Sex and Drugs

1. Sex and Drugs

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

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

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

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

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

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

8. Treating Substance Abuse in Offender Populations

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

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

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

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

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

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

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

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