Thursday, February 26, 2009
Skip the study and offer treatment
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Maurice S. Fisher
Fisher is a resident of Virginia and has been a therapist for 25 years, specializing in risk assessment and treatment of juvenile and adult sex offenders.
Recently a client asked, "What do you think is worse than having a chemical addiction and seeking treatment in Virginia?" I responded, "What?" My client's rejoinder was "being a sex offender in Virginia and having no treatment available for it except for being incarcerated."
As I pondered my client's query, I discovered The Roanoke Times editorial entitled, "Does the sex offender registry work?" (Feb. 15). Though I seldom agree with The Times on issues relating to mental health care, I must say that I was delighted to agree with this well-conceived beginning critique of how Virginia's sex offenders are managed.
Though there are many people who believe that the most appropriate intervention for a sex offender (who typically is a male) is castration, and/or pillorying him or her in a gallows somewhere, this is close, in my professional estimation, to the general treatment philosophy of the Virginia Department of Corrections and the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services.
In Virginia, both agencies will argue that there is no known treatment for sex offenders. According to these folks, the best we can do is to assess their risk for repeating a similar offense based on static traits (i.e., those that do not change) and dynamic traits (i.e., those that do change) for sex offenders released from a state prison. If the person is evaluated to be "dangerous," then we can civilly commit him for an undetermined amount of time -- irrespective of the fact that the commonwealth has already noted that said treatment does not work. How long it will take a wealthy sex offender and his attorney to cry double jeopardy or find a way to demonstrate that our leaders are holding him in a mental health facility after he has paid his societal dues? Perhaps the identified "violent sex offender" serving his time in Virginia could possibly be assessed upon entry into the system and treated while there.
Where I disagree with The Times is in its encouraging yet another study for Virginia. Our state leaders love studies, especially if the study includes an expert from another state. A historic case in point is the Geller Study commissioned by the mental health department to critique the public mental health system. However, the 1990s Jeffrey Geller Study did not produce what the then-mental health commissioner James Kelly and his benighted board expected, and the commonwealth attempted to renege paying for the study.
Virginia lessons learned: Our leaders like studies. Our leaders don't use the outcomes of studies. (Recall the recent series of studies conducted after the April 16, 2007, Virginia Tech mass murder by a violent mentally ill psychopath approximately two years hence. Where are the substantive changes in mental health system?) And if our leaders don't like the study's outcomes, they won't pay.
I would like to propose another lesson for our leaders and it's a fairly easy concept for them to embrace: vicarious learning. Vicarious learning implies learning from both the successes and failures of others and then attempting to put into motion what works best. Our leaders can learn from the New Jersey study on the sex offender recidivism that placing in public the pictures and addresses of adult sex offenders did not lower the risk of violent sex re-offenses.
From my clinical experience, I suspect that New Jersey's study is representative of what other states would find -- given that sex offenders are not the smartest of criminals, owing to the fact that they act out of passions, mental illness, poor socialization or a mixture of these. But more important, typically persons diagnosed with a paraphilia tend to not learn vicariously; they learn about and redirect their sexual urges by gaining both an awareness (i.e., that they are not normal) and a sensitivity (i.e., a willingness to change) to their psychosocially developmental sexual delays, as well as development of victim empathy. NBC's series "To Catch a Predator" has exhaustively demonstrated that even placing a sex offender's picture on a national television program does not serve as a deterrent.
The most straightforward intervention measure would be to provide money for the development of safety plans that protect the public and therapy that helps the sex offender redirect his libidinal energies to more socially appropriate outlets. Or, our leaders can do what they tend to do best -- spend taxpayer money and commission an expert to study the problem.
