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      Psychological treatment and therapeutic change in incarcerated rapists Translated title: Tratamiento psicológico y cambio terapéutico en agresores sexuales encarcelados

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          Abstract

          Abstract Most Spanish prisons provide specialised treatment for incarcerated sex offenders, both rapists and child molesters. This treatment is a cognitive-behavioural intervention that has shown relative effectiveness in previous research. With regard to offenders’ rehabilitation, recidivism assessments are necessary as a final measure of treatment effectiveness. However, the evaluation of recidivism by itself does not provide sufficient information on the treatment process and the specific effects that treated subjects could undergo. This paper aims to analyse the therapeutic effectiveness of psychological treatment provided to rapists (in general, males sentenced for committing a sexual offence against women). To this aim, a group of treated rapists (N = 153) serving a sentence in prison was analysed. Using a specially designed scale (PASSO), the global therapeutic change and ten specific variables (including assertiveness, readiness to change, cognitive distortions, impulsivity, etc.) were assessed. The within-subjects comparison showed that treated sex offenders improved, in therapeutic terms, globally as well as in most of the specific variables assessed (improvements not experimented by the control group). Also, different therapeutic subscales showed relevant associations between them. The findings regarding treatment effectiveness are discussed.

          Translated abstract

          Resumen La mayoría de los centros penitenciarios españoles ofrecen un programa de tratamiento psicológico especializado para agresores sexuales, tanto para violadores como para abusadores de menores. Se trata de un programa de orientación cognitivo-conductual, que en algunas evaluaciones ya realizadas ha evidenciado una eficacia terapéutica relativa en términos de reducción de las tasas de reincidencia. Aunque la evaluación de la reincidencia delictiva sea una medida necesaria para ponderar la eficacia final del tratamiento de los agresores sexuales, dicha medida no permite conocer con precisión las mejoras específicas que los sujetos pueden experimentar. Este artículo dirige su atención precisamente a evaluar con detalle la eficacia terapéutica del tratamiento de los agresores sexuales de mujeres adultas. Con esta finalidad, se analiza una muestra de agresores sexuales tratados (N = 153) que cumplen condena en prisión por un delito contra una mujer adulta. Para ello se evalúa mediante una escala diseñada al efecto (EPAS) el cambio terapéutico global de los sujetos tras el tratamiento y también su evolución en diez variables terapéuticas específicas (como asertividad, disposición al cambio personal, distorsiones cognitivas, etc.). La comparación intra-sujetos indicó que los agresores tratados mejoran, en términos terapéuticos, tanto globalmente como en la mayoría de las variables específicas evaluadas (mejoras que no se produjeron en el grupo control). Así mismo, se encontraron asociaciones significativas relevantes entre diversas variables terapéuticas. Finalmente, se comentan críticamente los resultados obtenidos y algunos de los retos existentes en el campo de la evaluación del tratamiento psicológico de los agresores sexuales.

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          Assessing risk for sexual recidivism: some proposals on the nature of psychologically meaningful risk factors.

          Risk assessment and treatment for sexual offenders should focus on individual characteristics associated with recidivism risk. Although it is possible to conduct risk assessments based purely on empirical correlates, the most useful evaluations also explain the source of the risk. In this review, the authors propose that the basic requirements for a psychologically meaningful risk factor are (a) a plausible rationale that the factor is a cause of sexual offending and (b) strong evidence that it predicts sexual recidivism. Based on the second of these criteria, the authors categorize potential risk factors according to the strength of the evidence for their relationship with offending. The most strongly supported variables should be emphasized in both assessment and treatment of sexual offenders. Further research is required, however, to establish causal connections between these variables and recidivism and to examine the extent to which changes in these factors leads to reductions in recidivism potential.
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            Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand.

            Childhood sexual abuse (CSA) has been associated with many adverse medical, psychological, behavioral and socioeconomic outcomes in adulthood. This study aims to examine the linkages between CSA and a wide range of developmental outcomes over a protracted time period to age 30. Data from over 900 members of the New Zealand birth cohort the Christchurch Health and Development Study were examined. CSA prior to age 16 was assessed at ages 18 and 21 years, in addition to: mental health, psychological wellbeing, sexual risk-taking behaviors, physical health and socioeconomic outcomes to age 30. After statistical adjustment for confounding by 10 covariates spanning socio-demographic, family functioning and child factors, extent of exposure to CSA was associated with increased rates of (B, SE, p): major depression (0.426, 0.094, <.001); anxiety disorder (0.364, 0.089, <.001); suicidal ideation (0.395, 0.089, <.001); suicide attempt (1.863, 0.403, <.001); alcohol dependence (0.374, 0.118, <.002); and illicit drug dependence (0.425, 0.113, <.001). In addition, at age 30 CSA was associated with higher rates of PTSD symptoms (0.120, 0.051, .017); decreased self-esteem (-0.371, 0.181, .041); and decreased life satisfaction (-0.510, 0.189, .007). Childhood sexual abuse was also associated with decreased age of onset of sexual activity (-0.381, 0.091, <.001), increased number of sexual partners (0.175, 0.035, <.001); increased medical contacts for physical health problems (0.105, 0.023, <.001); and welfare dependence (0.310, 0.099, .002). Effect sizes (Cohen's d) for the significant outcomes from all domains ranged from .14 to .53, while the attributable risks for the mental health outcomes ranged from 5.7% to 16.6%. CSA is a traumatic childhood life event in which the negative consequences increase with increasing severity of abuse. CSA adversely influences a number of adult developmental outcomes that span: mental disorders, psychological wellbeing, sexual risk-taking, physical health and socioeconomic wellbeing. While the individual effect sizes for CSA typically range from small to moderate, it is clear that accumulative adverse effects on adult developmental outcomes are substantial. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              First report of the collaborative outcome data project on the effectiveness of psychological treatment for sex offenders.

              This meta-analytic review examined the effectiveness of psychological treatment for sex offenders by summarizing data from 43 studies (combined n = 9,454). Averaged across all studies, the sexual offence recidivism rate was lower for the treatment groups (12.3%) than the comparison groups (16.8%, 38 studies, unweighted average). A similar pattern was found for general recidivism, although the overall rates were predictably higher (treatment 27.9%, comparison 39.2%, 30 studies). Current treatments (cognitive-behavioral, k = 13; systemic, k = 2) were associated with reductions in both sexual recidivism (from 17.4 to 9.9%) and general recidivism (from 51 to 32%). Older forms of treatment (operating prior to 1980) appeared to have little effect. Future directions for improving the quality of sex offender treatment outcome evaluations are discussed.
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                Author and article information

                Journal
                ejpalc
                The European Journal of Psychology Applied to Legal Context
                The European Journal of Psychology Applied to Legal Context
                Sociedad Española de Psicología Jurídica y Forense; Colegio Oficial de la Psicología de Madrid (Madrid, Madrid, Spain )
                1889-1861
                1989-4007
                June 2017
                : 9
                : 1
                : 41-49
                Affiliations
                [1] Cataluña orgnameUniversitat de Barcelona Spain
                Article
                S1889-18612017000100041 S1889-1861(17)00900100041
                10.1016/j.ejpal.2016.11.001
                15d3720c-9883-4821-834b-43dff7300e1f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 28 July 2016
                : 29 November 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 87, Pages: 9
                Product

                SciELO Spain

                Categories
                Articles

                Sex offenders,Treatment effectiveness,Therapeutic change,Psychological treatment,Eficacia del tratamiento,Cambio terapéutico,Tratamiento psicológico,Agresores sexuales

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