenarios, and should include monitoring, supervision, treatment and victim safety planning. Risk management should be proportionate and tailored to the individual case. Unnecessary restrictions should be avoided. Using an evidence-based approach grounded in a proper understanding of the individual can help guard against an approach distorted by subjective anxiety and fear. Practical assessment and management of risk in sexual offenders. Assessment Interviews Taking a sexual history Assessment of sexual deviance Penile plethysmography Viewing-time assessment Objective offending behaviour data Self-report measures Assessment of personality Psychometric tests Which risk assessment instrument?
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Yakeley, Jessica and Wood, Heather Paraphilias and paraphilic disorders: Advances in Psychiatric Treatment, Vol. Send article to Kindle. Your Kindle email address Please provide your Kindle email. Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services.
Interviews The first task in an interview is to engage the person. Taking a sexual history It is important to assess sexual development, knowledge, interest, relationships and functioning. BOX 1 Sexual history. Assessment of sexual deviance There are inherent difficulties associated with self-report of any behaviour, and this may be particularly problematic with sexual behaviour.
Penile plethysmography Penile plethysmography involves the monitoring of the participant's penile responses often along with other psychophysiological responses while he views or listens to material depicting sexual behaviour e. Viewing-time assessment Viewing-time measures are based on the finding that people spend longer looking at images that are sexually appealing.
Objective offending behaviour data Two scales have been developed: Self-report measures A number of self-report measures are available to assess sexual interests, knowledge and functioning e. Assessment of personality Sex offenders have significant rates of personality dysfunction and overt personality disorder see Darjee Psychometric tests A range of self-report psychometric tests can be used with sex offenders Craig Which risk assessment instrument?
We use the following seven steps when formulating a case.
Management The aim of risk management is to reduce the likelihood and impact of harm to others by developing and enhancing protective factors both extrinsic supports and intrinsic strengths. Monitoring Monitoring Box 2 involves repeated assessment of acute dynamic, stable dynamic and protective factors and compliance with restrictive measures. BOX 2 Key monitoring techniques. Supervision Supervision involves placing restrictions on the offender Box 3.
BOX 3 Examples of supervision strategies for sex offenders. Treatment Treatment includes all interventions which aim to improve psychosocial functioning by alleviating symptoms, changing problematic areas of functioning and improving skills which will allow more prosocial functioning. BOX 4 Specific treatments for sexual offenders.
Psychological treatment Psychological treatment for sexual offenders was primarily psychodynamic until the s, when behavioural treatments were introduced behavioural modification of sexual deviance and social skills training. In current practice, treatments should aim to: Medication Antilibidinals and SSRIs may be prescribed alongside psychological interventions to treat individuals who have problems with sexual regulation sexual preoccupation, sex as coping or sexual deviation that are not adequately addressed by other interventions Grubin, Victim safety planning Victim safety planning may involve restricting access to specific named victims or a group of potential victims e.
Circles of Support and Accountability Circles of Support and Accountability was established in Canada to provide social support and monitoring for very-high risk sexual offenders released at the end of a prison sentence with no statutory community supervision. Conclusions Whether sexual offenders have a mental disorder or not, they should undergo an assessment of risk using appropriate instruments that cover evidence-based risk factors.
MCQs Select the single best option for each question stem 1 Which of the following is an objective assessment of sexual interests: Criminal Justice and Behavior 3: In Sexual Offender Treatment: Journal of Consulting and Clinical Psychology Briken , P , Hill , A , Berner , W Pharmacotherapy of paraphilias with long-acting agonists of luteinizing hormone-releasing hormone: Journal of Clinical Psychiatry Brockman , B , Bluglass , R A general psychiatric approach to sexual deviations. In Sexual Deviation 3rd edn ed Rosen , I 1 — Criminal Justice Policy Review Council of State Governments.
Darjee , R , Russell , K What clinicians need to know before assessing risk in sexual offenders. Advances in Psychiatric Treatment Theory, Assessment and Treatment. Glasgow , DV Affinity: D Thornton, DR Laws: Grubin , D Medical models and interventions in sexual deviance. The Dynamic Supervision Project.
Psychiatrists have an important role to play in assessing and treating sexual offenders who may benefit from medication, in prison and in the community. Get to Know Us. Managing and Reducing the Risks Cullompton: Narrative descriptions of future risk scenarios laying out what the person has the potential to do, to whom, under what circumstances are of more pragmatic use. A number of self-report measures are available to assess sexual interests, knowledge and functioning e.
Department of the Solicitor General of Canada. Criminal Justice and Behavior Circles of Support and Accountability. Kemshall , H , Wood , J Community strategies for managing high-risk offenders: Alternatives to Throwing away the Keys. Letourneau , EJ A comparison of objective measures of sexual arousal and interests: A Journal of Research and Treatment Justice Research and Policy 9: