What is Clinical Assessment of those with inappropriate or illegal sexual behavior?
The primary forms of clinical assessments used are
- Psychosexual or sex offender–specific evaluations (addressed below);
- Psychiatric assessments (standard tools such as the Rorschach or ink blot test); and
- Physiological (e.g., plethysmograph, lie detector, Abel Screening) assessments of deviant arousal, interests, and preferences. (These will be discussed on the Physiological Assessment Tools page. Here.)
The assessments are not used to:
- Determine guilt or innocence;
- Identifying whether an individual is or is not a “sex offender” (because no specific type of assessment or set of assessment tools is designed for making this determination); or
- Concluding whether an adult or juvenile meets the “profile” of a sex offender (which does not exist; research consistently demonstrates the diversity of adults and juveniles who have committed sex offenses).
Information on sex offender risk assessment can be found at the Sex Offender Management Assessment and Planning Initiative section of the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering and Tracking (SMART) within the Office of Justice Program, U.S. Department of Justice, here.
A comprehensive discussion of risk assessment can be found at the Center for Sex Offender Management, The Comprehensive Assessment Protocol: A Systematic Review of Adult and Juvenile Sex Offender Management Strategies. Here.
An example of a State report on Risk Assessment from the Missouri Sentencing Commission
On the following pages we will provide more specific information the psychosexual assessments used for those who have demonstrated inappropriate or illegal sexual behavior.
Psychosexual evaluations (sometimes referred to as sex offender specific evaluations) are often requested to identify the level of risk associated with an individual demonstrating inappropriate or illegal sexual behavior. The information these assessments seek to discern are:
- Recommended types and intensity of interventions that will be most beneficial, including level of care (e.g., community versus more secure placement);
- The specific dynamic risk factors or criminogenic needs to be targeted through interventions;
- Amenability to interventions;
- Responsivity factors that may impact engagement in and response to interventions; and
- Strengths and protective factors relative to the individual, as well as those that exist within family, peer, and other community support systems.
- Level of risk for sexual and non–sexual recidivism;
Although similar to “general” psychological evaluations in some ways (e.g., conducting a social history, identifying potential mental health needs, using intellectual and/or personality testing, exploring harm to self or others), psychosexual evaluations are distinct in a number of ways.
A rather unique and critical component of the psychosexual evaluation is the detailed and thorough sexual history, which includes the exploration of sexual development, attitudes, fantasies, and adjustment. This is done to enhance the reliability, comprehensiveness, and usefulness of psychosexual evaluations, which is why the multiple sources of data must be taken into account (e.g., deviant sexual interests, impulsivity, parent–child relationships, antisocial values and behaviors, poor social skills, negative peer relationships).
Taken together, the use of psychosexual and physiological assessment tools, with other elements set the psychosexual evaluation apart from the general psychological evaluation.
Whatever their origin, there are three main approaches:
- “Actuarial” assessments involve obtaining the answers to a set, specified number of questions, (e.g. number of previous convictions). Some actuarial assessments can be completed from file information only (e.g. age at first conviction), while some require greater interaction and understanding about an offender (his or her attitudes to crime, for example).
To complete the actuarial assessment, the answers to each and every question are 'scored' and a total (and sometimes
- Structured anchored clinical judgments (SACJs), also known as structured professional judgments (SPJs), which were developed in an attempt to combine the expertise of clinical professionals with the numerical advantages of actuarial measures.
- Clinical, or unstructured assessment, involves interviewing people and trying to get an understanding of how they behave, and why. From this, one tries to make a judgment about how likely it is they will re-offend.
Unstructured assessments may be based not only on interviews, but also consideration of psychological test results,
staff information, the individual’s history, etc. The assumption is that professionals have skills based on years of
experience and can apply these to predicting future behavior.
The above was taken from PsyLegal: Applying Psychology to the Law. The links shown lead to further discussion regarding issues related to the effectiveness of each approach.
State Assessment Tools
Several States have developed their own risk assessment tools to be used in determining the potential risk that an individual may place to the community. These tools are used in determining sentencing options (probation or incarceration) as well as in the release of individuals who are incarcerated (parole).
Links to some of these State assessments can be found here.
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Disclaimer: This site is intended for general public information only. Information on this site should not be considered an alternative for medical or legal professional advice for specific or personal cases.