Article
Applying the Risk Principle
to Sex Offenders
The Prison Journal
Volume 89 Number 3
September 2009 344-357
© 2009 SAGE Publications
10.1177/0032885509339509
http://tpj.sagepub.com
hosted at
http://online.sagepub.com
Can Treatment Make Some Sex
Offenders Worse?
Brian Lovins
Christopher T. Lowenkamp
Edward J. Latessa
University of Cincinnati, Ohio
The risk principle states that higher risk offenders should receive more intensive
services, whereas lower risk offenders should receive less intensive services.
However, the criminal justice system routinely ignores the risk principle for
sex offenders and treats them all the same with little regard for level of risk.
This article explores the effects of different levels of treatment intensity on 238
sexual offenders who are on parole. The findings suggest that the risk principle
does, in fact, apply to sexual offenders.
Keywords: sexual offenders; risk principle; treatment effects; correctional
programming
H
istorically, treating sexual offenders has been much more an art than a
science. Sex offender treatment has targeted areas ranging from the
relationship an offender had with his mother to deviant sexual fantasies
(Allam & Brown, 1998). Ineffective treatment, in conjunction with public
opinion, has not only limited the opportunities sex offenders have for treatment but has also made sex offenders more susceptible to legislation that is
driven by the “worse case” scenario (Lynch, 2002).
Following conviction, sex offenders often face many obstacles. For
example, recent legislation has limited where some sex offenders can live,
work, and who they can interact with in the community. Furthermore, some
jurisdictions have placed sex offenders on lifetime supervision, mandated
long-term sex offender treatment, and passed civil commitment laws to
protect the community from future sex crimes. Although there is very little
evidence to support these “get-tough” strategies, legislators and community
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Lovins et al. / Applying the Risk Principle
345
members alike tend to react emotionally to high-profile sexual abuse cases
by developing even tougher strategies (Lynch, 2002). As such, the criminal
justice system has begun to treat sexual offenders as a homogeneous group
in which there exists little variation in risk to reoffend.
The Risk Principle
Although risk has been generally ignored in public policy, recent advancements in research have recognized the importance that risk plays in the management and treatment of offender populations. The principles of effective
intervention, including the risk principle, were developed as a guide for
evidence-based correctional programs (Gendreau, 1996). As delineated by
Andrews et al. (1990), the risk principle suggests that treatment is most
effective when intensive services are reserved for higher risk offenders.
Furthermore, there is evidence to suggest that when intensive correctional
interventions are applied to lower risk offenders, their likelihood of recidivism can actually increase (Andrews et al., 1990; Lowenkamp, & Latessa,
2002; Lowenkamp, Latessa, & Holsinger, 2006).
Lowenkamp and Latessa (2004) speculate that there are two reasons this
can occur. First, exposing lower risk offenders to higher risk offenders may
enhance negative social learning, thereby reinforcing antisocial attitudes
and beliefs. Second, placing lower risk offenders into intensive programs can disrupt prosocial networks and opportunities. The question
that remains is whether the risk principle can be applied to specialized
populations, such as sex offenders.
Results of Sex Offender Treatment
Although some variation exists, most studies show that sex offender
treatment has some effect in reducing new sex offenses as well as non–
sexually related offenses. In a review of the literature, Craig, Browne, and
Stringer (2003) found that 18 out of 19 studies published since 1995 found
positive effects for sex offender treatment. Hanson et al. (2002), using
meta-analytic techniques, found that the treatment groups had a 12.3%
recidivism rate across studies, whereas the comparison groups had a 16.8%
recidivism rate for new sex offenses. Moreover, cognitive–behavioral and
systemic treatments demonstrated stronger treatment effects for both sexual
recidivism (17% to 10%) and general recidivism (51% to 32%).
Similar to Hanson et al.’s (2002) findings that the type of treatment
matters, Hall (1995) found that cognitive–behavioral treatments as well
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as medical/hormonal treatments were effective in reducing recidivism.
Although Gallagher, Wilson, Hirschfield, Coggeshall, and MacKenzie
(1999) found methodological flaws in Hall’s (1995) use of medical treatments, they supported Hall’s findings regarding the effects of cognitive–
behavioral treatments. Further review of the research by Polizzi, Mackenzie,
and Hickman (1999) found that community-based cognitive–behavioral
treatments were the most effective, whereas prison-based treatments had
less positive results.
Although these studies found positive effects for treating sex offenders,
Bilby, Brooks-Gordon, and Wells (2006) found less support for sex offender
treatment. Using meta-analytic techniques to examine the effect of sex
offender treatment, Bilby et al. found that only 7 of the 17 treatment programs showed a positive effect. Similar results have been found in previous
studies, especially studies that have not taken into account the risk level of
the offender.
Quinsey, Khanna, and Malcolm (1998) found that sex offender treatment actually increased recidivism with more than half of the sample
being rearrested for a violent or sexual offense. Craig, Browne, and
Stringer (2003) pointed out that Quinsey et al. (1998) failed to take risk
into account, summing the treatment effects across a heterogeneous group
of sex offenders ranging from low to high risk. Similarly, Rice, Quinsey,
and Harris (1991) found that sex offender treatment was ineffective. In
a later review of Rice et al., Marshall, Anderson, and Fernandez (1999)
found that 80% of the offenders in the treatment group were identified
as high risk, leading to inflated recidivism rates compared with the lower
risk comparison group.
These contradictory findings, along with public misperceptions of sex
offenders, have led to an overabundance of legislative acts that often
assume that all sexual offenders are the same with regard to the risk they
pose to reoffend (Quinn, Forsyth, and Mullen-Quinn, 2004). The effects of
ignoring the risk principle as it applies to dosage or intensity of treatment
and supervision may have dramatic effects on the results of outcome evaluations. For instance, Lowenkamp and Latessa (2002) found that halfway
house programs treating all ranges of risk had no overall effect on recidivism, but when disaggregated by risk, the same programs averaged a 7%
reduction in recidivism for high-risk offenders compared with a 9%
increase in recidivism for lower risk offenders. Furthermore, Andrews and
Dowden (2006) reported that the treatment effects for low-risk offenders
were significantly lower than for higher risk offenders, and at times treatment was found to make lower risk offenders worse.
Lovins et al. / Applying the Risk Principle
347
Mailloux et al. (2003) examined the risk principle as it applies to sex
offender treatment. They examined the “dosage” of sex offender treatment
and purported that low-risk sex offenders may have received too much
treatment, declaring that treatment may have adverse affects on lower risk
offenders. Although there were several assumptions that were rebutted by
Marshall and Yates (2005), their message was clear that lower risk sex
offenders should receive less intensive services. Although Mailloux et al.
(2003) suggested that the risk principle applies directly to sex offenders,
there is very little evidence to support their claim.
This article will further explore the relationship between the level of
treatment intensity and risk of reoffending for sexual offenders being
released from prison. This is the first study to examine the direct effects of
the risk principle on sexual offenders. Based on the risk principle, the
hypotheses to be examined are the following:
Hypothesis 1: Intensive treatment is more effective for higher risk sex offenders.
Hypothesis 2: Less intensive treatment has greater effects for lower risk sex
offenders.
Method
Sample
The sample for this study was originally collected as part of a statewide
halfway house evaluation project (Lowenkamp & Latessa, 2002). To answer
the above hypotheses, data on all sex offenders were extracted and analyzed.
Two sampling frames were used to draw the sample of sex offenders. The
first comprised all sex offenders paroled from a state institution who were
referred to a halfway house for residential sex offender treatment. For consideration in the study, the sexual offender had to be terminated from the
halfway house between July 1, 1998, and June 30, 1999. Previous research
has noted that offenders who drop out of treatment tend to be less successful
than their counterparts who complete treatment (see Hanson & Bussiere,
1998). This study will therefore examine both successful and unsuccessful
terminations, resulting in a treatment sample of 110 sex offenders, 84 of
whom successfully completed the halfway house programs.
The second sampling frame comprised parolees who were released
directly to the community on discharge from the institution. Out of the
original 3,273 offenders in the comparison group, 238 had a sexual crime as
their instant offense. These comparison offenders may have been mandated
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to outpatient treatment in the community at release, but they did not receive
the more intensive residential sex offender treatment. Hence, the treatment
and comparison groups vary in terms of intensity of treatment. Thus, overall,
348 sex offenders were selected for this study, 110 of whom are in the treatment group, leaving 238 sex offenders in the comparison group.
Measures
Demographic data as well as offender characteristics were collected
from the state reporting system. Individual-level predictors for this study
included race, age, marital status, and risk. Race was measured as a dichotomous variable because there were only Caucasians and African American
offenders in this sample, with Caucasians coded as 1 and African Americans
coded as 0. Age was measured in years, whereas marital status was measured dichotomously as either married or single. For the purpose of this
study, “single” was defined as “not currently married” for any reason.
Risk scores were calculated using a modified version of the Salient Factor
Score (SFS; Hoffman, 1994).1 As noted previously, it is important to understand the effects of risk on intensity of programming. Because there was no
consistent measure of risk across programs and parole, the modified SFS was
used to determine level of risk. The modified SFS includes the following risk
factors: prior arrest, prior commitment, age at current offense, employed at
arrest, history of community control violations, and history of drug use. The
values for each variable are weighted and the total ranges from 0 to 10. Risk
categories were developed based on the raw values. The modified SFS consists
of four categories: low, low/moderate, moderate, and high. Each offender is
then placed in a category of risk that is associated with his raw score. Table 1
provides the correlations between the sex offender’s risk scores and incarceration. The modified Salient Risk Score was significantly correlated to the entire
sample (treatment plus comparison group), as well as the comparison group,
but was not correlated to the treatment only group.
Recidivism data were collected through official record checks conducted by the state correctional department. Recidivism was coded as
incarceration for any new offense, return to incarceration for a technical
violation, and any new arrests for a misdemeanor or felony offense. For the
purpose of this study, incarceration for any new offense and return to incarceration for a technical violation were collapsed into a single measure of
return to incarceration for any reason. Reincarceration was selected because
it provided the most reliable statewide measure of recidivism. Although
return to the institution is a conservative estimate of reoffending (Fisher &
Lovins et al. / Applying the Risk Principle
349
Table 1
Correlations Between Risk Score and Incarceration
Group
All
Comparison
All treatment
Successful treatment
Correlation
N
Significance
.30
.35
.16
.05
348
238
110
84
.000
.000
.090
.672
Thornton, 1993), reincarceration is generally accepted as an appropriate
measure of recidivism (Barbaree, Seto, Langton, and Peacock, 2001).
Table 2 provides the demographics for both the treatment and comparison groups. Confidence intervals were calculated to determine if any significant differences exist between groups. If no significant differences exist
the confidence intervals should overlap. There were significant differences
between the treatment and comparison groups on categories of race and
high-risk offenders, indicating that the comparison group comprised more
African Americans and more high-risk offenders. In contrast, the comparison group was similar on all other categories of risk and marital status. The
average age for the treatment group was 29.88 years, whereas the mean age
in the comparison group was 35.74 years. There was a significant difference between the treatment group and the comparison group on both age
and risk score, signifying that the comparison group was slightly older and
was composed of higher risk offenders.
Analysis
Several analyses were conducted to answer the research questions. First,
logistic regression was used to determine if race, age, marital status, and
risk predicted return to the institution for the treatment group. In addition,
logistic regression was used to determine if any of the same variables were
predictive of reincarceration for successful terminations only.
Second, adjusted probabilities were calculated from the logistic regression models. Logistic regression is a statistical technique that determines
whether the variables in question can predict a dichotomous outcome. The
outcome produced by the logistic regression equation can be calculated to
determine the probability of an event to occur given the characteristics of
interest. Of course, in the context of effective correctional treatment programs, it is very useful to know the likelihood of a person reoffending who
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Table 2
Demographics
All Treatment
Race
White
Black
Marital status
Married
Single
Risk category
Low
Low/moderate
Moderate
High
Age
Risk score
Successful completion
Comparison
N
Percentage
N
Percentage
86
23
79
21
142
96
60
40
36
74
33
67
91
147
38
62
14
23
55
18
13
21
50
16
14
57
87
80
6
24
37
34
N
Mean
N
Mean
110
110
29.88
59.86
238
238
35.74
65.21
N
Percentage
84
76
has a particular characteristic. For the purpose of this study, the probability
of reoffending was calculated for each risk category.
Findings
Tables 3 and 4 present the results of the logistic regression models predicting the outcomes for sex offenders who participated in residential treatment. Table 3 represents all sex offenders who were released to a halfway
house for treatment, whereas Table 4 provides the same analysis for successful terminations only. The estimated models predicted reincarceration
for any reason.
Table 3 presents the results of the logistic regression model examining
the relationship between variables of interest and reincarceration for all
sexual offenders who attended treatment. As indicated in the table, race was
the only variable that predicted reincarceration, indicating that African
Lovins et al. / Applying the Risk Principle
351
Table 3
Logistic Regression Model Predicting Incarceration
Within 2-Year Follow-Up, All Treatment Terminations
Variable
Race
Group membership
Risk category
Interaction risk by group
Constant
B
SE
Wald
Significance
Exp B
−0.50
−0.80
0.41
0.31
−1.17
0.24
0.85
0.23
0.28
0.70
4.20
0.88
3.15
1.18
2.81
.04
.35
.08
.28
.09
0.61
0.45
1.51
1.36
0.31
Table 4
Logistic Regression Model Predicting Incarceration
Within 2-Year Follow-Up, Successful Terminations Only
Variable
Race
Group membership
Risk category
Interaction risk by group
Constant
B
SE
Wald
Significance
Exp B
−0.32
−1.14
0.08
0.63
−0.89
0.26
0.90
0.27
0.31
0.76
1.58
1.58
0.08
4.01
1.34
.21
.21
.78
.05
.25
0.72
0.32
1.08
1.87
0.41
Americans were significantly more likely to be reincarcerated than whites.
Interestingly, exposure to treatment (group membership), risk, and the
interaction between risk and group membership were not predictive of
reincarceration for the entire treatment sample.
Table 4 provides the results from the second logistic analysis, which
examined the relationship between reincarceration and successful completion of treatment. The previous model included any offender who was
exposed to the treatment services, whereas this model has excluded those
offenders who were terminated for any reason other than successful completion. Race was no longer a significant predictor of being reincarcerated,
and neither was group membership nor risk. The only variable that was
predictive of reincarceration for successful completers was an interaction
term between risk and group membership. This relationship was in the
expected direction, leading to the conclusion that higher risk offenders who
successfully completed treatment were less likely to be reincarcerated.
Given that this relationship is significant, further investigation into the
results may provide insight into why risk is not a significant predictor, but
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Figure 1
Adjusted Probabilities of Incarceration by Risk Level
and Group Membership (Visual Display of Table 5)
70
64
60
50
50
47
47
43
39
40
32 32
30
20
24 26
26
29
29
27
19
10
0
Low
Low/Moderate
Comparison
Moderate
High
All Treatment
All
Successful Treatment
Table 5
Adjusted Probability of Recidivism by
Risk Category and Group Membership
Group
Risk Category
Comparison
All Treatment
Successful Treatment
Low
Low/moderate
Moderate
High
All
19
32
47
64
47
24
32
43
50
39
26
26
29
29
27
the interaction between group membership and risk is significant. Table 5
provides the adjusted probabilities for risk by group membership. As the
table indicates, sex offender treatment delivered in a halfway house setting
appeared to be effective for all risk categories except for low-risk offenders.
Figure 1 indicates that high-risk offenders who successfully completed the
residential sex offender program were more than 2 times less likely to be
Lovins et al. / Applying the Risk Principle
353
reincarcerated than those who were released directly into the community
and 1½ times less likely than offenders who were released to a halfway
house but were unsuccessfully terminated. Moreover, recidivism rates for
the entire sample of successful completers, as well as all sex offenders who
were exposed to halfway house services, were significantly lower than those
for offenders who were released directly to the community. Interestingly,
low-risk sex offenders who successfully completed treatment were 27%
more likely to be reincarcerated than sex offenders who did not receive
halfway house services.
Discussion
The purpose of this study was to test the risk principle for sexual offenders and, in doing so, examine the interaction effects of treatment intensity
by risk. The study compared sexual offenders who received intensive, residential sex offender treatment with sexual offenders who were released
directly on parole and received less intensive services. As noted previously,
few studies have examined the application of the risk principle with sex
offenders directly.
This study proposed two hypotheses. The first hypothesis was that intensive treatment should be more effective for higher risk sex offenders. In
support of this hypothesis, recidivism rates for the comparison group were
significantly higher than for similar offenders in the treatment group who
received halfway house services. In fact, high-risk sexual offenders who
completed intensive sex offender treatment were two times less likely to be
reincarcerated than high-risk sex offenders who were released directly to
the community.
This finding can be explained by the risk principle. High-risk offenders
have multiple needs that can be addressed simultaneously in a residential
setting. High-risk offenders are not identified as high risk because they
have a single need that is high; instead, they have a cluster of criminogenic
needs. Halfway house programs are designed to target a greater density of
criminogenic factors and therefore are more capable of addressing highrisk offenders.
The second hypothesis was that less intensive treatment will have
greater effects for lower risk sex offenders. This hypothesis was also supported by the findings. Low-risk sex offenders who were released to the
community without intensive interventions faired 27% better than low-risk
offenders who were exposed to halfway house sex offender treatment.
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Unlike high-risk offenders, low-risk individuals typically have one or two
isolated criminogenic needs. As noted previously, providing intensive services to such offenders may disrupt prosocial networks and opportunities as
well as reinforce negative social learning.
Conclusions
Although the public tends to view all sex offenders as high risk, clearly
the research does not support this. This study found that ignoring the risk
principle leads to a significant increase in recidivism for both low- and
high-risk sexual offenders. Hence, legislators, as well as criminal justice
agents, should recognize the importance of the risk principle in developing
strategies for addressing sexual crimes.
Although this research is the first to directly test the application of the
risk principle to sexual offenders, it is important to note the limitations of the
study. First, although the sample was representative, future studies would
benefit from a larger sample of offenders. This would provide statistical
power to examine further interaction effects and provide more confidence in
the results. Second, the follow-up period for the study was only 2 years.
Barbaree and Marshall (1988) suggest that follow-up periods for sexual
offenders should be a minimum of 5 years. Although 5 years is the standard
for measuring sexual recidivism, a 2-year follow-up has been accepted as
an appropriate measure of general recidivism. Finally, this study examined
the effects of the risk principle on sexual offenders using general recidivism as the outcome measure rather than sexual recidivism. Thus, future
studies should use a larger sample, increase the follow-up period to 5 or
more years, and incorporate multiple measures of recidivism, including
sex-specific offenses. Additional research in this area will assist the criminal justice community in designing effective intervention strategies for
sexual offenders.
Note
1. See Lowenkamp (2004) for a detailed discussion of the modified version of the SFS.
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Brian Lovins received his master’s in social work from the University of Cincinnati. He is
currently a research associate for the University of Cincinnati, Division of Criminal Justice.
He has worked in the field with youthful and adult offenders and has provided training and
consultation to programs regarding risk assessment, treatment delivery, and quality assurance.
Recent research projects have included evaluations on faith-based reentry programs, juvenile
justice programs, and the development of a juvenile risk assessment.
Christopher T. Lowenkamp received his doctorate in criminal justice from the University of
Cincinnati. He is currently an assistant research professor at the University of Cincinnati,
Division of Criminal Justice, and the director of the Center for Criminal Justice Research.
Prior to his appointment at the university, he was an adult probation officer and the emergency
jail release coordinator in Akron, Ohio. Over the past several years, he has provided consultation and research services to multiple agencies and jurisdictions in more than 25 states. His
research interests in risk and need assessment, evaluation of correctional interventions, and
criminological theory have led to publications in some of the field’s top journals. Recent
research projects have included evaluations of community-based correctional facilities, halfway house programs, and intensive supervision probation in Ohio.
Edward J. Latessa is a professor and head of the Division of Criminal Justice at the
University of Cincinnati. He has published more than 110 works in the area of criminal justice,
corrections, and juvenile justice. He is coauthor of seven books including Corrections in the
Community and Corrections in America. He has directed more than 100 funded research
projects including studies of day reporting centers, juvenile justice programs, drug courts,
intensive supervision programs, halfway houses, and drug programs. He served as president
of the Academy of Criminal Justice Sciences (1989-1990). He has also received several
awards including the August Vollmer Award from the American Society of Criminology
Lovins et al. / Applying the Risk Principle
357
(2004), the Simon Dinitz Criminal Justice Research Award from the Ohio Department of
Rehabilitation and Correction (2002), the Margaret Mead Award for dedicated service to the
causes of social justice and humanitarian advancement by the International Community
Corrections Association (2001), the Peter P. Lejins Award for Research from the American
Correctional Association (1999), ACJS Fellow Award (1998), ACJS Founders Award (1992),
and the Simon Dinitz award by the Ohio Community Corrections Organization.