Monday, July 27, 2015

In 500 words (or less): Talking Risk Management with Hazel Kemshall

Risk has been called the ‘world’s largest industry’ (Adams 1995: 31). We are faced with a bewildering array of risks in our everyday lives, ranging from health risks, crime risks, and those risks caused by climate change (Kemshall et al 2013), and we are constantly urged to ‘manage risk’.  Responding to the risks posed by others and reducing risks to vulnerable people are all in a day’s work for busy  practitioners in agencies such as social work, probation, and prison, or for those offering treatment and intervention to ‘risky groups’.   Risk management is an activity many of us regularly engage in, both in our personal and professional lives. But what is involved in this complex activity?

Risk management is inextricably linked to risk assessment.  The latter should clearly specify the risk factors that are present and their potential links with harmful outcomes; and identify any positive factors that have the potential to reduce or mitigate harm.  Risk management requires the careful matching of interventions and treatments to the risk factors outlined, and the enhancement, or at least consolidation, of any positive factors that can play a role in mitigating risk.  The failure to match interventions to risk factors plays a role in many risk management failures, including the failure to properly target those risky behaviours directly linked to harmful outcomes. Clarity of role and responsibilities, particularly in multi agency work, are also critical, with each agency making an agreed contribution to a focused, structured and clear plan, with delivery strategies and responsibilities clearly outlined with formal accountability structures to ensure delivery (Kemshall et al 2013).

Deciding thresholds of risk (low, medium, high for example), and particularly the thresholds of risk required to justify intrusive interventions including for example preventative or extended sentencing for sexual offenders, compulsory treatment programmes, and early interventions with ‘at risk families’ has been challenging.  Such thresholding can be dependent upon risk assessment tools that struggle to neatly categorise persons into tiers of risk. This can be exacerbated by practitioner subjectivity, and the atmosphere of ‘precautionary principle’ (better safe than sorry) that can permeate practice particularly following risk management failures.  The ethical, legal and moral challenges of preventative risk management, that is, risk management based upon preventing risks arising in the first place, have been acute (Titterton 2005).  In the risk management of sexual offenders this has most often occurred in legal and policy debates about indeterminate preventative sentencing; community notification; vetting and barring; restrictive licence conditions; and compulsory treatment (Kemshall 2008). 

Risk management measures for sex offenders in particular have attracted increasing evaluation of effectiveness.  Cognitive Behavioural Treatment interventions are the most supported by research (Schmuker and Losel, 2008). Other emerging programmes and approaches have been less well evaluated. However, there is effectiveness evidence for Circles of Support and Accountability (McCartan et al, 2014); Multi-Systemic Therapy (MST) which has been robustly evaluated in relation to adolescent sexual offenders (Borduin et al, 2009) and is also found to be promising by Finkelhor (2009); and programmes based on the Good Lives Model or desistance approaches (e.g. The Better Lives Sex Offender Programme in the UK) seem to be making promising contributions to the positive management of risk and reintegration of individuals (Barnett and Mann, 2011; Scoones et al, 2012).

The evidence to date would indicate that a combination of risk management techniques is required for maximum effectiveness, comprising both protective and integrative measures (see Kemshall 2008: 132).  These include an appropriate balance of restrictive measures, supportive and integrative measures, pro-social supervision, and effective treatment/programme interventions to be successful.

Hazel Kemshall, PhD

References

Adams, J. (1995) Risk.  London: UCL Press.

Barnett, G. and Mann, R. (2011) ‘Good lives and risk assessment: collaborative approaches to risk assessment with sexual offenders’, in H. Kemshall and B. Wilkinson (eds) Good Practice in Assessing Risk: Current Knowledge, Issues and Approaches, London: Jessica Kingsley.#

Borduin, C.M., Schaeffer, C.M. and Heiblum, N. (2009) ‘A Randomized Clinical Trial of Multisystemic Therapy with Juvenile Sexual Offenders: Effects on Youth Social Ecology and Criminal Activity’, Journal of Consulting and Clinical Psychology © 2009 American Psychological Association.

Finkelhor, D. (2009) The Prevention of Childhood Sexual Abuse; available at: http://files.eric.ed.gov/fulltext/EJ856320.pdf; accessed July 24th 2014.

Kemshall, H. (2008) Understanding the Community Management of High Risk Offenders.  McGraw Hill/Open University Press.

Kemshall, H., Wilkinson, B. and Baker, K. (2013) Working with Risk.  Skills for contemporary social work.  Cambridge: Polity Press.

Kemshall, H, Kelly, G. Wilkinson, B. and Hilder, S. (2014) What works in work with sexual offenders: A literature review.  Available at: http://www.somec-project.eu/default.asp?page_id=600&name=Effective management of high risk and dangerous offenders report; accessed 23 July 2015.

McCartan, K., Kemshall, H., Westwood, S., Solle, J., Mackenzie, G., Cattel, J. and Pollard, A. (2014) Circles of Support and Accountability (CoSA): A Case File Review of Two Pilots. Analytical Summary. London: Ministry of Justice, available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/293400/cosa-research-summary.pdf; accessed 23 July 2015.

Schumuker, M. and Losel, F. (2008) Does Sexual Offender Treatment Work? A systematic review of outcome evaluations. Psicothema 20, 10-19.


Scoones, C.D, Willis, G.M. and Grace, R. C. (2012) Beyond Static and Dynamic Risk Factors: The incremental validity of release planning for predicting sex offender recidivism. Journal of Interpersonal Violence, 27 (2) 222-238. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21859756; accessed July 24th 2014.

Saturday, July 18, 2015

Get it, Got it, Good? Media interpretation and sexual harm

This week in the British media we have numerous reports about paedophilia and individuals who commit sexual harm against children, with the news (BBC 4, BBC and the Guardian) focusing on the work of Dunklefeld as well as Circles of Support and Accountability. In the main these reports are good news stories focusing on the work that Dunklefeld does in preventing sexual harm while recognizing that we as a society, as well as individually, maybe uncomfortable with the story being done.  These media reports emphases two important things to me,

-   firstly, that media engagement is as important, if not more important, in changing social perceptions and attitudes towards sexual harm than the research and practice work that we all engage in; and

-          secondly, that we are starting to see a shift in the type of sexual harm stories that the media cover and a change in the language as well as the approach that they use.

The media plays a central role in modern society (Mc Quail, 2010). The media is still the main method for the dissemination of information, the shaping of public perception and the reinforcement of societal attitudes (Greer, 2012).  Meaning that the media can have a great deal of power and influence, in that it can shape and influence public opinion, while at the same time inform society in a quick in-depth fashion that legitimizes the subject, thereby re-establishing the credibility of the story (Mc Quail, 2010). Research suggests that the public engage with the media, especially the press, in a number of different ways, to either shape, reinforce or consolidate their existing opinions as well as to shape new ones (Howitt, 1998; McQuail, 2010; Bohner and Wanke 2009); however, the impact of the media upon the public depends upon the reader, the story and the credibility of the source (Bohner and Wanke 2009). This suggests that the media can affect attitudes through a series of psychological and sociological processes including, but not limited to, stereotyping, group processes and norm reinforcement. Which suggests that there seems to be a relationship between the media and the public, with the public selecting its media based upon personal preference and the media producing public interest stories (Cohen and Young, 1981; Howitt, 1998; Gamson, Croteau, Haynes & Sassoon, 1992), as such indicating a repetitive cycle with it’s between the media and target audience which results in the reporting as well as creating the news (Cohen & Young, 1981).

This interrelationship between the media, the public and the state is best crystallized through the medias’ representation of crime. One of the most significant and prevalent media stories and moral panics of recent years has been that of paedophilia (Silverman & Wilson, 2002); traditionally the media has helped to construct this through this frequency (Greer, 2012; Critcher, 2002), selectively, negative language and format with it discusses paedophilia (Silverman & Wilson, 2002; Thomas, 2005; McAlinden, 2006). This means that the media has often misrepresented and misunderstood the complexity of paedophilia tending to discuss it in one-dimensional, simplistic and stereotypical terms (Thomas, 2005; McCartan, 2010). This media misrepresentation is problematic as it works to weaken public understandings and social awareness resulting in an inappropriate and a skewed social construction of the realities of paedophilia. However, as previously stated this seems to be starting to change with a range of articles and shows taking about the complexity and reality of sexual harm from This American Life to the recent Dunklefeld stories. These considered  approaches to sexual harm stories (another example, published today, is how much consideration is given to victims of sexual harm when publishing new sexual harm stories and a consideration of Trigger Warnings)means that insightful and appropriate messages are going into the public domain, this does not mean that public attitudes will shift overnight (that’s another story for a another day), planting the seed for an informed debate. This realistic conversation about the nature of sexual harm; who perpetrates sexual harm; who are victims of sexual harm and the impact that it has on them; as well as sexual perpetrator prosecution, rehabilitation and reintegration. One positive conservation leads to a raft of other positive conversations. Therefore the media should be congratulated and worked with us by academics, professionals and practitioners in the sexual harm field (an approach advocated via Public Criminology with precedent in Public Protection Arrangements Northern Ireland and HMP Whatton) to help develop these stories, changes in narrative and new approaches to sexual harm.

Kieran McCartan, PhD

References

Bohner, G. and Wanke, M. (2009) ‘The psychology of attitudes and persuasion’, in J. Wood, and T. Gannon (eds) Public Opinion and Criminal Justice. Cullumpton: Willan.

Cohen, S. and Young, J. (1981) The manufacture of news: social problems, deviance and the mass media. Beverly Hills, California: Sage Publications.

Critcher, C. (2002) ‘Media, Government and Moral Panic: the politics of paedophilia in Britain 2000-1’, Journalism Studies, 3: 521-35.

Gamson, W. A., Croteau, D., Hoynes, W. and Sasson, T. (1992) ‘Media images and the construction of reality’, Annual Review of Sociology, 18: 373-93.

Greer, C. (2012) Sex crime and the media: Sex offending and the press in a divided society. Cullumpton; Willan.

Howitt, D. (1998) Crime, the media and the law. Chichester: Wiley.

McAlinden, A. (2006) ‘Managing Risk: From regulation to the reintegration of sexual offenders’, Criminology & Criminal Justice, 6: 197-218.

McCartan, K. (2010) Media constructions and reactions to, paedophilia in modern society. In: Harrison, K., ed. (2010) Managing High-Risk Sex Offenders in the Community: Risk Management, Treatment and Social Responsibilities. Willan Publishing, pp. 248-268.

McQuail, D. (2010) Mass Communication Theory, 6th Edition. London: Sage Publications.

Silverman, J., and Wilson, D. (2002) Innocence Betrayed: Paedophilia, the media & society. Cambridge: Polity.

Thomas, T. (2005) Sex Crime: Sex Offending and Society, 2nd edition. Cullompton: Willan.


Thursday, July 9, 2015

Q & A with Patrick Lussier author of “Juvenile Sex Offending through a Developmental Life Course Criminology Perspective: An Agenda for Policy and Research”


Lussier, P. (2015). Juvenile Sex Offending Through a Developmental Life Course Criminology Perspective: An Agenda for Policy and Research. Sexual Abuse: A Journal of Research and Treatment.  Advance online publication.

 


 

Abstract

Current American policies and responses to juvenile sex offending have been criticized for being based on myths, misconceptions, and unsubstantiated claims. In spite of the criticism, no organizing framework has been proposed to guide policy development with respect to the prevention of juvenile sex offending. This article proposes a developmental life course (DLC) criminology perspective to investigate the origins, development, and termination of sex offending among youth. It also provides a review of the current state of knowledge regarding various parameters characterizing the development of sex offending (e.g., prevalence, age of onset, frequency, persistence, continuity in adulthood, and versatility). The review highlights some heterogeneity across these developmental parameters suggesting the presence of different sex offending patterns among youth. In fact, it is proposed that, based on the current knowledge, such heterogeneity can be accounted for by a dual taxonomy of adolescents involved in sexual offenses: (a) the adolescent-limited and (b) the high-rate/slow-desister. The DLC criminology approach and the dual taxonomy are proposed as organizing frameworks to conduct prospective longitudinal research to better understand the origins and development of sex offending and to guide policy development and responses to at-risk youth and those who have committed sexual offenses.

Could you talk us through where the idea for the research came from?

This article is the result of close to fifteen years of research going back to the start of my PhD studies in criminology and, since then, several experiences working on longitudinal cohort studies on the psychosocial development of children and adolescents in Canada, USA, UK and the Netherlands. These experiences lead to the formulation of developmental life course (DLC) framework, as proposed in the article, to describe and explain the origins and developmental course of sexual violence and abuse. The idea for this article was sparked by three key observations: (a) misguided policy development regarding the prevention of sexual offenses, which includes measures that are too often based on myths, misconceptions, false and/or unsubstantiated claims about individuals having committed a sexual offense; (b) major advances in developmental research in the past three decades regarding the processes by which atypical, non - normative, and maladaptive behaviors start, develop and terminate, as well as the importance of recognizing the role and importance of age-graded factors contributing to their developmental course, and; (c) the lack of prospective longitudinal research to investigate the origins and the development of sexual violence and abuse to inform policymakers and treatment providers. This article offers a theoretical and research framework to better understand the origins and the development of sexual violence and abuse.  

What kinds of challenges did you face throughout the process?

The ideas put forth in the article have been extraordinarily well received. There seems to be an understanding that it is a necessary step for the advancement of research and policy in the field of sexual violence and abuse. The real challenge, now, is the implementation of a DLC research program to study the origins and the developmental course of sexual violence and abuse over time.

What do you believe to be to be the main things that you have learnt about juvenile sexual offending and its relationship to policy?

Much has been said about the significant and dangerous gap between research and policy with respect to juvenile sex offending and the disastrous consequences. Current policies are typically repressive, reactive, and after the fact. At that stage, for some young persons, the risk factors have been operating for years and these factors could have been identified and corrected sooner. For others, the risk factors are transitory and contextual and can be corrected through specialized intervention. This speaks of the diversity of developmental trajectories that can lead to the occurrence of sexual offending during adolescence.

Research in the field of juvenile sexual offending has also been reactive or in reaction to these misguided policies. A more proactive approach is necessary for better policy development and to align policies with empirically-based evidence. It starts with the implementation of prospective longitudinal research with community-based samples of families. It includes a program of research to better understand the development of normative and non - normative sexual behavior and associated risk and protective factors from the earliest developmental stages, such as pre/perinatal, infancy, etc. This program of research also takes into consideration that discontinuity of non - normative behavior is the general rule across developmental stages and that early identification of non - normative sexual behavioral development is more complex and subtle than commonly believed. In sum, the developmental life course perspective offers a proactive perspective to assist and guide policy development for the prevention of sex offending.

Now that you’ve published the article, what are some implications for practitioners?

The DLC perspective is a theoretical and research framework allowing this field of research to make a significant step toward the realities that practitioners are encountering on a daily basis. This step includes a common language for researchers and practitioners to communicate more clearly about the origins and the developmental course of sex offending. In doing so, the framework will stimulate the development of an understanding of sex offending in the context of developing human lives. Because the DLC perspective recognizes the diversity of human lives and individual development, it allows for a person-oriented perspective for assessment and treatment purposes, something currently lacking. In all, the proposed DLC framework aims to bring those realities into the realm of research and, most importantly, policy and prevention.

Friday, July 3, 2015

We are not that different after all.......

I have had an interesting couple of weeks discussing perpetrators of sexual harm (including youths, individuals with learning disabilities, Black and Ethnic Minority populations and females) and their victims (especially vulnerable, youth and male victims) in a number of different contexts (research symposium, CPD training, stakeholder meetings and academic conferences).  The one thing that has been reinforced in me – individuals who perpetrate sexual harm against others are not that different to each other (regardless of status – race, age, gender etc) or to non-sexually harmful individuals.

I am not saying that we have not recognized  these similarities before, but rather that when you spend your time talking about one or two particular subgroups of perpetrators of sexual harm  (so for me it’s usually medium to high risk males who sexually harm children) you tend to miss the big picture.  This lack of big picture perspective is often reinforced by the fact that we have in part, with the assistance of policy makers and the public because it suited their needs, created an industry based around the idea that perpetrators of sexual harm are radically different from all other types of perpetrators of crime and therefore need a highly specialized approach. The notion that individuals who perpetrate sexual harm are in some way unique is partly true because  different sub-types of perpetrators do need different degrees of  support, different types of treatment, unique policies and more research; but not the whole population. We still have things to learn about how perpetrators of sexual harm are similar to each other as well as to other offender groups at a baseline level.

One of the most predominant pieces of research in criminology is David Farrington’s Cambridge study, it sets the ground work for how we consider offending populations. In his study Farringtion found  that there are certain pre-cursors to criminal activity including, appropriate socialization, educational engagement and achievement, positive reinforcement, good family and peer stability, positive role modelling, positive attachment and the importance of having goals/plans. Although, Farrington’s initial study was about youths it developed into a longitudinal study that followed the same sample population across there lifespan (and is still going), therefore coming more about developmental pathways in crime rather than a snapshot of one sub-category/population. Farrignton’s findings are universal across all accepts of offenders, offending behavior and rehabilitation; although we may have different studies, authors and theories the basic premise is still the same – stability, positivity and life goals. We see them regulated for all sorts of offenders, including sexual offenders we just have to look at the pre-dominate theories in our field including Risk Need Responsivity, Good Lives Model, attachment and cognitive change to name but a few. This means that we need to look at the perpetrator as an individual, which we do, and not apply global, one size fits all models; which is the beauty of Farringtion’s work in that it offers a range of individual and complementary explanations for offending behavior which starch across a variety of offences.

The capacity to look outside of our field’s tradition research and practice silos will enable us to open up additional lines of enquiry and allow us to reframe the policy/treatment/research debates around sexual harm. One clear example of this being desistence theory , which is relatively new to the field of sexual harm but that criminology, public health and drug treatment had been using for years. In closing, I thought it would be useful to frame some of the main issues faced by perpetrators of sexual violence in the context of perpetrators of crime in general to highlight that actually “we are not that different after all…”:

-          Most perpetrators or crime are vulnerable themselves, maybe having been a victim of crime themselves. We know that not all victims go on to perpetrate, but we know that some do and not necessarily in the crimes that they were victims off.

-          We know that issues of vulnerability can, and often do, play out across victim and perpetrator groups.

-          Males can be victims of crime as well as females.

-          Mental health issues can play a role in the perpetration of crime and that there is a relationship between mental illness and incarceration.

-           Most youth perpetrators of crime tend to grow out of offending as they develop across the lifespan.

-          That evidence based policy and practice (evidence lead) is what we should be striving for but often we get policy based evidence (ideologically lead).

-          Female perpetrators of crime tend to be labeled as “doubly deviant” as opposed to male perpetrators, female perpetrators also tended to be more often labelled as mentally ill as opposed to males and are less likely to serve long prison sentences.

-          Male perpetrators of crime tend to be constructed as mad or bad, regardless of the crime.

-          The “what works”/individual treatment model is advocated for all types of perpetrators.

-          That social context (age, race, education, etc.) plays out across all perpetrator groups.

-          That there can be false allegations, issues with Eye Witness Testimony and police decision making/discretion.

-          There are issues, concerns, complaints and negative reaction from the public about offender re-entry.

-          The public and society are more likely to believe that youth and female perpetrator groups are more likely to reform and need social support than adult perpetrator.

Kieran McCartan, PhD


Sunday, June 21, 2015

The Minnesota Sex Offender Program: Federal Intervention Part 3 – The Ruling

This opinion piece is the third of a three-part series regarding a class-action lawsuit brought by clients of the Minnesota Sex Offender Program (MSOP).   Part 1 discussed some of the issues and concerns that led up to the federal trial.  Part 2 reviewed the 2014 report from a team of experts appointed by the Federal Court to examine the program.  On February 9, 2015, at the US District Courthouse in St. Paul, a federal trial commenced to determine the constitutionality of MSOP. After a five-week bench trial, the Federal Court has issued its ruling in Karsjens v. Jesson.

On June 17, 2015, the US District Court for Minnesota ruled that the Minnesota Sex Offender Program (MSOP), and the underlying sexual offender civil commitment (SOCC) laws in Minnesota are unconstitutional.  Federal Judge Donovan Frank, who has presided over three-and-a-half years of legal proceedings, wrote the ruling.  The decision appears to completely reject the arguments that were put forth by the Attorney General’s Office, which defended MSOP and the state of Minnesota.  Reactions to the ruling were swift.  Governor Mark Dayton immediately issued a statement that he disagreed with the ruling and that the state would continue to defend the constitutionality of MSOP.   Eric Magnuson, former Chief Justice of the Minnesota Supreme Court and Chair of the SOCC Task Force said the decision is not appealable until Judge Frank issues a final order.  Minnesota’s ATSA chapter issued a statement, calling the ruling “fair and necessary.”

Judge Frank’s 76 page ruling is highly critical of both MSOP as a program and the underlying statutes of SOCC, describing them as, “a three-phased treatment system with ‘chutes-and-ladders’-type mechanisms for impeding progression, without periodic review of progress, which has the effect of confinement to the MSOP facilities for life.”  (p.65)  “Although treatment has been made available, the treatment program’s structure has been an institutional failure and there is no meaningful relationship between the treatment program and an end to indefinite detention.” (p.67)

Even former MSOP Executive Director Dennis Benson did not try to defend the system, testifying that, “the politics around the program are really thick… politics guide the thinking process of those involved in the [release] process… this program is going to, I think, eventually be deemed unconstitutional, and in its current form probably should be.” (p.68) 

The reasons for the Federal ruling of “unconstitutional,” on face and as applied, can be summarized into the following areas of concern (from the “Conclusions of Law” p. 50-67):
·         The statutes and the program do not provide for periodic, independent risk assessments to evaluate whether or not an individual continues to meet constitutional criteria for commitment.  Those risk assessments that have been performed have not all been performed in a constitutional manner.  MSOP acknowledged that they do not know which clients meet criteria for commitment or release.

·         The statutes do not provide for judicial bypass – the ability for clients to seek relief from confinement by appealing directly to the courts.

·         The statutes render discharge from MSOP more onerous than the statutory criteria for initial commitment.  There is either no end to treatment, or clients who have completed treatment or sufficiently reduced their risk, remain confined.  Release cannot be predicated on completion of treatment, or readiness to reenter the community, but rather on sufficient reduction of “dangerousness.”  There must be one unifying criteria for commitment and release.

·         The statutes impermissibly transfer the burden to petition for a reduction of custody from the state to the client.  MSOP staff acknowledged that there are many clients who could be safely treated in less restrictive alternatives (LRAs).  MSOP only supports petitioning for clients in the final phase of treatment.  MSOP has failed to assist clients in petitioning, and fails to provide discharge planning to all clients. The statutes do not require the State to take any affirmative action to petition for reduction of custody or discharge on behalf of clients who no longer satisfy criteria for continued commitment.  The petition process can take years.

·         The statutes allow for placement of MSOP clients in less restrictive alternatives, but LRAs are effectively not available for clients.  There are no LRAs upon initial commitment, and few LRA’s for clients who petition for conditional release.  Only two clients are currently on provisional release, and no clients have ever been unconditionally discharged.

A key theme in Judge Frank’s ruling stems more from what MSOP hasn’t done than what it has, “Plaintiffs have shown that each Class Member has been harmed and their liberty has been implicated as a result of Defendants’ actions. For example, Defendants created the MSOP’s treatment program structure, developed the phase progression policies, and had the discretion to conduct periodic risk assessments of each Class Member and to petition on behalf of the Class Members, but have chosen not to do so. By failing to provide the necessary process, Defendants have failed to maintain the program in such a way as to ensure that all Class Members are not unconstitutionally deprived of their right to liberty.” (p.51)

Judge Frank wrote, “Treatment has never been a way out of confinement for committed individuals.” (p.64)  “Contrary to Defendant’s assertion that Plaintiffs allege merely a generalized concern, Plaintiffs have shown that all Class Members have suffered an injury in fact – the loss of liberty in a manner not narrowly tailored to the purpose for commitment.” (p.50)  “The overall failure of the treatment program over so many years is evidence of the punitive effect.” (p.65) “Each of the reasons set forth above are an independent reason for the Court to conclude that section 253D is unconstitutional as applied.” (p.65) 

Going forward, it appears that the standard for commitment, from initial confinement to criteria for release, must be the same (p.73): “It is constitutionally mandated that only individuals who constitute a ‘real, continuing, and serious danger to society’ may continue to be civilly committed to MSOP.” (p.60)  “… discharge must be granted if the individual is either no longer dangerous to the public or no longer suffers from a mental condition requiring treatment.” (p.62)

In the closing pages of Judge Frank’s ruling, he opined that Minnesota’s SOCC system is flawed for essentially two distinct, but interconnected reasons: (1) that society is frustrated with our inability to effectively mitigate crime broadly and sexual violence specifically, with sexual offenders being the target of “society’s opprobrium,” and (2) the blurry relationship with our criminal justice system.   Judge Frank concluded, “Consequently, the Court observes that, in light of the current state of Minnesota’s sex offender civil commitment scheme, it is not only the ‘moral credibility of the criminal justice system,’ that is at stake today, but the credibility of the entire system, including all stakeholders that work within the system, and those affected by the system, not forgetting those who have been convicted of crimes, their victims, and the families of both.” (p.68-72)

Eric Janus, William Mitchell College of Law President and Dean, has been a longtime critic of SOCC, and has described the federal ruling as a “sweeping condemnation” of sexual offender civil commitment in Minnesota.  Professor Janus has warned for more than two decades that SOCC is deceptively enticing, deeply flawed public policy, and constitutionally tenuous.  The federal courts have warned for two-decades that if SOCC becomes de facto preventive detention, they will intervene – and they did.

What’s Next?

Judge Frank has exercised judicial restraint for more than three years, but wrote in his powerful ruling, “As the Court has stated in a number of previous orders, and will now say one last time, the time is now for all of the stakeholders in the criminal justice system and civil commitment system to come together and develop policies and pass laws…” (p.74)

Judge Frank concluded his ruling with a request for top political leaders of Minnesota, and other stakeholders, to come together to discuss solutions at a “Remedies Phase Pre-hearing Conference” at the US District Courthouse in St. Paul, on August 10, 2015.  Judge Frank acknowledged that he cannot compel political leaders to attend, and given that one invitee, Governor Dayton, has said the state will defend the constitutionality of MSOP, it’s too soon to know if the Executive branch is planning to appeal or ready to engage in “remedies.”  Perhaps, after 20 years of complacency within state government, the state isn’t taking it seriously when the Federal Court says, “Recognizing that the MSOP system is unconstitutional, there may well be changes that could be made immediately, short of ordering the closure of the facilities…” (p.4) 

Perhaps it is too soon to know the reach of this federal ruling, but there are ramifications, for example, for a similar, concurrent federal lawsuit in Missouri.  Interestingly, Minnesota and Missouri are both in the Eighth Circuit of the US Court of Appeals, which means that an appeal from either or both states would be heard by the same Court.  While Judge Frank’s ruling is binding in Minnesota, a Federal Appeals Court ruling would be binding within the Circuit, and a federal court ruling in any part of the US can be influential across the country.  Undoubtedly, SOCC programs in all 20 states are taking note of this ruling, and the 30 states that don’t have SOCC might be thinking twice about going down that road. 

When a Federal Court drops the judicial “nuclear bomb” of “unconstitutional” on laws within the US, it is not just a legal opinion, it should be seen as a wake-up call that we have gone astray of “our constitution” – a set of human values that are so bedrock to a civilized society, and humanity, that we have enshrined those principles in the US Constitution - to be certain that they guide the formation of all laws and public policies, especially when causes, and people, are unpopular.

In recent years, many of our colleagues in the broadly related fields of psychology, social work, criminal justice, and mental health have also been deeply concerned about the troubling legal and ethical underpinnings of SOCC.  It is easy to forget that practicing mental health at its junction with the legal system can be an ethical minefield.

Many of our “civil laws” in the US, regarding the management of those who have sexually offended, from the sex offender registry, to residency restrictions, to SOCC, are not well grounded in science or research.  While recognizing, with great respect, all the professionals working at or near the front lines of SOCC treatment programs, perhaps Judge Frank’s ruling is also a reminder for all who work in SOCC to examine our individual professional roles in supporting a system that most knew was broken, long before it was “unconstitutional.” It is tempting to engage in unproductive finger pointing or think that the Minnesota experience can’t happen elsewhere.  Colleagues would be wise to study the events in Minnesota in order to understand what happened, and develop innovative ways of preventing similar occurrences elsewhere.  If we are going to use SOCC, we should do it in the most effective and ethical ways possible.

This is the beginning of a new era for MSOP and sexual offender civil commitment in Minnesota. We might start by being honest about whether we see sex offenders as “broken” or just “evil,” and whether we are going to offer veritable treatment, or just be really mad at them.  Judge Frank’s ruling explains that there are constitutional safeguards in the criminal justice system that do not exist in the civil commitment system, and that we should be mindful of that in forging solutions.  If we replace endless SOCC with endless prison sentences, it might be a lot more constitutional and a lot less just.  If stakeholders can avoid getting hijacked by anger, fear, or vengeance; and considerate new laws emanate from sound research, best practices, and constitutional principles, we can reform MSOP into a model program for SOCC, and show Minnesota, the Federal Courts, and the rest of the world that we can offer sincere hope and effective rehabilitation to people who were once thought to be evil or irreparably broken, and return them safely back to their communities and to their families.    

Jon Brandt, MSW, LICSW
David Prescott, LICSW



Readers might be interested in two excellent collections of essays on MSOP and SOCC.  One is titled “Civil Commitment and Civil Liberties” published in June, 2015 by the Cato Institute.  And another is the Spring, 2015 edition of the William Mitchell Law Review.

Thursday, June 11, 2015

Implementation, Integration, and “Implegration”: Science and Practice

Many years ago, I had a bad experience with a consultant. She promulgated an evidence-based treatment curriculum for a specific condition that my programs treat. The curriculum was excellent; the consultant was not. She complained bitterly to others when cases were not improving rapidly, and blamed some therapists even as she attempted to hire others away from our employ. At no time did she critically examine her own contribution to these circumstances. Good treatment with bad implementation does not produce a good outcome for anyone.

Central to our implementation problems was that our therapists needed time to get their minds around the specific treatment processes. Unfortunately, she and the funders were not patient. This was before I became aware of Dean Fixsen’s research on implementation efforts. He would argue that it takes two years to implement a treatment program with fidelity. In our case, this meant a good curriculum, good therapists, but poor consideration of implementation science.

Fast forward a few years and I have twice consulted to agencies this week on implementing treatments such as the good lives model and motivational interviewing. As you might expect, time is tight and money is short. From an administrator’s perspective, it always seems like a good idea at the time: “there is a good new treatment method out there; let’s get someone in to do training.” What often gets lost in the mix are some of the basics. For example, with every rollout of a new treatment method there is a minority of people who readily embrace change and another minority who wants nothing to do with it. One example of this took the form of “we’ve seen these new models come and go over the years. This one will probably go away as well.”

Even the greatest attempts at improving services meet with challenges along the way. An important consideration lies in how we can prevent implementation problems before they happen. Professionals sometimes do not want to change their behavior any more than mandated clients do.

Perhaps one place to start is in considering how best to get the program’s context right for change. Are we considering full implementation of a specific approach such as motivational interviewing or the good lives model? To do so with fidelity can mean even more effort in curtailing old approaches than in learning new ones. It can also mean stopping a program in its tracks and changing course, which can result in as much or more tumult for the clients as the program staff.

On the other hand, one might try integrating program components piecemeal. For example, one might try to go in a good-lives-model direction through a series of steps:

1)      Ensuring that the mission of the program is to build client capacities and wellbeing even as clients manage risks
2)      Focusing on developing goals that every client can approach rather than avoid
3)      Developing a deep understanding of each client’s common life goals
4)      Collaborative work with clients to understand their past behavior in accordance with the self-regulation model
5)      Consider full implementation of the good lives model

Another possible approach is to consider “Implegration.” This is a term coined by Swedish prison psychologist Carl Åke Farbring and refers to an integrated implementation effort (see here for a series of presentations in English and Swedish). Farbring came to conclude that simple efforts at motivational interviewing implementation were doomed to be less effective when they did not take place in the cultural context of the program. From his notes, he describes Implegration as involving:

  • An intentional process of implementation
  • Bottom-up perspective
  • An attitude of exploring and listening
  • Local ownership of processes (separate from the centrally decided goal orientation)
  • Balance between guidelines and mindlines
  • Adjusting to local conditions means deliberate integration
  • Positive monitoring and support

When considering the implementation of a treatment approach, it is often easy to overlook the potential contribution of local expertise. This can be achieved as simply as through the appointment of in-house experts who consult to both the model’s developer and the front-line clinicians. It can also use in-house relationships, such as having an enthusiastic front-liner organize regular discussions about how implementation is progressing.


For many years, it seemed acceptable to view clinicians as widgets in the service of sophisticated treatment regimens established by experts who were too often in another region. Recent research has confirmed the importance of improving treatment services one client at a time through close attention to the alliance. As our field continues its discussion of best treatment practices, it also seems vital to consider how we make these practices happen.

David S. Prescott, LICSW

Monday, June 1, 2015

The prevention of sexual abuse and violence in the UK


 Over the last four decades in the UK, survivors of sexual abuse and the women’s movement brought growing recognition of sexual abuse and sexual violence. For the purposes of this blog sexual abuse refers to the abuse of children and young people and sexual violence is a broader umbrella term which also includes sexual assaults against adults.  

During the 1980s small, mainly voluntary sector organisations began to provide help, support and treatment for victims and survivors of sexual violence.  Also during this time, many of the same organizations began to recognize the need to work with the source of the problem, the person causing the sexual harm. The Probation Service began to deliver relatively small scale individual and group work to  convicted sex offenders.

With a developing interest in “What Works” in treatment and rehabilitation, there was a growing  investment in treatment programmes for offenders that were subject to quite rigorous evaluations. Accredited sex offender programmes were developed and by the first decade of the 21st century and a growing body of research began to articulate the components of  effective assessment and treatment for those who sexually harmed children and/or adults.

This development in knowledge and resources was not matched in work with victims, with children and young people with harmful sexual behaviour and even less focus on  primary prevention. And this in the main remains the case today.  It seems that this is primarily due to the political attractiveness of being seen to address a “threat”(e.g., adult sex offenders) rather than the sometimes complex steps to prevent sexual violence from happening in the first place.

More recently high profile cases of historic abuse (Savile -  http://www.bbc.co.uk/news/uk-20026910, Hall - http://www.bbc.co.uk/news/uk-england-manchester-22942439 and others), child  sexual exploitation,  and an increased focus towards online abuse, combined with growing fiscal constraints have led policy makers to become more interested in primary prevention. Work by the NSPCC[1] has shown that the sexual abuse of children costs the UK economy over £3 billion (approximately $4.5 billion) a year. Government is beginning to understand and recognise that sexual abuse and violence is best understood as a public health problem. To the UK we now have a growing interest in prevention and real opportunities to evaluate what works, particularly in relation to primary prevention.

Two members of NOTA (who are also members of ATSA and on ATSA’s Prevention Committee) have taken the lead to  establish a prevention committee within NOTA.  The newly formed committee Is currently exploring how to best identify; promote and disseminate good and promising prevention practice, particularly in relation to primary prevention. The NOTA Prevention Committee works from the standpoint that there is much to be learned and adapted from other successful public health campaigns and initiatives. The main aims of the committee are:

·         To contribute to the development of awareness raising and practices to prevent  sexual  violence against children and adults in the UK and Ireland

·         To focus on all aspects of the prevention of sexual abuse and violence against children and adults and to have a particular focus on primary and secondary prevention 

·         To develop an annual, costed work plan

·         To develop a common understanding of what constitutes prevention is in the context of sexual violence

·         To oversee and drive the development of the Prevention Matters online forum

·         To develop policy positions

·         To facilitate links to other prevention activity in national or local governments or other organisations  

The NOTA Prevention Committee has already begun to meet and plans to address the goals above throughout the year.  And to help increase communications across the Atlantic, NOTA has invited ATSA prevention committee members to join the NOTA meetings.  From these collaborations, we expect to see some excellent opportunities to address this issue before it is a large institutional issue. 

One example of ATSA and NOTA working together is the community engagement events in San Diego (ATSA conference 2014), McCartan who organized the first event, is now coordinating events in Bristol UK and Dublin Ireland.  These events can help improve public understanding about sexual abuse and violence and articulate what can be done to prevent it.

The growth of these initiatives and the growing public attention to the issue of sexual violence, there are many new opportunities opening up with the possibility of having a significant impact in communities on both sides of the Atlantic. 

Jon Brown, M.Sc. , (NSPCC & Chair of the NOTA Prevention Committee)

Kieran McCartan PhD (NOTA Prevention Committee member)                   



[1] NSPCC (2014) Estimating the costs of child sexual abuse in the UK