Specialized Assessment of Juvenile Sex Offenders

1. Specialized Assessment of Juvenile Sex Offenders

2. Assessment • To estimate or determine the significance or importance of something(s) • To observe or monitor • To evaluate

4. Assessment as an Ongoing and Collaborative Process • In the traditional sense and in most other contexts, assessment is generally considered to be a clinical event • When considering management of juvenile sex offenders, assessment should reflect a process that extends far beyond the role of clinicians • Assessment data comes from a variety of sources and at various points of the management process

5. Assessment Data Sources • Interviews with juveniles • Interviews with parents/caregivers • Collateral interviews and contacts • Record reviews • Psychological tests and inventories • Sex offense-specific measures • Selective use of psychophysiological tests • Risk assessment • Multi-disciplinary observation and monitoring

6. Why a Specialized and Ongoing Process? • While the label “sex offender” implies that these juveniles are the same, in actuality they are a heterogeneous and diverse population • Levels of risk and types of needs are not static – they change over time • We must continuously and systematically assess and monitor the strengths and needs of juveniles and their families • The cumulative data – collected over time – greatly enhances our ability to effectively meet the needs of juveniles, families, victims, and communities

7. Assessments PromoteInformed Decisionmaking • INFORMED DECISIONMAKING • Sentencing Placement considerations Case management strategies Clinical treatment planning Supervision conditions and approaches Transition and reentry planning Pre-Sentence Investigation Psychosexual Evaluation & Risk Assessment VICTIM AND COMMUNITY SAFETY Ongoing, Multi-Disciplinary Assessment

8. Continuum of Care to Match Risk Level of Juveniles Low risk Moderate risk High risk Residential treatment centers, structured group homes, therapeutic foster care Secure correctional, secure residential, inpatient psychiatric facilities Community-based options, day treatment, outpatient services

9. Individualized Assessment DJJ Risk Assessment DJJ Sex Offender Risk Checklist Psychosexual Evaluation J-SOAP CANS-SD Case Management Protocols Community or residential placement Type and intensity of supervision and other interventions Readiness for stepdown/termination of treatment and supervision services Example of Risk/Need Matching: Virginia Department of Juvenile Justice

10. Example of Risk/Need Matching: Missouri Division of Youth Services Intake assessment with youth/family Risk assessment Needs assessment Moderate risk/need High risk/need sanction Low risk/need • Residential services continuum • High secure • Moderate secure • Group homes • Special needs/SED dorms and cottages • Young offender (13 and under) • Serious/certified offenders (up to 21) • Gender specific-programs Community-based services Day treatment/public school Outpatient sex offender groups Family therapy Case manager/p.o. Tracker/mentor Graduated sanctions sanction Community aftercare Day treatment/public school Outpatient sex offender groups Family therapy Case manager/p.o. Tracker/mentor Graduated sanctions

11. General Process Issues for Professionals • Focus on rapport • Avoid becoming an adversary • Create a safe atmosphere • Allow for sharing of questions or concerns • Remain non-judgmental in language and tone • Remain fair and firm • Be deliberate in your approach to inquiries – the goal is to obtain information • Lead with more neutral/non-threatening issues • Ask open-ended questions • Explore frequency versus mere absence/presence of behaviors • Resist the urge to immediately challenge inconsistencies • Reinforce disclosures • Remind the youth that you are part of a larger team • Information is shared and compared • Decisions are often made collaboratively

12. Pre-Sentence Investigation Psychosexual Evaluation and Risk Assessment Ongoing, Multi-Disciplinary Assessment

13. Pre-Sentence Investigation • Pertinent review of: • Family history/family functioning • Maltreatment/neglect/social service contacts • Academic/school performance and conduct • Medical/behavioral health needs • Substance abuse • Extracurricular involvement/leisure activities • Interpersonal relationships/peers • Delinquency/legal involvement • Offense-related factors • Overall development and maturity • Prior treatment/counseling interventions

14. Pre-Sentence Investigation:Summary/Recommendations • Findings from psychosexual evaluation • Family strengths and needs • Parent/caregiver response to disclosure/offense behaviors • Ability to provide adequate supervision • Ability to protect vulnerable family members • Parental risk factors • Violence/aggression within the home • Availability of weapons, alcohol/drugs, pornography, etc. • Least restrictive placement options • Suitability for community supervision • Access to victims • Risk for sexual/non-sexual violence • Other community safety considerations • Abscondence risk • Recommended specialized supervision conditions

15. Assessment via the Psychosexual or Juvenile Sex Offense-Specific Evaluation

16. Pre-Sentence Investigation Psychosexual Evaluation and Risk Assessment Ongoing, Multidisciplinary Assessment

17. Psychosexual Assessment • Why? • Level of risk • Treatment needs • Severity of disturbance • Assets and strengths • Amenability to treatment (accountability, motivation, and receptivity) • Required level of care • When? • Post-adjudication and presentence • By Whom? • Specially trained clinician • What and How? • Comprehensive, psychosexual • Style and substance; process and content

18. Psychosexual Assessment • Thorough record review • Clinical interview • Comprehensive sexual history • Psychometric assessment of personality and overall adjustment • Cognitive functioning • Development and maturity/special needs • Psychometric assessment of sexual attitudes, interests, and adjustment • Environmental considerations – Structure, supervision, victim access • Selective use of physiological measures • Risk assessment

19. Sexual History • Sexual development • How did individual learn about sex? • 1st sexual experience recalled • Masturbation (1st time, current frequency) • Turn-ons, fantasies • Pornography • Age-appropriate experiences • Victimization experiences • Perpetration experiences – Modus operandi – Victim selection – Range of offense behaviors • Other paraphilias

20. Psychometric Assessment: General Personality • MMPI-A • Millon Scales • Child Behavior Checklist

21. Examples of Psychosexual Assessment Measures • Child and Adolescent Needs and Strengths-Sexual Development (Lyons, 2001) • Adolescent Cognitions Scale (Hunter, Becker, Kaplan, & Goodwin, 1991) • MOLEST and RAPE Scales (Bumby, 1996) • Adolescent Sexual Interest Card Sort (Becker & Kaplan, 1988) • Multiphasic Sex Inventory-Juvenile Version (Nichols & Molinder) • Wilson Sex Fantasy Questionnaire (Wilson, 1978)

22. Child and Adolescent Needs and Strengths-Sexual Development(CANS-SD, Lyons, 2001) • Structured needs assessment of youth who have engaged in sexually abusive behavior • Information used to develop case plans, particularly from a risk-needs-responsivity perspective • Domains assessed include: • Functioning • Risk Behaviors • Mental health needs • Care intensity and organization • Caregiver capacity • Strengths • Characteristics of sexual behavior

23. CANS-SD:Examples of Areas Coded • Functional status • Developmental • 0 - No evidence of developmental delay • 1 - Evidence of mild developmental delay • 2 - Evidence of pervasive developmental disorder • 3 - Severe developmental disorder • Risk Behaviors • Violence • 0 - Youth has no history of violence against others • 1 - Youth has history of fighting and similar forms of violence against others but has not engaged in violent behavior in past year • 2 - Youth has engaged in fighting and similar forms of violence against others in past year. Or, youth has history of violence that has resulted in significant injury or death but not in the past year • 3 - Youth has engaged in violence in past year that has resulted in significant injury or death

24. CANS-SD: Examples of Areas Coded (cont.) • Family/caregiver needs and strengths • Supervision • 0 – …supervision and monitoring are appropriate and functioning well • 1 – …supervision is generally adequate but inconsistent. This may include a placement in which one member is capable of appropriate monitoring and supervision but others are not capable or not consistently available • 2 – …appropriate supervision and monitoring are very inconsistent and frequently absent • 3 – …supervision and monitoring are nearly always absent or inappropriate • Residential stability • 0 – …in stable housing with no known risks of instability • 1 – …currently in stable housing but there are significant risks of housing disruption (e.g., loss of job). • 2 – …family/caregiver who has moved frequently or has very unstable housing • 3 – …family/caregiver who is currently homeless

25. CANS-SD: Examples of Areas Coded (cont.) • Characteristics of sexual behavior • Age differential • 0 – Ages of the perpetrator and victim and/or participants equivalent • 1 – Age differential between perpetrator and victim and/or participants 3 to 4 years • 2 – Age differential between perpetrator and victim at least 5 years, but perpetrator less than 13 years old • 3 – Age differential between perpetrator and victim at least 5 years and perpetrator 13 years old or older • Prior treatment • 0 – No history of prior treatment or history of outpatient treatment with notable positive outcomes • 1 – History of outpatient treatment which had some degree of success • 2 – History of residential treatment where there has been successful completion of program • 3 – History of residential or outpatient treatment condition with little or no success

26. Adolescent Sexual Interest Cardsort: Example Items • “I go by the gym at school and look through the girls’ locker room window. I can see several girls in their bras and panties.” • “I am making an 8 year old boy bend over so I can have sex with him.” • “My sister and I are lying on the couch. I am rubbing her soft skin, all over her body. I’m feeling her breasts.” • “I’ve tied a girl down in the park. I’m hurting her, just beating her up.” • “I’m having sex with a pretty 15 year old girl. We really like each other.” • “My girlfriend is rubbing my penis. I feel it getting hard as she tells me how much she loves me.” (Becker & Kaplan, 1988)

27. MOLEST Scale:Example Items • “Sometimes, touching a child sexually is a way to show love and affection” • “Sexual activity with a child can help the child learn about sex” • “If a person does not use force to have sexual activity with a child, it will not harm the child as much” • “Some children are willing and eager to have sexual activity with adults” (Bumby, 1996)

28. RAPE Scale:Example Items • “Women who get raped probably deserve it” • “If women did not sleep around so much, they would be less likely to get raped” • “Victims of rape are usually a little bit to blame for what happens” • “A lot of times when women say ‘no,’ they are just playing hard-to-get and really mean ‘yes’ ” • “Many women have a secret desire to be forced into having sex” (Bumby, 1996)

29. Multiphasic Sex Inventory-Juvenile version: Example Items • “I am too shy to even talk to a girl my age” • “I am too embarrassed and ashamed to even try to have sex with a girl my age” • “I am [not] sexually attractive” • “After I date a person, they often do not want to go out with me again” (Nichols & Molinder)

30. Wilson Sex Fantasy Questionnaire: Example Items • Indicate how often you fantasize about the following themes… • Being forced to do something • Receiving oral sex • Watching others have sex • Tying someone up • Being excited by material or clothing (e.g., rubber, leather, underwear) • Exposing yourself provocatively • Having incestuous sexual relations (Wilson, 1978)

31. Assessment of Sexual Arousal, Interest, or Preference • Sexual arousal patterns not necessarily established fully for all adolescents; fluidity exists • Validity and reliability of physiological measures may be impacted by age, maturity, and development • Use selectively and cautiously – With older (> =14) male clients with more extensive offending histories and/or self-reported deviant interests and arousal – With clients who admit offenses – With full informed consent of client, parent/guardian, referral source

32. Assessment of Sexual Arousal, Interest, or Preference (cont.) • Generally, should use auditory stimuli designed for the juvenile population • Not to be used to determine innocence or guilt • May be useful for identifying juveniles with emergent paraphilic disorders • May help juveniles to gain awareness of their sexually deviant behaviors and patterns and strengthen their non-deviant sexual interests

33. Polygraph for Assessment • Often used to facilitate disclosure of sexual history • Used more frequently with adults than juveniles • Little research on its reliability and validity for juvenile offenders • Research suggests results can be influenced by client’s age and intelligence, physical and emotional state, examiner’s training • Utilization with juveniles should be selective and cautious, with informed consent of youth and parents

34. Risk Assessment

35. Risk Assessment • Clinical Judgment – Based on clinical experience and individual practices • Empirically Guided – Rate a fixed list of factors which are indicated by research to be associated with offending; review of item ratings leads to an overall determination of risk • Actuarial – Fixed number of statistically derived factors are evaluated using a structured and objective rating system; items summed to yield an overall risk score associated with defined level of risk

36. Risk Prediction Challenges for Juvenile Offenders • Low base rates of recidivism (typically 10% or lower) • Lack of controlled, empirical studies pertaining to risk prediction/assessment of juveniles • Limited tools specifically for juveniles – J-SOAP-II – ERASOR

37. J-SOAP-II(Prentky & Righthand) • Empirically guided risk assessment tool • Considers both static and dynamic elements • 28 items, 4 subscales • Sexual drive/preoccupation (static) • Impulsive, antisocial behavior (static) • Intervention (dynamic) • Community stability/adjustment (dynamic)

38. J-SOAP-II:Examples of Static Items • Prior legally charged sex offenses • Number of sexual abuse victims • Degree of planning in sexual offense(s) • Caregiver consistency • Pervasive anger • School behavior problems • Juvenile antisocial behavior

39. J-SOAP-II:Examples of Dynamic Items • Accepting responsibility for offense(s) • Empathy • Cognitive distortions • Quality of peer relationships • Management of sexual urges and desire • Stability of current living situation • Stability in school • Evidence of support systems

40. ERASOR(Worling & Curwen) • Empirically guided tool • Considers both static and dynamic elements • 5 broad factors • Sexual interests, attitudes, behaviors (static and dynamic) • Historical sexual assaults (static) • Psychosocial functioning (dynamic) • Family environmental functioning (dynamic) • Treatment (dynamic)

41. Review of PSI data Attitude toward treatment; amenability Degree of accountability Type and chronicity of sexual behavior Degree of paraphilic interest and arousal Behavioral health needs Capacity for empathy Environmental suitability Family functioning/needs Dangerousness to self/others Treatment needs/targets Responsivity considerations/special needs Level of risk Least restrictive placement options Strengths and assets Individual, family, and environmental Resource availability Summary/RecommendationsShould Include:

42. Pre-Sentence Investigation Psychosexual Evaluation and Risk Assessment Ongoing, Multi-Disciplinary Assessment

43. How do the Following Individuals Contribute to the Ongoing Assessment Process? School officials/teachers Juvenile probation/parole officers Family members Family therapists Victim therapists Treatment providers Employers Mentors

44. Ongoing, Multi-Disciplinary Assessment • Should occur throughout the treatment and supervision process • Provides for formal and informal reviews of treatment progress/needs • Informs changes to the level of supervision and the specific conditions/expectations – Need to be able to adjust structure appropriately as risk and needs increase or decrease • Promotes evaluation and monitoring of the family, environment, and other support systems – Strengths and concerns • Facilitates collaboration and critical information sharing and informs decisionmaking at many levels

45. Assessment During Residential or Institutional Placement • Primary assessment goal is readiness for community reentry • Focus is generally on dynamic, changeable factors • Denial, cognitive distortions, empathy, disclosure • Emotional management • Healthy communication • Awareness of risk factors, offense cycles • Development and effective use of coping skills • Family/environmental readiness

46. Multidisciplinary Assessmentin the Community • Primary assessment goals are stability and community risk/safety – Overall stability and adjustment – Ongoing awareness of risk factors, offense cycles – Avoidance of high risks, effective use of coping skills – Adherence to relapse prevention plan – Disclosure of concerns, communication with supports – Family/environmental stability, support systems – School/employment performance – Changes in affect or behavior – Adherence to supervision conditions – Need for sanctioning • Suitability of family/caregiver, environment • Utilization of available resources

47. Assessment of the Family/Caregiver • Needs assessment – Family violence, mental health difficulties, substance abuse – Structure, discipline – Availability of pornography, weapons, alcohol • Acknowledgment of the concern vs. denial of the problem • Response to system involvement • Willingness and ability to participate in – and support fully – treatment and supervision interventions • Strengths and assets

48. Environmental Assessment • Home and community • Access to pornography, alcohol, drugs • Victim presence • Access to potential victims • School • Peers

49. Assessments PromoteInformed Decisionmaking • INFORMED DECISIONMAKING • Sentencing Placement considerations Case management strategies Clinical treatment planning Supervision conditions and approaches Transition and reentry planning Pre-Sentence Investigation Psychosexual Evaluation & Risk Assessment VICTIM AND COMMUNITY SAFETY Ongoing, Multi-Disciplinary Assessment