NEARI Press and Training Center Newsletter - Volume 11, Issue 5: September 2018
The Effects of Specialized Treatment on the Recidivism of Juvenile Sex Offenders:
A Systematic Review and Meta-analysis
Greetings!
Welcome to September! Conventionally, it is said that the month of January begins a new year. But here at NEARI Press & Training Center, and likely for those of you who have school-age kids, September always feels like a new beginning. For one, September is when we launch our new annual webinar series, as we have each year since 2011. Please take a look below at the line-up of webinars that we have scheduled for the coming academic year. On September 12, we were lucky enough to have Su Robinson kick off the season with a brilliant and well-attended webinar on working with adolescent girls with sexual behavior problems. Next month, on October 9 at 3 p.m. EDT , is your opportunity to hear from Dr. Robin J. Wilson and Michele Burns in a webinar entitled Passport to Independence: Responsive Treatment Options for Persons Who Have Sexually Offended about their newest NEARI Press publication,  Passport to Independence: A Good Lives Model Workbook , earn CEs, and receive a discount on the book when you order it after the webinar ends. 

This month here in the e-newsletter, we take a look at the article  “The Effects of Specialized Treatment on the Recidivism of Juvenile Sex Offenders: A Systematic Review and Meta-analysis”  by Heather Hensman Kettrey and Mark W. Lipsey who want to know if specialized sex offender treatment programs for youth are more effective than generalized treatment programs in preventing sexual and non-sexual reoffense by youth who have committed a sexual offense. 
 
As always, we want to remind you to follow NEARI Press & Training Center and our Parent 2 Parent project on Twitter at  @NeariPress   and  @NeariP2P , and  on Facebook   to get updates about all that we are doing. 
 
And last, but far from least, please don’t hesitate to contact us about the articles, authors, and topics you’d like us to cover in the NEARI e-Newsletter, our webinars, and our in-person trainings. Please contact Alisa if you have ideas and thoughts about the particular kinds of training you’d like to see NEARI Press and Training Center offer in the coming year. Thank you for your interest in NEARI, and for the vital work that you do to keep children and adults safe from sexual harm,

Craig Latham, Executive Director, NEARI 
Alisa Klein, Director, NEARI Press and Training Center, aklein@neari.com  
This month, David S. Prescott and Alisa Klein examine the article:

The Effects of Specialized Treatment on the Recidivism of Juvenile Sex Offenders: A Systematic Review and Meta-analysis
AUTHORS
Heather Hensman Kettrey and Mark W. Lipsey (Please see below for full citation and abstract.)

THE QUESTIONS
Are specialized treatment programs for youth who have been convicted of a sex offense effective in preventing  sexual and general recidivism by these youth? Are specialized treatment programs more effective in reducing sexual recidivism than the non-specialized treatment programs used in juvenile justice systems?   

THE RESEARCH
The authors point to a study by Pullman and Seto (2012), which concludes that the majority of youth who commit a sexual offense are “generalist offenders,” while only a small minority of these youth are “specialist offenders” who are at increased risk for committing future sexual offenses. This conclusion, note the authors, counters the premise that specialized sex offender treatment for youth is necessary. In fact, they note, current research indicates that few youth who commit a sex offense are at risk for sexual recidivism. In a meta-analysis of 106 studies by Caldwell (2016), sexual recidivism rates were at approximately 5 percent (and 2.75 percent for studies since 2000), whereas general recidivism was higher at 41 percent.

To determine whether or not specialized sex offender treatment for youth is effective – and necessary, the authors conducted a systematic review and meta-analysis of specialized youth treatment and recidivism studies that they had determined to be of high methodological quality. The authors note that many previous meta-analyses on this topic may have produced biased findings due to poorly-controlled treatment-control comparisons, so they focused their meta-analysis solely on the methodologically strongest studies in the field. 

The outcome variables in the study were sexual and general recidivism (defined as arrest or court contact). The final sample for the meta-analysis consisted of eight studies with the sample size ranging between 16 and 190 largely male (90 to 100 percent) participants. All of the treatment programs were tailored to youth who had committed a sexual offense with a primary treatment modality of “some variant of counseling.” Three were group counseling models; two were family counseling; one was individual counseling; another was a combination of group, family, and individual counseling; and one was an adventure-based skill-building behavior management program. The authors do caution regarding their meta-analysis that, “ the small number of studies and their relatively small sample sizes did not provide a great deal of statistical power for these analyses.” 

RESULTS AND CONCLUSIONS
The authors found that the sexual recidivism rates ranged from 0 to 12.7 percent for specialized treatment groups and from 3.7 to 75 percent for comparison groups. They found that general recidivism rates were higher than sexual recidivism rates, ranging between 18.9 and 53.8 percent for specialized treatment groups and between 16.5 and 75 percent for comparison groups. Based on these numbers, the authors concluded that on average, participants who received specialized treatment did not significantly recidivate sexually more than participants in the comparison groups.  They further state that based on their meta-analysis, they could not  confidently conclude that specialized treatment programs for youth who have committed a sex offense are more effective for reducing sexual recidivism than general treatment that is used in juvenile justice systems.

IMPLICATIONS FOR PROFESSIONALS 
This study highlights the importance of individualized, assessment-driven treatment (as opposed to giving all adolescents the same intervention). Further, it gives professionals pause to consider what the referral question actually is on a case-by-case basis. In other words, what is this young person at risk for, and how can professionals best prioritize treatment goals? It is entirely possible for the same program to provide specialized care to one client and a more generalized approach to another. The ultimate question may be less whether one should provide this or that kind of treatment, but rather “what is the best approach adults can take so that this young client can develop a lifestyle in which harmful behavior is unnecessary and undesirable?

IMPLICATIONS FOR THE FIELD
This meta-analysis provides further evidence that youth can present with many types of risk, and that professionals must be expert in a wide range of areas, from human sexuality and adolescent development to understanding the life-course trajectories of harmful behaviors. Although it has now been said many times, one size does not fit all when it comes to assessment and treatment. Further, it is crucial that treatment programs look beyond reducing risk in any specific area to building strengths, skills, and wellbeing in all areas of a youth’s life.  

ABSTRACT
Objectives  Specialized treatment programs for juvenile sex offenders (JSOs) are com- monly used in juvenile justice systems. Despite their popularity, the evidence base for the effectiveness of these specialized programs is limited in both scope and quality. This systematic review and meta-analysis updates previous meta-analyses while focus- ing on studies of relatively high methodological quality.

Methods  A vigorous literature search guided by explicit inclusion criteria was conduct- ed. Descriptive and statistical information for each eligible study was coded indepen- dently by two coders and disagreements resolved by consensus. Odds ratio effect sizes were computed for sexual recidivism and general recidivism outcomes. Mean effect sizes and their heterogeneity were examined with both fixed and random effects meta- analysis.

Results  Only eight eligible studies were located, seven of which were quasi-experi- ments. The mean effect size for the seven studies reporting sexual recidivism favored treatment but was not statistically significant (OR = 0.74, 95% CI 0.40, 1.36). The mean effect size for general recidivism was significant and also favored treatment (OR = 0.58, 95% CI 0.42, 0.81).

Conclusions  Remarkably little methodologically credible research has been conducted on specialized programs for JSOs despite their prevalence. The best available evidence does not support a confident conclusion that they are more effective for reducing sexual recidivism than general treatment as usual in juvenile justice systems. Future research should not only use randomized designs but should also distinguish generalist offenders who are at low risk of sexual recidivism from specialist offenders who are at higher risk of committing future sexual offenses.

CITATION  
           
NEARI Press & Training Center is so pleased to offer you these opportunities to enrich your knowledge base and practice. All of our webinars are FREE and Continuing Education credits (CEs) are always available.

Join us every month, or just when the webinar topic particularly "speaks" to you.

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On August 28, RALIANCE released an exciting new publication –  Where we’re going and where we’ve been: Making the case for preventing sexual violence  written with the  Berkeley Media Studies Group (BMSG) .  

RALIANCE writes that prevention is a multifaceted, layered, and sustained endeavor that it is difficult to communicate so it often remains unseen and misunderstood. 

The organization writes in its announcement about the new report:

Our work brings us into contact with the realities of sexual violence every day – including the reality that prevention is possible. We know sexual harassment, abuse, and assault can be prevented at all stages of life. We know each of us has a stake in building and maintaining safe, stable, thriving communities. But if that’s true — and we know that it is — then why do we always seem to be talking to ourselves? Why does prevention get lost? 

One big reason prevention gets lost is communication. We embarked on this project with BMSG because we knew something needed to change in the way our field communicated about sexual violence – and what to do about it. We partnered with BSMG to develop message strategies to get us closer to this destination.

Included in the guide are the basics of messaging strategies, the components of an effective message, "rules of the road" for sexual violence prevention messaging, and lots of sample messages to get you started.
By: Toni Cavanagh Johnson, Ph.D.
Duration: 3-4 hours; CE Credits: 4

By:   Joan Tabachnick
Duration: 1-2 hours; CE Credits: 2

By: David S. Prescott, LICSW
Duration: 3-4 hours; CE Credits: 4

By: Steve Bengis, Ed.D., L.C.S.W. 
Duration: 4-5 hours; CE Credits: 5

By Reverend Debra Haffner & Joan Tabachnick 
Duration: 3-4 hours; CE Credits: 4

by Jamie Suvak, L.M.H.C. 
Duration: 1-2 hours; CE Credits: 2



Please help NEARI Press and Training Center keep our annual webinar series free by becoming a sponsor of the series. Annually, we have a great lineup of nationally-recognized authors presenting their workbooks, research, and approaches to working with youth and adults with sexual behavior problems.  

For $98 for individuals, or $250 for organizations, we will guarantee you up to 14 seats for the webinar AND you have access to FREE CE credits . To thank you, we do all of the work to sign you up each month, offer you two free NEARI Press books, and publicize your sponsorship in all of our promotional literature and on the webinars. 

For more information or to sign up, visit our website at www.nearipress.org OR contact Diane Langelier at 413.540.0712 x14, email info@nearipress.org .
NEARI Press & Training Center provides resources and training for the prevention of sexual abuse. We are a source of practical, cutting-edge information about promising and best-practice interventions for individuals with sexual behavior problems. We believe that by addressing healthy sexual development in children and adolescents, and responding to sexual behavior problems in children, adolescents, and adults, we can prevent sexual abuse before it is perpetrated.
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