Search results

This paper aims to report on the results of a global search to identify the characteristics of successful sexual offender treatment programs, with a view to providing guidance for program development.

A keyword search was conducted of criminology and social science databases. Successful programs were selected on evaluations that used standard scientific designs.

This study identified 18 evaluations of 16 programs showing significant reductions in reconvictions. Most programs used cognitive behavioural therapy (CBT), with both group and individual sessions; and many evidenced multisystemic therapy (MST) approaches involving families and/or local communities. CBT-based approaches were also common in the 20 unsuccessful programs identified in the study, although fewer MST-oriented features were in evidence. Noncustodial settings, and combined custodial-noncustodial settings, were also more prominent in the successful programs.

There is a shortage of studies focused on the specific components of successful treatment programs for sexual offenders, including for subsets of offenders, such as ethnic minority groups and women.

The findings demonstrate the need for more investment in treatment programs with strict evaluation processes. New and modified programs are likely to benefit from the application of CBT, MST and a community-based reintegration component. More research is needed on effective elements of sexual offender treatment programs.

To the best of the authors’ knowledge, this appears to be the first study that examines features of successful sexual offender treatment programs, compared to unsuccessful programs, using a case-study approach. The findings reinforce the known value of CBT and systemic approaches as core features of programs but raise important questions about what other components are key to activating success.

Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical literature on treatments for this clinical population.

The authors searched PsycInfo and MEDLINE (via PubMed) for studies that evaluated outcomes of treatments with juvenile sexual offenders.

There are a small but growing number of treatment studies (n=10) with juvenile sexual offenders, and all of these studies evaluated cognitive-behavioral therapy or multisystemic therapy for problem sexual behaviors. The results of these studies are promising, although conclusions about treatment effectiveness have been frequently limited by methodological problems.

The authors provide recommendations for treatment providers and policymakers to consider in their decisions about interventions for juvenile sexual offenders. Furthermore, the authors offer suggestions for researchers who seek to develop effective interventions targeting this clinical population.

In order to examine the sustainability of programme effectiveness, we investigated whether the effects of multisystemic treatment (MST) on a second group of adolescents would match those reported in an earlier randomised controlled trial (RCT). Pre‐ and post‐treatment assessments were analysed in a participant group of 105; 55 youths were referred to MST in the programme's second year of operation (MST2), and 50 youths were included in the RCT the first year in which 30 were randomly assigned to MST (MST1) and 20 to regular services (RS).At two project sites, MST clinical outcomes in the second year of programme operation matched and, for key indices of anti‐social behaviour, surpassed those achieved during the first year. In addition the MST treatment delivered in the second year was more effective than regular child welfare services in preventing out of home placement and reducing internalising and externalising behaviour. Together, these results demonstrated sustained effectiveness of the programme as well as indication of programme maturation effects. No group differences were registered for social competence. MST youths treated in the second year were significantly younger than those referred to treatment in the first year (MST1) but age had no moderating effect on the outcomes.

Multisystemic therapy (MST) is described and contrasted with practice in traditional services for young people who have committed crime, behaved anti‐socially, abused substances or suffered family conflict. The challenges to traditional services posed by MST are examined, including consideration of the process of engagement in therapy, the intensive individualised therapy delivered in the young person's own home or local community, and the quality assurance systems.

This study aims to investigate outcomes of multisystemic therapy (MST) using the Youth Level of Service/Case Management Inventory (YLS/CMI) – part I.

This study, using a pre-post design, included a sample of 2,123 Norwegian youths (mean age = 14.7, SD = 1.34). The MST team supervisors assessed the YLS/CMI risk factors in addition to five behavioral treatment goals (Lives at home, Attends school/work, No violence/threats, Law-abiding and Drug-free) before and after treatment. In addition, data included responses from parent interviews six months post treatment.

Significant correlations were found between the total and dynamic YLS/CMI change scores and the additive index of behavioral treatment goals. In addition, the YLS/CMI change scores predicted the five treatment goals at the termination of treatment and at six-month follow-up.

The results indicate that the YLS/CMI is a valuable assessment tool for predicting the achievement of MST behavioral goals in adolescents with serious problem behavior.

This study provides an evaluation of the YLS/CMI in a Norwegian context and adds support for continued use of the YLS/CMI in MST.

This paper provides new insights about the YLS/CMI inventory as a tool for examining treatment change in MST. Results show that the YLS/CMI captures relevant risk factors in the youths’ environment.

Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement toward evidence-based practice. Results from several studies indicate that youth served in traditional residential or inpatient care may experience difficulty re-entering their natural environments, or were released into physically and emotionally unsafe homes (Bruns & Burchard, 2000; President's Commission on Mental Health, 1978; Stortz, 2000; Stroul & Friedman, 1986; U.S. Department of Health and Human Services, 1999). The cost of hospitalizing youth also became a policy concern (Henggeler et al., 1999b; Kielser, 1993; U.S. Department of Health and Human Services, 1999). For example, it is estimated that from the late 1980s through 1990 inpatient treatment consumed nearly half of all expenditures for child and adolescent mental health care although the services were found not to be very effective (Burns, 1991; Burns & Friedman, 1990). More recent analyses indicate that at least 1/3 of all mental health expenditures for youth are associated with inpatient hospitalization (Ringel & Sturm, 2001).

Introduction: As we enter a period of economic downturn, the question of further demonstrating meaningful child and adolescent mental health services (CAMHS) outcomes becomes more salient (Department of Health, 2010). Early research had been stymied by a need to develop age‐appropriate measures (Roth & Fonagy, 2005), as well as childhood being a culturally specific and historically changing construct (Buchanan, 1996). However, Weisz et al (1995; 2005) argued that the current literature provides a basis for understanding what practices are effective.Method: A range of search terms, including ‘child mental health’, ‘CAMHS’ and ‘evidence base’ were entered into ASSIA, EBSCOhost, IngentaConnect, PsychINFO and Web of Knowledge. This revealed 197 hits. Only 19 papers focused upon the ‘implications of the evidence base’. Due to conceptual overlap, three papers were reviewed in greater depth. Additionally, due to the nature of the question, I reviewed two seminal texts to better understand the theoretical framework that constructed the area.Findings: Any conclusions drawn from the evidence base are largely influenced by three main tensions and limitations. These are: 1) the need to demonstrate the efficacy and cost effectiveness of CAMHS; 2) the impact of the theoretical allegiances of researchers (Kuhn, 1970); 3) the need to meet and better integrate a range of theoretical perspectives (particularly social approaches) into the evidence base (Department of Health, 2001; World Health Organization, 2000).Conclusions: The current evidence base is well placed to direct clinicians upon treating conditions that commonly present to CAMHS. However, there are significant tensions and limitations within the literature, which future research may be well placed to reconcile. Once these have been addressed training, supervision and consultancy, to inform the future direction of CAMHS.

The assessment of risk of recidivism in sexual offenders is fundamental to clinical practice. It is widely accepted that, compared with actuarial measures of risk, unaided clinical judgment has generally been found to be of low reliability. Consequently, the literature has shown a surge in actuarial measures. However, a major difficulty in assessing risk in sex offenders is the low base rate, leading to an increased likelihood of making a false positive predictive error. To overcome this, risk assessment studies are increasingly using the receiver operating characteristic (ROC), which displays the relationship between level of risk and decision choice. This note summarises the methodological issues in measuring predictive accuracy in assessing risk of re‐offending in sexual offenders, and identifies from the literature both static and dynamic risk factors associated with sexual offence recidivism.

Training clinical child psychologists necessitates explicit attention to the importance of developing cultural competencies for practice in diverse communities. This case study, comprising relevant social history, cultural models of child psychopathology and conceptual analysis of complex systems in bicultural Aotearoa New Zealand, offers salutary lessons for clinical practice internationally. In New Zealand, indigenous perspectives on children's mental health needs are holistic, encouraging trainee practitioners to recognise the systemic influences of extended family, school and community. Accommodating the expectations, values, and hegemony of both Māori and European populations requires service providers to acknowledge a broad interpretation of evidence‐based practice. In terms of true scientific progress, future best practice will require a rapprochement between the traditional knowledge of indigenous cultures and the empirically‐derived insights of psychology as an international discipline. The imperative to share power in decision‐making moves the debate beyond conventional multicultural sensitivities. Moral and political issues are inextricably entwined with clinical and professional activities.

The article aims to examine the process and challenges of setting up and implementing evidence‐based programmes in regular service systems.

The article offers a first‐hand account of a service manager seeking to implement Multisystemic Therapy and Triple P.

The process of setting up and implementing evidence‐based programmes involved significant challenges, including securing funding, managing stakeholders, finding suitable staff, arranging training, and managing supply and demand. Various relational, cultural and systemic issues need to be addressed if the professional system is to embrace evidence‐based programmes.

Few evidence‐based programmes in the UK have been implemented extensively in regular service systems. This is a first‐hand account of a rare attempt to do so.