Comprehensive Study Notes: Treatment for Sexual Offending

Introduction and Practical Announcements

• Quiz Night Information: A quiz night event is scheduled for the week following this lecture. Students can attend immediately following their 335 lecture. There is a QR code available for sign-up. The lecturer noted a bonus point for those who can identify a spelling mistake on the event flyer.

• Lecture Context: This session focuses on the treatment for sexual offending, building upon previous discussions regarding general rehabilitation and yesterday's focus on violent offending.

• Sensitivity Warning: The lecturer acknowledged that sexual offending is a distressing topic. While detailed clinical descriptions of specific offenses will not be provided, the lecture covers techniques utilized in the field and broader systemic responses.

• Academic Application: Students are expected to use the content of this lecture in their upcoming labs to evaluate programs designed to reduce sexual offending.

The Necessity of Treatment: Recidivism Statistics and Risk Assessment

• Societal Stigma: There is significant public stigma surrounding sexual offending, often based on the assumption that all people who have sexually offended are high-risk and almost certain to re-offend.

• General Recidivism Rates (Department of Corrections Potomac Annual Report): Based on New Zealand data from the previous year, recidivism rates for sexual assault are generally lower than for other offense types (violent or drug offenses).

  • Post-Prison Release (Two-Year Period):

    • Re-imprisonment rate: $11\%$

    • Re-sentenced rate (new offense): $16\%$

  • Community-Based Sentences (Two-Year Period):

    • Re-imprisonment rate: $4\%$

    • Re-sentenced rate (new offense): $10\%$

• Comparative Risk: Among various offense categories, sexual offending typically shows the lowest general recidivism rates, suggesting that, as a group, these individuals are relatively lower risk compared to the broader correctional population.

Comparative Analysis: Child vs. Adult Victimization

• Past Behavior as a Predictor: Consistency with general risk assessment principles shows that those with an extensive history of offending (recidivists) have significantly higher rates of re-offending than first-time offenders.

• Offending Against Children:

  • The recidivism rate for repeat offenders against children is more than three times higher than for first-timers.

  • Often, this type of offending is more isolated and less likely to be part of a broader antisocial or violent criminal pattern.

• Offending Against Adults:

  • First-time offenders against adults have higher recidivism rates (approximately $2.5\times$ higher) than first-time offenders against children.

  • The general risk is consistently shown to be higher for those offending against adults, as this behavior often exists within a pattern of general violence and a broader antisocial lifestyle.

Sexual Recidivism Specificity

• Five-Year Re-Imprisonment Rates for New Sexual Offenses:

  • First-time offenders against children: $1.5\%$ committed a new sexual offense against an adult; $2.8\%$ committed a new sexual offense against a child.

  • Recidivists against adults (highest risk group): $9.6\%$ re-imprisoned for a new sexual offense against an adult within five years.

• Overall Trends: Across all categories, sexual recidivism remains low, often between $3\%$ and $3.5\%$ in New Zealand datasets.

• International Comparisons (Karl Hansen et al.):

  • Five-year sexual recidivism: $5\%$ to $15\%$.

  • Ten-year sexual recidivism: $10\%$ to $20\%$.

• Recent Meta-Analytic Findings (2021): A meta-analysis of nearly 500 studies ($n \approx 400,000$) found an average sexual recidivism rate of approximately $9\%$. Studies conducted after the year 2000 show a declining trend in these rates, potentially due to intervention quality or changes in the offending cohort.

• High-Risk Subgroups: Despite low overall rates, a small group of high-risk individuals shows significant recidivism: $22\%$ over five years, $44\%$ over ten years, and over $50\%$ within twenty years.

The "Dark Figure" of Sexual Crime

• Attrition Rates: Most sexual offending does not come to the attention of authorities. For those that do, many cases do not result in a conviction.

• Three Positions on Official Data:

  1. Reject estimates based only on official data as untrustworthy.

  2. Acknowledge inevitable limitations and continue using the data while working toward better measures.

  3. Use adjusted estimates (e.g., if official rates are $5\%$, adjusting based on a hypothetical calculation of undetected crime).

• Detection Rates and Sanctioning (Sharon Kelly and colleagues): Research suggests that the detection rate of sexual offenses increases after an initial sanction. Law enforcement and the community pay closer attention to convicted individuals, meaning the "dark figure" of sexual recidivism may be smaller (approximately $35\%$ detection rate) than the dark figure for initial offending.

Treatment Infrastructure in Aotearoa (New Zealand)

• Community-Based Services (NGOs): Generally funded by the government, these serve individuals at the lower end of the risk scale (e.g., those on home detention) and those who have not been convicted but display harmful sexual behavior.

  • Wellstop: Operates in the Lower North Island (including Wellington).

  • SAFE: Operates in the Northern North Island.

  • Stop: Operates in the South Island.

  • Kota Weima to Manako: A Kaupapa Māori service provider.

• Correctional Treatment Pathways:

  • Medium Intensity Group Treatment: Standard group programs for mid-range risk incarcerated individuals.

  • Special Treatment Units (STUs): Dedicated therapeutic communities for high-risk individuals.

    • Kia Marama (Christchurch): For those released for offending against children.

    • Te Piriti (Auckland): For those released for offending against children; known for leading the integration of Kaupapa Māori concepts.

  • Offending Against Adults: There is no specific dedicated unit for this at current, as these offenses are often addressed in violent offending units (e.g., Te Whare Manaakitanga).

  • Individual Psychological Treatment: Used for high-risk individuals in the community or those for whom group environments are inappropriate.

Characteristics and Mechanics of Effective Treatment

• Theoretical Models: Programs are predominantly based on Cognitive Behavioral Therapy (CBT), Relapse Prevention, and increasingly, the Good Lives Model (GLM).

• Strengths-Based Approach: Rather than just "cutting off risk," treatments focus on building healthy relationships, emotional regulation, and fulfilling lives.

• Program Structure: Typically involves nine months of intensive work, including three groups per week (three hours each) and individual sessions.

• Rolling vs. Closed Groups:

  • Closed Groups: A fixed cohort of 10 people starts and finishes together.

  • Rolling (Open) Groups: Individuals can enter or exit at different times, offering flexibility for sentence durations.

• Specific Adaptations:

  • Programs for individuals with cognitive limitations.

  • Deniers' Groups: Since denial is not strongly correlated with recidivism, programs can target potential triggers, emotional regulation, and "alleged offending" factors without requiring full confession.

• Arousal Management: Most modern programs do not claim to eliminate sexual interest (e.g., pedophilia) but focus on giving people tools to manage those thoughts and fantasies without acting on them. Historically, behavioral reconditioning (e.g., associating deviant fantasies with negative stimuli) was used, but modern research (Sarah Christofferson) is exploring new techniques like Eye Movement Desensitization and Reprocessing (EMDR).

Evaluation of Treatment Effectiveness

• General Outcomes: Meta-analyses (2015) show treatment reduces recidivism from $14\%$ (untreated) to $10\%$ (treated).

• Methodological Challenges: Because recidivism is low, very large sample sizes are required to prove statistical significance.

• New Zealand Context: Evaluations of Kia Marama and Te Piriti show significant reductions in re-offending.

• The Problem of Attrition: Those who drop out of treatment consistently show higher recidivism rates than those who never attended.

• Lowest Risk Programs: An evaluation of a New Zealand program for low-risk individuals showed no impact on recidivism, highlighting that treating low-risk individuals is not cost-effective and may even be counter-productive, though it identified some previously mis-assessed high-risk individuals.

• Key Components of Success:

  1. Adherence to Risk, Need, Responsivity (RNR) principles.

  2. Focus on high-risk individuals.

  3. Staffed by highly qualified psychologists.

  4. Delivered in the community rather than prison where possible (though Prison-based STUs remain effective for high-risk groups).

Prehabilitation: Stand Strong Walk Tall

• Concept: Primary and secondary prevention for people with sexual interest in children who have not yet offended.

• Current Pilot: Based in Christchurch and led by Sarah Christofferson and Gwen, adapted from a German model.

• Ethical and Clinical Challenges:

  • Clinicians must balance the therapist-client confidentiality with the duty to report imminent risk.

  • Lower thresholds for disclosure in some countries can cause clients to disengage, potentially increasing long-term risk.

  • Germany pioneered this due to higher legal thresholds for mandatory disclosure of risk.

• Purpose: To offer a free, specialist, non-referral-required therapeutic service to help individuals live fulfilling lives while preventing the occurrence of sexual abuse.