Pamela M. Yates

The Good Lives Model and the Risk Need Responsivity Model: a critical response to Andrews, Bonta, and Wormith (2011)

CRIMINAL JUSTICE AND BEHAVIOR, Vol. XX, No. X, Month 2007 94-XXX DOI:

How to integrate the good lives model into treatment programs for sexual offending : an introduction and overview

The good lives model (GLM) represents a new theoretical framework informing sex offender treatment programs; however, substantial variation has been observed in terms of how GLM-related ideas and practices have been applied. Integrated appropriately, the GLM offers potential for improving outcomes of programs following a cognitive-behavioral therapy (CBT) approach and operating according to a narrow operationalization of risk, need, responsivity (RNR) principles. Conversely, misguided or otherwise poor integration could increase the very risk practitioners work to prevent and manage. The purpose of this article is to provide an introduction and overview on how to integrate the GLM into treatment using CBT and RNR. The authors describe clinical implications of the GLM as they relate to program aims and orientation, assessment and intervention planning, content, and delivery.

Diagnosing Sexual Sadism in Sexual Offenders: Reliability across Diagnosticians:

On the basis of detailed accounts of offences committed by 12 dangerous sexual offenders and of descriptions of their life histories, their responses to various tests, self-reports of offenders’sexual interests and activities, and results of phallometric evaluations, 15 expert forensic psychiatrists diagnosed whether each offender met the criteria for sexual sadism. The psychiatrists also indicated their confidence in the diagnoses they made and rated the relevance to the diagnosis of sexual sadism for various features of the offence and the offender. Results revealed unsatisfactory levels of diagnostic agreement among the psychiatrists. On the other hand, they agreed quite well on the importance for the diagnosis of several of the offence features described. Suggestions are offered for clinical practice.

Issues Concerning the Reliability and Validity of the Diagnosis of Sexual Sadism Applied in Prison Settings

This study examined limited aspects of the diagnoses of sexual sadism among incarcerated sexual offenders. The diagnoses examined in this study were made by experienced forensic psychiatrists following DSM-III-R or DSM-IV criteria. Archival data was extracted on 51 sexual offenders for whom a psychiatric evaluation had been requested. Analyses of offense history and features, offender self-reports, and phallometric data, indicated few differences between those offenders diagnosed as sadists and those not so diagnosed. In fact, where there were differences, the data indicated that the nonsadists were the most deviant. The results are discussed in terms of their meaning for both forensic practice in prisons and the value of the diagnosis of sexual sadism.

Long-Term Predictive Validity of the Risk Matrix 2000 A Comparison With the Static-99 and the Sex Offender Risk Appraisal Guide

The purpose of this study is to examine the predictive accuracy of the Risk Matrix 2000 on an independent sample of 351 sexual offenders, followed in the community for an average duration of 11.4 years (range 0-20 years, SD = 4.4 years). For comparison purposes, this study also examines the predictive accuracy of two other risk assessment instruments, specifically modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide (SORAG). Results indicate that the Risk Matrix 2000 demonstrates convergent validity by correlating with the other risk assessment instruments. Moreover, the Risk Matrix 2000 is predictive of recidivism above chance levels, exhibiting medium to large effect sizes, although in general, the other two instruments, particularly the SORAG, are superior. Results also indicate differences in predictive validity when comparing 2-year, 5-year, and variable follow-up periods. Finally, a cumulative meta-analysis compares and integrates current findings with those obtained from the accumulation of previous studies, and new cumulative estimates are provided.

Effectiveness of Sex Offender Treatment for Psychopathic Sexual Offenders

Meta-analyses have suggested that sexual offender treatment (SOT) completion is associated with lowered sexual recidivism rates for convicted sexual offenders. The paucity of properly designed studies allows for the alternative explanation of less recidivism among treated samples as reflecting that lower risk offenders disproportionately self-select into treatment. A test of the “self-selection explanation” can occur by investigating treatment effect on known high-risk offenders. Psychopathy correlates with increased sexual recidivism risk, such that an exploration of the SOT effect on psychopathic offenders could clarify the accuracy of the self-selection hypothesis. Additionally, the debated degree to which psychopaths are treatable might obtain clarification by a research review. This article examines empirical findings concerning the effectiveness of SOT for psychopathic sexual offenders. Ten studies were found to meet the minimal quality standards used, stemming from only four data sources. Shortcomings of existing research precluded clear conclusions, though trends in the data are delineated.

Treatment of Sexual Offenders: Relapse Prevention and Beyond

Publisher Summary This chapter reviews treatment approaches utilized historically with a focus on recent adaptations to the relapse prevention (RP) model that have been applied to the treatment of sexual offenders. The treatment of choice for sexual offenders at present adheres to the principles of effective correctional intervention in which treatment is matched to the risk posed by individual offenders. Effective treatment also follows the cognitive-behavioral model, which demonstrates the greatest impact on reoffense rates of sexual offenders. The RP model as applied to sexual offenders has been widely accepted as a method of treatment for sexual offenders. The RP model as applied to sexual offending also fails to account adequately for variations in the degree of planning of sexual offending, which for some individuals is quite extensive and explicit. The self-regulation model (SRM) posits nine phases in the offense progression and four distinct pathways that lead to sexual offending. It is found that the SRM contains a number of pathways, representing different combinations of offense-related goals, and the use of distinct regulation styles in relation to sexually offensive contact.

Comment on Mailloux et al.’s (2003) Study “Dosage of Treatment to Sexual Offenders: Are We Overprescribing?”

In their recent study, Mailloux et al. (2003) described an appraisal of sexual offender programs operated by the Correctional Service of Canada (CSC) in the Ontario region. Their stated intent was to determine the adequacy of the dosage of treatment provided to these offenders. This is a laudable aim because there are grounds for supposing that too much treatment may have iatrogenic effects, whereas too little treatment may be ineffective. As Mailloux et al. correctly point out, the CSC has established operational rules for allocating sexual offenders to treatment. Those at high risk and having high needs are allocated to high-intensity programs, whereas those with moderate risk and needs receive moderate-intensity treatment, and those with low risk and needs enter a low-intensity program. In addition, because the static and dynamic risk factors associated with sexual recidivism carry different weights (Hanson & Morton, 2003) and because offenders present with variability in characteristics that may affect engagement with the treatment process, treatment placement is determined based on risk, need, and responsivity factors, in combination. For example, sexual offenders assessed as possessing sexual deviance (e.g., via phallometric assessment) but who present a moderate static actuarial risk to reoffend may receive treatment at the high-intensity level because of the strength of association of this risk factor with sexual recidivism (d = .12 to .33; Hanson & Morton, 2003). Similarly, sexual offenders presenting elevated risk for nonsexual violence or with psychopathic traits may be placed in higher intensity treatment programs than would be indicated based solely on actuarial risk for sexual recidivism, as a result of the presence of these additional criminogenic needs and responsivity factors. The high-intensity treatment program at the Regional Treatment Centre in Ontario, the program in which participants in the Mailloux et al. study participated, is one such specialized program for offenders meeting these

The Self-Regulation Model of Sexual Offending: Intermediate Outcomes and Posttreatment Recidivism

The self-regulation model (SRM) is a nine-phase, four-pathway offense process model designed specifically for sexual offenders that is now being applied to the treatment of this group in many settings and jurisdictions. In the present prospective study, we evaluated the validity and utility of the SRM in a sample of 275 adult male sexual offenders treated within the Correctional Service of Canada. Results indicated that participation in treatment resulted in moderate to large sized improvements from pretreatment to posttreatment on a dynamic risk assessment measure and several self-reported treatment targets. These changes were, in some cases, differentially associated with self-regulation pathways, suggesting that offense pathway is a clinically relevant variable when evaluating treatment change and in conceptualizing sexual offender treatment. In terms of outcome, individuals following the approach pathways, particularly the approach-automatic pathway, demonstrated higher failure rates than individuals following avoidant pathways. However, many of these differences were less pronounced when taking risk for recidivism into account. Implications of these findings for the effective assessment and rehabilitation of sexual offenders are discussed.

Diagnostic issues in sexual sadism among sexual offenders

This paper provides an integration of our findings on the diagnosis of sexual sadism among sexual offenders. A summary of our review paper is provided followed by a description of two studies that we conducted where we examined both the application of the diagnosis in clinical settings and the inter-diagnostician agreement of the diagnosis based on detailed case descriptions. On the basis of our findings suggestions are offered regarding the future application of the diagnosis.