Government, on behalf of society, has long grappled with discovering ways to protect communities from sexual offenders while, at the same time, determine effective ways to treat the offenders. Sexual offenses span a wide range of behaviors from public indecency to fondling to buying or selling children for the purposes of prostitution.
One difficulty in creating services for sex offenders is that as a group they are as heterogeneous as the general population. No distinct group of causal factors has been identified, and there are numerous types of offenders. Sexual offenders come from every segment of our society, may be any race, age and gender (Connecticut Sexual Assault Crisis Services, Inc., 2014).
It is difficult to quantify recidivism rates of sex offender given the large amount of variation in the populations examined (Prentky, Lee, Knight, & Cerce, 1997). For this reason, governing bodies and members of society are concerned about the risk involved in releasing convicted sexual offenders back to the community. In some cases, the offenders themselves are concerned as rarely does incarceration involve treatment. Additionally, many sexual offenders leave jail in fear for their safety which is a reflection of the abuse suffered within the prison system (Jacobs, n.d.).
Many have opposed funding for programs aimed at treating sex offenders because of the belief that such efforts are useless with sex offenders. Some believe in addition, that programs are ineffective because sex offender cannot control their own behavior and thus the only way to deal with them in a manner that protects the public is to keep them locked up. However, many advocates state that there needs to be a focus on treatment for the benefit of the offender in addition to the community.
While studies measuring treatment efficacy have not demonstrated that such treatment is, in fact, successful, there is evidence this is because recidivism is the only outcome measure examined. Using recidivism as the sole indicator of treatment outcome is a problem for several reasons, particularly because recidivism rates are only about 20 percent and of those who commit additional sexual crimes after being released from prison, the police catch only 20 percent. In other word, 20 percent of 20 percent of sex offenders are known to commit additional crimes. This low sample size limits the ability to determine treatment efficacy. In addition, limiting the outcome measure to recidivism and not to changes that occur during treatment to target individual behaviors is another problem in determining treatment efficacy. Focusing on what are considered “dynamic risk factors” such as psychological status, thoughts and behavior would provide a clearer indication of treatment outcomes in sex offenders (Jones & Tatum, 2009).
Treatment Approaches for Sex Offenders in Pennsylvania
Based on a report from the Vera Institute of Justice (2008), all sex offenders in Pennsylvania state prisons can participate in a treatment program. Programs are specialized according to level of functioning and for special needs such as mental retardation or other disabilities. Offenders are placed in programs based on their willingness to attend and prioritized based on length of time until expected release. In the Pennsylvania State Prison System approximately 14% of the 6000 inmates, or 840 are sex offenders and of these 35 percent to 40 percent decide not to participate although participation is required for release. At a given time about 20% of the sexual offender population is in one of the treatment programs. The ratio of providers to offenders is 1:300.
Inside the prison system, treatment efforts include Cognitive Behavioral Therapy, Relapse Prevention, and Arousal Control. Community based treatment components include cognitive behavioral therapy, psycho-education, drug therapy, and truth test. In regards to re-entry programs, Pennsylvania has pre-release services and post release case managers but no specific state initiatives or special sex offender reentry programs. Cognitive Behavioral Therapy includes cognitive restructuring of maladaptive thoughts and thought blocking in response to risk related thought combined with behavioral strategies that are incompatible with undesirable behaviors. Psycho-education provides information about the etiology, treatment and risk factors related to sex offenses. Relapse prevention is aimed at identifying risk related situations and developing strategies to avoid or cope with them. Finally, drug therapy is a last effort when others have failed, and involves chemical methods of decreasing or eliminating arousal.
Recidivism and Reintegration
A report from Pennsylvania showed the recidivism rate indicated by re-arrest for sex offenders over three years to be 5.3 percent. This was low compared to the recidivism rate for non-sex offenders, and sex offenders had low re-arrest rates for all types of crime compared to non- sex offenders (43 percent to 68 percent respectively). When re-arrested sexual offenders were brought in for less serious crimes as well. Seventy-five percent of re-arrested sex offenders were charged with felonies compared to 84 percent of rearrested non-sexual offenders. However, these figures reflected only a three year follow-up and studies show that recidivism rates for both sexual offenders and non-sexual offenders increase gradually over time. The positive implication of these statistics is that treatment efficacy has been linked to strength of motivation and occurrence of repeat offense in sexual offenders. This indicates the possibility that at least some sex offenders have responded positively either to previous enrollment in treatment in the correctional system or in the community after release (Pennsylvania Department of Corrections, 2004).
However, treatment programs in Pennsylvania have not been shown to be effective in terms of helping offenders reintegrate into the community. This has been shown to be related to the availability of social support, housing and employment and these factors have also been associated with media portrayals. Research has indicated that offenders are less likely to re-offend if they have access to positive social relationships, jobs, housing and other community related supports. However, with the reporting laws that were implemented under Megan’s Law, in Pennsylvania, sex offenders required to be registered with the state as soon as they are convicted even before sentencing occurs and their information is placed in a database searchable by the public. This limits the chances they have of successful re-integration.
Pennsylvania has some of the strictest laws on released sexual offenders, and they collect a great deal of information on offenders including release dates, addresses, and job status among other personal information. This is all entered into the data base which is searchable by the public. The public also has the ability to file a right to now petition, which, if granted, allow them to be notified of any change in status of certain sexual offenders. Interviews with prior sex offenders in Pennsylvania have shown that prior offenders have trouble reintegrating into society due to personal information released to the public before they have been released. They report rejection, the inability to find work or stable housing and general social rejection such that they are attempting to reintegrate into the community with no support. The one thing that cannot be released to the public is treatment related information and while such detailed information as a map showing directions to an offender’s home is easily accessible, treatment status and other positive efforts toward complete rehabilitation is not included on the State Police site. This means that treatment and reintegration efforts are largely separate and other than gaining help coping with failed integration effort the two factors are largely independent of each other.
Furthermore, released offenders report that the sensationalized stories about sexual offenders presented by the media also increase community rejection and at time lead to violence again some released offenders. Many reported that the media covered their release from before it occurred through the time they attempted to reintegrate into the community which often led to aggressive acts against them. Again treatment, which was a separate process and not considered in regards to possible positive actions the offenders were taking, was not linked to reintegration in any way (Pennsylvania Department of Corrections, 2004).
Specific Programs Used for Sex Offenders in Pennsylvania
The Pennsylvania Correctional facility uses the Medlin Model, an empirically based treatment model which incorporates outpatient therapy and a therapeutic community. Although these are four separate programs, (therapeutic community, outpatient, high risk, low risk) the same information is applicable to both. The Medlin Model incorporates both individual and group therapy the correctional unit uses only group therapy. The low risk group attends three of the seven phases: The low risk group is required to complete three of the Medlin phases including Responsibility Taking, Behavioral Techniques and Relapse Prevention. The Moderate/High risk group takes all seven phases which adds Emotional Well-Being, Victim Empathy, Anger Management and Sex Education. The programs were evaluated based on the degree to which they incorporated techniques that were empirically shown to be effective. Both the therapeutic community and outpatient programs in all facilities were determined to be ineffective and to need significant improvement. Evaluations took into account staff effectiveness and support, content of programs, individual treatment areas, risk reduction, degree to which the intervention meets group needs, degree to which intervention fosters responsivity, and overall treatment efficacy.
Programs based on empirically validated treatment principles. However these principles are extremely complex yet do not provide enough detail to be easily carried out. For example, the first principle reads,
Programs should be intensive and behavioral in nature. The most effective programs last between three and nine months and occupy at least 40 percent of the offenders’ time with behavioral interventions . . . (excluding aftercare) . . . In addition to the length and intensity of services, the type of treatment services must also be considered. It is also important that interventions are based on a cognitive-behavioral model. In part, this requires that programs incorporate a cognitive restructuring component and regular skill building via staff modeling of prosocial behavior and offender practice of such skills via role playing (Daly, 2008, 7).
Planning criteria to meet this one principle alone, provided research has not supported any specific techniques for sex offenders, would take an entire research team to establish if it could be established given the heterogeneity of the population. Another principle states that “Programs should have well-qualified and well-trained staff who can relate to the offenders” (8). One would assume this should always be the case for any type of intervention so it is unclear how to determine what would make this different for sex offenders, specifically. These difficulties apply to all four of the programs mentioned under the Medlin Model.
References
Connecticut Sexual Assault Crisis Services, Inc. (2014). Sex offenders in our community.
Retrieved from http://www.connsacs.org/SexOffenders.htm
Corabian, G., and Hogan, N. (2012). Collateral Effects of the Media on Sex Offender
Reintegration: Perceptions of Sex Offenders, Professionals, and the Lay Public. Sexual Offender Treatment, 7(2). Retrieved from http://www.sexual-offender-treatment.org/110.html.
Daly, R. (2008). Treatment and Reentry Practices for Sex Offenders: An Overview of States.
Vera Institute of Justice. Retrieved from
http://www.csom.org/pubs/Treatment%20and%20Reentry%20for%20SO%20an%20overview%20of%20states.PDF
Jacobs, D. (n.d.). Why Sex Offender Laws Do More Harm Than Good. American Civil
Liberties Union of New Jersey. Retrieved from https://www.aclu-nj.org/theissues/criminaljustice/whysexoffenderlawsdomoreha/
Jones, T. & Tatman, A. W. (2009). Another Look at Sex Offender Treatment Efficacy:
A Within-Treatment Design. Iowa Department of Correctional Services. Retrieved from http://fifthdcs.com/includes/SotpArticle_1.pdf
Pennsylvania Department of Corrections. (2004). Sex Offender Treatment. Retrieved from
Prentky, R.A., Lee, A., Knight, R., and Cerce, D. (1997). Recidivism rates among child
molesters and rapists: A methodological analysis. Law and Human Behavior 21:635-659.
