Evaluation of a treatment program for individuals with an intellectual disability who have high risk behaviours

In the past two decades numerous programs have emerged to treat individuals with developmental disabilities who have sexual offending behaviours. There has, however been very few studies that systematically examine the effectiveness of long term treatment with this population. The present research examines the therapeutic outcomes of a multi-modal behaviour approach with six individuals with intellectual disabilities previously charged with sexual assault. The participants also exhibited severe behavioural challenges that included verbal aggression, physical aggression, destruction and self-injury. These six participants (5 males, 1 female) were admitted to a Long Term Residential Treatment Program (LTRTP), due to the severity of their behaviours and due to their lack of treatment success in other programs. Individualized treatment plans focused on the reduction of maladaptive behaviours and the enhancing of skills such as positive coping strategies, socio-sexual knowledge, life skills, recreation and leisure skills. The treatment program also included psychiatric, psychological, medical, behavioural and educational interventions. The participants remained in the Long Term Residential Treatment Program (LTRTP) program from 181 to 932 days (average of 1.5 years). Pre and post treatment evaluations were conducted using the following tools: frequency of target behaviours, Psychopathology Inventory for Mentally Retarded Adults (PIMRA), Emotional Problems Scale (EPS), Socio-Sexual Knowledge and Attitudes Assessment Tool (SSKAAT-R) and Quality of Life Questionnaire (QOL-Q). Recidivism rates and the need for re-hospitalization were also noted for each participant. By offering high levels of individualized interventions, all six participants showed a 37 % rate of reduction in maladaptive behaviours with zero to low rates of inappropriate sexualbehaviour, there were no psychiatric hospitalizations, and there was no recidivism for 5 of 6 participants. In addition, medication was reduced. Mental health scores on the PIMRA were reduced across all participants by 25 % and scores on the Quality of Life Questionnaire increased for all participants by an average of 72 %. These findings add to and build upon the existing literature on long term treatment benefits for individuals with a intellectual disability who sexually offend. By utilizing an individualized and multimodal treatment approach to reduce severe behavioural challenges, not only can the maladaptive behaviours be reduced, but adaptive behaviours can be increased, mental health concerns can be managed, and overall quality of life can be improved.

An examination of how youth understand their rights during the criminal process

In order for young people to meaningfully participate in the criminal justice system they must possess an understanding of their rights and legal procedures. To examine their understanding, 50 young people between the ages of 13-17 who received an extrajudicial sanction or were sentenced to probation, were recruited from the Finch Courthouse in Toronto, Ontario. Semi-structured interviews were conducted with participants regarding their understanding of their due process rights and their rights under the United Nations Convention on the Rights of the Child. Youth who indicated involvement in plea bargaining were also asked about their experiences during this procedure. In addition, the present study examined youths' perceptions of power differences in their interactions with criminal justice officials working within an institution that has tremendous control over offenders' lives. The results indicate that while youth seem to have some understanding oftheir rights and legal procedures, they nevertheless feel ill-equipped to invoke their rights in an adult-led criminal justice system. Furthermore, while past literature has often conceptualized youth understanding based on age (e.g., Crawford & Bull, 2006) the findings of the present study demonstrate that while age plays some role, the lack of power experienced by youth vis-a-vis adults, and specifically criminal justice professionals, has the most bearing on the inability of youth to exercise their rights.

Role Differences in the Perception of Injustice

The current dissertation examined role differences in the perception of injustice; specifically, differences in how victims and offenders respond to a situation that they both agree is unfair. Past research has demonstrated that role affects reactions to transgressions and injustice, including recall of transgressions, and attributions of blame and responsibility (e.g., Baumeister, Stillwell, & Wotman, 1990; Mikula, Athenstaedt, Heschgl, & Heimgartner, 1998). However, to date, little work has examined role differences in perceptions of why an event is perceived as unfair (i.e., how an injustice is framed) or how justice should be restored. These were the perceptions I focused on in the present thesis. I also examined potential concerns that may motivate victims' and offenders' justice reactions, as well as the potential interaction between role and relationship quality in predicting justice reactions. In Studies 1 and 2, several of the predicted role differences in concerns were found; however, these did not lead to the expected differences in framing and restoration. In Study 1, using a vignette methodology, I found differences primarily in how victims and offenders believed justice should be restored. Overall, the significant role effects showed an accommodating response pattern (e.g., offenders proposed punishment more than did victims and neutral observers, whereas victims recommended minimal compensation more than did offenders and neutral observers), inconsistent with previous research and my hypotheses. Study 2, which employed a sample of romantic couples, substantiated the accommodating pattern found in Study 1. Study 3, which sampled a broader range of relationships, also showed i \ examples of accommodating reactions. In addition, Study 3 provided some support for the hypothesized interaction between role and relationship quality, such that responses were more accommodating as relationship quality increased. For example, offenders more strongly endorsed methods of restoration such as offender apology and recognition of the relationship with increasing relationship quality. Overall, the results from this dissertation support the general notion that victims and offenders respond to injustice differently, and, in-line with previous research on other justice-related responses (e.g., Mikula et at, 1998), suggest that victims and offenders show an other-serving, accommodating tendency in justice reactions when relationship quality is high.

Managing Risk in a Culture of Rights: Providing Support and Treatment in Community-Based Settings for Persons with Intellectual Disabilities who Sexually Offend

People with intellectual disability who sexually offend commonly live in community-based settings since the closing of all institutions across the province of Ontario. Nine (n=9) front line staff who provide support to these individuals in three different settings (treatment setting, transitional setting, residential setting) were interviewed. Participants responded to 47 questions to explore how sex offenders with intellectual disability can be supported in the community to prevent re-offenses. Questions encompassed variables that included staff attitudes, various factors impacting support, structural components of the setting, quality of life and the good life, staff training, staff perspectives on treatment, and understanding of risk management. Three overlapping models that have been supported in the literature were used collectively for the basis of this research: The Good Lives Model (Ward & Gannon, 2006; Ward et al., 2007), the quality of life model (Felce & Perry, 1995), and variables associated with risk management. Results of this research showed how this population is being supported in the community with an emphasis on the following elements: positive and objective staff attitude, teamwork, clear rules and protocols, ongoing supervision, consistency, highly trained staff, and environments that promote quality of life. New concepts arose which suggested that all settings display an unequal balance of upholding human rights and managing risks when supporting this high-risk population. This highlights the need for comprehensive assessments in order to match the offender to the proper setting and supports, using an integration of a Risk, Need, Responsivity model and the Good Lives model for offender rehabilitation and to reduce the likelihood of re-offenses.

Bridging the Conceptualization of Youth with Intellectual Disabilities to Sentencing under the YCJA

The current study examined how disability and the concepts of risk, need and responsivity are understood by criminal justice professionals and inform their perceptions of young offenders with ID at sentencing under the ‘different but equal’ philosophy. Semi-structured interviews were conducted with 11 lawyers and 8 mental health workers across 6 major urban areas in Ontario. Participants primarily perceived ID through a medical discourse, overlooking social and structural barriers that, in some cases, may hinder adherence to sentencing dispositions. Specifically, participants discussed balancing the reduced culpability of offenders (e.g., intent) – justifying lenient sentencing – with public safety concerns (i.e., ID viewed as a barrier to rehabilitation) – justifying increasing the severity of sentences. Participants assessed clients with ID and their risks, needs and responsivity within the context of other legal factors: criminal history, severity of the offence, and YCJA objectives. Participants articulated the importance of tailored courthouse identification programs, services/funding, and education/training.