The Effectiveness of Sex Offender Interventions - Essay Example

Sex Offender Interventions Introduction Sexual offences have been increasing in the last few years, it has now become both a social and a health problem; a social problem because of the challenges that face a society with such offender in terms of security and relationships, and a health problem because of the medical complications that the victims face (Barbaree & Marshall, 2008, p176). From the large number of research that has been carried out in sexual offending, medical specialists may assume that there clinically effective ways that can be used to treat sexual offenders (Seto, 2008, p90; Lösel & Schmucker, 2005, p124). However, since the treatment is very complex and involves multiple etiologies, individualized risk reductions and risk management, medical experts have been trying to identify the most effective treatments that can address these behaviours. This paper will analyse two interventions among sexual offenders that are likely to be the most effective. Psychological interventions for treatment of sexual offenders Before sentencing of sexual offenders, psychological interventions must be carried out to determine the mental fitness of the offender when committing the crime; however, these interventions have usually been accepted without anyone questioning their effectiveness (Brooks-Gordon, Bilby & Wells, 2006, p452). A number of studies have been carried out in regard to psychological interventions, these studies included randomised controlled trials involving 567 male offenders; among those, follow up was conducted for a 231 of them for ten years (Harris, Scott & Helmus, 2007, p123). The findings of these trials found out that the behavioural treatment therapies were usually too little to provide any meaningful information; however, it was also found out that there was noteworthy improvement in some of the sexual offenders who underwent the treatment. Cognitive behavioural group therapy was found to reduce the rates of individuals committing the offence for a second time; this was especially manifest among child offenders within one year of the offence as compared to the normal standard care (Borduin, Schaeffer & Heiblum, 2009, p26). However, despite the child sexual offenders showing improvements after cognitive behavioural group therapy, they had the worst attitudes during treatment as compared to transtheoritical counselling group therapy. Information that is available as a result of randomised and controlled trials does not provide full information especially regarding the repeat sexual offenders, where the repeated offence can mean any form of crime (Letourneau et al, 2009, p89). The reason for repeat offences has always been pointed to failed treatment since offenders who complete the whole process of therapy are less likely to be involved in repeat offences and when they do, the offence in most cases is less serious compared to the initial offence; this is in comparison to those who have not achieved the level required in dealing with their psychological issues. This method of helping sexual offenders is however, without its challenges which compromises its effectiveness, for instance, a randomised controlled survey in a complex environment will not give clear results on whether a programme is effective or not (Ryan, Leversee & Lane, 2011, p111). Although qualitative research can be helpful in determining the way psychological therapy is conducted and followed by sexual offenders, little amount of research has been conducted regarding the same. Sexual offending cases cannot be cured completely; therefore, a better understanding on the various psychological alternatives available to control or mitigating the harm caused would be of much help. The studies of psychological therapies to sexual offending have some several shortcomings in their methodologies and measurements. First, most studies conducted on sexual offenders do not have control groups; this is because withholding treatment from these sexual offenders will result in psychological and physical injuries to both the victims and the offenders (Yates, 2004, p217). Secondly, these studies rely to a large extent on recidivism or recurrence offending as the sole measure of outcome on psychological treatment. The recurrence of offending is usually got from arrests and convictions records with the authorities, this ignores the fact that some of the victims of the offences never report. In addition, criminal behaviours data show that a criminal has usually committed at least two or more offenses before he is apprehended. This therefore distorts the accuracy of the data available on efficacy of psychological methods of treating sexual offenders (Hanson, Bourgon, Helmus & Hodgson, 2009, p877). Another challenge that has been found to affect studies in treating sexual offenders is the phallometric assessment which makes it easier for the offender to hide the real response to the treatment or misrepresent the results, however, this assessment can be helpful in situations where the treating officer takes the necessary measures to avoid false results Marshall et al, 2005, p1107). Pharmacological treatment of sexual offenders Pharmacological treatments among sexual offenders usually targets their endocrine cause factors such as testosterone and neurotransmitters such as serotonin, which are responsible for sexual drive; therefore, they are targeted at reducing the sex drive of the offenders. One of the pharmacological treatments is the selective serotonin reuptake inhibitors, which act by inhibiting serotonin uptake in the synaptic cleft. Studies that have been carried out regarding its use in treating sexual offenders has found out that it is effective; a study carried out using 200 offenders who received fluoxetine and fluvoxamine showed that 50 to 70 per cent of them responded to the treatment. Studies conducted using serotonin have not been broad and conclusive enough and for its effect to be completely understood, further research will need to be carried out. Naletrexone has also been used to treat sexual offenders after it was found out that it was effective in treating alcohol addicts and perennial gamblers; a study carried out with 21 sexual offenders corroborated this fact with almost all of them showing improvements at a dosage of 50mg/d (Bradford & Federoff, 2006, p371. Due to the small sample that was used to test this drug, the results have been disputed since most of the subjects who were used in the sample had previously been involved in at least one or more therapy to reduce their likelihood of committing sexual offences. Medroxyprogesterone acetate (MPA), which is a derivative of progesterone, is effective in reducing testosterone levels in serum through blocking its production; the dosage recommended for sex offenders is accepted to be between 100 to 600mg/d orally or 100 to 700 mg IM weekly. In one study conducted among 100 sexual offenders where they were administered with a dosage of 250mg IM after every two weeks, for a period of 3 years, there was only one case of recidivism. In another study that involved 275 sex offenders and a follow up period of 5 years, the subjects were divided into two groups; high risk and low risk groups, part of the high-risk group received a MPA dosage of 200 to 400 mg IM after every two weeks while the other part did not receive any treatment. The results showed there was not a single case of repeat offence among the high risk individuals who were given MPA while the high risk who were given had a 18 per cent recidivism; the low risk group had recidivism rates of 15 per cent (Briken & Kafka, 2007, p611). However, the side effects of this medication may further outweigh the benefits since more than half of the subjects that used this medications were found to have erectile and other medical complications. Gonadotropin-releasing hormone (GNRH) agonists work by causing an increase in secretion of LH enzyme, which is followed by a regulation of the gonadotroph cells and LH concentration to a point of almost complete loss of sexual desires. In a study conducted among 118 sex offenders, Gonadotropin-releasing hormone agonists were found to significantly reduce erections, orgasms and ejaculation; the offenders reported to feeling more relaxed and the levels of repeat offences were minimal, offenders who were not affected by other forms of pharmacological treatments responded well to this intervention (Codispoti, 2008, p676). The ethical use of this form of treatment has not been solved since its side effects were found to last for long periods of time therefore denying the victims the chance to enjoy active sexual life after rehabilitation. References Brooks-Gordon, B., Bilby, C., & Wells, H. (2006). 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