Sex Offender Treatment Program

Introduction

An effective and meaningful research into sex offender treatment program is indeed quite difficult. There is little evidence today that could go on to conclusively establish superiority of one program over the other. In other words, whether or not a particular program can effectively reduce recidivism is still debatable. However, it cannot also at the same time be asserted that a particular program is not effective (Conroy 2000).

Determining the effectiveness of a treatment program conclusively can be difficult for several reasons. An ideal study must take into account a large number of offenders and compare the recidivism rate among those that were treated and those not treated. The two groups – those that received the treatment and those that did not – must for the purpose of an effective study be similar in every possible manner apart from the similarity that all of them are sex offenders. Unless, they are a homogeneous group it would not be possible to conclusively establish that the reduced recidivism rate in the group that was exposed to the treatment could be pinned to the effectiveness of the treatment program. The researchers are also likely to confront ethical and legal challenges when randomly assigning the members to the two groups of treated and untreated.

The scope of treatment programs

While it could be morally indefensible to leave out a group untreated, victims of untreated group might file a claim of negligence. Therefore, the intervention agencies are unlikely to deliberately withhold treatment for the fear of legal implications and media outcry originating from their deliberate act of negligence (Barbaree 1997). Moreover, long existing treatment programs did not anticipate follow up studies of released offenders from the perspective of methodological rigor at the time these programs were initiated. Therefore, while re-offending data over a time period might be available without any control group (Maletsky and Steinhauser 2000). The researchers then, at best, can compare the published re-offence rate with their result, even as there may be tremendous variation in published recidivism rates (Prentky 1999).

Nonetheless, studies on sexual offences over the last decade or two offer us useful insight into the issue that can offer us a framework on an effective intervention program.

According to Home Office Criminal Statistics (1995) while more than 50 percent of the sex offenders are served imprisonment or youth custody followed by probation (more than 23 percent), fines and the other means, approximately 8 to 9 percent of the offenders are absolutely discharged. According to estimates, one in ten children is likely to be sexually abused during childhood (MacMillan et al, 1997) and the prevalence rate of rapes has been shown to vary from 5 to 44 percent (Resnick and Markaway, 1991). Moreover, studies indicate that sex offending is embedded in social and family structures blurring the boundary between the victim and offender with perpetuation of the cycle of child sex abuse.

One of the impacts of being sexually abused could be a higher risk for mental, social, and emotional health in later life. Yet, it is well documented that sex offenders are most probably those that have themselves been the victims of sexual, physical, and emotional abuse during their formative years (Morrison et al, 1990; Waterhouse et al, 1994). Therefore, it is essential that the treatment approach takes into account childhood precursors of personality disorder leading to sex offending (Marshall, 1996).

There are a large number of sex offender treatment programs in place. These programs are now increasingly being seen as complementary rather than in conflict. The police are known to increasingly rely on clinical approach in apprehending sex offenders (Perkins, Hilton and Lucas 1990). Information on sex offender risk factors can go a long way in assisting child protection (Morrison, et al, 1990). Therefore, a joint approach involving treatment along with police, probation and child protection can complement towards developing a comprehensive and effective approach to the issue (Beech et al 1998).

Types of offender treatment approaches

There are diverse sex offender treatment approaches including surgical treatments, pharmacological treatments, and psychological treatments. These broadly include surgical treatments, pharmacological treatments, and psychological treatments. Although surgical treatments are rare currently, they have been extensively used in the past. Surgical techniques are also at the same time fraught with ethical consequences of surgically removing healthy tissues and their side effects. Moreover, the procedures are irreversible. Several studies have reported low conviction rates after the performance of surgical castration. Nonetheless, Sturup’s study (1968) also indicated that 33 percent of the castrated offenders went on to commit violent but non-sexual offences. Yet another surgical technique stereotaxic hypothalamatomy has been criticized for ethical inadequacy and lack of credible scientific model on which the technique is based.

Pharmacological Treatments

Pharmacological interventions for sex offenders have also been studied for their efficacy in reducing recidivism. Diverse agents ranging from anti-androgens to serotonic drugs have been used in the treatment. For instance, a study based on 10 year evaluation determined that DepoProvera is quite useful in reducing the sex drive of their patients and hence of considerable value as a therapeutic measure (Emory, Cole and Meyer 1992). In another study, MPA users were found to have a considerably reduced rate of re-offence (15 percent) as against 68 percent for the non-users (Fedoroff et al 1992).

While anti-libidinal medication can be useful from the perspective of the flexibility of their use, it is unlikely that they will completely meet the challenges of reducing recidivism for many sex offenders commit the crimes from the motives other than purely sexual gratification. Moreover, the compliance of offenders is a necessary part of treatment, and therefore, these treatments can only be effective so long as drug is administered. Nonetheless, psychological treatment can be effective in combination with medication that can reduce anxiety and sexual arousal.

Psychological approach to treatments broadly follow a three-pronged pattern of assisting the offender gain an insight into their offending behavior, their causes and available remedies followed by helping them reduce or remove influences leading to their offending behavior, and finally helping them overcome the tendencies to relapse into offending under vulnerable circumstances. Researchers agree that all three areas are important and not one is any less significant than the other. The pharmacological treatment of the sexual offenders follows the belief that in most cases, behavior is motivated by sex. At the same time, the suppression of the sexual drive is seen as an effective way through which to reduce sexually deviant behavior. The use f pharmacological approach in treatment of sexually deviant behavior has but one major goal- preservation of normophillic sexual interests as well as behaviors while at the same time reducing the deviance in sexual drives or paraphillic behaviors. The application of the approach yields the suppression of sexual fantasies, urges and behavior. At the same time, non-deviant fantasy, urges, as well as behavior are promoted and preserved. The application of pharmacological treatment approach reverses the fundamental pathology in pedophilia.

Perhaps the application of pharmacological treatment programs in the aversion of deviant sexual behavior has a major focus on reducing or eroding sexual feelings. As demonstrated through the reversal of pedophilia; the phenomenon that promotes deviant sexual behavior, pharmacological treatment programs play a major role in the reversal process. The application of different biological treatments has been known for many years in the past. For instance, some specific biological treatments such as surgical castration and stereotaxic neurosurgery have been applied in the past. They have been seen as effective methods of treating sexual offenders who later reduce their sexual drive as well as prevent recidivism (Sturup, 1968). Researchers have observed through studies that low rates of recidivism (5%) have been reported following the application of biological intervention programs. The rates have been recorded following a long period of study on the outcome of the intervention programs.  As a basis for the study of pharmacological treatment programs, surgical castration provided the basis for which the theoretical comprehension of the treatment program:  pharmacological treatment.

Pharmacological treatment embraces certain aspects of the intervention programs that relate to the treatment of the paraphilias. There are certain effects associated with application of surgical castration and androgen suppression by antiadrogens as well as the agents used on the hormonal reversal on sexual behavior.  Different pharmacological treatments are applied in the treatment of deviant sexual behavior. To start with, Antiandrogens, which are also known as Cyproterone Acetate, are widely used. Similarly, hormonal agents that lack specific Antiandrogen profile as also used. These hormonal agents are agents are also known as Medroxyprogesterone acetate, LHRH analogues. The third category of the pharmacological treatments used is the Serotonin specific reuptake inhibitors.

Analysis of the pharmacological offender treatment programs                        

The different forms of pharmacological treatment programs are effective in disseminating relevant information pertaining to the relevance of all the major aspects of the treatment programs that are used at different conceptions of the pharmacological perspectives. Cyproterone acetate (CPA) has various aspects that make it effective as a pharmacological intervention program.  CPA contains antiadrogenic, progestational as well as antigonadotropic effects. Some of the major a\features of CPA is the fact that it is 100% bioavailable during the times when it is taken orally and it contains a halve-life of 38 hours. On the other hand, the injectable form is able to reach the maximum plasma level in a period of about 82 hours. The form has a halve life of a close to 72 hours. Oral and parental dosages have certain aspects make them differ in their levels of amounts that are given to individuals. For instance, an oral dosage contains 50mg to 200mg daily. A parental dosage on the other hand contains 200mg to 400mg for every 1-2 weeks. The effects of application of CPA are seen in the rate of reduction on the sexual drive, deviant sexual fantasy as well as sexual urges. CPA is known to be available only in some parts of Canada through it is not available in USA.  In spite of the positive impacts that are attributed to the application of CPA, there are certain side effects that are attributed to use of CPA in the treatment of the sexual deviance. For instance, liver dysfunction, adrenal suppression as well as feminization with gynecomastia have been associated with the use of CPA.

Other drugs such as the Medroxyprogesterone acetate (MPA) and LHRH seem to have less serious effects on the reversal of sexual desires and drives. The need to define the most effective pharmacological method to apply in the reversal of the methods of treatment is determined by the application of the various aspects of indefinite ongoing treatments especially in high risk individuals. It is an essential requirement that stronger drugs are applied in the the individuals in order to promote reduction of recidivism.

Evaluation of the offender treatment programs         

The sexual offending behavior programmes unit endeavors in the establishment of the analytical series of the usage of the analytical series due t the use of the various considerations associated with the analysis of the various conceptions about the use of sex offender treatment programs. In an analytical series of the significance of the treatment programs that are fit into the Sex Offender Treatment Programme (SOTP). The intervention programs that are used need to recognize the offender needs. The accredited program that offers the most effective treatment of the sex offender should be based upon some major elements of the discussion of the major conceptions regarding the usability of intervention programs. Some of the major aspects of the treatment program that need to be addressed include: explicit, empirical model of change that draws from the available literature. The treatment programme should also recognize the need intervention programs that target criminogenic need. The intervention programs should therefore analyze the extent of the results that need to be addressed in the various issues associated with the nature of the offender.

One more crucial requirement that of the reasons that make the intervention programs apply the most effective treatment programme for the treatment is the analysis of the effectiveness. The treatment program needs also to be responsive on ways such as engaging their active participation in the treatment program. The effectiveness of the programmes applied in the intervention programs relate to the effectiveness of the undertakings concerned with the application of the applicability of the applicability of the intervention programs as applied in the overall reason for the analysis of the treatment programs. The treatment programs are also dependent on the factors that regard the effects of normative application of the main target for integrating the treatment program. The accredited methods of the treatment programs depending on the various components of the sex offender programme. The need for a treatment programme that recognizes the special needs of the sex offender is effective as it discourages chances of recidivism. The major concept about the application of effective treatment programme that recognizes the all the major components of the sex offending habits associated with the recognition of the offence and eventually embarking on better methods that are used to relate the offender with the future offending.

The effectiveness of the sex offender treatment programs offers a wide perspective about the main concept relating t the effectiveness of the treatment programmes. In the intervention programs undertaken, there are certain needs of the offender that are being considered. The policy that recognizes the effectiveness of the intervention programmes relates to the use of the available treatment programs in accordance to the needs of the offender. The policy has also recognized various aspects of the programs associated with the change of the behavior as well as eventual recognition of the practical application of the practices. The need for an elaborate intervention programme that recognizes the major inclinations of the treatment programmes relates to the use of various aspects of the analysis in relating all major aspects of the programs offered. The importance of the reactive programs relates to the use of the major concerns of the intervention programs associated with the analytical approach about the eventual coordination of the treatment programs. As a crucial requirement, the major components of the intervention programs associated with the use of the major aspects of the programmes relates  to the application of various components of all the major evaluations and treatment options for the sex offenders (Barbaree, 1997). The SOTP also delves in issues such as the progressive monitoring of staff selection as well as well as the amount of intensity as well as the sequencing of the treatments appropriate for the seriousness as well the persistence in the offending behavior.

Theoretical and social forces behind the policy                                                                                                              

The need to establish a system that recognizes the offensive behavior portrayed by the sexual offenders and their apparent needs relates to the recognition of differences in offending habits and extents. The policy requirements are based on a series of inspection ands audits on the inspections and requirements. The three main evaluative considerations about the effectiveness of the treatment programs include: treatment integrity, treatment impact and the treatment outcome.  The application of these evaluative channels of the treatment programs touches on various aspects of the consideration that governs the implementation of different aspects of the consideration. The methods used in the evaluative processes touch on theoretical and social forces behind the implementation of the policy requirements. Treatment integrity relates to the use of the effective treatment programmes that are fine-tuned. The treatment programs that are used rely on the design of the treatment programmes offered. The use of the different models in the treatment of the sexual offending behavior creates a guide on the policy requirements laying emphasis on the social as well as theoretical perspectives of the treatment programmes. The integrity of the treatment programmes delves into various perspectives such as independent and direct intervention programmes which are easily accessed (Fedoroff et al, 1992).

The two other theoretical and social intervention programmes are treatment impact and treatment outcome (Maletsky & Steinhauser, 2002). They all relate to the recipient of the intervention programmes. Depending on the effectiveness of the differed modes of the opportunity recognition as well as the use of different aspects of the social and theoretical approaches, the modes of the intervention are effectively analyzed. The need for all the analysis the usefulness of the all the different treatment programs embraced.

Critique of the effectives of the treatment program

The treatment program embraced has various aspects that lead to either positive or negative impacts to the offenders. This is in spite of the fact that all the intervention programs embraced are meant to change the offensive sexual behavior into a desirable one. The recognition of the need for the implementation of the various treatment programs relate to the modalities of the behavior change among the offenders. To start with, the intervention programs offered are the major prerequisites for the implementation of the different intervention programs offered at different periods of time. But for the presence of the intervention program, there would be a culture of offensive sexual behavior being bred in the society. This culture would not be contained or prevented due to the absence of reliable methods through sexual offensive behavior could be treated. The importance of the different aspects of the treatment program has also brought about low return to the offensive sexual behavior relating to the opportunities created by the overall effectiveness of the treatment programs (Conroy, 2000).

Nevertheless, the treatment program possesses a horde of negative implications to the sexual offenders. The need for an elaborate system that favors a more unified treatment programs need to be addressed. Pharmacological treatment programs are characterized by different negative implications regarding to the sexual lives of the offenders. The implementation of the pharmacological treatment programs leads to the effects of the differential programs of the overall attitudes of the offenders (Marshall & Pithers, 1994). The application of the various pharmacological treatment programs can lead to total destruction of the sexual desires of the offenders. This is not a fair way of correcting the behavior. The use of the treatment program has more negative impacts on the offenders to the extent of disregarding their human rights.

 

 

References

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Conroy, M.A. (2000). Assessment of Sexual Offenders, in Van Dorsten, B. (Ed.) Forensic Psychology from Classroom to Courtroom, Plenum, N.Y., p. 232

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Prentky, R.A. (1999). Child sexual molestation. In Van Hasselt, V. & Hersen, M. (Eds.). Handbook of psychological approaches with violent offenders. Plenum, N.Y. P. 289.

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Sturup, G. K. (1968). Treatment of sexual offenders in Herstedvester Denmark: The rapists. Acta Psychiatrica Scandinavia Supplement, 204 5-62.

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