A meta-analysis of 82 recidivism studies (1,620 findings from 29,450 sexual offenders) identified deviant sexual preferences and antisocial orientation as the major predictors of sexual recidivism for both adult and adolescent sexual offenders. Antisocial orientation was the major predictor of violent recidivism and general (any) recidivism. The review also identified some dynamic risk factors that have the potential of being useful treatment targets (e.g., sexual preoccupations, general self-regulation problems). Many of the variables commonly addressed in sex offender treatment programs (e.g., psychological distress, denial of sex crime, victim empathy, stated motivation for treatment) had little or no relationship with sexual or violent recidivism.

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The Characteristics of Persistent Sexual Offenders: A Meta-Analysis of Recidivism Studies.

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.

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

The effectiveness of treatment for sexual offenders remains controversial, even though it is widely agreed that certain forms of human service interventions reduce the recidivism rates of general offenders. The current review examined whether the principles associated with effective treatments for general offenders (risk-need-responsivity; RNR) also apply to sexual offender treatment. Based on a meta-analysis of 23 recidivism outcome studies meeting basic criteria for study quality, the unweighted sexual and general recidivism rates for the treated sexual offenders were lower than the rates observed for the comparison groups (10.9%, n = 3,121 vs. 19.2%, n = 3,625 for sexual recidivism; 31.8%, n = 1,979 vs. 48.3%, n = 2,822 for any recidivism). Programs that adhered to the RNR principles showed the largest reductions in sexual and general recidivism. Given the consistency of the current findings with the general offender rehabilitation literature, the authors believe that the RNR principles should be a maj...

The Principles of Effective Correctional Treatment Also Apply To Sexual Offenders: A Meta-Analysis

Contrary to popular belief, not all sex offenders who target children are pedophiles, and not all pedophiles commit sexual offenses. But what is unequivocal is that pedophilia, which is defined as a persistent sexual interest in prepubescent children, is an emotionally charged and controversial topic. Parents are understandably worried about the safety and well-being of their children and want to protect them from being sexually exploited. Mental health and criminal justice professionals want to learn more about the assessment methods and intervention techniques that are available to develop and implement effective policies and practices.In this book, author Michael C. Seto addresses key concerns and questions in dealing with these clinical populations: How can pedophilia be detected? What causes pedophilia and sexual offending against children, and what is the relationship between the two? How do we assess risk to sexually offend? Finally, what do we know about intervention and prevention to reduce the occurrence of sexual offenses against children? In addition to a comprehensive synthesis of theory and research, the author demonstrates how this knowledge informs current treatment practices with the inclusion of illustrative case examples, sample interview questions, assessment tools, and online resources.

Pedophilia and Sexual Offending Against Children: Theory, Assessment, and Intervention

This study examined the recidivism rates of 195 adult male sex offenders who were referred to a prison-based cognitive-behavioral treatment program. Of this sample, 56 participants completed treatment, 49 entered but did not complete treatment, and 90 refused treatment services. Although participants were not randomly assigned to treatment conditions, there were no between-group differences on participants’ pre-treatment risk for sexual recidivism as appraised on two actuarial risk measures, the RRASOR and Static-99. Over a mean follow-up period of almost 6 years, the sexual reoffense rate for the completed-treatment group was 5.4% versus 30.6% for the some-treatment and 30.0% for the no-treatment groups. Lower sexual recidivism rates were also found among those participants who received aftercare treatment and correctional supervision services in the community.

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Outcome of a Treatment Program for Adult Sex Offenders From Prison to Community

Recidivism rates were examined for the near-exhaustive sample of 122 sex offenders placed in a rural Vermont county under correctional supervision from 1984 through 1995. Participants were at risk for an average of 62.9 months. Of this sample, 71 nonrandomized participants enrolled in a comprehensive outpatient cognitive-behavioral and relapse-prevention-based treatment program, 32 participants received less specialized mental health treatment, and the remaining 19 participants received no treatment. Pretreatment, between-group comparisons identified the no-treatment group as having more extensive criminal histories. No other statistically significant between-group differences among factors related to reoffense risk were found. At follow up, the cognitive-behavioral treatment group demonstrated a statistically significant treatment benefit. The treatment program is described.

Cognitive-Behavioral Treatment of Sex Offenders: A Treatment Comparison and Long-Term Follow-Up Study

This study compared a group of 104 adult male sex offenders who received community cognitive-behavioral treatment, correctional supervision, and periodic polygraph compliance exams with a matched group of 104 sex offenders who received the same type of treatment and supervision services but no polygraph exams. Polygraph exams focused on whether participants were following their conditions of community supervision and treatment and had avoided committing new sexual offenses. The two groups were exact pair-wise matched on three variables: (1) Static-99 risk score (Hanson & Thornton 2000, Law and Human Behavior, 24, 119–136), (2) status as a completer of prison sex offender treatment, and (3) date placed in the community. At fixed 5-year follow-up periods, the number of individuals in the polygraph group charged with committing a new non-sexual violent offense was significantly lower than in the no polygraph group (2.9% versus 11.5%). However, there were no significant between-group differences for the number of individuals charged for new sexual (5.8% versus 6.7%), any sexual or violent (8.7% versus 16.3%), or any criminal offense (39.4% versus 34.6%). The results are discussed in terms of their clinical and research implications.

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Outcomes in a Community Sex Offender Treatment Program: A Comparison Between Polygraphed and Matched Non-polygraphed Offenders

The present study aimed to revise the Vermont Assessment of Sex Offender Risk (VASOR) Reoffense Risk Scale, a commonly used sex offender risk assessment tool The revised tool was named the VASOR-2 Among models tested to revise the scale, a logistic regression model showed the best balance between simplicity of use, goodness of fit, and internal validity (as tested with K-10 cross-validation), and maximized predictive accuracy Predictive accuracy was tested using four meta-analytically combined data sets drawn from Canada and Vermont (N = 1,581) At 5-year fixed follow-up, the predictive accuracy for sexual recidivism for VASOR-2 (AUC = 74) was similar to the VASOR (AUC = 71) The findings show the VASOR-2 is well calibrated with observed recidivism rates for all but the highest risk sex offenders The instrument showed good interrater reliability (ICC = 88) An advantage of the VASOR-2 is that it has fewer items and simpler scoring instructions than the VASOR Norms are presented for a contemporary, nonselected, routine sample of Vermont sex offenders (n = 887)

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Development of Vermont assessment of sex offender risk-2 (VASOR-2) reoffense risk scale.

Little is known about suicide attempts among sex offenders. This study examines the rates of nonfatal suicide attempts among a sample (= 3,030) of incarcerated N male sex offenders. Overall, the authors found that 14% of sex offenders in the study sample had made a suicide attempt at some point in their lives. Of those, 11% had reported a suicide attempt prior to incarceration, 0.5% had made a suicide attempt while incarcerated, and 2.5% made suicide attempts both prior to and during incarceration. Sex offenders who made suicide attempts were significantly more likely than those who did not make suicide attempts to have had an abusive childhood, a history of psychiatric problems, intellectual impairment, male victims, and related victims. Suicide attempters also scored higher on actuarial risk measures than nonattempters. No differences were found in attempter status between sex offenders who committed sex offenses against children and those who committed sex offenses against adults. A history of psychiatric problems and treatment as well as childhood abuse/neglect and perpetration against male victims predicted suicide attempter status. These findings are discussed as they pertain to suicide prevention, risk assessment, and the collateral consequences of sex offender legislation.

Stephen E. Hoke

Papers

Outcome of a Treatment Program for Adult Sex Offenders From Prison to Community

Cognitive-Behavioral Treatment of Sex Offenders: A Treatment Comparison and Long-Term Follow-Up Study

Outcomes in a Community Sex Offender Treatment Program: A Comparison Between Polygraphed and Matched Non-polygraphed Offenders

Development of Vermont assessment of sex offender risk-2 (VASOR-2) reoffense risk scale.

Treatment of Research and Sexual Abuse: A Journal