Magazine article Clinical Psychiatry News

Treating Sex Offenders Can Be Effective

Magazine article Clinical Psychiatry News

Treating Sex Offenders Can Be Effective

Article excerpt

Statistics belie the general presumption that most convicted sex offenders will repeat their crimes.

"Sex offenders" are a heterogeneous group. Some have committed violent sexual assaults on strangers; others have molested children, engaged in various criminal sexual behaviors, or had inappropriate sexual contact with family members. Making such distinctions among individual sex offenders is important because reoffense rates vary, depending on the type of offender and the specific characteristics of the crime, such as victim gender and relation to the offender.

For many sex offenders, appropriately selected prison and community-based interventions can prevent further offenses.

Reported recidivism rates for sex offenses typically range from 5% to 20%, among the lowest of all types of crimes. A U.S. Bureau of Justice Statistics study found that 5.3% of more than 9,700 incarcerated sex offenders were rearrested for another sex crime within 3 years of their 1994 release from prison. In contrast, 68% of those incarcerated for nonsexual offenses were rearrested during the same time period.

A more detailed picture was painted in a quantitative metaanalysis that examined recidivism rates and risk factors from 95 studies. The findings showed the rate of repeat arrests for new sex crimes over an average 5-year follow-up to be 13.7%. The rates for nonfamilial child molestation, familial child molestation, and rape were 12.7%, 8.4%, and 18.9%, respectively ("Predictors of Sexual Recidivism: An Updated Meta-Analysis," Public Safety and Emergency Preparedness Canada).

Most investigators concede that the published recidivism rates are limited by certain factors, including the underreporting of sexual crimes by victims who are too frightened or ashamed to come forward.

What is undeniable, however, is the impact of treatment programs on recidivism. In 1999, a landmark metaanalysis by Dr. Margaret Alexander, clinical director of the sex offender treatment program at the Oshkosh (Wis.) Correctional Institution, reviewed recidivism rates for treated and untreated sex offenders from 79 outcome studies (Sex. Abuse 1999;11:101-16).

Overall, offenders who completed treatment programs had a rearrest rate of 11%, compared with 18% for untreated offenders. Among rapists, the rearrest rate of those who received treatment was 20%, compared with 24% of those who were untreated. Treated child molesters had a 14% rearrest rate, while 26% of those who did not receive treatment were rearrested. Treatment resulted in the most substantial decline in reoffending among exhibitionists, whose rate of rearrest dropped from 57% to 20% with treatment.

The metaanalysis showed that the treatment effect diminished over time. However, even after 10 years, treated offenders had reoffended at a lower rate than their untreated counterparts. Interestingly, the study also showed that offenders who received treatment after 1980 had lower rates of recidivism than those who were treated before 1980.

A 1998 study of Vermont sex offenders is one of many that bear this out. The study included 122 sex offenders under state supervision between 1984 and 1995 and tracked whether they were rearrested or reconvicted of a new sex crime.

Of the 71 men enrolled in a specialized, community-based sex offender treatment program, only 1 committed another sex crime. In contrast, 5 of the 32 men in non-specialized treatment reoffended sexually, as did 2 of the 19 men who did not participate in treatment (Crim. Justice Behav. 1998;25:203-25). "There is a misconception that treatment doesn't work for this population. Clearly that's wrong," said Georgia Cumming, director of the Vermont Department of Corrections sex offender treatment program. (See sidebar.)

"Treatment can be effective in the same way that treating an alcoholic can be effective. You never talk about curing an alcoholic, but an alcoholic can choose to live his or her life differently, and most need outside help to do that. …

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