The "HEALTH" model- part 1 : treatment program guidelines for complex PTSD

This paper outlines the development and piloting of the “HEALTH” model for treatment of Complex PTSD in clients who have experienced multiple traumas across childhood and adulthood - particularly child sexual abuse and sexual assault in adulthood. As a guideline-based treatment model, HEALTH outlines six stages of intervention: (1) having a supportive therapist; (2) ensuring personal safety; (3) assisting with daily functioning; (4) self-regulation - learning to manage core PTSD symptoms; (5) treating Complex PTSD symptoms; and, finally, (6) having patience and persistence to enable “ego strengthening”. Using a case study approach, we provide both qualitative and quantitative assessment data for the individuals in the study, all of whom displayed numerous pre-treatment symptoms of Complex PTSD. Such programs are different to standard PTSD treatment programs that focus predominantly on core PTSD symptoms of re-experiencing, avoidance and arousal. The results of this study provided support for the use of guideline-based treatment programs that cater specifically for the needs of those who have suffered long-term/multiple trauma experiences by targeting Complex PTSD symptoms.

Personality-based typology of adolescent sexual offenders using the Millon Adolescent Clinical Inventory

Previous research suggests that identifying specific subgroups amongst the population of adolescent sexual offenders may contribute to understanding the aetiology of their offending. Such knowledge may also help to improve the treatment outcomes for this group. The Millon Adolescent Clinical Inventory (MACI) profiles of 25 adolescent male sexual offenders aged 13 to 17 in a community-based treatment sample were analysed to determine if this measure could be used to identify different subtypes of offenders based on personality variables. Three groups were identified by cluster analysis: one group of antisocial and externalising types (n = 11), another group of withdrawn, socially inadequate types (n = 7) and a third group displaying few traits of clinically significant elevation (n = 7). Support was also shown for the hypothesis that adolescent sexual offenders exhibit personality profiles similar to those of delinquent non-sexual offenders. The observed typology suggests potentially different etiological pathways and different treatment needs.

Assessing risk for sexual offenders in New Zealand : development and validation of a computer-scored risk measure

A growing research base supports the predictive validity of actuarial methods of risk assessment with sexual offenders. These methods use clearly defined variables with demonstrated empirical association with re-offending. The advantages of actuarial measures for screening large numbers of offenders quickly and economically are further enhanced when the variables used can be extracted from existing electronic databases. This study reports the results of applying a computerized set of historical variables with a sample of 1,133 male sexual offenders released from prison by the New Zealand Department of Corrections. Area under the curve figures of 0.70-0.78 were obtained over periods of 5 to 15 years, reflecting a significant level of association with sexual recidivism. Detected rates of re-offending across risk levels were comparable to those previously reported for the Static-99. Rates of sexual re-offending by child molesters for all sexual offences and offences against child victims are reported separately.

Extended supervision of sexual offenders in Australia and New Zealand : differences in implementation across jurisdictions

Australia and New Zealand have joined the movement of many Western societies in recent years to address a perceived gap in public safety by passing legislation allowing for extended supervision of sex offenders in the community after their release from prison. The Australian State of Victoria passed a law similar to that of New Zealand, and both laws have now been in effect for a similar period of time. Yet despite having comparable laws and approximately comparable base populations, there have been 145 extended supervision orders imposed in New Zealand and 20 such orders in Victoria. This article examines the differences in implementation and the underlying procedures used in the two jurisdictions to understand these very different outcomes. Implications for professional practice, ethics, public safety, and policy development are discussed.

Risk assessment of sexual offenders for extended supervision orders in New Zealand : basic principles and current practice

A growing number of jurisdictions in North America, the United Kingdom, and Australasia have enacted legislation allowing for special sentencing, civil commitment, and community supervision options for high risk sexual offenders. In New Zealand, one example of this concern for public protection is the Parole (Extended Supervision) Amendment Act 2004, which provides for additional supervision of sexual offenders with child victims for up to 10 years after their release from prison. Recent experience with expert evidence and judicial decision making in such cases suggests that those involved in the process might benefit from a more thorough understanding of the current state of sexual offender risk assessment that can be provided by mental health professionals.

Typology of adolescent sexual offenders : millon adolescent clinical inventory profiles, developmental factors, and offence characteristics

The Millon Adolescent Clinical Inventory (MACI) profiles of 82 adolescent male sexual offenders aged 13-19 in a community-based treatment sample were analysed to identify different subtypes of offender based on personality variables. Four groups were identified by cluster analysis: a withdrawn, socially inadequate type (n = 25); an antisocial and externalising type (n = 11); a conforming type (n = 20); and a passive-aggressive type (n = 26). Between-group comparisons showed that the proportion of adolescents reporting physical abuse by their parents was significantly different across the four groups. Subgroup membership was unrelated to victim age, victim gender, and offender history of sexual victimisation. Adolescents who had been victims of sexual abuse were significantly more likely to have had a male victim than those offenders without a history of sexual victimisation. The results of this study provide evidence for the heterogeneity of adolescent sexual offenders in terms of personality characteristics and psychopathology, while also suggesting potentially different aetiological pathways and different treatment needs.

Risk of sexual recidivism as a function of age and actuarial risk

The study of risk for sexual recidivism has undergone substantial development in recent years. The foundation for advances in this area has been the use of actuarial measures to identify subgroups of offenders with different observed rates of sexual re-offending over time. An unresolved issue within this research area has been the moderating function of age in the assessment of risk. The current study examined sexual re-offending as a function of age and actuarial risk in a large sample of sexual offenders released from prison between 1990 and 2004. There was an overall decrease in the rate of sexual re-offending over the age of 50. However, a small group of offenders from the higher actuarial risk categories of the older age groups continued to re-offend at higher rates than their lower-risk peers.

Professional issues related to allegations and assessment of child sexual abuse in the context of family court litigation

This article focuses on the challenge of dealing with allegations of child sexual abuse in the context of the Family Court of Australia. Of all cases that come before the Court, those involving such allegations are relatively uncommon. they tend to be the most difficult cases, however, and are more likely to require a trial and the involvement of qualified practitioners. The review establishes that parental separation is a special circumstance in which sexual abuse may be more likely to occur, and many allegations of sexual abuse are found to be true. There is evidence, however, that a proportion of allegations made by people other than the child concerned may be false. Whether these false allegations are well intentioned and genuinely believed, or maliciously motivated has been a contentious issue. Issues considered include the mishandling of cases, the failure by professionals to consider equally plausible alternative hypotheses than the sexual abuse of a child, confirmation bias, and the profound repercussions of allegations for all members of the family. It is concluded that all allegations of child sexual abuse must be evaluated in a thorough and sensitive manner to separate the few false allegations from the many that are true.