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Sex Offenders: Identification, Risk Assessment, Treatment, and Legal Issues

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Abstract

Provides an interdisciplinary overview of existing knowledge about sex offenders. It provides in-depth coverage of the problem of identification, risk assessment and management, treatment, and legal solutions. It seeks to ensure public safety while at the same time maintaining medical integrity and respect for due process. The book is intended for psychiatrists, clinical psychologists, and researchers who work with sex offenders, as well as attorneys, members of the judiciary, and policymakers. Citation: .M. Saleh, A.J. Grudzinskas, Jr., J.M. Bradford & D. J. Brodsky (eds.) (2009) Sex Offenders: Identification, Risk Assessment, Treatment, and Legal Issues, New York, NY: Oxford University Press. A partial preview of this book is available via Google Books.

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... The consensus within the clinical and judicial domains alike gravitates towards appreciating that behavioral changes following treatment are real. Saleh et al. cite the US Department of Justice's report of lower rates of relapse among sexual offenders than those convicted of other serious crimes [43]. In fact, the proportional contribution of said individuals to new sexual offenses annually is minimal. ...
... Non-biological interventions for paraphilic disorders prioritize mitigating criminogenic factors and, in turn, re-offense. Poor results with psychodynamic and psychoanalytic methods have translated to a focus on other styles of therapies [43]. These range in method from behavioral therapies such as aversion, biofeedback, masturbatory satiation, and other modalities; to cognitive behavioral therapy (CBT), which addresses the distorted cognitions that maintain and cause relapse of paraphilic behaviors. ...
... Orchiectomy has long been one of the most effective biological treatments to prevent recidivism among sex offenders [56,57], achieving remarkable reductions in overall recidivism rates against controls. The demonstrated physiological outcomes of testosterone-lowering pharmaceuticals have rendered such surgical procedures obsolete for most clinical cases [43,55]. Net hypoandrogenism from such medications raise the index of suspicion for adverse outcomes such as osteopenia or osteoporosis [58][59][60] as well as negative changes in body mass and appetite [61,62]. ...
... According to Saleh, Grudzinskas, Bradford, & Brodsky (2009), one who sexually offends is an individual with abnormal or disordered sexual behavior. This is an individual who fails to exercise the responsibility necessary to honor and respect the physical and psychological boundaries of others and, consequently, commits a sexual offense. ...
... Also, according to a national crime victimization survey from the United States Department of Justice in 2000, about 70% of rape and sexual assault crimes were not reported to the police from 1993 to 1999 (Rennison, 2001). Despite the vast numbers of surveys and samplings that have been obtained over the years, the prevalence or incidence of sexual offenses or paraphilic sexual behaviors in the general population are unknown (Saleh et al., 2009). It is not known if an individual is considered to be a sexual offender until they are actually arrested or if they are referred for clinical treatment for this type of crime. ...
... Two-thirds of reported victims between the ages of 18 and 29 years revealed that they had had a prior relationship with the offender (Greenfield, 1997). Saleh et al. (2009) explicitly explain that the normality of sexual behavior is determined by the form and function of a behavior. The form of a behavior is the physical and mental activity, as well as its manner of expression in regard to frequency, intensity, and duration. ...
Thesis
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Juvenile sex offender registration and public notification policies have been deemed by some as unconstitutional and unethical. It has been claimed that legislation regarding this issue has been enacted by policy-makers who have not taken certain aspects into account. The statutes that they have created over the last several decades are referred to by some researchers as a method of creating a distorted sense of security for an emotionally reactive society. Moreover, several different types and subtypes of legality are inconsistent from state to state and are further inconsistent among jurisdictions within states. This inconsistency is a substantial contribution to a large problem within the justice system while we fail to differentiate sexual deviancy from normal sexual development or innocuous sexual curiosity of the naturally sexual beings of which humans are comprised. Although it is clear what the costs are for implementing these acts, it remains unclear what benefits are gained. More importantly, we are able to estimate the financial costs but less able to justify the emotional cost and general effectiveness to the juvenile and possibly including society. This literature review will reflect the current state of research and controversy regarding the lifetime registration and community notification of convicted juvenile sex offenders. The lack of universality of definitions, classifications, and legal procedures are significant attributes of the controversy. This general lack of consistency maintains the consequential issue of the lifetime registration and public notification for juvenile sex offenders. Keywords: juvenile sex offender legislation, registration and public notification, controversy, jurisdiction, states, requirements, unintended consequences
... Cognitive attributions or expectancies regarding the effects of alcohol have also been argued to be influential in the role of alcohol on sexual assault. Cognitive factors such as the anticipation of alcohol effects have been identified as facilitators for sexual aggression, particularly among offenders with anti-social personality traits (Saleh, Grudzinskas, Bradford, & Brodsky, 2009). Aromaki and Lindman (2001) compared rapists (n = 10) and child molesters (n = 10) with comparison subjects (n = 31). ...
... Given the seriousness of sexual offending and the frequency at which it is believed to occur, numerous resources have been directed towards the rehabilitation and management of offenders of these crimes (Saleh et al., 2009). Rehabilitative interventions, such as treatment programming, have been shown to be a more cost-efficient method of providing treatment in comparison to punishmentoriented interventions, such as boot camp or imprisonment (Brown, 2005). ...
Article
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Substance abuse, and in particular alcohol abuse, has been linked to the aetiology and maintenance of violent offending generally and sexual offending specifically. The current paper reviews the literature pertaining to substance abuse among sexual offenders and highlights theoretical developments in the area. An emphasis on issues associated with the therapeutic alliance is stressed when working with high-risk clients who present with multiple needs, including alcohol abuse. The discussion concludes with some practical suggestions regarding assessment and treatment of groups of moderate- to high-risk offenders.
... Similarly to the non-cognitively impaired population, treatment goals of problematic sexual behavior among the cognitively impaired include ameliorating pain and suffering, improving quality of life, and restoring psychosocial function. Treatment of problematic sexual behavior among the cognitively impaired is particularly important, as this population has been reported to be particularly susceptible to reoffending after stopping treatment [24]. The Association for the Treatment of Sexual Abusers (ATSA) has published a document on the assessment, treatment, and supervision of individuals with intellectual disabilities with problematic sexual behaviors [25••]. ...
... The habilitative model of behavioral management of problematic sexual behaviors is the modality that has been most explored in the cognitively impaired [24]. The premise behind this is that the environments cognitively impaired individuals live in are often rather limiting. ...
Article
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Although the cognitively impaired are frequently included in heterogeneous studies of problematic sexual behavior, the epidemiology, etiology, and approach to assessment and treatment of persons with dementia and intellectual disability are distinct from those of the general population. The incidence of inappropriate sexual behavior among the intellectually disabled is 15–33%; however, the nature tends to be more socially inappropriate than with violative intent. Limited sociosexual education is a large contributor, and better addressing this area offers a target for prevention and treatment. A thorough clinical assessment of problematic sexual behaviors in the cognitively impaired requires understanding the patient’s internal experience, which can be challenging. Assessment tools validated for the general population have not been validated for this population. Very few studies have assessed treatment approaches specifically among the cognitively impaired; however, research does suggest utility in habilitative, psychotherapeutic, and pharmacologic approaches which have been validated among the general population.
... Chemical and/or surgical castration is authorized in seven other US states: Georgia, Iowa, Louisiana, Montana, Oregon, Texas, and Wisconsin. The purported goal of chemical castration is to curb the libido, thereby making it easier for sexual offenders to desist [53], but echoes of negative eugenics reverberate throughout the policy. Chemical castration has the double effect of blunting the sexual drive and interfering with the ability to procreate. ...
... Now is the time for a study of the eugenic effect of black hyper-incarceration. The criminal justice system sometimes exerts a very direct effect upon reproductive rights, such as when sex offenders are chemically castrated [53] or when women (usually poor black women) are prosecuted for using drugs (usually crack) while pregnant. As Dorothy Roberts notes, "The prosecution of women who use drugs during pregnancy...is the punishment of reproduction. ...
Article
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In the early twentieth century, the eugenics movement exercised considerable influence over domestic US public policy. Positive eugenics encouraged the reproduction of "fit" human specimens while negative eugenics attempted to reduce the reproduction of "unfit" specimens like the "feebleminded" and the criminal. Although eugenics became a taboo concept afterWorldWar II, it did not disappear. It was merely repackaged. Incarceration is no longer related to stated eugenic goals, yet incapacitation in prisons still exerts a prophylactic effect on human reproduction. Because minorities are incarcerated in disproportionately high numbers, the prophylactic effect of incarceration affects them most dramatically. In fact, for black males, the effect of hyper-incarceration might be so great as to depress overall reproduction rates. This article identifies some of the legal and extralegal variables that would be relevant for such an analysis and calls for such an investigation.
... In many countries, the diagnosis and treatment of paraphilic disorders are extensively entangled with the criminal justice systems and policies that regulate sexual behaviour and criminal status (First & Halon, 2008;Saleh et al., 2009). It is generally established that an individual's state of awareness of the nature or quality of their actions is a assigning factor for establishing criminal responsibility for individuals diagnosed with a mental disorder, and paraphilic disorders are not an exception (Abdalla-Filho et al., 2019; Briken & Muller, 2014;Briken et al., 2019;Dobbrunz et al., 2020;Makhlouf et al., 2020;Martínez-López et al., 2019). ...
Article
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Aim: This study aimed to identify whether clinicians’ gender, clinical experience, and personal attitudes influenced their perception of criminality of specific sexual behaviours, their judgments about criminal liability if mentally disordered, and the need for treatment as part of criminal settings for those having ICD-11 paraphilic disorders. Method: In a secondary analysis of data only vignettes with the least (do not meet paraphilic disorder diagnostic requirements) and most extreme (met paraphilic disorder diagnostic requirements) descriptions of ICD-11 frotteuristic, coercive sexual sadism, and exhibitionistic arousal patterns and related behavior were randomly presented to participants. A total of 1,101 clinicians rated one to three vignettes (a total of 1,884) answering questions regarding diagnosis, criminal features, and their own attitudes. Results: The ICD-11 diagnostic guidelines were adequately used to distinguish paraphilic disorders from non-pathological arousal patterns.Vignette severity was the most important predictor for clinicians’ determination that a crime was committed. Results showed an interaction of the classification of paraphilic disorders, clinicians’ gender, and personal attitudes with judgments about concepts associated with criminality, criminal liability if a diagnosis was indicated, and the need for treatment in forensic settings. Conclusions: Increased formal education, clinical training about these disorders, and evidence-based treatment guidelines are required to avoid biases that may come from preconceived ideas and personal attitudes. Laws and policies that unnecessarily restrict the treatment of these patients in non-forensic settings—for example, when the individual is distress about the arousal pattern but no crime has been committed—should be examined.
... Results showed that individuals convicted of sexual violence had higher alcohol-related cognitive expectancies than non-sexually violent offenders. Changes in cognitive factors and expectancies subsequent to alcohol use may exacerbate sexually deviant behaviour in susceptible individuals and may increase the likelihood of sexual aggression, specifically in persons with antisocial personality traits (Di Fazio, Abracen, & Looman, 2001;Hare & Neumann, 2008;Saleh, Grudzinskas Jr, Bradford, & Brodsky, 2009). ...
Article
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Substance use and dependence may play an essential role in the risk of reoffending by sex offenders. Research examining the influence of substance use and dependence on the criminal behaviour of psychopathic sex offenders is limited. Alcohol and drug use have been identified as factors which promote criminal behaviour and are suspected to contribute, at least partially, to the probability of reoffending. For instance, previous research showed that elevated scores on the Michigan Alcohol Screening Test (MAST) contribute to the predictability of the Hare Psychopathy Checklist – Revised (PCL-R) on recidivism. The current study retrospectively evaluated a database of incarcerated high-risk offenders registered in the Regional Treatment Center, Sex Offender Treatment Program (RTCSOTP); in order to assess the contribution of self-disclosed histories of alcohol and substance use and dependency have, in concert with measures of psychopathic characteristics, on the predictability of recidivism. Results of the retrospective data identified PCL-R and DAST (Drug Abuse Screening Test) scores as significant predictors of sexual and violent recidivism of male inmates undergoing treatment in RTCSOTP within 5 years of their release. MAST scores, however, did not significantly contribute to the predictability of sexual and violent recidivism in this population. We conclude, drug use should be considered as an important factor when addressing recidivism in sexual offenders who demonstrate psychopathic characteristics.
... A positive correlation has been found between executive functioning and adaptive functioning in individuals with ID (Marshall, 2013). Deficits in executive functioning have been linked to challenging and offending behaviour (Nesik, 2008;Saleh et al., 2009). For individuals on the autistic spectrum, the more pronounced the deficits in executive functioning the greater the intensity and frequency of challenging behaviour (Matson and Rivet, 2008). ...
Article
Purpose Assessment of executive functioning is an important element of a comprehensive assessment of intellectual abilities. Few assessments available are accessible for individuals with intellectual disabilities (ID) and none have population-specific norms. This paper aims to describe the adaptation of the behavioural assessment of dysexecutive syndrome (BADS). Design/methodology/approach Adaptations were made to the BADS tests to create the BADS – intellectual disabilities (BADS-ID). Data from three doctoral dissertations were combined to explore the utility, reliability, validity and component structure of the BADS-ID. Properties of the BADS-ID were compared with the Cambridge Executive Functioning Assessment (CEFA). Findings The BADS-ID is accessible to IQ range 50–70 and has a two-component structure. It has good inter-rater reliability, but poor internal consistency. It has a good face and content validity but evidence for concurrent and discriminative validity is weak. All properties are comparable to or better than the CEFA. Research limitations/implications Further research is needed to improve reliability and validity. The development of an accessible test battery with known reliability and validity for individuals with ID should facilitate research into executive functioning in this population. There is the potential to develop population-specific norms from the data. Practical implications An accessible test battery for individuals with ID is helpful in clinical situations. Originality/value To the best of the authors’ knowledge, this is the first study to explore the adaptation of the BADS for use with individuals with ID.
... Before 2005, the faces of these models were clearly visible, whereas after 2005, when the images were digitalized, the faces were blurred but the rest of the image still remains clear. This was a choice made by our laboratory, given the changing legal and political climate around the use of nude images of children distributed by Farrell Instruments (Saleh, Grudzinskas, Bradford, & Brodsky, 2009). ...
Article
The role of the facial images in arousal and attraction has been examined before but never via penile plethysmography (PPG). This retrospective chart review aimed to determine the significance and magnitude of differences in arousal measured by PPG in 1,000 men exposed to slide stimuli with or without facial blurring in subjects of various ages. Arousal in response to blurred stimuli was significantly higher than nonanonymized stimuli with modest effect sizes for slides across age and gender categories. Facial blurring increased differences in arousal between adults and adolescents with a modest effect size. Our findings support the use of facial blurring to further protect the anonymity of models and limit the ethical and legal challenges of using slide stimuli with child models.
... (2005) suggest that sex abusers who have been prosecuted need counseling to reduce the risk of reoffending (see also Clayton, 2002; Farkus & Miller, 2008; Lösel & Schmucker, 2005). Treatment for sex abusers includes cognitive-behavioral therapy (CBT; Friendship, Mann, & Beech, 2003; Hanson et al., 2002; Harkins & Beech, 2007; Schaffer, Jeglic, Moster, & Wnuk, 2010; Seidler & Nasr, 2013; Yates, 2003), group therapy (Beech & Hamilton-Giachritsis, 2005; Garrett, Oliver, Wilcox, & Middleton, 2003; Levenson, MacGowan, Morin, & Cotter, 2008; McGrath, Cumming, Burchard, Zeoli, & Ellerby, 2010), relapse prevention (Keeling & Rose, 2005; Marques, Wieneranders, Day, Nelson, & van Ommeren, 2005; Saleh, Grudzinskas, Bradford, & Brodsky, 2009), risk-needs-responsivity (Andrews, Bonta, & Wormith, 2011; Bonta & Andrews, 2007; Bonta, Bourgon, Rugge, Scott, Yessine, Gutierrez, & Li, Nelson, & van Ommeren, 2005; Nicholaichuk, Gordon, Gu, & Wong, 2000; Zgoba, Sager, & Witt, 2003also Craig, Browne, & Stringer, 2003; Helmus, Hanson, Thornton, Babchishin, & Harris, 2012; McGrath, Cumming, Burchard, Zeoli, & Ellerby, 2010;). Research on sexual child abuser treatment. ...
Thesis
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This dissertation will discuss the research question, “What is the experience of providing therapy to sex abusers?” based on the results of a qualitative case study. A literature review will establish the preceding research related to sex abuse treatment. By filling a gap in previous research, this researcher seeks to encourage sex abuse treatment providers by authenticating their experiences, to provide valuable information to educators, as well as to inform legislators, the judiciary, and the general public about sex abuse treatment. Based on nine transcribed and analyzed interviews with providers of sex abuse treatment to adult male sex abusers who abuse children, this researcher discovered five themes and fourteen patterns within the providers’ experiences. This study augments awareness of the field of sex abuse treatment as articulated by practicing providers.
... Some researchers have tried to explain the VT effect from an evolutionary psychology point of view, hypothesizing that human attention systems might have adapted to detect appropriate mates efficiently in order to enable successful reproduction (Quinsey, Ketsetzis, Earls, & Karamanoukian, 1996). Almost all previous explanations argue that the picture's content is responsible for eliciting the delayed response (Kalmus & Beech, 2005;Laws & Gress, 2004;Saleh et al., 2009;Thornton & Laws, In their experiments, Imhoff et al. (2010) compared a standard VT procedure to different variations of the standard approach. In the standard procedure, heterosexual and homosexual subjects had to rate the sexual attractiveness of individuals clothed in swimsuits in each of the five Tanner stages of maturation (Tanner, 1978) on a five-point Likert scale that was presented alongside a stimulus until a rating was given. ...
Article
The viewing time method (VT) is an indirect measure of sexual interest in which participants are usually asked to rate the sexual attractiveness of target stimuli while their response latencies are unobtrusively measured. Higher response latencies for a certain group of depicted individuals indicate sexual interest in that group. Contrary to the general assumption that the picture content accounts for this effect by eliciting affect- or attention-based response delays, we hypothesized that the attractiveness rating task might be responsible for the VT effect. To test this hypothesis, we used two different tasks. Our heterosexual and homosexual male participants (N = 50) were instructed to rate the attractiveness or the sex of the depicted individuals. As expected, VT effects only emerged in attractiveness rating trials. Based on these findings, we conclude that VT effects are task dependent and are unlikely to be caused by affective or attentional processes (at least when participants are instructed to rate the attractiveness of target stimuli). We argue that rating tasks in VT measures cause participants to use affect independent response strategies. These response strategies seem to undermine stimulus-driven processes (like increased attention directed toward salient stimuli) which were thought to cause VT effects according to previous hypotheses.
... The results show that cognitive-behavioural approaches, described in the literature as having the greatest impact on the risk of recidivism [19][20][21][22], are the least used, even though they are the most indicated. This finding concerns both individual (4th place) and group (9th and last place) cognitive-behavioural approaches. ...
Article
Summary Study aim. — To identify psychiatrists and psychologists providing care to sex offenders (SOs) in Brittany, the therapeutic approaches they use with their SO and non-sex offender (NSO) patients, and professionals who would like to join a care network dedicated to SOs. Materials and methods. — We carried out a questionnaire-based survey among all psychiatrists and psychologists practicing in Brittany. The questions concerned psychotherapeutic modalities used with SOs and NSOs, the size of the active patient population and the desire to participate in a care network. The analysis variables were profession (psychiatrist/psychologist), mode of practice (institutional/independent) and location (four departments of Brittany). Results. — Out of a total of 1788 questionnaires, 557 were filled in, giving a response rate of 31%. Proportionally more psychologists were providing care to SOs (P = 0.026). There was no significant difference between independent and institutional professionals. Effective therapeutic approaches, in terms of reduction of recidivism risk, were the least used. A greater variety of therapeutic approaches was used with NSO subjects than with SO subjects (P < 0.001). The majority of respondents wanted to join a care network dedicated to SOs, including professionals not currently providing this type of care. Conclusion. — The current provision of care to SOs in Brittany supports the feasibility of creating a dedicated care network in order to revamp the role of the mental healthcare system in line with current literature and with the dual objective of treatment and prevention of recidivism.
... Dr. Gregory will want to think about appropriate behavioral restrictions with Mr. Green as a condition of continuing to work with him in therapy. Dr. Gregory has made a start by warning Mr. Green of the illegality of viewing and downloading child pornography and obtaining Mr. Green's agreement that the results of doing so would be "catastrophic" [8]. There are other potential dangers that must be addressed in terms of an overall "safety plan" for Mr. Green. ...
Article
Opinion 5.05 of the American Medical Association’s Code of Medical Ethics, recognizing that physicians are impeded in providing appropriate treatment if their patients do not feel safe in disclosing personal information, holds that “information disclosed to a physician by a patient should be held in confidence…subject to certain exceptions which are ethically justified because of overriding considerations” [1]. Such exceptions include threats to inflict “serious physical harm” on the self or others with a “reasonable probability that the patient may carry out the threat” [1]. In such instances, the physician should take “reasonable precautions” to protect the intended victim, including notifying law enforcement. Physicians are further admonished to “disclose the minimal information required by law, advocate for the protection of confidential information and, if appropriate, seek a change in the law” when the law is contrary to the best interests of patients [2]. It would be hard to overstate the importance of the Tarasoff decisions with respect to medical ethics in general and confidentiality in particular [3]. The essence of the Tarasoff decisions is the dictum that, in conflicts between patient-therapist confidentiality and serious danger to reasonably identifiable others, protection trumps privilege. In his alliterative distillation of this dictum, California Supreme Court Justice Mathew O. Tobriner, for the majority, wrote: “The protective privilege ends where the public peril begins” [4]. It is important to note, however, that, while Tarasoff triggered a rash of “duty-to-warn” or “duty-to-protect” statutes nationwide, 16 states have adopted a discretionary approach to those duties and four states currently have no duty-to-warn or -protect statutes [5].
... A titre d'exemple, si l'on imagine le cas d'un individu arrêté pour fait d'agressions sexuelles sur mineurs, ces nouvelles techniques d'imagerie permettraient de savoir si cet individu répond bien au diagnostic de psychopathe pédophile (de par des stigmates objectifs -non encore démontrés à ce jour -mis en évidence par l'imagerie) ou d'un individu souffrant par exemple, comme cela s'est déjà vu, d'un crâniopharyngiome, qui de par sa localisation, entraîne une paraphilie inaugurale 55 . En effet, certaines tumeurs cérébrales, par leur topographie, peuvent déterminer des compor tements sexuels inadéquats, tels des paraphilies 56 . A l'heure actuelle, la clinique reste l'élément essentiel. ...
Article
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Although psychopathy has traditionally been cited as a disorder of personality, confusion arises as the term is used interchangeably with the terms antisocial personality disorder of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR) or dissocial personality disorder, both of which are largely behaviorally based. This paper aims to provide a clinical and scientific overview of the literature on the topic of psychopathy, which examines this conundrum. This article begins with a wee bit of history about Hervey Cleckley's work, The Mask of Sanity, and then presents the definitions and nosography of psychopathy, focusing on the distinction between the antisocial psychopath and the successful psychopath. The discussion will then lead on the epidemiological aspects and diagnosis, especially psychometric and measurement tools used to assess psychopathy in the individual: Hare's Psychopathy Checklist-Revised (PCL-R), as this is the most frequently used and validated measure of psychopathy. The second section of the article reviews several studies dealing with structural and functional neuroimaging in psychopaths. The final part of this overview considers the treatment and interventions that are available to psychopathic offenders and the implications for future research, especially in terms of prevention. This review demonstrates that studies and further research are still required in psychopathy, particularly using functional neuroimaging techniques, as fMRI and magnetoencephalography, that can describe the functional neuroanatomy of human emotion. Today, cognitive and social neurosciences constitute one of the most promising way to study psychopathy.
Article
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(1) Background: Throughout the history of medical and psychology practice, specialists have worked to improve the quality of treatment and rehabilitation, which has led to the emergence of concepts such as serious games. These tools focus on different areas of intervention procedures, one of which is to help people with intellectual disability (ID). Individuals with ID have problems with executive functions (EFs), which are related to adaptive functioning. Recent studies showed that serious games positively impact cognitive, social, and communication skills in people with ID. The purpose of this study is to analyze the solutions that have been found in EF training for adults with ID in recent years, evaluating them with a number of key parameters and identifying the features and possible problems in the further development of our system. (2) Methods: A review was conducted starting with 573 articles in English related to serious games and selected from studies that had been published since 2015. Finally, 10 were examined in detail as they focused on EFs in adults with ID. They were searched in seven major databases (“Association for Computing Machinery” (ACM), IEEE Xplore database, DBLP computer science bibliography, Google Scholar, PubMed, SCOPUS, and PsycInfo). (3) Results: It was determined that the most frequent EFs referred to in the studies analyzed were planning and decision-making, followed by working memory and social cognition, behavioral regulation, flexibility, and inhibition capacity. The basic approach to the creation of support systems was also analyzed in terms of technical and program execution. The trend results’ analysis evidenced improvements in EFs, even though they were not significant. This comprehensive technique enabled the identification of the main features and aspects to be taken into account for further development of our system.
Article
Introduction: The World Health Organization (WHO) has made substantial changes to the classification of paraphilic disorders for the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11), recently approved by the World Health Assembly. The most important is to limit paraphilic disorders primarily to persistent and intense patterns of atypical sexual arousal involving non-consenting individuals, manifested through persistent sexual thoughts, fantasies, urges, or behaviors, that have resulted in action or significant distress. Aim: To analyze the legal, regulatory, and policy implications of the changes in the ICD-11 classification of paraphilic disorders for forensic practice, health systems, adjudication of sex offenders, and the provision of treatment in Mexico. Methods: An expert Mexican advisory group was appointed to conduct this evaluation following an assessment guide provided by the WHO. Main Outcome Measures: The WHO assessment guide covered (i) laws related to sexual behaviors; (ii) the relationship between legal and clinical issues for non-forensic health professionals; (iii) implications of mental disorder classification for forensic practice; (iv) other implications of ICD-11 paraphilic disorders proposals; and (v) contextual issues. Results: A variety of factors in Mexico make it highly unlikely that appropriate, evidence-based treatments for paraphilic disorders will be provided to those who need them, even if they seek treatment voluntarily and have not committed a crime. Mexican law focuses on the punishment of specific sexual behaviors rather than on underlying disorders. A paraphilic disorder would not be considered sufficient grounds for exemption from criminal responsibility. The application and scope of mental health evaluations in Mexican legal proceedings are quite limited, and individuals who commit sexual crimes almost never undergo forensic evaluations to establish the presence of paraphilic disorders. Psychiatric services may be mandated for sex offenders in highly specific circumstances but cannot exceed the duration of the criminal sentence. Clinical Implications: Evaluation and treatment guidelines should be developed based on international evidence and standards and promulgated for use with individuals with paraphilic disorders in forensic and non-forensic poopulations. The much greater specificity and operationalization of the ICD-11 guidelines as compared with the ICD-10 guidelines provide a better basis for identification and case formulation. Strengths & Limitations: Major strengths of this analyses were that it was conducted to facilitate international comparability across several participating countries and the fact that it was conducted by a diverse multidisciplinary group representing various relevant legal, forensic and and clinical sectors. A limitation was that it was only possible to examine relevant federal laws and those of Mexico City rather than those of all 32 Mexican states. Conclusion: The descriptions of paraphilic disorders in the ICD-11 could support substantial improvements in the treatment of individuals with paraphilic disorders and the adjudication of sex offenders in Mexico, but specific changes in Mexican law would be required.
Article
This article provides a comparison and comprehensive analysis of varied approaches to the assessment of sexual interest and behaviours at different international sexual behaviour assessment labs. The assessment protocols are described for four sexual behaviour laboratories: the Royal Ottawa Mental Health Centre’s Sexual Behaviours Clinic in Canada; the Medical University of South Carolina’s Sexual Behaviours Clinic and Laboratory in the US; the Laboratory of Evolutionary Sexology and Psychopathology in the Czech Republic; and the Laboratory of Forensic Sexology in Russia. An overview of examinee demographics and types of cases assessed is provided for each lab. Assessment protocols, including psychometric measures and objective measures of sexual interest and arousal, such as penile plethysmography or eye-tracking, are also reviewed. The differences across labs may lead to interesting and productive cross-cultural investigations and studies about the efficacy of specific assessment methods.
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The article presents an information-analytical review for the purpose of introducing the psychophysiological approaches to assessment of disorders of sexual preference with the use of penile plethysmography and the polygraph. It briefly explores the historical aspects of the use of psychophysiological methods in criminological and sexological practice. The necessity for their use in the forensic psychiatric examinations is substantiated. The methodological support for both methods has been described in detail. The article focuses on the problems, which generally affect the validity and reliability of penile plethysmography and the polygraph.
Article
Purpose As recently highlighted by Creaby-Attwood and Allely (2017), it is crucial that the possible innate vulnerabilities that contributed to sexual offending behaviour in an individual with an autism spectrum disorder (ASD) are taken into consideration for the application of a diversion programme to avoid the stigma of a criminal conviction or during sentencing for a non-custodial outcome. Specifically, in those defendants with a diagnosis of what used to be referred to as Asperger’s syndrome (AS) and now is recognised as an ASD and who are charged and convicted of a non-contact sexual offense, education and mental health intervention will best serve the interests of justice. The paper aims to discuss this issue. Design/methodology/approach This paper focusses on one particular type of sexual offending behaviour, namely, possession of child pornography. A systematic PRISMA review was conducted. Findings The authors linked examples of child pornography in the research literature to the ASD symptomology and describe how the symptomology explains such behaviour as not reflecting actual sexual deviance. Originality/value Downloading and viewing of child pornography by individuals with ASD has received relatively little research outside the mental health field. This review is of particular importance to those in the criminal justice system who may not have much knowledge and understanding of ASD. It is suggested that diversion programmes and mental health courts should be set up for this particular population charged with this particular crime in mind so that the necessary treatment/intervention/support and care can be given to this particular group.
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Zusammenfassung Psychopathie gilt als Unterform der antisozialen Persönlichkeitsstörung und umfasst u. a. manipulatives Verhalten, egozentrische und überhebliche Charakterzüge, Risikoverhalten sowie mangelnde Empathie. Empirische Ergebnisse zur Prävalenz zu Psychopathie und antisozialer Persönlichkeitsstörung unter Straftätern variieren stark in Abhängigkeit vom Studiendesign und der Stichprobenzusammensetzung. Straftäter, die sowohl Gewalt- als auch Sexualstraftaten begangen haben, scheinen mit höherer Wahrscheinlichkeit antisoziale Eigenschaften zu haben als Straftäter, die nur durch Gewalt- oder nur Sexualstraftaten auffällig geworden sind. Im Kontext von Schuldfähigkeit und Kriminalprognose bei Sexualstraftätern werden antisoziale und psychopathische Eigenschaften als prognostisch negativ beurteilt. Viele Studienergebnisse – wenngleich auch nicht alle – weisen zudem darauf hin, dass die Kombination von psychopathischen Eigenschaften und sexueller Devianz (d. h. z. B. auch einer paraphilen Störung wie sexuellem Sadismus) bei Sexualstraftätern eine besonders hohe Rückfallwahrscheinlichkeit bedingen kann. Aufgrund der interpersonellen Besonderheiten (u. a. dominantes, provokatives Verhalten, übersteigertes Selbstwertgefühl) gestaltet sich die Behandlung von Sexualstraftätern mit antisozialen und psychopathischen Zügen oftmals schwierig. Die regelmäßige Supervision des Therapeuten ist daher unerlässlich, um einer schädlichen Beziehungsdynamik oder einer verzerrten Wahrnehmung des Therapeuten entgegenzuwirken.
Chapter
The identification, assessment, treatment, and community management of two distinct but overlapping criminal justice populations have mustered over the past two decades the increased interest of clinicians, researchers, policy-makers, and politicians: those with major mental illness and those who have committed a sexual offence. Although much is known about the clinical characteristics of offenders with major mental illness and best management of sex offenders, a body of research has only recently evolved that addresses the clinical, legal, and policy-related aspects regarding mentally ill sex offenders. This chapter examines the extant scientific literature on the co-occurrence of major mental illness and sexual offending, identifies knowledge gaps, and explores public policy and mental health responses and implications for clinical excellence and public safety.
Chapter
The last two decades have brought intense focus on identifying, containing, and managing the burgeoning number of individuals who sexually offend. Similar to other emotional and behavioral problems, i.e., depression, substance abuse, and violent behavior, sexual offending may or may not be driven by psychiatric factors and need to be considered in a biopsychosocial context. Similar to how substance abuse has been dealt with in the past, sexual offending is primarily dealt with as a law enforcement/criminal justice issue focused on retribution, incapacitation, and deterrence. Treatment, when considered at all, rarely involves the use of medications even though a significant percentage of offenders have psychiatric disorders including paraphilia. Pharmacotherapy, unequivocally established as a standard of care for mood and anxiety problems and increasingly considered for addiction, is rarely used for treating sex offenders. Nevertheless, the human and financial costs of sexual crimes in society call for the use of every effective strategy in dealing with it. Most mental health professionals who deal with sexual offenders do not have medical backgrounds and may not be aware that medications can help manage paraphilic disorders or the comorbid psychiatric conditions that may trigger or worsen such behavior. This chapter addresses the barriers to pharmacologic management, state of the art of patient selection, and use of antiandrogen and other psychiatric drugs in this population. Turf issues, the reluctance of psychiatrists to be involved in treating sex offenders, patient resistance, treatment rationale, and the various classes of drugs use are discussed. Guidelines for medical workup, patient safety and autonomy, informed consent process, monitoring compliance, and legal and ethical issues are addressed.
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Where do we come from? What are we? Where are we going?Process and motivational issuesStrength-based approachCognitions, behaviors, and emotionsIntegrating pharmacological strategiesAssessment of treatment-induced changesTreatment outcome evaluationConclusions References
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In the United States of America, child pornography is described in the law as a form of sexual abuse and exploitation in which the depiction of children engaging in sexually explicit conducts poses a serious threat to the physical and mental health, safety and well-being of children. Real images (as opposed to computer generated images and drawings) of child pornography are seen as a permanent record of the victim’s abuse, and its creation and distribution is considered a serious crime in the United States Federal Code. The possibility of such use for grooming purposes is often used as a justification for the criminalization of possession of child pornography as well as for the criminalization of the creation, execution, distribution and possession of computer generated pseudo-photographs. In fact, there has been a great deal of public attention to child pornography offenders in recent years, particularly with the emergence of the Internet and pornographic content that it has made available. A particularly salient question is whether child pornography offenders are likely to commit a sexual offense involving contact with a child. This paper describes the legislative development in the United States and most important current literature on what is known about the risk of individuals using the Internet to commit felonies of sexual abuse or sexual contact with minors.
Article
Physicians have become accustomed to and appreciate the value provided by the availability of organ donor registries, cancer registries, and other disease registries. However, applying the registry concept in the mental health and corrections arenas raises questions about its ultimate effectiveness. The rationale for such registries is that they protect the public in several ways: by restricting the actions of those considered dangerous (e.g., by limiting the access to guns of people in mental health treatment or where sex offenders can live and work) and by making the government or the public aware of the presence of those considered dangerous (as in registries of sex offenders or mandated reporting of threats of harm). But these registries increase the stigmatization of those listed on them, and, because of their focus on those with mental illness, they distort and magnify the role of mental illness in violence. Language: en
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IntroductionPreparationData CollectionData InterpretationCommunication
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This article briefly discusses the historical development of the constructs of paraphilia and psychopathy. An overview of recent developments in the assessment of these constructs for legal purposes is also provided. The historical, clinical, legal, and ethical obligations of clinicians who work with persons suffering from paraphilias and co-morbid psychopathy is then reviewed. An emphasis of the current article is integrating recent developments in the construct of psychopathy into a discussion of sex offender risk assessment and treatment. The co-morbidity of psychopathy and paraphilias as factors in predicting risk of recidivism is reviewed. The need for practitioners to remain cognizant of language requirements in both legal and clinical contexts is addressed. Finally, this article reviews the legal history of sex offender legislation and its evolution into current United States Supreme Court jurisprudence. Copyright © 2010 John Wiley & Sons, Ltd.
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In its report on its recent visit to the Czech Republic, the Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) of the Council of Europe calls for an immediate stop to the surgical castration of detained sex offenders on the basis that this intervention, carried out comparatively frequently in the Czech Republic, "amounts to degrading treatment".This evaluation should have repercussions on respective activities in Germany and other countries where surgical castration is still used in the treatment of sex offenders. This paper therefore reports data on the use of surgical castration with sex offenders in Germany from the last decade and outlines shifts in the validation of its use during recent German history.
Article
In the effort to identify and manage sex offenders, the differences between legal and medical/psychiatric terminology and approaches are readily apparent. This article discusses the different definitions and approaches of the two fields and considers both the behaviors that create risk to others and the strategies for reducing that risk. Particular attention is paid to the subcategory of paraphilic sex offenders. Treatment goals, modalities, and efficacies are discussed, as are evolving legal strategies for risk control and the need for interaction between law and medicine/psychiatry in order to accomplish common goals of risk management.
Adolescent Sexual Development, the Digital Revolution and the Law
  • F M Saleh
  • Jr Grudzinskas
  • A J Judge
Saleh, F.M., Grudzinskas, Jr., A.J., & Judge, A (2013) " Adolescent Sexual Development, the Digital Revolution and the Law, " New York, NY: Oxford University Press (In press).
To develop strategies for improving Juvenile Justice protections in these jurisdictions. Also included is the development of a 50 state survey of Juvenile Competency to stand trial standards The Boston Police Study
  • J Co-Investigator Albert
  • Grudzinskas
  • J D Jr
  • Funder
  • R Sidney
  • Jr Baer
Co-Investigator, 30% effort The goals of this project are to determine the nature and application of Juvenile Competency to Stand Trial Laws and Judicial Decisions in Pennsylvania, Illinois, Washington, and Louisiana. To develop strategies for improving Juvenile Justice protections in these jurisdictions. Also included is the development of a 50 state survey of Juvenile Competency to stand trial standards. 2007-2012 " The Boston Police Study " Albert J. Grudzinskas, Jr., J.D. (PI) Funder: Sidney R. Baer, Jr. Foundation $582,000.00 Period: 10/01/07 to 9/30/10 & 10/01/10 – 8/01/12
Informed consent and the right to refuse treatment, " presented for Integrating Ethics into Professional Practice Conf
  • Aj Grudzinskas
Grudzinskas, AJ, " Informed consent and the right to refuse treatment, " presented for Integrating Ethics into Professional Practice Conf. Natick, MA 6/11/10.
Batman in Jail: Assessing Crisis Situations with Children and Adolescents, Safe Schools Initiative, Mass Association of Juvenile Police Officers
  • Aj Grudzinskas
  • K Haynes
  • Jc Clayfield
Grudzinskas, AJ, Haynes, K, Clayfield, JC: Batman in Jail: Assessing Crisis Situations with Children and Adolescents, Safe Schools Initiative, Mass Association of Juvenile Police Officers, Leominster, MA, Mar. 25, 2009.
Managed Care Effects on Arrest and Forensic Commitment: Impact on Diversion" The National GAINS Center
  • Aj Grudzinskas
  • W Fisher
  • K Roy-Bujnowski
Grudzinskas AJ, Fisher W, Roy-Bujnowski K "Managed Care Effects on Arrest and Forensic Commitment: Impact on Diversion" The National GAINS Center 2002
Mifflin Memorial Fund $10
  • H George
  • A Jane
George H. and Jane A. Mifflin Memorial Fund $10,000
Mental Health Training for Personnel of the Boston Municipal Court Department. Developed and delivered four hour training for court personnel to introduce working with emotionally disturbed defendants
  • Aj Grudzinskas
  • Jc Clayfield
  • Ce Tillbrook
  • J Shapiro
  • A Hall
  • Df Ryan
  • M Richardson
  • Ke Coffey
Grudzinskas AJ, Clayfield JC, Tillbrook CE,, Shapiro J, Hall A, Ryan DF, Richardson M, Coffey KE: Mental Health Training for Personnel of the Boston Municipal Court Department. Developed and delivered four hour training for court personnel to introduce working with emotionally disturbed defendants. October 12, 2006.
Knowledge Assets -Law and Psychiatry Issues Kenneth Appelbaum, MD (PI) Funder: Commonwealth Medicine
  • Co-Investigator
Co-Investigator, "Knowledge Assets -Law and Psychiatry Issues" Kenneth Appelbaum, MD (PI) Funder: Commonwealth Medicine 7/01/07 -6/30/10, 5.5% effort 2008-2010
Attorneys and the Forensic Mental Health Evaluation Developed program, course materials, Moderator. Training Sponsored by the Division of Forensic Mental Health
  • Aj Grudzinskas
  • T Grisso
  • I Packer
Grudzinskas AJ, Grisso T, Packer I: "Attorneys and the Forensic Mental Health Evaluation" Developed program, course materials, Moderator. Training Sponsored by the Division of Forensic Mental Health, Massachusetts Department of Mental Health and developed by the Law & Psychiatry Program, University of Massachusetts Medical Center. (2002).
Not About Me Without Me: Consumer Involvement in the Development, Delivery and Evaluation of Police Mental Health Training Curricula. Paper presented at the
  • J Clayfield
  • J Mcdonald
  • A Grudzinskas
Clayfield J, McDonald J, & Grudzinskas A: Not About Me Without Me: Consumer Involvement in the Development, Delivery and Evaluation of Police Mental Health Training Curricula. Paper presented at the 2006 American Psychology – Law Society Conference, St. Petersburg, FL, March 4, 2006.
Understanding the Sex Offender Registry Process in Massachusetts
  • A Grudzinskas
  • Benedict
  • L Guidry
Grudzinskas, A, Benedict, P & Guidry, L " Understanding the Sex Offender Registry Process in Massachusetts, " Dept. of Mental Health, Westboro, MA Mar. 28, 2011
New Technology Meets Old Law Adolescent Sexual Development, the Digital Revolution and the Law
  • Jr Grudzinskas
  • A J Cody
  • R Saleh
  • F M Grudzinskas
  • A J Judge
Grudzinskas, Jr., A.J. & Cody, R. (2013) " New Technology Meets Old Law, " in Saleh, F.M., Grudzinskas, Jr., A.J., & Judge, A (2013) " Adolescent Sexual Development, the Digital Revolution and the Law, " New York, NY: Oxford University Press (In press).
Expert testimony In Light of G.E. v. Joiner & Daubert Conference of the American Academy of Psychiatry and the Law
  • Aj Grudzinskas
  • Ka Appelbaum
  • R Schouten
  • Mw Richardson
Grudzinskas AJ, Appelbaum KA, Schouten R, Richardson MW: "Expert testimony In Light of G.E. v. Joiner & Daubert" Conference of the American Academy of Psychiatry and the Law, New Orleans, LA (1998).
Crisis Intervention & Risk Management Training and Risk Assessment and Stress Management for Correction Officers Co-Sponsored by Massachusetts Department of Public Health and the Massachusetts Sheriff's Association, Middlesex County
  • Jr Grudzinskas
  • A J Feldman
Grudzinskas, Jr., A.J. & Feldman, B " Crisis Intervention & Risk Management Training and Risk Assessment and Stress Management for Correction Officers, " Co-Sponsored by Massachusetts Department of Public Health and the Massachusetts Sheriff's Association, Middlesex County: May 21, & August 15, 2012; Franklin County: June 6 & June 18, 2012; Worcester County: June 12, 2012; State-Wide Conferences, Holyoke: June 9, 2012 and Plymouth, June 15, 2012.
Gun Control and Mental Illness: The shootings at Virginia Tech bring the gun control lobby and the National Rifle Association together on an issue
  • Aj Grudzinskas
  • F Saleh
Grudzinskas, AJ, Saleh, F (2007): Gun Control and Mental Illness: The shootings at Virginia Tech bring the gun control lobby and the National Rifle Association together on an issue. Worcester Medicine Magazine, Worcester, MA.
F: Forensic and Ethical Issues in Developmental Disability Psychiatry, American Academy of Psychiatry and the Law
  • Jp Federoff
  • Grudzinskas
  • Aj
  • M Hauser
  • Richards
  • Saleh
Federoff, JP, Grudzinskas, AJ, Hauser, M, Richards, D & Saleh, F: Forensic and Ethical Issues in Developmental Disability Psychiatry, American Academy of Psychiatry and the Law, Baltimore, MD, Oct. 29 – Nov. 1, 2009.
N: Drug – Related Arrests in a Cohort of Mental Health Services Recipients: Data from the Massachusetts Mental Health – Criminal Justice Cohort Study
  • Aj Grudzinskas
  • Fisher
  • Wh
  • Banks
  • Sm
  • Jc Clayfield
  • Roy-Bujnowski
  • Wolff
Grudzinskas, AJ, Fisher, WH, Banks, SM, Clayfield, JC, Roy-Bujnowski, K & Wolff, N: Drug – Related Arrests in a Cohort of Mental Health Services Recipients: Data from the Massachusetts Mental Health – Criminal Justice Cohort Study, American Psychology – Law Society Convention San Antonio, TX, Mar. 5 -7, 2009.
Managing Mental Health Issues in the Boston Municipal Court Department
  • Aj Grudzinskas
  • M Richardson
  • J Clayfield
Grudzinskas AJ, Richardson M & Clayfield J: " Managing Mental Health Issues in the Boston Municipal Court Department. " Trial Court Training Center, Boston, MA (2004).
Understanding Evidentiary Requirements for the Introduction of Psychological Tests in Expert Testimony
  • Aj Grudzinskas
  • J Clayfield
  • Fisher
  • K Roy-Bujnowski
Grudzinskas AJ, Clayfield J, Fisher, W & Roy-Bujnowski, K: " Understanding Evidentiary Requirements for the Introduction of Psychological Tests in Expert Testimony. " AP-LS Conference, LaJolla, CA (2005).
Privacy Training, Presented for the Department of Mental Health and the Center for Mental Health Services Research Consumer Satisfaction Survey
  • Aj Grudzinskas
Grudzinskas, AJ: Privacy Training, Presented for the Department of Mental Health and the Center for Mental Health Services Research Consumer Satisfaction Survey, Worcester, MA, May 1, 2008
Crisis Intervention and Risk Management: Recognizing Mental Illness and Substance Abuse" Developed and presented one day course for Massachusetts Probation Department train the trainers program
  • Aj Grudzinskas
  • M Richardson
  • J Clayfield
Grudzinskas AJ, Richardson M, Clayfield J: "Crisis Intervention and Risk Management: Recognizing Mental Illness and Substance Abuse" Developed and presented one day course for Massachusetts Probation Department train the trainers program (2003).
Outpatient Commitment: A Competency-Based Justification. Poster presented at the 2006 American Psychology – Law Society Conference
  • A Grudzinskas
  • W Fisher
  • J Clayfield
Grudzinskas A, Fisher W, Clayfield J: Outpatient Commitment: A Competency-Based Justification. Poster presented at the 2006 American Psychology – Law Society Conference, St. Petersburg, FL, March 3, 2006.
Creating Diversion Programs in Diverse Settings" The National GAINS Center
  • Aj Grudzinskas
  • J Clayfield
  • M Richardson
Grudzinskas AJ, Clayfield J, Richardson M: "Creating Diversion Programs in Diverse Settings" The National GAINS Center 2002 Conference San Francisco, CA Prepared and presented program (2002).
Crisis Intervention & Risk Management Training " Developed and presented eight hour course for Worcester
  • Aj Grudzinskas
  • J Geller
  • A Cavanaugh
Grudzinskas AJ, Geller J, Cavanaugh A: " Crisis Intervention & Risk Management Training " Developed and presented eight hour course for Worcester, MA Police Department (1997).
Confidentiality and Privilege " Prepared course material and presented topic for mental health professionals at Bridgewater State Hospital for the Massachusetts Department of Correction
  • Aj Grudzinskas
  • I Packer
Grudzinskas AJ, Packer I: " Confidentiality and Privilege " Prepared course material and presented topic for mental health professionals at Bridgewater State Hospital for the Massachusetts Department of Correction (1999).
Personality Assessment Comes to Court: Presenting and Defending Data. The 9 th Annual Conference on the Contemporary Applications of Psychological Testing. Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center
  • J Brant
  • Aj Grudzinskas
  • R Kinscherff
  • D Medoff
Brant J, Grudzinskas AJ, Kinscherff R, & Medoff D: Personality Assessment Comes to Court: Presenting and Defending Data. The 9 th Annual Conference on the Contemporary Applications of Psychological Testing. Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center, Boston, MA (2005).
Signs & Symptoms of Mental Illness and Applied Risk Management Training. Developed and presented four hour training to train 25 veteran police officers as part of in-service training for the University of Massachusetts Police Force
  • Aj Grudzinskas
  • Jc Clayfield
  • Ce Tillbrook
Grudzinskas AJ, Clayfield JC, Tillbrook CE: Signs & Symptoms of Mental Illness and Applied Risk Management Training. Developed and presented four hour training to train 25 veteran police officers as part of in-service training for the University of Massachusetts Police Force. September 27-29, 2006.
B: Working Effectively With Mentally Ill Clients in the Criminal Justice System for Social Workers Presented for the Massachusetts Committee for Public Counsel Services
  • D Pinals
  • Grudzinskas
  • Aj
  • I Packer
  • N Kitie
  • Larson
  • Howard
Pinals, D, Grudzinskas, AJ, Packer, I, Kitie, N, Larson, K & Howard, B: Working Effectively With Mentally Ill Clients in the Criminal Justice System for Social Workers Presented for the Massachusetts Committee for Public Counsel Services, Worcester, MA, January 10, 2008
Understanding IRB Issues in Neuro-Imaging " International Neuropsychiatric Coordinating Committee
  • A Grudzinskas
Grudzinskas, A: " Understanding IRB Issues in Neuro-Imaging " International Neuropsychiatric Coordinating Committee, Quebec City, Ontario, Canada June 24 -26, 2011.
Police as First Responders to Community Based MH Crisis: A Systems Integration Approach" Developed and presented University of Massachusetts Medical School
  • Aj Grudzinskas
  • M Richardson
  • J Clayfield
  • K Roy-Bujnowski
Grudzinskas AJ, Richardson M, Clayfield J, Roy-Bujnowski K "Police as First Responders to Community Based MH Crisis: A Systems Integration Approach" Developed and presented University of Massachusetts Medical School, Dept of Psychiatry Grand Rounds (2003).
Assessment of Competency: Guardianship Issues for Qualified Psychiatric Nurse Mental Health Clinical Specialist
  • Aj Grudzinskas
  • D Pinals
  • G Moak
Grudzinskas AJ, Pinals D, Moak G "Assessment of Competency: Guardianship Issues for Qualified Psychiatric Nurse Mental Health Clinical Specialist " Massachusetts Nurses Association, McLean Hospital (2002).
What is Mental Illness: Assisting Pro Se Litigants: A Program for Probate & Family Court Personnel" Developed and presented four hour course for Massachusetts Probate & Family Court
  • Aj Grudzinskas
  • Ja Dudek
  • Hl Shore
Grudzinskas AJ, Dudek JA, Shore HL: "What is Mental Illness: Assisting Pro Se Litigants: A Program for Probate & Family Court Personnel" Developed and presented four hour course for Massachusetts Probate & Family Court (2002).
Legal Updates, Changes in Massachusetts Civil Commitment Law " Harrington Hospital Grand Rounds
  • Aj Grudzinskas
Grudzinskas AJ : " Legal Updates, Changes in Massachusetts Civil Commitment Law " Harrington Hospital Grand Rounds, Southbridge, MA (2000).
Risk Identification and Management Training for Correctional Personnel Funder: Dept of Public Health Period: 1/1
  • Presenter
Presenter, " Risk Identification and Management Training for Correctional Personnel " Funder: Dept of Public Health Period: 1/1/11 – 6/30/11 $14,100 Contract (awarded in 2011).
Implementing Integration: Bridging the Substance Abuse
  • Aj Grudzinskas
  • J Clayfield
  • M Richardson
  • R Keane
  • Roy-Bujnowski
Grudzinskas AJ, Clayfield J, Richardson, M., Keane, R. & Roy-Bujnowski, K: " Implementing Integration: Bridging the Substance Abuse, Mental Health, & Criminal
Improving the Professional Response to Children in the Legal System" Children's Law Manual Series
  • Aj Grudzinskas
  • Sm Cahn
  • Jt Ouderkirk
  • Dm Siegel
Grudzinskas AJ, Cahn SM, Ouderkirk JT, Siegel DM (2000): Chapter 11 Confidentiality & Privilege In the Juvenile Court Setting, in: "Improving the Professional Response to Children in the Legal System" Children's Law Manual Series. National Association of Counsel for Children (2000 Ed.) 157-166.
Supervision for Adult & Juvenile Forensic Services – Best Practices " Prepared and presented a two day seminar highlighting best practices in six New England states and
  • T Grisso
  • Aj Grudzinskas
  • C Puleo
Grisso T, Grudzinskas AJ, Puleo C: " Supervision for Adult & Juvenile Forensic Services – Best Practices " Prepared and presented a two day seminar highlighting best practices in six New England states and New York and Maryland. Worcester, MA (2000).
Certificate of Confidentiality: How & Why to Obtain a Certificate, Presented at the Center for Mental Health Services Research, Brown Bag Seminar Series
  • Aj Grudzinskas
  • Simon
  • Wh Fisher
Grudzinskas AJ, Simon, L & Fisher WH: Certificate of Confidentiality: How & Why to Obtain a Certificate, Presented at the Center for Mental Health Services Research, Brown Bag Seminar Series, January 15, 2008
Legal and Ethical Issues in the Court- Mandated Treatment of Batterers Intimate Violence: Contemporary Treatment Innovations
  • A Rosenbaum
  • Wj Warnken
  • Aj Grudzinskas
Rosenbaum A, Warnken WJ, Grudzinskas AJ, Legal and Ethical Issues in the Court- Mandated Treatment of Batterers, in: Dutton, D.G. and Sonkin, D.J. (2003) Intimate Violence: Contemporary Treatment Innovations. New York: Haworth Trauma and Maltreatment Press.
A competencybased approach to court-ordered outpatient treatment, in: New Directions for Mental Health Services: Can Mandatory Treatment Be Therapeutic? Munetz, MR
  • Jl Geller
  • M Mcdermeit
  • Aj Grudzinskas
  • T Lawlor
  • Wh Fisher
Geller JL, McDermeit M, Grudzinskas AJ, Lawlor T, Fisher WH (1997): A competencybased approach to court-ordered outpatient treatment, in: New Directions for Mental Health Services: Can Mandatory Treatment Be Therapeutic? Munetz, MR, Ed. No.75, pp.81-95.
Benevolent Coercion to Facilitate Treatment of Persons with Chronic Mental Illness Developed and presented one day seminar for University of Massachusetts Public Sector Psychiatry Conference
  • Jl Geller
  • Aj Grudzinskas
  • M Richardson
Geller JL, Grudzinskas AJ, Richardson M: " Benevolent Coercion to Facilitate Treatment of Persons with Chronic Mental Illness. " Developed and presented one day seminar for University of Massachusetts Public Sector Psychiatry Conference, Leominster, MA (2001).
Bullying, Cyberbullying, & Youth Suicide: Unraveling the Connection Working with Clients with Mental Illness
  • Jr Grudzinskas
  • A J Saleh
  • F M Feldman Saleh
  • F M Grudzinskas
  • A J Treatment
Grudzinskas, Jr., A.J., Saleh, F.M., & Feldman, B (2013) " Bullying, Cyberbullying, & Youth Suicide: Unraveling the Connection, " in Saleh, F.M., Grudzinskas, Jr., A.J., & Treatment: Working with Clients with Mental Illness, " presented for the District Attorney for the Middle District, Worcester, MA Mar. 25, 2010.
Informed Consent & Ethical Issues in Treatment
  • A Grudzinskas
Grudzinskas, A: " Informed Consent & Ethical Issues in Treatment " Univ. of Mass. Medical School, Dept. of Psychiatry, Ethics Committee, Grand Rounds, Mar. 9, 2011.
Jail Diversion through Partnership in Central Massachusetts
  • K Roy-Bujnowski
  • Aj Grudzinskas
  • J Clayfield
Roy-Bujnowski K, Grudzinskas AJ & Clayfield J: " Jail Diversion through Partnership in Central Massachusetts. " The 2004 GAINS National Conference, Las Vegas, NV (2004).
Coercion, Compliance and Outpatient Commitment Conference of the American Academy of Psychiatry and the Law
  • Aj Grudzinskas
Grudzinskas, AJ: "Coercion, Compliance and Outpatient Commitment." Conference of the American Academy of Psychiatry and the Law, San Juan, Puerto Rico. (1996).