Advanced Issues i n Scoring and Use: T he Structured Risk Assessment- Forensic Version LIGHT

1. Advanced Issues in Scoring and Use: The Structured Risk Assessment- Forensic Version LIGHT Deirdre M. D’Orazio Ph.D. CCOSO Annual Conference 9 May 2013 drdorazio@cccfpsych.com

2. Introduction • SRA-FVL is an instrument intended to assist professionals in identifying Criminogenic Needs relevant to male adult sexual offending. • It was developed and cross-validated in research carried out by David Thornton and Ray Knight. • The current version of the Scoring Guide was developed by David Thornton & Deirdre D’Orazio. • Questions about scoring may be sent to Deirdre D’Orazio at drdorazio@cccfpsych.com. Include agency name in email. • Questions about research involving the instrument may be sent to David Thornton at david17thornton@aol.com.

3. Workshop Outline • Introduction • SRA Four Step Risk Assessment Model • Conceptual Framework of SRA-FVL • Review of SRA-FVL Scoring Rules • Challenging Scoring Scenarios & Case Studies • Treatment Planning guided by SRA-FVL • Any and All Questions about SRA-FVL

4. The Role of State Authorized Risk Assessment Tool for Sex Offenders • SARATSO requires SRA-FVL as a State Authorized risk assessment instrument • They based this decision on their review of research findings indicating that SRA-FVL predicts sexual recidivism &adds predictive information beyond that included in Static-99R • SRA-FVL scores should be recorded on the 2-page SRA-FVL Coding Form and sent within 30 days of the assessment, to the probation or parole officer. The PO must send it to the DOJ secure email server at cahrso@doj.ca.gov • SARATSO has developing a number of California-based professionals to act as “Super Trainers”

5. Steps to become a Skilled User Activities Achievements Understand the conceptual model Be familiar with the findings from foundational research Understand the Norms and Interpretative Guidelines Understand the scoring rules and be able to apply them reliably • Participate in at least one full day initial scoring training on SRA-FVL • Use the instrument • Participate in other relevant trainings • Work with colleagues or a local super-trainer to improve your reliability

6. Why Use the SRA-FVL? SRA-FVL has been designed to assist in several kinds of decision making regarding sexual offenders: • The selection of treatment targets • Placement of offenders in groups that differ in relative risk of recidivism. This allows prioritization of resources assigned to manage their risk • Selection of the appropriate recidivism norms to use with Static-99R (though this use will not be covering in this training)

7. The Conceptual Model of Structured Risk Assessment

8. SRA Refers toa Four Step Risk Assessment Process • Step One: Static Risk Indicators • Placing offenders into broad risk-groups based on easily available statistical risk indicators • Step Two: Need Assessment • Identification of long-term vulnerabilities (i.e. criminogenic needs) • Refined assessment of long-term risk • Step Three: Progress Assessment • Evaluating change in response to energetic intervention • Step Four: Risk Management • Identifying re-offense scenarios & acute risk fluctuation

9. SRA isunderstood in the context of the Risk Need Responsivity Principles Risk: Assignresources according to level of risk Need: Focus treatment efforts on addressing factors closely linked to recidivism (“Criminogenic Needs”; in SRA often called LTVs). Treatment that systematically targets Needs is twice as effective at reducing recidivism (Andrews & Bonta, 2006; Bonta & Andrews, 2007) Responsivity: Use methods that maximize offenders’ response to treatment as delivered. These are appropriate to the culture and learning style of the offenders as individuals and generally

10. The SRA Need Assessment Conceptual Framework • Developed in the late 90s to assist psychologists involved in assessment and treatment of sexual offenders in Her Majesty’s Prison Service • Based on theory, clinical experience and the then available research literature (Thornton, 2002) • Comparing index-only offenders to those with index plus priors • Place in offense-cycle/behavior chains • Recidivism studies • Key elements • Need Assessment is one of the foursteps in complete risk process (static; need; progress, risk management) • Four domains of psychological risk factors identified • Constructs deliberately defined at a theoretical level • A valid implementation of an SRA Need Assessment assesses at least three of the four domains • Preference should be given to protocols that provide more credible assessment for the context in which it will be used

11. There are several implementations of SRA Need Assessment Beech et al’s questionnaire sets HMPS questionnaire sets Therapist Rating Scale (not intentionally designed as such) Structured Assessment of Risk and Need (SARN) STABLE 2000 & 2007 (not intentionally as such) Violence Risk Scale-Sexual Offender Version (not intentional) SRA-FV made available to clinicians in 2010; SRA-FVL 2011

12. First SRA-FV Reference? In Knight & Thornton (2007) it was referred to as “SRA Need Assessment” in Table 5 and the text. Knight, R.A. & Thornton, D. (2007). Evaluating and improving risk assessment schemes for sexual recidivism: a long term follow up of convicted sexual offenders. Final Report: US Department of Justice, Award Number 2003-WG-BX-1002. http://www.ncjrs.gov/pdffiles1/nij/grants/217618.pdf The name “SRA-Need Assessment – Forensic Version” (SRA-FV) was subsequently introduced to distinguish it from other implementations of SRA. See Thornton, D. & Knight, R. (2009) Using SRA Need Domains based on Structured Judgment to revise Relative Risk Assessments based on Static-2002 and Risk Matrix 2000. Paper presented at the 28thATSA Annual Research and Treatment Conference on October 1st in Dallas, Texas

13. SRA-FVL Need Assessment • This instrument is intended to assess Long-Term Vulnerabilities (LTVs) • Identified LTVs should form the focus of the offender’s treatment plan • Response to treatment can be judged in terms of how well the offender learns to manage their LTVs • Scores on SRA-FVL change when healthy functioning in the community has been sustained for long enough to signal changes in the underlying LTVs. It is insensitive to lesser degrees of change.

14. What are Long Term Vulnerabilities? • A way of functioning that has become sufficiently persistent and generalized that it is likely to reoccur, regardless of whether it is currently displayed • Examples: • A “schema” that may or may not be active at any particular time • A sexual interest that may or may not lead to fantasies at any one time • A way of coping that is habitually employed in response to stress • LTVs normally change over decades rather than days, months or years • Acute traumatic events may be an exception to this

15. According to the Structured Risk Assessment model LTVs fall into Four Domains

16. The Forensic Version of SRA • SRA-FV is designed to allow LTVs to be assessed in a forensic context where offenders are often uncooperative or defensive • SRA-FV & FVL do not assess the Distorted Attitudes domain because it is hard to determine someone’s real beliefs if they are not prepared to talk openly • SRA-FV seeks to assess LTVs in the remaining three domains as indicated on the next slide • The difference between the Full and Light version of SRA FV is that the Light does not include the factors involving PCL-R scores

17. SRA-FV Factors Sexual Interests Domain (SID) • SID1: Sexual Interest in Children • SID2: Sexualized Violence • SID3: Sexual Preoccupation (average of narrow and broad sexual preoccupation) Relational Style Domain (RSD) • RSD1: Lack of Emotionally Intimate Relationships with Adults (LEIRA) • RSD2: Emotional Congruence with Children • [RSD3: Callousness (facet 2 from the PCL-R)] • RSD4: Grievance Thinking (average of internal grievance thinking and poorly-managed anger) Self-Management Domain (SMD) • [SMD1: Lifestyle Impulsiveness (facet 3 from the PCL-R)] • [SMD2: Resistance to Rules and Supervision (facet 4 from the PCL-R)] • SMD3: Dysfunctional Coping

18. What canSRA-FVL provide the treatment provider? 1. A rating of the presence and intensity of each of the Needs assessed • This is useful for deciding what to focus on in treatment • Because it isn’t a fully comprehensive assessment of Criminogenic Needs your clients may well have additional treatment needs (see next slide) 2. An overall Need rating • This is useful in deciding how much treatment the offender is likely to require and making judgments about relative and absolute risk

19. Known Criminogenic Needs not Covered by SRA-FVL • Distorted Attitudes • Generalized beliefs that make it easier to give oneself permission to offend • Social Deviance • Lifestyle Impulsiveness • General Criminality • Callousness

20. Scoring

21. Be Mindful for Possible Score Reductions! After scoring all the items, review those that you have scored a 2. Reduce the score to a 1 if either of the following applies. • The 5-Year Rule: Evidence of the factor operating was absent during both the offender’s last 5 years in the community and during intermingled and subsequent time in prison or other forms of secure custody. • Juvenile-only Rule: The only evidence for the factor relates to behavior before the offender was 18 years old.

22. The 5-Year Rule In this example, we will consider Sexual Interest in Children (SID1) In the above example, the 5-Year Rule WOULD NOT apply: 3 years on parole + 6 months on probation < 5 years in the community (3.5 years). If the 12-year-old male in this example was the offender’s third victim in a span more than 6 months, he would retain a score of “2” for factor A. 22

23. Sexual Interests Domain (SID) • This domain incorporates long-term vulnerabilities that have to do with the direction, form and strength of sexual interests. • SRA-FVL assesses three SID factors • Sexual Interest in Children (SID1) • Sexualized Violence (SID2) • Sexual Preoccupation (SID3)

24. SID1: Sexual Interest in Children Factor

25. Tom Provided gifts and money in exchange for sexual favors from three stranger boys over a 4 year period (victims all age 14). He was also convicted for possession of child pornography involving nude photos of teenage boys. He is currently serving a prison sentence for the above offenses.

26. Gerry Has 3 known victims, the first when he was 22 and the most recent when he was 30; two boys (age of 10 and 12) and a girl aged 12. Gerrywas arrested when he was 32. He was in prison until he was 37. Since his release he has resided in the community without further known problems. He is now 46.

27. Adam At the age of 40 Adam offended against a 10-year-old female child. He knew the child but she was not a relative. He was placed in probation. Then 12 months later, while under supervision, he attempted to groom another girl aged 12. He reports sexually fantasizing about the first child for three months prior to the offense and about the second child for a month before he started to groom her. He asserts strongly that he was not planning to offend against the older child. He is now 42.

28. Suppose • Adam is currently on supervision following a sentence given for burglary. His last known sex offence (see previous slide) happened 15 years ago. He completed four years supervision for this offense. Three years ago he was convicted for burglary. He was again placed under community supervision. There has been no subsequent evidence of an interest in children • How would this change his score on SID1

29. SID2: Sexualized Violence Factor

30. Remember Score 2 when: Offenses against 3 different victims each involving behavior beyond, and spanning more than 6 months (per scoring rules count preferential PPG to sexual coercion, significant arousal to non-sexual violence and sexually violent or sadistic pornography as one victim) OR self-reported rape fantasies spanning more than 6 months Score 1 when: One or two offenses involving “behavior beyond” and no self-report of rape fantasies, preferential PPG to sexual coercion/significant arousal to non-sexual violence or sexually violent pornography

31. Which involves “behavior beyond”? • Mr. A broke into a woman’s home and then threatened her with a knife saying that he would cut her if she didn’t cooperate. The woman then disrobed at his instruction and he vaginally raped her then fled out the window through which he entered. • Mr. B came from behind woman who was jogging in a park, grabbed her by her hair and pulled her off the path and to the ground. He demanded that she give him oral sex. As she complied, he repeatedly called her a whore. Then he pushed her down to the ground, stripped her and vaginally raped her. While doing this he continued calling her derogatory names. He then told her he had only given her what she deserved and ran off.

32. Which involves “behavior beyond”? • Mr. A overpowered a woman and then penetrated her vagina and anus with a beer bottle. • Mr. B met a woman in a bar and persuaded her to come back to his place saying he had some drugs he would share with her. He was sure that she would let him have sex with her and when she refused he beat her violently until she stopped resisting his advances. After the rape it was determined that his blows had broken her nose and cracked two ribs.

33. SID3: Sexual Preoccupation Factor Two Items are averaged for this Factor: • SID3A Sexual Preoccupation (rule-based) • SID3B Sexual Preoccupation (concept-based) To compute the score for SID3: • (SID3a + SID3b) / 2

34. Sean Over the past two years, Sean spends increasingly larger amounts of time engaged in sexual practices with blow up dolls. This frequently results in multiple sexual outlets daily. Nearly every weekend he goes to clubs seeking to find sexual partners who will bind and beat him. These sexual practices have impaired his work performance and relationships.

35. Cameron • His lifestyle over the last three years has involved the following elements most months. • Spends an hour viewing Internet porn most Saturday mornings • Encourages his wife to have sex with other men while he watched • Picks up a woman for casual sex three of four times a month • Attempts to spy on women changing in and out of swimwear in a public pool • Recurrently makes unwanted sexual jokes to female shop assistants when buying groceries

36. Sexual Interests Domain (SID) Total Score • Average the three factors • Sexual Preference for Children (SID1) • Sexualized Violence (SID2) • Sexual Preoccupation (SID3) • SID Average = (SID1 + SID2 + SID3) / 3

37. Using the Scoring Form and Evidence Grid • Enter evidence for and against the presence of each factor in the Evidence Grid • Enter Scores for each item into the Scoring Form • Do the arithmetic to calculate scores for factors and domains, and the total Need score • Look at the Scoring Form. You enter your item ratings into gray cells and all the scores you calculate also go into gray cells • The next few slides illustrate this for the sexual interest domain

39. The Relational Style Domain (RSD) • The Relational Style domain is about general patterns in the way the offender relates to others and the feelings that are embedded in these relational patterns. • It particularly concerns capacity for marital-type relationships and how friendships and social interactions are conducted • SRA-FVL assesses three RSD factors • LEIRA (RSD1) • Emotional Congruence with Children (RSD2) • Grievance Thinking (RSD4)

40. RSD1: Lack of Emotionally Intimate Relationships with Adults (LEIRA) Factor

41. Joel Joel is 32 yrs-old and has never been married. He has been in a relationship with another inmate since he entered prison at age 19.

42. Wes Wesis now 60. He has been in prison since he was 50. He was married for many years. He reported feeling lonely throughout this relationship and committed many sexual offenses against stranger women during the period he was married.

43. Paul Paulwas married for sixyears. He and his wife were madly in love when they married and for four years they were happy together, seemed to communicate well, and shared many common interests. Sometime in the fifth year times became harder, he lost his job, and they started arguing incessantly. In the six year they drifted further apart and eventually he started an affair with a woman who lived near them. Dick has now been divorced for five years. He has had one long term girlfriend over this period.

44. Would it change the scoring for Paulif his marriage had been good for two years but had broken down in the third year?

45. RSD2: Emotional Congruence with Children Factor

46. Eli Eli believed that children loved him, they enjoyed spending time with him, they were interested in him and his welfare, and they could reliably be counted on to make him feel better when he needed comfort and solace. He had found that children accepted him and understood him and that he had obtained an elevated status of importance and prestige with them that adults didn’t accord him. With adults he typically felt uncomfortable, found it difficult to trust them, and felt that he had to earn their affection whereas children just gave their affection freely. This pattern of relating to children and adults has gone on for most of his adult life (he is now 45).

47. Earl • Earl is 35. He has always found it difficult to make friendships with adults. He says he can get on alright with children but has had no particular child friends.

48. Ed Ed is now 45. He has always found it easy to make relationships with children; he says he understands their feelings and they respond to him by becoming his friends. He has had several child friends of this kind and has only offended sexually against one of them. He says having a friendship with a child is a truly sweet and precious thing. Ed is married and reports several close friendships with adults

49. RSD4: Grievance Thinking Factor • RSD4 averages two items • RSD4A: Internal Grievance Thinking • RSD4B: Poorly-Managed Anger • RSD4 = (RSD4a + RSD4b) /2

50. Frank As a teenager Frank developed a powerful sense of resentment about the way his mother treated him. He also resented the popular girls who didn’t pay attention to him and complained about being asked to babysit for his brother’s children when his brother was providing him with a home. Later, as an adult, he resented his wife and his daughters spending their free time with his wife’s family and not staying home with him and his fellow workers who he felt were unfairly favored by their boss. He tended to brood over these resentments and express them in angry terrifying rages at home where he would yell loudly at his wife and children. Although he felt resentful at work he tended only to express this in occasional snide comments since he knew that anything more would rebound on him. The above pattern continued until he was arrested. He is now in prison.