Most Colorado sex offenders don't get treated in prison

UPDATE 5-10: DOC disputes 9WTK sex offender investigation (See letter below)

5-7-2014 Colorado:

A six-month investigation by 9Wants to Know discovered most sex criminals were not allowed to attend specialized sex offender therapy programs while in prison.

The Colorado Department of Corrections is responsible for rehabilitating the 5,000 sex offenders currently behind bars, but the DOC strategic plan indicates just 103 actually completed the sex offender treatment program in the last state fiscal year.

Kellie Wasko, executive deputy director of corrections, says her department is trying to expand the size of the in-prison program, but she admits it's hard to find enough therapists. As of last month, more than 25 percent of program positions were vacant.

Until recently, corrections officials say they only allowed inmates sentenced under the state lifetime sentencing law to begin treatment in prison. Those offenders' sentences required them to stay in prison until they show satisfactory progress in treatment. Lifetime sex offenders make up one-third of the convicted sex criminals behind bars. The other two-thirds of offenders, inmates with traditional sentences, were specifically excluded.

Convicted child molester Donald Chapman, serving a traditional 32 year sentence for child molestation, told his parole hearing officer last month he needed treatment and "I can't seem to get treatment in here."

The Glass is Half Something, But What? Thoughts on the Does-Treatment-Work Debate

2-27-2013 National:

At the beginning and end of each day, all professionals in our field want to prevent sexual violence. How successful we are is debatable, and sorting out our priorities can be confusing to both the public at large and ourselves (Hindman, 2007). The only thing that is clear is that doing nothing with people who have sexually abused is unacceptable.

Recent discussions among treatment providers for persons who have sexually abused have again focused on whether our treatment programs are actually successful at reducing sexual recidivism among adults clients. Concerns include that while people who complete treatment programs re-offend at lower rates than those who don’t, professionals still don’t have data from randomized trials showing that the actual treatment we are providing works. In fact, some studies of apparently good treatment programs seem to have produced few effects (e.g., Marques, Wiederanders, Day, Nelson, & van Ommeren, 2005; Hanson, Broom, & Stephenson, 2004).

A meta-analysis by Karl Hanson and his colleagues (Hanson, Gordon, Marques, et al., 2002) found that people who completed treatment programs tended to have lower sexual re-offense rates (by about 25%) than comparison groups. The authors noted the limitations of the studies and that these figures don’t account for those who refuse or drop out of treatment. For many, this simple fact is a deal-breaker; our numbers simply don’t add up to optimism about our efforts. Three years later, the long-awaited randomized clinical trial (RCT) by Janice Marques and her colleagues found no difference between those who completed the treatment program and those in the control group. However, the authors concluded that those treatment participants who “got it” and meaningfully completed their treatment goals really did re-offend at lower rates. This single study has been used as a source of optimism for many, and for others remains the ultimate proof that we still don’t know whether we can effectively treat sexual aggression. Spirited debate followed. Marshall and Marshall (2007) argued that RCTs are not the final word in scientific evidence. A host of others (e.g., Seto, Marques, Harris, et. al., 2008) disagreed. The end of the last decade saw the most recent treatment outcome meta-analysis (Hanson, Bourgon, Helmus, & Hodgson, 2009) suggesting that programs adhering to the principles of risk, need, and responsivity have the greatest effect on sexual re-offense.

Significant questions remain: What about those people who do complete treatment programs? Should our research and practice efforts be focused on creating what Marques et al., referred to as those who “got it”? Elsewhere, Prescott and Levenson (2009) have asked whether our field is actually asking the right questions. For example, beyond does treatment work, there are questions regarding with whom it works, under what conditions, with what kinds of providers, etc.? More recently, Prescott (2011) suggested shifting the focus to building willing partners in treatment programs. That is, what can professionals do to create programs in which those at risk for refusing treatment or dropping out do to “get it” and meaningfully change? Whatever the case, it’s important to remember that treatment attrition is a serious problem in all of criminology. Olver, Stockdale, and Wormith (2011) found an overall attrition rate of 27.1 percent and ...continued... by David S. Prescott, LICSW

Media distortion of the public's perception of recidivism and psychiatric rehabilitation

1991:

OBJECTIVE: The public's perception about the success or failure of psychiatric rehabilitation is frequently dependent upon information received through the news media. The primary objective of this report is to present an example of how the news media can distort public perceptions of treatment outcome.

METHOD: Verbatim quotations were presented from a television news series that alleged criminal recidivism by nine patients purportedly treated for various paraphilias at a large, community-based sexual disorders clinic. Brief case vignettes about each of the nine were then reviewed. This allowed for comparisons between what the media had alleged and what had actually occurred.

RESULTS: Two of the nine cases were relatively minor instances of recidivism involving no genital contact, although the media presentation had either failed to report this or had suggested otherwise. A third case of alleged recidivism involved a patient who was evaluated but never actually treated by the clinic in the community. A fourth patient had refused recommended clinic treatment upon prison release, and a fifth patient had been discharged from treatment at the clinic because of noncompliance years before recidivating. Other cases presented contained additional misleading information. None of the nine cases was reported by the media in the context of a balanced approach that included treatment successes. Clinic staff were constrained from responding publicly to correct certain misinformation because of patient-psychiatrist privilege.

CONCLUSIONS: Inaccurate media presentations about psychiatric rehabilitation that ignore treatment successes and focus only on alleged failures do a disservice to patients, mental health workers, and society at large.

For the remainder of this article: by FS Berlin and HM Malin, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205.

Media Distortion of the Public's Perception of Recidivism and Psychiatric Rehabilitation by Fred S. Berlin, M.D., Ph.D., and H. Martin Malin, Ph.D.,
American Journal of Psychiatry, 148, 15, pp. 1572-1576, 1991.