Rehabilitation : beyond the risk paradigm

Providing a succinct summary and critique of the scientific approach to offender rehabilitation, this volume for students of criminology, sociology and clinical psychology gives a comprehensive evaluation of both the Risk-Need-Responsivity Model and the Good Lives Model." "Rehabilitation is a value-laden process involving a delicate balance of the needs and desires of clinicians, clients, the State and the public. Written by two internationally renowned academics in rehabilitation research, this book argues that intervention with offenders is not simply a matter of implementing the best therapeutic technology and leaving political and social debate to politicians and policy-makers.

Current empirical assessment methods for adolescents and children who sexually abuse others

The assessment of adolescents and children who commit sexually abusive behavior is a complex and challenging task. Incorporating empirically based assessment methods into psychosexual evaluations promises appropriate coverage of relevant domains, sound interpretation of the meaning of data, reduced clinician biases and error, and greater certainty in decision-making. In this paper we review empirically-based assessment methods currently available for use in psychosexual assessment of adolescents and children who sexually abuse others. Our review describes the robustness of these measures and provides guidance for their appropriate use in assessment. The review highlighted that several empirically-based measures are suitable for clinical use with adolescents, but very little is available to guide assessment of children's abusive behavior per se.

Rape : psychopathology, theory and treatment

Whether treatment programs are effective at rehabilitating rapists is yet to be determined empirically. From a scientist–practitioner perspective, treatment should be based on an empirical understanding of rape and rapists, and evidence-based knowledge of treatment outcome with rapists. In this paper we comprehensively review the characteristics of rapists, etiological features implicated in the commission of rape, and relevant treatment outcome research. We pay particular attention to contemporary knowledge about the core vulnerabilities and features required to understand and treat rapists effectively, and, where possible, highlight similarities and differences between rapists, child molesters and non-sexual violent offenders. We use an epistemological framework to (a) critique the various etiological accounts of rape available and (b) help guide professionals' use of such knowledge in both treatment design and evaluation. Gaps in the understanding of rapists' characteristics and etiological features are highlighted, as are discrepancies between current knowledge and treatment approaches. We conclude by highlighting areas for future research and practice innovation.

The role of culture in understanding child sexual offending : examining feminist perspectives

Psychological theories on child sexual abuse continue to dominate etiological and rehabilitative approaches to understanding and treating sexually abusive behavior. However, even though psychological researchers are motivated toward development of comprehensive and highly integrated theories, there has been continued neglect of the cultural dimensions of child sexual abuse. Feminist theories of child sexual abuse have been particularly helpful in filling this explanatory gap, as they have persisted in locating sexually abusive behavior within a cultural context. In this paper we review and critique selected feminist theories on child sexual abuse with the aim of establishing their explanatory scope and utility. Overall, we found that feminist perspectives were useful in justifying and establishing social policies aimed at preventing the sexual abuse of children from ever commencing. However, despite this strength, they offer little guidance in the treatment of individual offenders.

Motivating offenders to change in therapy: an organizing framework

Objectives. Motivating offenders to change in therapy is an important aspect of effective offender treatment, yet despite this, offenders' motivation to change has received little close attention in the academic and professional literature. This situation is a result of an over-emphasis on the risk management model of rehabilitation, and a consequent failure to construe motivation within an overarching theory of offender rehabilitation.

Method. We present a social cognitive model of offender motivation — the Good Lives Model (GLM) — that provides a framework for incorporating factors that have been shown to be of importance in enhancing offender motivation. This is based upon the notion that all humans strive to achieve primary goods that are intrinsically rewarding and essential to well-being. Where offenders are concerned, criminogenic problems relate, not to the goods offenders seek, but to the way they seek them. Any treatment approach should take this into account and focus positively on equipping people with the skills required to achieve goals rather than simply look to manage risk. The motivational construct that we use here is that of goals. In the GLM, goals are the less abstract depictions of primary human goods and it is with these that people are typically engaged in their day-to-day activities and lives. Looking at therapeutic goal-setting, methods and styles of therapy, and therapist approaches, we derive theoretically-based key issues in motivating offenders to change in therapy.

Conclusion. In conclusion, we present a summary of 12 strategies and techniques that will not only help practitioners enhance their therapeutic effectiveness, but hopefully also act as a catalyst in the development of research on offenders' motivation to change.

Punishment or therapy? The ethics of sexual offending treatment

The claim that sex offender treatment is a form of punishment and as such cannot be covered by traditional ethical codes is a controversial one. It challenges the ethical basis of current practice and compels clinicians to rethink the work they do with sex offenders. In this paper I comment on Bill Glaser's defence of that idea in a challenging and timely paper and David Prescott and Jill Leveson's rejection of his claims. First, I consider briefly the nature of both punishment and treatment and outline Glaser's argument and Prescott and Levenson's rejoinder. I then investigate what a comprehensive argument for either position should look like and finish with a few comments on each paper.

An integrated theory of sexual offending

This paper represents a first attempt to provide an integrated framework to explain the onset, development, and maintenance of sexual offending. According to the Integrated Theory of Sexual Offending (ITSO), sexual abuse occurs as a consequence of a number of interacting causal variables. We examine the factors that affect brain development (evolution, genetic variations and neurobiology) and ecological factors (social and cultural environment, personal circumstances, physical environment) and discuss how they impact upon core neuropsychological functions underpinning human action. The ITSO then explains how clinical symptoms arise from the interaction between these neurological systems and ecological factors. The capacity of the ITSO to incorporate competing theories of sexual offending is considered, and we end the paper by critically evaluating its usefulness in stimulating research and further theory development.

Extending the mind into the world : a new theory of cognitive distortions in sex offenders

A recent trend in cognitive science and neuroscience has been the stress on the importance of human embodiment for cognitive development and the way external factors can be viewed as part of human beings' extended cognitive system (Clark, 2008; Johnson, 2007). Our aim in this paper is to present the extended mind theory (EMT) and outline its implications for understanding and treating cognitive distortions in sex offenders. We will first briefly examine the two most prominent theories of cognitive distortions in the sexual offending arena, Abel et al.'s (1984) post offense theory and Ward's (2000) implicit theory model. We will then examine their limitations and provide an overview of the EMT. Finally, we will apply the EMT to the sexual offending area and demonstrate the advantages of this novel conception of cognition.

Repairing the rupture : restorative justice and the rehabilitation of offenders

Restorative justice is a social justice movement that aims to deal with consequences of crime through repairing and restoring relationships of three key stakeholders: victims, offenders, and communities. Unfortunately, it is often unclear where offender rehabilitation fits within the constructs of repair and reintegration that drive this justice paradigm. An analysis of the relationship between restorative justice theory and offender rehabilitation principles reveals tensions between the two normative frameworks and a lack of appreciation that correctional treatment programs have a legitimate role alongside restorative practices. First, we outline the basic tenets of the Risk–Need–Responsivity Model and the Good Lives Model in order to provide a brief overview of two recent models of offender rehabilitation. We then consider the claims made by restorative justice proponents about correctional rehabilitation programs and their role in the criminal justice system. We conclude that restorative justice and rehabilitation models are distinct, although overlapping, normative frameworks and have different domains of application in the criminal justice system, and that it is a mistake to attempt to blend them in any robust sense.

Time for a change : applying the Good Lives Model of rehabilitation to a high-risk violent offender

In this article we operationalise the theoretical concepts of the Good Lives Model (GLM) of offender rehabilitation by providing a step-by-step framework for assessment, formulation, treatment planning, and monitoring with a high-risk violent offender residing in the community. The case study illustrates how the GLM can be applied to complement and enhance traditional Risk-Management interventions and shows how the GLM's clinical relevance extends from sex offending to broader offending typologies.

Understanding young offenders: developmental criminology

The role of criminological theory should be to inform practice. Program developers should start with a recognized theory about the causes of crime and then design interventions that target factors identified in that theory. Unfortunately, the link between theory and practice is not always apparent. In this paper, a number of prominent developmental theories of crime are considered. These theories are significant in that they provide a strong basis for understanding young offending, and how both the criminal justice system and service providers should approach the task of working constructively with those who appear before the court. This is followed by a review of programs that have been designed to address the risk factors identified in these developmental theories.

Association between sexual behavior and cervical cancer screening

Background: Not much is known about whether women who follow Pap testing recommendations report the same pattern of sexual behavior as women who do not.
Methods: Data come from part of a larger population-based computer-assisted telephone survey of 8656 Australians aged 16–64 years resident in Australian households with a fixed telephone line (Australian Longitudinal Study of Health and Relationships [ALSHR]). The main outcome measure in the current study was having had a Pap test in the past 2 years.
Results: Data on a weighted sample of 4052 women who reported sexual experience (ever had vaginal intercourse) were analyzed. Overall, 73% of women in the sample reported having a Pap test in the past 2 years. Variables individually associated with Pap testing behavior included age, education, occupation, cohabitation status, residential location, tobacco and alcohol use, body mass index (BMI), lifetime and recent number of opposite sex partners, sexually transmitted infection (STI) history, and condom reliance for contraception. In adjusted analyses, women in their 30s, those who lived with their partner, and nonsmokers were more likely to have had a recent Pap test. Those who drank alcohol at least weekly were more likely to have had a recent test than irregular drinkers or nondrinkers. Women with no sexual partners in the last year were less likely to have had a Pap test, and women who reported a previous STI diagnosis were more likely to have had a Pap test in the past 2 years.
Conclusions: There are differences in Pap testing behavior among Australian women related to factors that may affect their risk of developing cervical abnormalities. Younger women and regular smokers were less likely to report a recent test. Screening programs should consider the need to focus recruitment strategies for these women.

Childhood sexual abuse and adolescent eating disorder : findings from the Victorian Adolescent Health Cohort study

Objective: To examine the relationship between childhood sexual abuse (CSA) before the age of 16 years and later onset of bulimia and anorexia nervosa symptoms in females.

Design: A longitudinal cohort study of adolescents observed from August 1992 to March 2003. The cohort was defined in a 2-stage cluster sample using 44 Australian schools in Victoria.

Setting: Population based.

Participants: A total of 1936 persons participated at least once and survived to the age of 24 years, including 999 females. The mean (SD) age of females at the start of follow- up was 14.91 (0.39) years; and at completion, 24.03 (0.55) years.

Main Exposure: Self-reported CSA before the age of 16 years was ascertained retrospectively at the age of 24 years.

Outcome Measures: Incident Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)–defined partial syndromes of anorexia and bulimia nervosa were identified between waves 4 (mean age, 16.3 years) and 6 (mean age, 17.4 years) using the Branched Eating Disorder Test.

Results: The incidence of bulimic syndrome during adolescence was 2.5 (95% confidence interval, 0.80-8.0) times higher among those who reported 1 episode of CSA and 4.9 (95% confidence interval, 1.9-12.7) times higher among those who reported 2 or more episodes of CSA, compared with females reporting no episodes, adjusted for age and background factors. The association persisted after adjusting for possible confounders or mediators measured 6 months earlier, including psychiatric morbidity and dieting behavior. There was little evidence of an association between CSA and partial syndromes of incident anorexia nervosa.

Conclusion: Childhood sexual abuse seems to be a risk factor for the development of bulimic syndromes, not necessarily mediated by psychiatric morbidity or severe dieting.

Oral language competence in incarcerated young offenders : links with offending severity

Previous research in Australia and overseas has shown that young offenders serving community-based orders are at high-risk for undetected but clinically significant oral language difficulties. However, this phenomenon has received little attention in incarcerated samples, and links with offending severity, mental health, and other markers of early risk have not previously been systemically examined. A cross-sectional examination of 100 young offenders (mean age 19.03 years) completing custodial sentences in Victoria, Australia was conducted. A range of standardized oral language, IQ, mental health, and offending severity measures was employed. Forty-six per cent of participants were classified as language impaired (LI), and these were compared with the non-LI sub-group on background and offending variables. When the sub-group with high scores on a measure of offending severity was compared with those with (relatively) lower offending scores, significant differences on a range of language measures were identified. A range of early risk indicators (such as placement in Out of Home Care) was also examined with respect to language impairment in this high-risk group. Results are discussed with respect to policy and practice pertaining to early intervention for vulnerable children, and implications for service delivery within the justice system. In particular, emphasis is placed on the need to closely examine the oral language skills of children who struggle with the transition to literacy and then display behavioural difficulties in the classroom. Once a young person is engaged with youth justice services, a high index of suspicion should be maintained with respect to their oral language skills; for example, in relation to forensic interviewing and the ability to benefit from verbally mediated interventions.

Principals and legal risk : complacency or concern?

There has been an increasing awareness across many jurisdictions of potential legal issues that might arise in schools. These issues range from bullying to sexual misconduct, from injury to negligence. In a recent study in Singapore, despite the increased attention to such issues, school principals displayed a range of attitudes toward legal risk and a diverse range of strategies to minimise it. The findings were compared to those from a small scale study of senior educators in Queensland in order to ascertain commonalities and differences of view. This paper summarises those views and suggests some basic principles to help those in positions of leadership to avert unwanted legal attention.