Provisions for the Treatment of Sexual Offenders Requiring Higher Intensity Programs: The Impact of Paraphilic Diagnoses
Why we did this study
As part of the Transformation Agenda there have been a series of proposed changes to the way in which correctional programs have operated. One of these proposed changes has been the possibility of offering a higher intensity sex offender treatment program to sexual offenders with a diagnosis of a paraphilia (i.e., sexual deviation as defined by the American Psychiatric Association or APA). The APA’s Diagnostic and Statistical Manual of Mental Disorders (the latest version of which is the DSM-IV-TR) contains all accepted diagnoses in relation to the paraphilias. Research related to the paraphilias was reviewed in an attempt to evaluate the efficacy of assigning sexual offenders to treatment based on a diagnosis of a paraphilia. Where relevant, other research related to the assessment of sexual offenders was also presented.
What we did
A literature review was conducted in order to determine whether a diagnosis of a paraphilia would be reasonable grounds on the basis of which to assign a sexual offender to a higher intensity treatment program. Research related to the mental health histories of sexual offenders and the utility of actuarial assessment procedures with sex offenders was also reviewed.
What we found
Research in relation to the paraphilias suggests that these diagnoses have poor reliability. Further, no APA recognized diagnosis exists for rape related behaviours. The lack of a diagnosis related to rape behaviour would make the process of assigning offenders who have committed sexual assault against adults very difficult if a diagnosis of a paraphilia were required for program placement. Further, given that there are significant numbers of sexual offenders with psychiatric impairment more generally, it was suggested that this factor should also be assessed prior to placement in a higher intensity sexual offender treatment program. The relevant research also suggests the need for actuarial assessment of risk for sexual offending.
What it means
Based on a review of the literature it was recommended that the assessment of four issues should be considered prior to an offender being placed in a higher intensity sex offender treatment program. These factors are: 1. Actuarial assessment of risk for sexual offence recidivism, 2. assessment of mental health functioning, 3. assessment of deviant sexual arousal (which is related to but different than a diagnosis of a paraphilia), 4. An assessment of the offender’s relationship history/social skills deficits should be conducted. With rare exceptions, only sexual offenders deemed to be at moderate or high risk for sexual offence recidivism based on the actuarial assessment of risk for sexual offence recidivism should be considered for higher intensity sex offender treatment programs.
For more information
Abracen, J.,& Looman, J. (2011). Provisions for the treatment of sexual offenders requiring higher intensity programs: The impact of paraphilic diagnoses. Ottawa, Correctional Service of Canada.
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