Sex Offender Evaluation AOIC DVD - Evaluations 2005 Sex Offender Evaluation Donya L. Adkerson, MA, LCPC Alternatives Counseling, Inc. Donya L. Adkerson, MA, LCPC

What an Evaluation can do: Clarify recidivism risk level Identify problem areas and complications to the offending problem Identify treatment needs Identify supervision needs Lay groundwork for treatment

What an evaluation can NOT do Determine guilt or innocence regarding a specific crime Give a 100% complete picture of the person

Components of the Evaluation Review of History Collateral interviews Client interview Client testing Actuarial assessment Written report

Review of History Information Possible sources include Police records & interviews Child welfare investigations & interviews Prior mental health records Prior criminal history records Trial transcripts

Collateral Interviews Consider interviewing Spouse or partner Former spouse or partner Parents Usually NOT the victim

Client Interview Broad topics to cover include Family of Origin Education & employment Relationships and parenting Health, substance use, treatment history Sexual history Criminal history

Client Testing Physiological Clinical Self-report

Actuarial Assessment Assessment based on research statistical analysis of factors strongly correlated with recidivism risk. This type of assessment is currently only available for adult male sexual offenders. Continuing research is needed before such tools will be available for minors and for females.

Written report The product from the evaluation process. The report serves to document, educate and guide decisions regarding the client’s containment and treatment. It should be detailed and specific.

Relevant Standards for sexual offender assessment Association for the Treatment of Sexual Abusers (ATSA) Illinois Sex Offender Management Board (SOMB) SOMB Standards include ATSA Ethics Code by reference

Some relevant ATSA Ethics Guidelines “…there is no know psychological test, profile, evaluation procedure, of combination of such tools that prove or disprove whether an individual has committed a specific sexual act.” Follow all applicable reporting laws, including duty to warn or protect.

ATSA Evaluation Standards: AOIC DVD - Evaluations 2005 ATSA Evaluation Standards: Apply to work with Adult Male offenders; there may be variations from these standards in work with juveniles or females Donya L. Adkerson, MA, LCPC

Overview of ATSA Standards specific to Evaluations: AOIC DVD - Evaluations 2005 Overview of ATSA Standards specific to Evaluations: 2005 Edition (Note that Standards are revised regularly) Donya L. Adkerson, MA, LCPC

Strive for Objective, fair, and impartial evaluations Informed consent (or at least assent) Right to refuse Nature & purpose of eval Who gets the results Understand how legal status impacts eval Don’t overstate your information/findings

Obtain comprehensive information, including: AOIC DVD - Evaluations 2005 Obtain comprehensive information, including: Community support Criminal and other antisocial behavior, Access to potential victims, Developmental history and family background, Deviant sexual interests and arousal. Education and employment histories, Donya L. Adkerson, MA, LCPC

Gather information about AOIC DVD - Evaluations 2005 Gather information about History of aggression or violence, History of sexually abusive behavior, including details about victims, tactics used in the commission of the offense, and the circumstances in which the sexual abuse occurred, Level of cognitive functioning, Medical and mental health histories, Official and unreported history of sexual and nonsexual crimes, Donya L. Adkerson, MA, LCPC

Gather information about Peer and romantic relationship histories, Substance use/abuse Relevant personality traits such as, but not limited to suspiciousness, hostility, risk-taking, impulsivity, and psychopathy,

Gather information about AOIC DVD - Evaluations 2005 Gather information about Sexual history, including sexual fantasies, urges, and behavior, early sexual experiences; number and duration of sexual relationships; gender identity and sexual orientation; masturbation and intercourse frequency; sexual functioning; unusual sexual interests or behavior that are not sexually deviant Use of sexually arousing materials (e.g., magazines, videos, computer porn, internet sites, phone sex) Donya L. Adkerson, MA, LCPC

Use multiple sources of information, NOT client self report alone! AOIC DVD - Evaluations 2005 Use multiple sources of information, NOT client self report alone! Review of official documents, including criminal justice records, witness statements, previous assessment and treatment reports, medical records, and victim impact statements. Collateral interviews, as applicable (family members, romantic partner/spouse, employer, previous service providers, probation/parole officer), Donya L. Adkerson, MA, LCPC

Use multiple sources of information AOIC DVD - Evaluations 2005 Use multiple sources of information Sexual preference measures Relevant psychometric testing Risk assessment Client interview Donya L. Adkerson, MA, LCPC

Use multiple sources of information AOIC DVD - Evaluations 2005 Use multiple sources of information Note significant discrepancies between client self-report and collateral information in the evaluation report. Donya L. Adkerson, MA, LCPC

Do not base conclusions on Client self report alone Describe the sources of information Identify any significant missing information in the report and note the impact this information could have on results/recommendations

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines Use extreme caution if interviewing the victim, due to potential to add to victim harm. Use caution to avoid conflict of interest if evaluating both the offender and his/her victim(s). Donya L. Adkerson, MA, LCPC

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines Physiological testing Get informed consent Do not use physiological testing as a as sole criteria for findings. Use appropriately trained examiners who follow their profession’s standards and guidelines Donya L. Adkerson, MA, LCPC

ATSA Eval - Special considerations Be trained for any special populations you evaluate Address any biases/assumptions based on age, cultural differences, socioeconomic differences, education, language, level of intellectual functioning, and mental or physical disability

Evaluation Guidelines AOIC DVD - Evaluations 2005 Evaluation Guidelines compared to the literature on adult male sexual abusers, less is known about the risk factors and prognosis for clients with developmental disability, offenders with major mental illnesses and female sexual abusers. Donya L. Adkerson, MA, LCPC

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines If you don’t speak the client’s language, refer to someone who does. If no native language evaluator is available, use a PROFESSINAL interpreter and document the use. Donya L. Adkerson, MA, LCPC

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines Clients who cannot read at a level sufficient for completing written measures can often be tested using an auditory (taped or read) version of the instrument where such versions exist. Meet the special needs of clients with mental or physical disabilities during evaluations (e.g., using taped versions of questionnaires for vision-impaired clients). Donya L. Adkerson, MA, LCPC

ATSA Evaluation Guidelines Select tests and instruments appropriate for that client. Adapt for special needs (such as taped questionnaires for vision impaired or illiterate clients) Note that modifications of testing might affect validity or reliability of testing

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines Screen for mental or physical disabilities, major psychiatric disorders, substance abuse, and suicide potential. These conditions may have to be dealt with before evaluation or treatment for sexually abusive behavior begins Recognize that treatment for a concurrent disorder or condition is, in most cases, not a substitute for sex offense specific treatment. Donya L. Adkerson, MA, LCPC

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines Make recommendations for treatment, case management or supervision in clear and specific language. Consider community safety and clients’ ability & willingness to manage their sexual offending when making recommendations. Donya L. Adkerson, MA, LCPC

ATSA Evaluation Guidelines AOIC DVD - Evaluations 2005 ATSA Evaluation Guidelines Release evaluation results to others only with written consent from the clients, unless legally obligated to do so. Securely retain notes, raw test scores, and other documentation (including a copy of the evaluation report) for a minimum of five years after completing an evaluation. Donya L. Adkerson, MA, LCPC

Illinois Sex Offender Management Board Practice Standards for Evaluation

Illinois SOMB Evaluation Standards Public Act 093-0616 mandated use of the SOMB Standards and pre-sentencing eval for sex offenders considered for release to the community. It became effective January 1, 2004.

P.A. 093-0616 On Evaluations Evals must be done by an SOMB approved evaluator Done according to SOMB standards Must be considered by the judge at sentencing

Finding SOMB Evaluators & Treatment Providers A list of approved evaluators and Treatment providers is available on the Illinois Attorney General’s Website. The Standards are also available on the website.

SOMB Eval Standards Overlaps with ATSA Standards – Get informed consent & waivers of confidentiality Be sensitive to diversity issues

SOMB: Purpose of Evaluation Document treatment needs (offense specific and other) Re-offense risk & amenability to treatment Help determine setting, intensity, and level of supervision Identify needs for supervision & support for community safety

SOMB: Areas to Assess Mental & Organic disorders Drug & Alcohol use IQ Organic Brain Syndrome Mental Illness Drug & Alcohol use Use/abuse history Number of relapses

SOMB: Areas to Assess Degree of Psychopathology Stability of Functioning Marital/Family stability Employment & Education Social skills, including dating history

SOMB: Areas to Assess Developmental History Self-image & self-esteem Medical screening

SOMB: Areas to Assess Sexual Evaluation Sexual history Reinforcement of deviant behavior Culture, environment, cults, gangs Arousal pattern

SOMB: Areas to Assess Specifics of sexual crimes Sexual deviance patterns Sexual dysfunction Sexual preferences Sexual practices Attitudes and cognitions (thoughts) about sexuality & offending

SOMB: Areas to Assess Level of denial and deception Level of violence and coercion Evaluation of risk

Factors Evaluator Must Consider in Making Recommendations Admission of offenses Accountability Cooperation Offense history & victim choice Escalation patterns; violence & dangerous behaviors

Factors Evaluator Must Consider in Making Recommendations Sexual deviance, arousal, interest patterns Social interest Lifestyle characteristics & Psychopathology Developmental markers History of criminal behavior Substance abuse

Factors Evaluator Must Consider in Making Recommendations Social support systems Overall control and interventions Motivations of treatment and recovery Previous treatment Victim impact and victim access Availability of treatment & supervision in the community

Recommendations Must Address: Level & intensity of offense specific treatment needs Assessment or treatment needs for co-existing conditions Methods to lessen victim impact Appropriateness of community based placement

Recommendations Must Address: Appropriateness of community placement with emphasis on the risks associated with the home, neighborhood, school or community Level and intensity of behavioral monitoring needed

Recommendations Must Address: External controls that should be considered specifically for that sex offender (e.g., controls of work environment, access to children, leisure time, or transportation; life stresses; or other issues that might increase risk and require increased supervision)

Preparing yourself for the evaluation AOIC DVD - Evaluations 2005 Preparing yourself for the evaluation The right preparation makes all the difference Donya L. Adkerson, MA, LCPC

Structuring the Evaluation Safe and comfortable setting Full days vs. multiple short sessions Collateral before client interviews Start with low defense areas, move to difficulty subjects later

As the Evaluator, you should: AOIC DVD - Evaluations 2005 As the Evaluator, you should: Know your subject – sexual offenders – before doing any S.O. evaluation Get education, training, supervision and experience Donya L. Adkerson, MA, LCPC

As the Evaluator, you should: AOIC DVD - Evaluations 2005 As the Evaluator, you should: Do your homework. There is no substitute for thorough background research before your client interview Think Kojak/Columbo/C.S.I. – NOT Carl Rogers! Understand your client’s agenda; it will not be the same as yours Respect the client as a person capable of positive change Donya L. Adkerson, MA, LCPC

Evaluation Interview skills AOIC DVD - Evaluations 2005 Evaluation Interview skills Take thorough notes. Get the name, age, gender of every person the client mentions Don’t give away what you know. Rephrase and re-ask questions at different points in the interview. Bring your poker face. Smile pleasantly at appropriate opportunities to help put the client at ease. Donya L. Adkerson, MA, LCPC

Evaluation Interview skills Use education to facilitate comfort and honesty; beware of over-educating in the evaluation – don’t teach them how to ‘fake good’ Keep a time line in mind – ask age, grade, place of residence or other markers to help the client provide a time frame. Be aware that low functioning clients will be poor at this even when honest

Watch the NONVERBAL language Words are not the only way people communicate, and nonverbal communication becomes very important when working with people who may be motivated to be dishonest. No matter how good you are at reading nonverbals, you still won’t catch every lie.

Watch the NONVERBAL language Eye contact/changes noted Voice tone/changes noted Tearfulness Power/control behaviors (i.e., walks around office during interview, handles objects from desk, tries to direct interview, silence)

Watch the NONVERBAL language Nervous behaviors (i.e., leg shaking, tapping) Defensive/evasive posturing (arms tightly closed, refuses to remove coat, gaze fixed to side or ceiling) Destructive (to body, clothing, furniture, office objects, other) Intimidation (i.e., invades space, covert threats, finger shaking, yells/curses at examiner, unwarranted touch, hostile stare)

Watch the NONVERBAL language Aggressive (breaks objects, makes overt threats, assaults examiner) Sexually suggestive/seductive behaviors or comments Overt/covert exposure Erection during interview Observed or suspected masturbation “Accidental" rubbing against examiner/staff

Creating Comfort with the Client AOIC DVD - Evaluations 2005 Creating Comfort with the Client Assure the client of your knowledge, experience, comfort with the issues to help decrease embarrassment. Choose language appropriate for the client’s developmental age and functioning. Be sure terms are understood. Use the client’s terms whenever possible. Donya L. Adkerson, MA, LCPC

Using Discomfort in the Interview Use silence to your advantage when you want the client to tell more. Don’t rush to speak. Use hints of your information without details to elicit information in areas the client first omits.

Questioning Styles Open–ended vs. closed-ended Forced choice questions Open: “Tell me about your marriage.” Closed: “Do you have a good marriage?” Forced choice questions “Is your marriage good or bad?”

Helpful Interview Techniques Mind-reading Prediction Leading

Mind-reading Using info you know about the person/problem to tell the client what he is thinking/feeling. This can help the client feel you understand, and feel that pretenses and denial won’t work with you.

Mind-reading examples “I’m sure you don’t want to be here right now. I imagine you are worried about whether you will say and do the right things to make a good impression in this evaluation.” “You’ve been thinking if you can just get through this it will never happen again; that you’ll find a way to make it up to (the victim).”

Prediction Laying groundwork for positive movement in the evaluation and treatment. This can create hope for recovery. It is most effective when coupled with mind-reading.

Prediction Examples “You will find yourself feeling increasing anxiety and discomfort as we start talking about the sexual offenses today. What you will find is, as you begin to talk honestly about the problem here with someone who understands, you will become more comfortable as you talk more openly.”

Prediction Examples (for offenders claiming memory loss) “I know you don’t want to remember and that is why it is hard for you right now. But as we talk, bits and pieces will of your memory will return, triggered by my questions. Those bits & pieces will come faster as we go along.”

Leading Leading presupposes a given direction for the answer. This technique often goes against the therapist’s training. In SO evals, it models the acceptability of talking about specifics and communicates the therapist expects and will not be shocked by even the most extreme answers.

Leading Examples “Which of your children did you touch most often?” “How long before the incident had you been spending time in the park?” “Which part was more exciting to you – when you had your mouth on his penis or when you were rubbing his penis with your hand?”

Use Caution with Leading ! Low functioning individuals may be led into admitting erroneous information. Leading should be used very cautiously with such people. Double check information obtained by trying to lead the client in the opposite direction and see if they remain consistent or simply follow the lead.

Additional cautions with low functioning clients Expect poor time frames Expect inconsistent estimations of frequency or number of occurrences Inconsistent information may be a function of the person trying to be compliant rather than being misleading.

Testing which may be used in evaluations AOIC DVD - Evaluations 2005 Testing which may be used in evaluations Physiological Clinical Collateral completed inventories Self- Report tests and inventories Donya L. Adkerson, MA, LCPC

Physiological Testing types AOIC DVD - Evaluations 2005 Physiological Testing types Visual Reaction Time (Abel Screen) Plethysmograph Polygraph History Maintenance Specific issue Donya L. Adkerson, MA, LCPC

Clinical Testing examples Personality testing Examples: MMPI-2, MMPI-A, Millon IQ testing Examples: Wechsler (WAIS, WISC), Kaufman (KBIT) Projective Testing Examples: TAT, Rorschach (Ink Blot)

Collateral Testing examples For parents of minors: Behavior System Assessment for Children Child Sexual Behavior Inventory Adkerson Information & Beliefs Questionnaire for Parents For partners: Adkerson Partner Information & Beliefs Questionnaire

Self- Report Testing examples Attitudes/beliefs about offending Multiphasic Sex Inventory Abel & Becker Cognitions Scale Bumby Sexual Attitudes Scales Burt Rape Myth Acceptance Inventory Remorse or empathy measures Carich-Adkerson Victim Empathy Scale

Self- Report Testing examples Depression, anxiety or trauma Beck Depression Scale Sexual fantasies Wilson Sexual Fantasy Questionnaire Hostility or violence Buss-Durkee Hostility Inventory Other Sex Offender Incomplete Sentence Blank

Actuarial Risk Assessment Think insurance tables – taking aggregate data about risk is how insurance companies know to charge more for car insurance for a 18 year old male, single, D-student living on Elm St. than a 34 year old married female college graduate living on Maple St.

Clinical vs. Actuarial Risk Assessment Actuarial Risk assessments are based on aggregate data, as obtained through meta-analysis studies. Their overall accuracy is better than clinical judgment alone. Current SO-specific actuarial tools use STATIC (unchangeable) data to determine risk level They do not give info on treatment needs

Clinical vs. Actuarial Clinical risk assessment is the judgment of a clinician, based on training and experience, of the risk presented This judgment can include DYNAMIC (changeable) factors as well as static factors Clinically-Adjusted Actuarial Assessment combines both techniques and allows for individuation with a solid research base

Important Points about Actuarial Assessment in 2005 Current tools are validated only with ADULT MALES Although there are currently no true actuarial tools for juvenile sex offenders, there are guided clinical tools Additional instruments continue to be researched

Actuarial Assessment Tools Some of the most common actuarial assessment instruments currently in use are: RRASOR Static-99 VRAG & SORAG LSI- Revised

RRASOR: Rapid Risk Assessment for Sexual Offense Recidivism 4 items, all static factors Easily scored Moderately accurate predictor of sex offense recidivism, little relationship to general or non-sexual recidivism

Static- 99 (revised scoring 2003) Incorporates and expands on the RRASOR Uses only static risk factors Greater predictive validity than RRASOR alone for sexual recidivism Moderate accuracy for predicting any violent recidivism

Sex Offender Risk Appraisal Guide (modified from Violence RAG) VRAG is one of best measures for general violence recidivism, but not designed to assess sexual recidivism SORAG is also a good predictor of violence recidivism SORAG only moderate predictor of sexual recidivism Requires sophisticated administration (includes the PCL-R)

Level of Service Inventory- Revised Designed to measure general criminal recidivism Includes dynamic as well as static factors NOT designed for sex offense specific use; omits important factors with strong correlation to sexual recidivism (e.g., relationship to the victim)

Static Factors Associated with Increased Recidivism Prior charges or convictions for sex offense (higher # = higher risk) Violence in current or past offense Young age (under 25) Never had a live-in partner (for at least 2 years)

Static Factors Associated with Increased Recidivism Victim Characteristics Male Non-family Stranger Hand-off (non contact) offenses

Static Factors Associated with Increased Recidivism Physiological assessment shows deviant arousal Personality disorder (esp. Antisocial) History of anger problems Diverse sex crimes

Static Factors Associated with Increased Recidivism Early onset of offending Failure to complete treatment Prior non-sexual offenses

Some Dynamic Factors Associated with Increased Recidivism Intimacy deficits Negative peer influences Noncompliant with treatment/supervision Attitudes tolerant of sexual assault

Pitfalls to watch out for in evaluation interviews AOIC DVD - Evaluations 2005 Pitfalls to watch out for in evaluation interviews Interviewing without background info Revealing what you know prematurely Talking over the client’s head Donya L. Adkerson, MA, LCPC

Pitfalls to watch out for AOIC DVD - Evaluations 2005 Pitfalls to watch out for Allowing parent or other collateral to set tone of denial in front of client Engaging in power struggles Addressing the offense history too early Donya L. Adkerson, MA, LCPC

Pitfalls to watch out for AOIC DVD - Evaluations 2005 Pitfalls to watch out for Accepting vagueness or generalities Showing embarrassment, discomfort or disgust Giving up too soon Donya L. Adkerson, MA, LCPC