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An Evidence-Based Relapse Prevention Program

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  • Forensic Assessment Training & Research LLC
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... The original model of relapse prevention was adapted and developed for addressing sexual offending behaviour by Pithers (e.g. Pithers et al., 1983) and Marques (e.g.), and since this time has been incorporated into many treatment approaches for sexual offenders (Marques, Day, Nelson, & Miner, 1989; Mann & Thornton, 2000). The goal in relapse prevention is for the sexual offender to develop self-management skills in order to avoid offending (similar to avoiding a return to substance abuse). ...
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The adaptation of relapse prevention theory to sexual offending (W. D. Pithers, J. K. Marques, C. C. Gibat, & G. A. Marlatt, 1983) has represented an important movement in cognitive-behavioural treatment for sexual offenders. However, this model of relapse prevention has been criticised for its limited view and oversimplification of the relapse prevention process (R. K. Hanson, 2000; T. Ward & S. M. Hudson, 1996). As a result, T. Ward and S. M. Hudson (2000a) have developed a multiple pathway model of the relapse prevention process based on self-regulation theory. Although this model continues to be empirically validated on sexual offenders (J. A. Bickley & A. R. Beech, 2002; T. Ward, S. M. Hudson, & J. C. McCormick, 1999), there has been no empirical research regarding the application of this theory to intellectually disabled sexual offenders. This paper discusses whether the characteristics of offenders in each of the relapse offence pathways, as described by T. Ward and S. M. Hudson (2000a), may be similar to the characteristics of intellectually disabled sexual offenders. From a review of the literature, it appears that the intellectually disabled sexual offender may be most likely to offend via the approach-automatic pathway or the avoidant-passive pathway. The potential treatment implications of the self-regulation model for intellectually disabled sexual offenders is discussed, as well as the need for empirical evaluation with regards to the application of this model to the intellectually disabled sexual offender population.
Chapter
This chapter describes a literature search that was performed to review publications on the effectiveness or outcome of cognitive-behavioral treatment programs for violent and sexually violent offenders. The review aimed to identify factors and conditions that contribute to a decrease in recidivism rate. Many programs have been evaluated with a broad group of offenders, whereas other programs focus on specific subgroups of offenders such as sex offenders, domestically violent offenders, and addicted offenders. However, the literature on the effects of cognitive-behavioral group treatment programs for violent offenders is limited. Based on the literature consulted, criteria or standards for treatment programs are presented that may contribute to a relatively lower rate of recidivism for both violent and sexually violent offenders.
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FORENSIC) ________________________________________________ The Association for the Treatment of Sexual Abusers' (ATSA) 2005 Practice Standards and Guidelines (PSG) are reviewed with reference to the American Psychological Association' s (2002a) Criteria for Practice Guideline Development and Evaluation. The 2005 ATSA PSG show considerable improvement over the 2001 version, and suggestions are made for further improvements. It is recommended that future iterations of PSG should list standards and guidelines separately, and not include treatment guidelines within the same document. Careful review of empirical research should precede development of treatment guidelines, and it is suggested that there is insufficient empirical basis to warrant the establishment of sex-offender treatment guidelines at this time. Significant public damage sparked by the 2001 PSG has not been repaired by simply replacing the old version with a new model. Repairing the damage to states' laws and rules is a priority for mental-health professionals.
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As a result of a high treatment attrition rate two significant changes were made from August 2005 to the New South Wales Department of Corrective Services custody-based intensive treatment programme for sexual offenders (CUBIT) that directly reflect advances in the field of sex offender treatment. This article outlines the rationale and outcomes of these changes. It is argued that the implementation of an open-ended (rolling) group treatment format has significant advantages over a closed group treatment format. Secondly, the programme is now emphasizing the importance of the use of positive therapist characteristics within the programme and in so doing has moved away from an overly manualized delivery of cognitive behaviour treatment. The positive outcomes produced by the changes are discussed.
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IntroductionRationale For Sex Offender ProgrammesEvidence Base For Programme TargetsProgramme Content and Application IssuesOutcome Evidence For Sex Offender ProgrammesFuture Directions For Sex Offender ProgrammesReferences
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IntroductionDeveloping the Becoming New Me Sex Offender Treatment ProgrammeProgramme Content and StructureThe Becoming New Me Adapted Sex Offender Treatment Programme FacilitatorsAuditing Treatment DeliveryAssessment of Treatment Need and Treatment ChangeEnsuring Psychometric ResponsivityConclusions References
Article
Final results from a longitudinal investigation of the effectiveness of cognitive-behavioral treatment with sexual offenders are presented. The study was a randomized clinical trial that compared the reoffense rates of offenders treated in an inpatient relapse prevention (RP) program with the rates of offenders in two (untreated) prison control groups. No significant differences were found among the three groups in their rates of sexual or violent reoffending over an 8-year follow-up period. This null result was found for both rapists and child molesters, and was confirmed in analyses using time to reoffense as the outcome and those controlling for static risk differences across the groups. Closer examination of the RP group's performance revealed that individuals who met the program's treatment goals had lower reoffense rates than those who did not. Although our results do not generally support the efficacy of the RP model, they do suggest a number of ways in which this kind of treatment program can be improved. This study also emphasizes the importance of including appropriate control groups in treatment outcome research. Additional controlled investigations are needed to address the many questions that remain about when and how treatment works for sexual offenders.
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