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.
Andrews, D.A., & Bonta, J.S. ( 1998). The psychology of criminal conduct (2nd ed.). Cincinnati, OH: Anderson.
2.
Andrews, D.A., & Bonta, J.S. (2003). The psychology of criminal conduct (3rd ed.). Cincinnati, OH: Anderson.
3.
Association for the Treatment of Sexual Abusers. (ATSA). (2004). Practice guidelines for members of the Association for the Treatment of Sexual Abusers. Beaverton, OR: Author.
4.
Barrett, M., Wilson, R.J., & Long, C. (2003). Measuring motivation to change in sexual offenders from institutional intake to community treatment. Sexual Abuse: A Journal of Research and Treatment, 15,269-283.
5.
Beech, A., Fisher, D., & Thornton, D. (2003). Risk assessment of sex offenders. Professional Psychology: Research and Practice, 34, 339-352.
6.
Beech, A., Friendship, C., Erikson, M., & Hanson, R.K. (2002). The relationship between static and dynamic risk factors and reconviction in a sample of U. K. child abusers. Sexual Abuse: A Journal of Research and Treatment, 14, 155-167.
7.
Berliner, L. (2002). Commentary. Sexual Abuse: A Journal of Research and Treatrrtertt,14, 195-197.
8.
Bickley, J.A., & Beech, A.R. (2003). Implications for treatment of sexual offenders of the Ward and Hudson model of relapse. Sexual Abuse: A Journal of Research and Treatment, 15, 121-143.
9.
Borduin, C.M., Schaeffer, C.M., & Heilblum, N. (2000, May). Multi-systemic treatment of juvenile sexual offenders: A progress report. Paper presented at the 6th International Conference on the Treatment of Sexual Offenders, Toronto, ON.
10.
California Coalition on Sexual Offending. ( 2001). Effective management of sex offenders residing in open communities. Retrieved on June 1, 2004 from http://www.ccoso.org/papers/containment.html.
11.
California Laws. (1981). Chapter 928, codified as California Penal Code, Sections 1364 and 1365.
12.
California Laws. ( 1982). Chapters 1529 and 1549, amending California Penal Code, Sections 1364 and 1365.
13.
Center for Sex Offender Management. (2000). The collaborative approach to sex offender management. Retrieved on June 1, 2004 from http://www.csom.org/pubs/collaboration.pdf .
14.
Colorado Sex Offender Management Board. (1999 ). Standards and guidelines for the assessment, evaluation, treatment and behavioral monitoring of adult sex offenders. Denver: Colorado Department of Public Safety.
15.
Craig, L.A., Browne, K.D., & Stringer, I. (2003). Treatment and sexual offence recidivism. Trauma, Violence, and Abuse, 4, 70-89.
16.
English, K. (1998). The containment approach: An aggressive strategy for the community management of adult sex offenders. Psychology, Public Policy and Law, 4, 218-235.
17.
Furby, L., Weinrott, M.R., & Blackshaw, L. (1989). Sex offender recidivism: A review. Psychological Bulletin, 105, 3-30.
18.
Gallagher, C.A., Wilson, D.B., Hirschfield, P., Coggeshall, M.B., & MacKenzie, D.L. (1999). A quantitative review of the effects of sex offender treatment on sexual reoffending. Corrections Management Quarterly, 3, 19-29.
19.
Gendreau, P., & Andrews, D.A. (1990). Tertiary prevention: What the meta-analyses of the offender treatment literature tell us about "what works." Canadian Journal of Criminology, 32, 173-184.
20.
Grossman, L.S., Martis, B., & Fichtner, C.G. (1999). Are sex offenders treatable? A research overview. Psychiatric Services, 50, 349-36 1.
21.
Grubin, D. (1998). Sex offending against children: Understanding the risk. Police Research Series Paper 99. London: Home Office.
22.
Hanson, R.K. (1997a). The development of a brief actuarial risk scale for sexual offense recidivism. (User Report 97-04). Ottawa : Department of the Solicitor General of Canada. Retrieved on June 1, 2004 from http://www.psepc-sppcc.gc.ca/publications/corrections/199704_e.pdf .
23.
Hanson, R.K. (1997b). How to know what works with sexual offenders . Sexual Abuse: A Journal of Research and Treatment, 9, 129-145.
24.
Hanson, R.K. (2000). Treatment outcome and evaluation problems (and solutions). In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp 485-499). Thousand Oaks, CA: Sage.
25.
Hanson, R.K., Gordon, A., Harris, A.J.R., Marques, J.K., Murphy, W., Quinsey, V.L., et al. (2002). First report of the Collaborative Outcome Data Project on the effectiveness of treatment for sex offenders. Sexual Abuse: A Journal of Research and Treatment, 14, 169- 194.
26.
Hanson, R.K., & Harris, A.J.R. (2000). Where should we intervene? Dynamic predictors of sexual offense recidivism. Criminal Justice and Behavior, 27, 6-35.
27.
Hanson, R.K., & Thornton, D. (2000). Improving risk assessment for sexual offenders: A comparison of three actuarial scales. Law and Human Behaviour , 24, 119-136.
28.
Hollin, C.R. (2002). An overview of offender rehabilitation: Something old, something borrowed, something new. Australian Psychologist , 37, 159-164.
29.
Huot, S. (2002, October). Recidivism, recidivism, recidivism! An update of several Minnesota recidivism studies. Paper presented at the 2lst annual meeting of the Association for the Treatment of Sexual Abusers, Montreal, QC.
30.
Langton, C.M., Barbaree, H.E., Seto, M.C., Harkins, L., & Peacock, E. (2002, October). How should we interpret behavior in treatment?Paper presented at the 21 st annual meeting of the Association for the Treatment of Sexual Abusers, Montreal, QC.
31.
Looman, J., Abracen, J., & Nicholaichuk, T.P. (2000). Recidivism among treated sexual offenders and matched controls: Data from the Regional Treatment Centre (Ontario). Journal of Interpersonal Violence, 15, 279-290.
32.
L6sel, F. (1995). The efficacy of correctional treatment: A review and synthesis of meta-evaluations. In J. McGuire (Ed.), What works: Reducing re-offending: Guidelines from research and practice. Chichester, UK: Wiley.
33.
Mann, R.E. (2000). Managing resistance and rebellion in relapse prevention intervention. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp. 187-200). Thousand Oaks, CA: Sage.
34.
Mann, R.E., & Thornton, D. (2000). An evidence-based relapse prevention program. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp. 341-350). Thousand Oaks, CA: Sage.
35.
Marlatt, G.A. (1980). Relapse prevention: A self control program for the treatment of addictive behaviors. Unpublished manuscript, University of Washington, Department of Psychology , Seattle, WA.
36.
Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention. New York: Guilford.
37.
Marques, J.K. (1982, March). Relapse prevention: A self-control model for the treatment of sex offenders. Paper presented at the annual meeting of the Forensic Mental Health Association of California , Asilomar, CA.
38.
Marques, J.K. (1984). An innovative treatment program for sex offenders: Report to the Legislature. Sacramento: CaliforniaDepartment of Mental Health.
39.
Marques, J.K. (1999). How to answer the question, "Does sex offender treatment work?" Journal of Interpersonal Violence, 14, 427-441.
40.
Marques, J.K., Day, D.M., Nelson, C., Miner, M.H., & West, M.A. (1991). The Sex Offender Treatment and Evaluation Project: Fourth report to the Legislature in response to PC 1365. Sacramento: California Department of Mental Health .
41.
Marques, J.K., Day, D.M., Nelson, C., & West, M.A. (1994). Effects of cognitive-behavioral treatment on sex offender recidivism: Preliminary results of a longitudinal study. Criminal Justice and Behavior, 21, 28-54.
42.
Marques, J.K., Nelson, C., Alarcon, J.M., & Day, D.M. (2000). Preventing relapse in sex offenders: What we learned from SOTEP's experimental program. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp. 321-340). Thousand Oaks, CA: Sage.
43.
Marques, J.K., Nelson, C., West, M.A., & Day, D.M. ( 1994). The relationship between treatment goals and recidivism among child molesters. Behaviour Research and Therapy , 32, 577-588.
44.
Marshall, W.L., & Anderson, D. (2000). Do relapse prevention components enhance treatment effectiveness ? In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp. 39-55). Thousand Oaks, CA: Sage.
45.
McGrath, R.J., Cumming, G.C., Livingston, J.A., & Hoke, S.E. (2003). Outcome of a treatment program for adult sex offenders: From prison to community. Journal of Interpersonal Violence , 18, 3-17.
46.
McGuire, J. (Ed.). (2002). Offender rehabilitation and treatment: Effective practice and policies to reduce re-offending. Chichester, UK: Wiley.
47.
Miller, W. R., & Rollnick, S. (Eds.) (1991). Motivational interviewing: Preparing people to change addictive behavior. New York : Guilford.
48.
Miner, M.H., Day, D.M., & Nafpaktitis, M.K. ( 1989). Assessment of coping skills: Development of a situational competency test. In D. R. Laws (Ed.), Relapse prevention with sex offenders (pp. 127-136). New York: Guilford .
49.
Nicholaichuk, T. (1996). Sex offender treatment priority: An illustration of the risk/need principle. Forum on Corrections Research , 8(2), 30-32.
50.
Nicholaichuk, T., Gordon, A., Gu, D., & Wong, S. (2000). Outcome of an institutional sexual offender treatment program: A comparison between treated and matched untreated offenders. Sexual Abuse: A Journal of Research and Treatment, 12, 139-153.
51.
Nichols, H.R., & Molinder, I. (1984). The Multiphasic Sex Inventory: A test to assess psychosexual characteristics of the sexual offender. Tacoma, WA: Nichols & Molinder.
52.
Prentky, R.A. (2003). A 15-year retrospective on sexual coercion: Advances and projections. In R. A. Prentky, E. S. Janus, & M. C. Seto (Eds.), Sexually coercive behavior: Understanding and management (pp. 13-32). New York: Annals of the New York Academy of Sciences.
53.
Rice, M.E., & Harris, G.T. (2003). The size and sign of treatment effects in sex offender therapy. In R. A. Prentky, E. S. Janus, & M. C. Seto (Eds.), Sexually coercive behavior: Understanding and management (pp. 428-440). New York: Annals of the New York Academy of Sciences.
54.
SAS Institute. (1999 ). SAS user's guide, version 8. Cary, NC : SAS Institute, Inc.
55.
Seto, M.C. (October, 2002). Interpreting the treatment performance of sex offenders. Paper presented at the 27th Annual Cropwood Round Table Conference, Cambridge, UK.
56.
Thornton, D. (2001). Civil commitment of dangerous, personality-disordered offenders—Developing a model. In A. Schlank (Ed.), The sexual predator: Legal issues, clinical issues, special populations (pp. 6.1-6.12). Kingston, NJ: Civic Research Institute .
57.
Thornton, D. (2002). Constructing and testing a framework for dynamic risk assessment. Sexual Abuse: A Journal of Research and Treatment , 14. 139-154.
58.
Ward, T., & Hudson, S.M. (1998). A model of the relapse process in sexual offenders . Journal of Interpersonal Violence, 13, 700-725.
59.
Ward, T., & Hudson, S.M. (2000). Self-regulation model of relapse prevention. In D. R. Laws, S. M. Hudson & T. Ward (Eds.), Remaking relapse prevention with sex offenders: A sourcebook (pp. 39-55). Thousand Oaks, CA: Sage.
60.
Zgoba, K.M., Sager, W.R., & Witt, P.H. (2003). Evaluation of New Jersey's sex offender treatment program at the Adult Diagnostic and Treatment Center: Preliminary results . Journal of Psychiatry and Law, 31, 133-164.
