Psychopathy, treatment change, and recidivism in high-risk, high-need sexual offenders.

Correctional Service of Canada.
Journal of Interpersonal Violence (Impact Factor: 1.64). 06/2005; 20(5):549-68. DOI: 10.1177/0886260504271583
Source: PubMed

ABSTRACT The present study investigated 154 consecutive admissions to the Regional Treatment Center (Ontario) Sex Offender Treatment Program with reference to psychopathy and outcome. Ratings of treatment behavior, as well as clinical judgments as to whether risk was reduced, were coded based on treatment reports. With reference to Psychopathy Checklist-revised (PCL-R) scores, survival analyses indicated that high scorers recidivated at significantly higher rates than low scorers. However, offenders who received high PCL-R scores and lower scores on measures of treatment behavior recidivated at the same rate as low scorers on the PCL-R. Furthermore, among high PCL-R offenders, those rated as lower risk at post treatment in fact reoffended at a lower rate than those whose risk was rated as unchanged, although this difference failed to reach significance. Findings are discussed in light of the clinical and research literature.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: People commonly question whether highly psychopathic offenders are treatable. Little scientific research has addressed this question despite key developments in the last 20 years in two relevant areas: reliable measurement of psychopathy, and effective treatments for reducing criminal and antisocial behavior in offenders. One obstacle to progress is confusion about defining psychopathy; a necessary preliminary step to advancing intervention. After outlining the principal definitional issues, we review past and recent research on psychopathy and treatment, concluding that a handful of newer, well-designed studies suggest grounds for optimism about psychopathy and treatability. Although psychopathy characteristics—along with other indices of criminal risk—signal responsivity challenges, well-conceived programs for higher risk offenders can reduce recidivism in highly psychopathic offenders and appear to do so by reducing dynamic risk factors. There are no clear indications yet of whether PCL-psychopathic offenders differ from other high-risk offenders in their ability to respond to such treatments. The questions of whether psychopathy itself responds to treatment, and if so, what forms such treatment might take have not yet been addressed. We conclude by suggesting that advances will come from the use of more divergent measures of psychopathy, and in particular, dynamic measures of psychopathy traits that will allow us to document whether change is occurring.
    Aggression and Violent Behavior 09/2013; 18(5):592–603. DOI:10.1016/j.avb.2013.06.003 · 1.95 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die Tradition der Evaluation der Sozialtherapie ist in Deutschland so alt wie die Institution der Sozialtherapie selbst. Man erhofft sich einerseits, dadurch den empirischen Nachweis ihrer Wirksamkeit zu erbringen, und andererseits, Ergebnisse zu generieren, die zur Weiterentwicklung der sozialtherapeutischen Interventionen beitragen und somit die Straftäterbehandlung verbessern helfen. Forschungsergebnisse deuten dabei nur auf moderate Effekte der Sozialtherapie hin. Der vorliegende Beitrag beschäftigt sich zunächst mit grundlegenden Fragen zur Messung des Erfolgs von Sozialtherapie. Es folgt eine kritische Auseinandersetzung mit wesentlichen methodischen Herausforderungen, denen man in der Evaluationsforschung der Sozialtherapie begegnet. Schließlich werden neuere Ergebnisse aus einer eigenen empirischen Längsschnittuntersuchung zur Evaluation der Sozialtherapie vorgestellt und vor dem Hintergrund der dargestellten Dilemmata reflektiert. Es wird diskutiert, warum es der Sozialtherapie nur schwerlich gelingt, einen überzeugenden Wirksamkeitsnachweis zu erbringen und dass sich daraus mitnichten eine Abkehr vom Behandlungsvollzug ableiten lassen sollte. Abstract The tradition of social therapeutic evaluation research in Germany is as old as the institution of social therapy itself. Social therapeutic facilities constitute the royal road to correctional treatment in the German prison system providing an integrated approach for offender treatment by means of psychotherapy (mainly cognitive-behavioral), vocational and job training, social work and leisure time therapy embedded in a therapeutic community. It was generally expected that evaluation research would prove the effectiveness of this method and generate results for the advancement of offender treatment. However, research results have yielded only moderate findings concerning the effects of social therapeutic interventions. This article considers how the outcome of social therapy and offender treatment is measured. Fundamental methodological challenges that evaluation research has to face are identified. In addition, a short overview of recent results from a longitudinal evaluation study is presented to substantiate the dilemmas and solutions of evaluation research in this field. It is discussed why it is so difficult to provide evidence for effectiveness of correctional treatment and concluded that this can by no means lead to a renunciation of the correctional treatment approach.
    Forensische Psychiatrie Psychologie Kriminologie 02/2013; 8(1):49-58. DOI:10.1007/s11757-013-0242-3
  • [Show abstract] [Hide abstract]
    ABSTRACT: The present manuscript is a review of program and offender characteristics, attrition, treatment change, and recidivism outcomes in programs targeting high risk sexual offenders. We begin by providing an overview of the characteristics of such programs within the lens of the risk, need, responsivity (RNR) model. We then review treatment outcome research from four international high intensity sex offender programs and discuss the methodological, clinical, and practical limitations of this body of work. We proceed to discuss the issue of treatment change in high risk sexual offenders, the broad methods through which change may be evaluated, and review the literature examining within-program change and its relationship to sexual and violent recidivism. A brief review of the sexual offender treatment attrition literature follows, particularly in regards to the RNR issues embedded within this clinical conundrum given that high risk sex offenders pose the greatest risk for non-completion yet also stand to yield the most benefit from services. Finally, we review the research on the therapeutic responses of psychopathic sexual offenders and discuss the clinical implications for treating and managing individuals with substantial psychopathic traits applying the RNR framework. Future clinical and research directions with high risk sexual offenders in terms of treatment, risk reduction, reducing attrition, and attempting to effect positive changes are discussed.
    Aggression and Violent Behavior 09/2013; 18(5):579–591. DOI:10.1016/j.avb.2013.06.002 · 1.95 Impact Factor

Full-text (2 Sources)

Available from
May 15, 2014