Sex and Drugs

Sex Offending Types of Sex Offender? – Not homogenous group Why this matters – Causes of offending – Effectiveness of interventions

Sex Offender Assessment Standard Corrections Assessments – Risk/Need – Limitations? Sex-offender specific – Phallemetric Marshall  less structured interview (PCL)

Theories of Sex Offending Is a general theory desirable/possible? – Rape – Child Molestation – Exposing/peeping, etc. General Risk factors – Objectification/sexualization of women/children – Lack of prosocial role models – Lack of interpersonal skills

Empirically, what is known? Social Skill deficits Criminal thinking errors Depression/anxiety (?)

Interventions Pre-1960s = psychodynamic 1960s-1970s = radical behavioral 1980s = extend to social skills 1980s/90s = cognitive behavioral 1990s-now = add relapse prevention

Meta-analysis of sex offending treatment Overall mean effect of.14 Radical behavioral only = -.14 Cognitive behavioral and hormonal were best bets .20 and beyond – Treatment effect larger with longer follow ups – Sex offenders may be at risk for 20+ years

Treating Substance Abuse in Offender Populations

Theory Why is “theory” important? Theory and Substance Abuse – Social learning theory – Biology/genetics – Low self-control – General Strain Theory – Self-esteem/other issues? Is Substance Abuse a “Disease” or a “Behavioral Problem”

Assessment How is “abuse” or “use” assessed in a correctional environment? – Dependence (physiological, psychological) – Abuse (extent to which it creates problems) LSI – Law violations, marital/family problems, school/work, medical problems, other Why is assessment important? How are assessment scores used?

Models for Rx Psychodynamic Radical Behavioral – Aversion (Covert Sensitization) – Operant conditioning (tokens, contracting, etc.) Cognitive Behavioral – Cognitive restructuring – Cognitive skills Therapeutic Communities Family Therapies (“Intervention”)

Relapse Prevention Another “skill” acquired via social learning – Identify all of the problems substance use causes – Identify high risk situations – Identify coping strategies for each situation Succeeding in high risk situations builds self-efficacy Be careful of “Abstinence Violation Effect” – Lapse snowballs into total loss

Self-Help/Support Groups AA/NA, etc. – History – The “12 step model” Spiritual, physical, mental disease Admit a problem and acknowledge all the areas in your life you have affected, make amends, help others with disease… – Turn life over to “god” or similar being… – What does research tell us about these groups? – AA and the PEI Points of agreement Points of disagreement

Pharmalogical Approaches Harm reduction models – Like the Green Bay Packers’ offense, “You cannot stop it, you can only hope to contain it.” Benefits of controlled use? – Methadone Newest use is for methamphetamine users – Other examples Needle exchanges “Safe use” educational programs

Responsivity Issues General responsivity Specific responsivity – Race – Gender – “Readiness” Stage of change idea Unique causes/consequences of problems – Use for….enjoyment, stress relief, – Problems = marital, employment…

Effectiveness What counts as failure (recidivism)? Meta-analysis results – Most successful were… Cognitive/behavioral (skills, contracting, relapse prevention…) – Least successful were EDUCATIONAL APPROACHS LIKE D.A.R.E. – Dare to say no to D.A.R.E.