Forensic Aftercare Facilities and Their Impact on the Releasability of Persons Who Committed Sexual Offenses: A Three Group Comparison

Partly due to a lack of release options for individuals who committed sexual offenses, forensic follow-up treatment has been strengthened latest since 2007. The current study investigates whether the foundation of a professionalized follow-up-treatment has actually improved release options for individuals who committed sexual offenses. Thus, the aim of the present study was to assess the difference in criminogenic needs and recidivism relevant characteristics (e.g., index offense, criminal history, psychiatric diagnoses and risk assessment) between three groups who had been released from forensic psychiatry at different times or under different outpatient follow-up modalities: (1) individuals released prior the foundation of professionalized follow-up-treatment, (2) individuals released after the foundation and received treatment, and (3) individuals released after the foundation but not receiving this special treatment. It was found that with the availability of professionalized forensic followup treatment, persons with higher scores in common risk assessment tools and a longer duration of implacement had been released. Indeed, this indicates an increased risk tolerance among decision makers. However, it was not those who were released after the foundation of the professionalized forensic follow-up treatment but without this specific treatment who showed the lowest initial risk, but those who were released prior to the foundation. Results are discussed in terms of possible explanations and methodological issues.

Who With Whom: Matching Therapist and Client in Correctional Institutions

The current study investigated variables that are being considered when assigning psychotherapists to individuals convicted of sexual and violent offences. Its main aim is to inform practitioners and researchers alike of potentially beneficial combinations between therapist and client and infer hypotheses for future studies. A mixed-methods approach, combining interviews and a follow-up questionnaire, was employed. Nineteen interviews with forensic practitioners working in socio-therapeutic facilities in Germany were conducted. Relevant matching criteria were extracted from all interviews. 1.) Capacities of therapist, 2.) therapist's professional background, 3.) (severity of) clinical disorder, 4.) personal fit, and 5.) fit of client into existing groups emerged as top five matching criteria. Directive therapists were viewed as a good match for antisocial or psychopathic offenders. Opinions diverged regarding personality similarity or complementarity in client-therapist dyads. A flexible matching approach may offer unique strengths to enhance treatment outcome. Implications and ideas for future research are discussed.

Pinpointing change in virtual reality assisted treatment for violent offenders: a pilot study of Virtual Reality Aggression Prevention Training (VRAPT)

Preventing relapse into violence and its destructive consequences among persistent re-offenders is a primary concern in forensic settings. The Risk-Need-Responsivity framework models the best current practice for offender treatment, focused on building skills and changing pro-criminal cognitions. However, treatment effects are often modest, and the forensic context can obstruct the delivery of interventions. Developing treatments for offenders should focus on the best method of delivery to make "what works work." Virtual reality (VR)-assisted treatments such as Virtual Reality Aggression Prevention Training (VRAPT) are a new and innovative approach to offender treatment. This pilot study followed 14 male violent offenders who participated in VRAPT in a Swedish prison context and measured changes from pre-treatment to post-treatment and 3-month follow-up in targeted aggression, emotion regulation, and anger. It also investigated potential impact factors (pro-criminal cognitions, externalizing behaviors, psychosocial background, and childhood adverse experiences). In Bayesian linear mixed effects models, participants showed a high probability of change from pre-treatment to post-treatment and to follow-up on all outcome measures. All outcome measures demonstrated a low probability of change from post-treatment to follow-up. Analysis of reliable change showed that participants' results ranged from recovery to deterioration. We discuss the implications of the study for VRAPT's impact on the target group, those who might benefit from the approach, and suggested foci for future studies in the field of VR-assisted offender treatment. The study was preregistered at the International Standard Randomized Controlled Trial Number registry (https://doi.org/10.1186/ISRCTN14916410).

Development of an Evidence-based Violence Rehabilitation Program for Offenders With Intellectual Disability

A review of the current literature on evidence-based violence prevention programs developed for individuals with an intellectual disability (ID) reveals a paucity of direct evidence for this population. In addition, the existing offence-specific programs are primarily grounded in adapted cognitive behaviour therapy (CBT) programs designed for the mainstream offender population, which may not be suitable for offenders with co-morbid mental health and personality disorders. The current paper discusses the development of a violence rehabilitation program for offenders with an ID. The focus of the article is on the exploration of the empirically supported risk factors associated with violent offending and the incorporation of these dynamic risk factors into the program modules. A case study example was utilized to examine the process of VRP-ID and how the modules targeted the offenders' treatment needs. Responsivity issues are addressed by identifying cognitive difficulties experienced by this cohort and the implications for treatment. The Risk/Need/Responsivity (RNR) model and the good lives Model (GLM) are widely used offender rehabilitation models that can be considered the guiding principles in developing this program. Furthermore, it utilizes contemporary therapeutic frameworks such as motivational interviewing (MI), cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), and GLM reconceptualization and skills. The program is grounded in trauma-informed principles, which acknowledge this client group's high prevalence of victimization.

A critical analysis of stalking theory and implications for research and practice

This article comprehensively reviews and critiques theories providing an aetiological account of stalking. We evaluate applications of preexisting psychological theories to stalking (attachment theory, evolutionary theory, social learning theory, information processing models of aggression, coercive control theory, and behavioural theory) as well as the only novel theory of stalking to date: Relational goal pursuit theory. Our aim was to identify which are supported by research, identify gaps in theoretical scope and explanatory depth and examine how current theories might inform clinical practice. This evaluation suggests that theories of stalking are underdeveloped relative to other areas of forensic clinical psychology and the theoretical literature is relatively stagnant. Consequently, there is limited research into clinically meaningful constructs that can guide the assessment, formulation and treatment of this client group. We identify similarities across existing theories, discussing implications for future research and clinical practice with people who stalk.

Effectiveness of social-therapeutic treatment for serious offenders in juvenile detention: A quasi-experimental study of recidivism

Due to legislative changes in Germany, there has been an increasing expansion of social-therapeutic facilities for juvenile offenders over the past 15 years. Social therapy comprises an eclectic mix of psychotherapeutic, educational, vocational, and recreational measures in a milieu-therapeutic setting to reduce recidivism of high-risk violent and sexual offenders. This study examined the effectiveness of social-therapeutic treatment on post-release recidivism among juvenile offenders. The sample included male offenders (n = 111) of the juvenile detention center in Berlin, Germany, aged 14-22 years, who were convicted of a violent (94%) or sexual offense (6%). Seventy-three subjects admitted to the social-therapeutic unit were compared to an offense-parallelized control group (n = 38) from the regular units using a propensity score based matching procedure. Initially, the groups did not differ with respect to risk (i.e., Level of Service Inventory - Revised) or risk-related characteristics (e.g., age). Subsequent Cox regression analyses revealed no average treatment effect on recidivism. Since the results indicated that the control group was not untreated, differential treatment effects were examined in a second step. School and vocational trainings had an effect on recidivism. The findings are discussed in light of the challenges in evaluating legally mandated offender treatment.

When sexual offender treatment in prison-based social-therapeutic treatment is not completed: Relationship to risk factors and recidivism after release

BACKGROUND

Various studies have demonstrated that people who do not complete sex offender treatment have higher recidivism rates than completers or untreated controls. The mechanism behind this association, however, remains unclear. One explanation is that responsivity issues are more prevalent in high-risk offenders, making treatment failure and recidivism more likely, especially if treatment intensity is insufficient to match criminal needs. In addition, dropout may have a negative effect on offenders by increasing feelings of frustration or self-doubt.

AIMS

To retest for a link between treatment discontinuation and recidivism by sex offenders and analyse the mechanisms mediating the link between treatment discontinuation and their recidivism. We hypothesise that non-completion has a negative effect on recidivism after controlling for a priori differences in risk of recidivism.

METHODS

We analysed data from all sex offenders released from Bavarian prisons between 2004 and 2015 who had participated in prison-based social-therapeutic treatment and compared non-completers (n = 100) to offenders ending treatment as planned (n = 428). Criminal risk, offence characteristics, and treatment-related propensities were measured by a comprehensive assessment instrument, including the Static-99. Recidivism data were obtained from Federal Official Records with an average time-at-risk of 9.43 years (SD = 3.29).

RESULTS

Treatment non-completion was significantly associated with recidivism after controlling for criminal risk, offence characteristics and treatment duration. This was mainly accounted for by men who had spent at least two years in treatment before premature termination and return to an ordinary prison setting.

CONCLUSIONS

Our findings aid understanding the potentially negative impact of discontinuing social-therapeutic treatment for male sex offenders; termination after substantial commitment may be particularly problematic. Future research should encompass large enough sample sizes to study details behind staff or prisoner decisions to return the prisoner to ordinary prison conditions and to mitigate harms by loss of privileges.

Predicting Attrition and Engagement in the Treatment of Young Offenders

Premature treatment termination in offender treatment is linked to negative consequences for clients, practitioners, and the criminal justice system. Therefore, identifying predictors of treatment attrition is a crucial issue in offender rehabilitation. Most studies on this topic focus on adult offenders; less is known about adolescent offenders. In our study, therapy attrition and engagement were predicted via logistic and linear regression to examine the link between pretreatment variables, engagement, and treatment failure in 161 young offenders treated in a social-therapeutic unit in Germany. Engagement could be predicted by motivation, disruptive childhood behavior, low aggressiveness, and higher age. In turn, low motivation, substance abuse, and young age predicted attrition, but their impact diminished when engagement was added to the model with only substance abuse remaining significant. The effect of substance abuse on attrition disappeared, when the offender's initial motivation was high. Implications for assessment and treatment planning are discussed.

Well-Being as a Precursor and Consequence of Micro-Processes in a Group Psychotherapy With Forensic Patients

Psychotherapy is an important approach for the treatment of psychiatric disorders. Apart from treating disorders as such, psychotherapy aims at increasing patients' well-being. The Therapeutic Cycles Model (TCM) is a process-oriented theoretical model that makes predictions about the psychotherapeutic progress based on verbatim content. The model helps to identify therapeutic factors on a language level. The present study aims at analyzing transcripts of group therapy sessions with forensic psychiatric patients using the rationale of the TCM. Furthermore, the relationship between linguistic features of psychotherapy sessions and patients' well-being before and after therapy are investigated. In order to identify therapeutic factors, a group psychotherapy with nine drug addicted forensic psychiatric patients was videotaped and transcripts of N = 16 sessions were analyzed. Process-oriented measures were rated by the patients, their therapists, and an external observer. Patients' self-reported well-being before therapy was negatively related to Connecting (indicating emotional insight), and the frequency of therapeutic cycles, which are both thought of as key moments in therapy. Well-being of forensic patients is not necessarily a helpful precursor for insightful and productive events in therapy to occur. The findings help to better understand psychotherapeutic micro-processes throughout forensic therapies, and their relationship with patients' well-being. Implications for research and the forensic practice are discussed.

Targeting Misconduct in Prison by Modifying Occupational Factors in Correctional Facilities

Misconduct in prison is a phenomenon, which by its nature is hard to observe. Little is known about its origins and its modifiability. This study presents data on the level of misconduct in prison perceived by staff members and examines its impact on occupational factors. Data from officers, which also included i.e. team climate, job satisfaction, self-efficacy, and sick days, was collected at three different correctional units in Berlin, Germany (N = 60). The study reveals higher rates of perceived misconduct in prison on regular units as compared to treatment units within the observed facilities. In addition, regression analysis provides evidence for an association of rates of misconduct in prison, sick days, and low self-efficacy. Results are discussed in terms of providing a model that supports the idea of a network entailing occupational factors and misconduct in prison and which can be utilized to target misconduct in prison with suitable interventions.

Let's Work Together - Occupational Factors and Their Correlates to Prison Climate and Inmates' Attitudes Towards Treatment

The role of psychosocial and structural occupational factors in mental health service provision has broadly been researched. However, less is known about the influence of employees' occupational factors on inmates in correctional treatment settings that mostly seek to apply a milieu-therapeutic approach. Therefore, the present study investigated the relationships between occupational factors (job satisfaction, self-efficacy, and the functionality of the organizational structure) and prison climate, the number of staff members' sick days as well as inmates' treatment motivation. Employees (n = 76) of three different correctional treatment units in Berlin, Germany, rated several occupational factors as well as prison climate. At the same time, treatment motivation of n = 232 inmates was assessed. Results showed that higher ratings of prison climate were associated with higher levels of team climate, job satisfaction and the functionality of the organizational structure, but not with self-efficacy and sick days. There was no significant relationship between occupational factors and the perceived safety on the treatment unit. Inmates' treatment motivation was correlated with all aggregated occupational factors and with average sick days of staff members. Outcomes of this study strongly emphasize the importance of a positive social climate in correctional treatment units for occupational factors of prison staff but also positive treatment outcomes for inmates. Also, in the light of these results, consequences for daily work routine and organizational structure of prisons are discussed.

Therapists' and Patients' Perspectives on Therapeutic Dynamics Leading to Therapy Failure in Forensic Addiction Treatment

Background: Among drug- or alcohol-addicted offenders under forensic treatment, therapy failure is a potent predictor of substance-related re-delinquency. Given this evidence, high drop-out rates pose a major problem in forensic addiction treatment in Germany. Legal preconditions for a premature discharge due to therapy failure are defined, and behavioral correlates are well described, but the precedent dynamics between patients and therapists have rarely been analyzed. The present study intended to shed light upon the subjective perception of the treatment course prior to therapy failure. Methods: Applying parallel questionnaires and structured interviews, patients' and therapists' perspectives on perceived reasons for therapy failure were retrospectively investigated and compared to each other on a dyadic level. Following this predominantly qualitative and explorative approach, the examination of 32 dyads could be realized; 13 patients with regular (i.e., successful) therapy termination served as controls. All patients had been treated within two specialized forensic addiction hospitals in the German federal state of Baden-Württemberg and were assessed shortly before discharge took place. Results: As expected, patients' and therapists' perspectives differed largely on perceived reasons for failure. In most cases, they appeared to have very different views on what happened during treatment and why therapy eventually failed. Patients mentioned psychological tension and aggressiveness, frequent quarrels with fellow patients, and a bad therapeutic environment as most important reasons for therapy failure. Therapists highlighted patients' unwillingness to make an effort or to change behavior. The analysis of patients' narratives regarding how to explain the negative treatment course confirmed pre-assumptions on predominantly negative feelings and attitudes towards the clinic. The precedent dynamics of therapy failure were shown to be highly individual. However, despite varying notably, a cluster analysis revealed that they seemed to follow "typical patterns" that could partially be linked to patients' characteristics. Conclusions: A better understanding of treatment dynamics during forensic addiction therapy is a prerequisite for the avoidance of therapy failure with negative effects on re-delinquency. It seems that the incapacity to establish a common frame of reference for assessing the therapy process could be one of the major reasons why treatment dynamics take on a life of their own towards a disruption of the therapeutic relationship, leading to therapy failure. The knowledge of "typical" risk patterns towards therapy failure could facilitate early therapeutic measures.

A Call for Research on Sex Offender Treatment Programs

The effects of sex offender treatment programs have been addressed in the literature, but there are opportunities to expand research and potentially improve existing sex offender treatment programs. The Federal Bureau of Prison's Sex Offender Treatment Program gives offenders the opportunity to change their behavior by reducing criminality and recidivism, and receive transition services as offenders exit the prison system and reenter society. This program is evidence-based and utilizes landmark research in sex offender treatment, however there are a few details that may present limitations to the effectiveness of the treatment program within the Federal Bureau of Prisons. Entry requirements, such as literacy, cognitive, and remaining sentence requirements, as well as the treatment program environment, present opportunities for research to evaluate the effects of these variables on the convicted sex offender population.

Prison Climate and Its Role in Reducing Dynamic Risk Factors During Offender Treatment

Although several offender treatment experts have suggested that therapeutic relationships play an important role in offender treatment, empirical finding supporting those arguments are scarce. The present study has therefore examined the relationship between prison climate, treatment motivation, and their influence on changes in risk factors in N = 215 inmates and detainees in four correctional facilities in Berlin, Germany. The inmates' perception of prison climate significantly correlated with their attitudes towards treatment. More positive climate in terms of therapeutic hold and more positive treatment attitude in terms of trust in therapy were also the best predictors of stronger decreases in dynamic risk factors measured by the Level of Service Inventory-Revised (LSI-R). Our results support the importance of treatment relationship factors within the course of offender rehabilitation.

The RESTORE program of restorative justice for sex crimes: vision, process, and outcomes

The article reports empirical evaluation of RESTORE, a restorative justice (RJ) conferencing program adapted to prosecutor-referred adult misdemeanor and felony sexual assaults. RESTORE conferences included voluntary enrollment, preparation, and a face-to-face meeting where primary and secondary victims voice impacts, and responsible persons acknowledge their acts and together develop a re-dress plan that is supervised for 1 year. Process data included referral and consent rates, participant characteristics, observational ratings of conferences compared with program design, services delivered, and safety monitoring. Outcome evaluation used 22 cases to assess (a) pre-post reasons for choosing RESTORE, (b) preparation and conference experiences, (c) overall program and justice satisfaction, and (d) completion rates. This is the first peer-reviewed quantitative evaluation of RJ conferencing for adult sexual assault. Although the data have limitations, the results support cautious optimism regarding feasibility, safety, and satisfactory outcomes. They help envision how conferencing could expand and individualize justice options for sexual assault.

A multi-site, randomized study of strengths-based case management with substance-abusing parolees

OBJECTIVES: To test whether strengths-based case management provided during an inmate's transition from incarceration to the community increases participation in community substance abuse treatment, enhances access to needed social services, and improves drug use, crime, and HIV risk outcomes. METHODS: In a multi-site trial, inmates (men and women) in four states (n = 812) were randomly assigned (within site) to receive either Transitional Case Management (TCM group), based on strengths-based principles, or standard parole services (SR group). Data were collected at baseline and at 3 and 9 months following release from prison. Analyses compared the two groups with respect to services received and to drug use, crime, and HIV risk behavior outcomes. RESULTS: There were no significant differences between parolees in the TCM group and the SR group on outcomes related to participation in drug abuse treatment, receipt of social services, or drug use, crime, and HIV risk behaviors. For specific services (e.g., residential treatment, mental health), although significant differences were found for length of participation or for number of visits, the number of participants in these services was small and the direction of effect was not consistent. CONCLUSION: In contrast to positive findings in earlier studies of strengths-based case management with mental-health and drug-abuse clients, this study found that case management did not improve treatment participation or behavioral outcomes for parolees with drug problems. The discussion includes possible reasons for the findings and suggestions for modifications to the intervention that could be addressed in future research.

A Critical New Pathway Towards Change in Abusive Relationships: The Theory of Transition Framework

This article explores the use of "Transition Framework" as a conceptual framework for individual and social change. William Bridges introduced Transition Framework in the 1970s as a three-pronged model explaining how people respond to change in their lives. This article argues that such an approach has the potential to help clients recognize and grieve the loss of their old identities, become comfortable with new ways of communicating, understand their cycles of relapse and make positive changes. The relevance of this model to transformative change in domestic violence treatment is explored.

Adherence to Scheduled Sessions in a Randomized Field Trial of Case Management: The Criminal Justice-Drug Abuse Treatment Studies Transitional Case Management Study

The Transitional Case Management (TCM) study, one of the projects of the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative, was a multi-site randomized test of whether a strengths-based case management intervention provided during an inmate's transition from incarceration to the community increases participation in community substance abuse treatment, enhances access to needed social services, and improves drug use and crime outcomes. As in many intervention studies, TCM experienced a relatively large percentage of treatment-group participants who attended few or no scheduled sessions. The paper discusses issues with regard to participation in community case management sessions, examines patterns of session attendance among TCM participants, and analyzes client and case manager characteristics that are associated with number of sessions attended and with patterns of attendance. The average number of sessions (out of 12) attended was 5.7. Few client or case manager characteristics were found to be significantly related to session attendance. Clinical and research implications of the findings and of adherence in case management generally are discussed.

Filling service gaps: Providing intensive treatment services for offenders

Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders.