Federal Abortion Policy and Politics: 1973-1996 Why is Abortion Such a Controversial issue in the United States Barriers to Access to Abortion Services The Impact of Anti-abortion Activities on Women Seeking Abortions Black Women and the Question of Abortion Latinos and Abortion Abortion and Asian Pacific Islander Americans The Acceptability of Medical Abortion to Women Understanding the Relationship of Violence Against Women to Unwanted Pregnancy and it's Resolution Testing a Model of the Psychological Consequences of Abortion Men and Abortion: The Gender Politics of Pregnancy Resolution Abortion Among Adolescents A Cognitive Approach to Patient-Centered Abortion Care Abortion Issues in Psychotherapy Bringing Lessons Learned to the United States Improving Access to Abortion Services Abortion Practice, Policy, and Research: Recommendations for the 21st Century

Violent offenders: Appraising and managing risk.

This meta-analytic review examined the effectiveness of psychological treatment for sex offenders by summarizing data from 43 studies (combined n = 9,454). Averaged across all studies, the sexual offence recidivism rate was lower for the treatment groups (12.3%) than the comparison groups (16.8%, 38 studies, unweighted average). A similar pattern was found for general recidivism, although the overall rates were predictably higher (treatment 27.9%, comparison 39.2%, 30 studies). Current treatments (cognitive–behavioral, k = 13; systemic, k = 2) were associated with reductions in both sexual recidivism (from 17.4 to 9.9%) and general recidivism (from 51 to 32%). Older forms of treatment (operating prior to 1980) appeared to have little effect. Future directions for improving the quality of sex offender treatment outcome evaluations are discussed.

First report of the collaborative outcome data project on the effectiveness of psychological treatment for sex offenders.

Child and adolescent therapy outcome research findings attest to the efficacy of a variety of treatments. This article illustrates promising treatments for selected internalizing (anxiety and depression), externalizing (oppositional, and antisocial behavior), and other (obesity and autism) conditions, and for other aims (preparation for medical and dental procedures). Studies in these areas illustrate worthwhile characteristics that can help inform the search for empirically supported treatments. These characteristics include randomized controlled trials, well-described and replicable treatments, tests with clinical samples, tests of clinical significance, broad-based outcome assessment including measures of real-world functioning, and others. Continued research progress will depend on greater attention to magnitude and maintenance of therapeutic change, long-term follow-up, moderators and mediators of change, and development and testing of treatment in conditions relevant to clinical practice.

Identifying and developing empirically supported child and adolescent treatments

The article reports a meta-analysis on controlled outcome evaluations of sexual offender treatment. From 2,039 documents published in five languages, 69 studies containing 80 independent comparisons between treated and untreated offenders fulfilled stepwise eligibility criteria (total N = 22,181). Despite a wide range of positive and negative effect sizes, the majority confirmed the benefits of treatment. Treated offenders showed 6 percentage points or 37% less sexual recidivism than controls. Effects for violent and general recidivism were in a similar range. Organic treatments (surgical castration and hormonal medication) showed larger effects than psychosocial interventions. However, this difference was partially confounded with methodological and offender variables. Among psychological programs, cognitive–behavioral approaches revealed the most robust effect. Nonbehavioral treatments did not demonstrate a significant impact. There was no outcome difference between randomized and other designs, however, group equivalence was associated with slightly larger effects. Various other moderators had a stronger impact on effect size (e.g., small sample size, quality of outcome reporting, program completion vs. dropout, age homogeneity, outpatient treatment, and authors’ affiliation with the program). More differentiated, high-quality evaluations are needed to clarify: What works for whom under which circumstances?

The effectiveness of treatment for sexual offenders: A comprehensive meta-analysis

Multisystemic therapy (MST) delivered through a community mental health center was compared with usual services delivered by a Department of Youth Services in the treatment of 84 serious juvenile offenders and their multiproblem families. Offenders were assigned randomly to treatment conditions. Pretreatment and posttreatment assessment batteries evaluating family relations, peer relations, symptomatology, social competence, and self-reported delinquency were completed by the youth and a parent, and archival records were searched at 59 weeks postreferral to obtain data on rearrest and incarceration. In comparison with youths who received usual services, youths who received MST had fewer arrests and self-reported offenses and spent an average of 10 fewer weeks incarcerated. In addition, families in the MST condition reported increased family cohesion and decreased youth aggression in peer relations. The relative effectiveness of MST was neither moderated by demographic characteristics nor mediated by psychosocial variables.

Family preservation using multisystemic therapy: an effective alternative to incarcerating serious juvenile offenders.

This study compared the efficacy of multisystemic therapy (MST) and individual therapy (IT) in the outpatient treatment of adolescent sexual offenders. Sixteen adolescent sexual offenders were randomly assigned to either MST or IT conditions. Youths in the MST and IT conditions received an average of 37 hours and 4S hours of treatment, respectively. Recidivism data were collected on all subjects at an approximately 3-year follow-up. Betweengroups comparisons showed that significantly fewer subjects in the MST condition had been rearrested for sexual crimes and that the frequency of sexual rearrests was significantly lower in the MST condition than in the IT condition. The relative efficacy of MST was attributed to its emphasis on changing behavior and interpersonal relations within the offender's natural environment.

Risa J. Stein

Papers

Multisystemic Treatment of Adolescent Sexual Offenders