Crime Library: Criminal Minds and Methods

Child Sex Offenders

Risk Assessment

During the 1970s and 1980s, psychiatrists assumed they could make an accurate risk assessment, but it soon became clear that they were little better at it than someone with no experience or training at all. In fact, they proved to be slightly better than chance. Thus, psychologists developed risk assessment tools that addressed a combination of factors in an offender's background and past behavior. The factors generally considered for categorizing risk include the offender's post-incarceration level of supervision, the status of their therapy or counseling, their criminal background, degree of remorse for criminal acts, substance abuse, employment or schooling status, psychological or psychiatric profile, and a history of hanging around locations where children congregate.

According to John Monahan, risk assessment research must meet certain criteria, such as segregating the notion of risk into component parts, relying on a rich array of relevant factors, scaling harm in terms of its seriousness, and relying on good statistical data. These criteria are met in the MacArthur Risk Assessment Study, in which a professional team spent a decade examining the relationship between mental disorder and violent behavior. They utilized interviews with patients, interviews with collateral individuals, and official sources of information such as hospital records. They relied on a list of 134 risk factors across four domains (dispositional/personal, historical, contextual, and clinical) that had been associated with violence in prior research or were believed by present clinicians to be so associated. This list included factors such as social support, impulsiveness, anger control, psychopathy, and delusions.

Book cover: MacArthur Risk Assessment Study
Book cover: MacArthur Risk
Assessment Study

Of the four domains, only contextual and clinical factors were relevant to risk management because these factors could be changed. But among those factors that were most potent for violence were the following: being male, having a prior record of violence or aggression, physical abuse in childhood, having a parent who was a substance abuser or criminal, living in a disadvantaged neighborhood, having a diagnosis of an adjustment disorder or substance abuse, evidence of psychopathy, having a suspicious attitude toward others, having had an auditory hallucination that commanded a violent act, thinking or fantasizing about harming others, and a high score on the Novaco Anger Scale.

Dr. Patrick McGrain
Dr. Patrick McGrain

Once the assessment is done, the next step involves devising a program for therapy or retraining. Dr. Patrick McGrain, assistant professor at DeSales University, teaches a course on Sexual Deviance and the Law.  He has also studied addictive behavior in the criminal arena. To his mind, effective treatment must identify individual issues and respond with a specialized program. "Differential treatment can be expensive," he admits, "but biological, psychological and sociological theories all point to the offenders as having differing motives. Before developing a program, we need to realize what we're dealing with." 

In other words, it's important to identify the triggers in each individual case, and that relies on an offender's ability to disclose and articulate them. That often means intensive therapy, with homework, journals, and other means for eliciting accurate information from people who may be reluctant, angry, uneducated, or ashamed. They must be taught to empathize with their victims, take responsibility for their choices, and develop a lifetime management plan to avoid, interrupt or confront the triggers. The most effective programs will assist them to implement what they have learned.

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