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In most jurisdictions in the United States, a person convicted of a sex crime is mandated to treatment. This treatment tends to be group therapy with the primary modality being Cognitive Behavior Therapy, also known as CBT. As a community of treatment provider0,s we are always striving to improve our practices, use evidenced based treatment modalities and use the interventions best suited to our clients to help decrease their risk of recidivism. So the question of whether or not what we are doing is helpful or harmful comes up, we need to pay attention.
The keynote address Thursday morning at this year’s ATSA conference was by Dr. Teresa Gannon. She presented her recently published meta-analysis of the effectiveness of sexual offender treatment. This article was recently published in Clinical Psychology Review and is open access. The study looked at all types of violent offending but Dr. Gannon spoke this morning specifically about treatment for sexual offending.
There have been some studies that have been published that have provided a grim picture of treatment. Most specifically, Dr. Gannon points to a 2017 report from the UK Ministry of Justice that stated that people who had committed sexual crimes and had treatment had a 25% increase in their rates of recidivism. To those of us who do this work, that is a shocking number. No treatment provider wants to do more harm than good and none of us would ever knowingly do anything that would increase the risk of harm to anyone.
Enter Dr. Gannon and her colleagues. They embarked on a meta-analysis of 70 studies on offending behavior. Specifically they also looked at variables that could influence treatment outcomes. Their work asked three specific questions. 1). Does offense specific treatment influence recidivism risk? 2). Is a trained psychology professional needed? And 3). What program variables are important for success. Again, if you want to read the full journal, you can obtain it free from the journal Clinical Psychology Review.
The results of the meta-analysis were both encouraging and enlightening. The results indicated that over a 6 year follow up period, those individual who engaged in sex offender specific treatment reoffended at a rate of 9.5% and those individuals who did not attend sex offender specific treatment reoffended at a rate of 14.1%. This means that those who attended treatment were 32.6% less likely to reoffend than those individuals who did not attend treatment. This result is the encouraging part.
The next set of results elucidated what program variables were important for reductions in recidivism. The first important question involved the presence of a licensed psychology professional. Was there a licensed professional involved in provision of treatment? This was broken down into unclear/none meaning that a psychology professional was not directly involved with providing treatment or it was unclear. The other categories were inconsistent and consistent. The results indicated that treatment is more effective when a psychology professional is consistently hands on in the treatment process.
The last set of factors that were investigated involved actual variables in the treatment program. It was found that offenders who attended group only had better outcomes than those who attended group and individual therapy. Those programs where there was supervision by a licensed psychology professional had better outcomes. Programs that used arousal conditioning had lower recidivism rates and those programs that did not use the polygraph had better outcomes than those programs that did use polygraph testing.
This meta-analysis posits that when providing treatment for people who have sexually offended, we need to think about several key elements shown in this study to improve outcomes and reduce recidivism. The most effective treatment programs had the following characteristics: A licensed psychology professional with expertise in treating sexual offenders, who is hands on and consistent in the treatment. Inappropriate sexual interest is addressed. It is group based and supervision by a psychology professional is provided. The polygraph is not used in treatment.
On a side note, the study indicated that the countries with the best outcomes for treated offenders were Canada, New Zealand and Australia.
This is the most up to date meta-analysis of sexual offender treatment efficacy published. It is the first to provide some evidence for the efficacy of arousal conditioning. It also indicates that it is not just treatment that is effective but treatment provided by individuals with expertise in the field and offer supervision to treatment providers.
A recent posting about our intensive program for sexual offenders on a professional social network greatly upset a person on the network. This person felt that it was disgusting that we offer a treatment program that can aide sentence mitigation for people accused of sexual crimes, or to paraphrase, that we help sex offenders get lighter sentences for financial gain. This upset me greatly as I take our work with people who have committed sex crimes very seriously and consider it prevention of sexual abuse. As I consider part of my work as an expert to counter emotion with science, I thought to put my own emotions on the back burner and write something educational about sentence mitigation.
What is Sentence Mitigation?
When someone is being sentenced for a crime a judge is obligated to take into consideration all of the information about that person. It is the job of the prosecution to present evidence of all of the aggravating factors in the case. These are the things that help them make an argument for stronger and harsher sentences. Aggravating factors can include prior offenses, vulnerable victims, hate crimes, violence, etc.
It is the job of a defense attorney to present the facts about the person that would support a less harsh sentence. Any facts presented for sentence mitigation are not related to the guilt of the person, they have acknowledged what they have done (pled guilty). Mitigating factors can be those that were in place prior to the offending such as lack of criminal record, mental illness, addiction, physical illness, history of being abused. Other mitigating factors are those the occur after the offense has happened. These can be acceptance of responsibility, rehabilitation post offense (treatment), cooperation with law enforcement, addiction, mental illness, etc. Mitigating factors do NOT excuse a crime but help provide an explanation.
Therapy as a Sentence Mitigation Tool
Do defense attorneys suggest clients go to therapy so they have some fuel for sentence mitigation? In a word, Yes. Many of our clients are referred to us by their attorneys after they have had a visit from the police or the FBI. This happens basically no matter the type of offense. DUI? Get a drug and alcohol assessment. Domestic Violence charge? Do some classes. Assault charge? Complete an anger management program.
What most people might not know, but all of us in the treatment community do know, is that very few people self-refer for treatment relating to addictions of any kind or offending. In over 10 years of practice ownership, I can count on one hand the number of clients who came to treatment with no outside pressure because they felt like they had a problem. Many clients are pressured into treatment. This pressure may come from a partner, spouse, employer or the police. People don’t self-refer for many reasons, shame, fear, stigma and wait until they are caught in some way shape or form be that watching pornography at work, getting a DUI, getting caught in an affair, running up the credit cards with gambling debt, etc.
The act of going to therapy itself does not help the defense attorney make a mitigation argument. It is what happens in therapy that can help a defense attorney make a mitigation argument. If a client is referred by an attorney for treatment, the initial thought might be something like “ok this will look good to the judge.” Any good therapist will know whether or not a client is taking the therapy work seriously. If the client is just biding time, trying to look good for a judge, that is reflected in the treatment reports that go to the attorney. Trust me that bad treatment reports never make it to court. Same thing for evaluations that deem a client high risk to re-offend. They hardly ever see the light of day in a court room.
What gets a person in the door of a therapy office is not necessarily what keeps them there. The goal with pre-sentence treatment is to help the person move from the “oh shit I’m caught” stage into really deeply and truly looking at their actions and the motivations for the actions. Though it is popular to believe that people who commit sexual crimes are deviant monsters who deserve to die, most (not all) people who are committing these crimes know they have a problem, feel a good deal of remorse and want to do what they can to help themselves. Thus, an attorney referral to help with sentence mitigation can turn into a person who really wants to do a lot of work on themselves to get better and make sure they never offend again.
Sitting at the end of a day filled with many emotions, I reflect on the work I do. I am proud of the work that I and my staff do working with people who have committed sexual offenses. I realize that I work with a population of people that the world would rather forget about and many people think don’t deserve treatment. Though it would be great if more people self-referred, I ultimately don’t care if it is an attorney referral that gets them through the door. Those of us who work with sexual offenders are doing prevention work.
My final words are not mine but those of one of my wonderful colleagues: Everyone deserves treatment. Period. Full Stop.
First, here is my proviso and you will hear it a lot. I am NOT AN ATTORNEY. I am not writing this in any way as a form of legal advice. That’s not my role. My role is to help people advocate for themselves and find the criminal defense attorney that is the best fit for their needs.
If you have had a visit from some type of law enforcement and they told you that you are now under investigation, you need an attorney. Most people do not have a criminal defense attorney on speed dial so you, or a family member or loved one, are likely frantically trying to figure out several things. First, what attorney do you use and second, how the heck are you going to pay for it?
What do you need to look for in an attorney?
- You need an attorney who has experience with sex crimes. Many criminal defense attorneys spend their entire careers mostly working with DUI type cases. They don’t all work with sex crimes. If you are searching attorney websites, they should state on the site that they have defended sex crimes. If their website does not state this specifically, if you call, you need to ask whether or not they have experience with sex crimes. And by experience I don’t mean they have tried one or two cases. I mean that they have worked on many sex crime cases and know all about the laws and how to help mitigate your sentence.
- You need an attorney who has experience with sex crimes in your jurisdiction. This means a few things. First, they obviously need to have passed the bar and are approved to practice law in your state. Second, they need to have experience in the court where your case will be seen. What court your case will be in depends on who showed up at your door. If the FBI or Homeland Security is investigating you, you need a defense attorney who has experience trying sex crimes in the federal court system. The federal courts and county courts handle these cases differently. There are nuances in the Federal System that someone who has not seen cases in that venue will not know. If your case is a county case, you want an attorney who has worked on a number of cases in your county. Part of this process is the relationship that your attorney has with the prosecutor.
- You need an attorney with a strategy. When you are interviewing attorneys, you want to know what type of strategy they propose for your case. At this point, they will not be able to create an actual solid plan as they do not know the details and will not know until the discovery is provided by the prosecution. However, they should still have an idea of how to proceed and give you some things that you can do now to help with the case.
- You need an attorney with good reviews. Just like a doctor or a restaurant, there are sites that will help you find a lawyer and also will give you information on the lawyers rating. For example, you can go on avvo.com to find a criminal defense attorney and read client ratings. The website www.superlawyer.com can help you find a criminal defense attorney with a good track record and good ratings.
In the legal process, the decision about what attorney to use is so important. I cannot understate how critical it is to have an attorney with experience specific to cybersex crimes. Do not choose rashly or lightly. Take some time. Talk to the attorney. Do some research. Any attorney is going to be expensive. The price tag will likely be daunting. If you have any ability to find the money for an attorney, it is my suggestion that you go for it. If you cannot afford an attorney and have to use a public defender, your defense will not be nearly as customized, and you will have to do a lot of this work yourself.
The next article in our series will discuss the psychosexual evaluation.
Dr. Weeks is a forensic psychologist who specializes in the evaluation and treatment of cybersex offenders. Her treatment program provides counseling both pre-trial and after adjudication and she provides expert witness testimony.