Wednesday, November 25, 2015

Polygraph Testing and Sex Offenders

We recently had a blog post on the polygraph by David Prescott which readers may want to look at in relationship to this new one.
Polygraph testing of sex offenders has come in for a good deal of recent criticism.  While polygraphy in general, and post-conviction sex offender testing (PCSOT) in particular, is not without its problems, many of the negative comments are based on misunderstandings, misconceptions, and sometimes just plain mischievousness.  Other criticisms, however, are based on genuine concerns, a number of which are eloquently described in a recent blog by David Prescott (2015).  But what is often unclear is the extent to which these objections are fundamental to polygraph testing and PCSOT, or whether they relate to poor or outright bad practice in delivery.
Supporters of PCSOT argue that it makes an important contribution to sex offender treatment and management by facilitating disclosure, bringing to attention changes in risk (both increases and decreases), and encouraging offenders to modify their behaviour.  As these outcomes are also sought by treatment providers and offender supervisors in their work with sex offenders, it would seem that it is not the ends of PCSOT that critics don’t like, but the way in which it gets there. 
Objections to PCSOT are of two types, ethical and practical.  As Mark Chaffin astutely observed (Chaffin, 2011), good practice standards are not the same as ethical principles – even where the delivery of PCSOT is well managed, potential ethical objections don’t disappear.  If PCSOT falls at the first, ethical hurdle then there is little point in carrying on, so it makes sense to start there. 
Ethical objections are not hard to find.  Terms commonly used in critical commentaries are ‘coercion’, ‘intrusion’, ‘psychological manipulation’, ‘intimidation’, ‘self-incrimination’, and ‘overriding autonomy’.   Many of this frightening terminology arises from the notion that polygraphy is primarily about interrogation, stated explicitly by Chaffin (2011) who described it as “fundamentally a coercive interrogation tool for extracting involuntary confessions” (p. 320).  But PCSOT need not, and should not, be about interrogation and confession.  Instead, it should be seen as an interview process in which lying is explicitly discouraged but which otherwise mirrors ordinary interviewing practice.  The questions asked during PCSOT are asked by supervisors and treatment providers already, and if they’re not then they shouldn’t be asked by the polygraph examiner.  Offenders have an opportunity to explain deceptive outcomes, but they are not intimidated into doing so. 
Provided that the questions asked during the polygraph test are directly relevant to treatment or supervision, how is it coercive, or morally problematic, to expect the offender to answer honestly?  The problem comes not with the answers, but when an offender who is judged to be deceptive in the absence of disclosures is whisked back to jail, thrown off a treatment programme, or has his progress impeded in some other way on that basis alone.  This is rightly troubling given the procedure’s error rate, which is probably in the region of 10-20%.  It is not, however, a moral issue for polygraphy, but for how its results are used.  A ‘deceptive’ test in the absence of disclosure should be seen as a warning sign, an indication that something requires further investigation or attention, but it should not on its own trigger definitive action.  While that may seem a flimsy use of a muscular outcome, PCSOT is meant to contribute information to treatment and supervision, not drive it.  To that end, it would be a great help if we moved away from talking about ‘passed’ and ‘failed’ tests altogether.
Mandatory PCSOT is of course coercive in that there are penalties for non-cooperation.  But we’re talking about convicted and usually high risk offenders, who by virtue of their criminal convictions are required to accept a range of restrictive and coercive measures such as conditions on where they live, limitations on employment, curfews, and treatment requirements. 
There is, however, a belief that the way in which information from polygraph testing is obtained is inherently hypocritical, with examiners deceiving offenders by telling them that the procedure is error free while at the same time demanding that the offender should always tell the truth.  While this may occur, it is certainly not good practice, nor is it necessary.  Indeed, the British Psychological Society (2004) stressed that participants should be informed of known error rates, a sentiment with which it is hard to disagree.  There is no reason to believe that PCSOT would cease to be effective in these circumstances, and indeed in our experience it has not happened in the UK where we are honest about error rates.
Keeping with the hypocritical theme is another objection that one of the most commonly used polygraph formats, the ‘probable lie technique’, requires the examiner to force the offender to lie to some questions in order to compare the response to answers to so-called relevant questions.  But though this is what tends to be taught, it is not the lie but the uncertainty of the answer that is probably the basis of the effect.  Regardless, those with qualms about ‘probable lies’ can make use of an aligned technique in which the offender is told to lie to certain questions, removing any subterfuge and also avoiding the risk of the examinee admitting to transgressions that have nothing to do with sexual risk.
The loudest and most forceful ethical objections seem to come from those in the adolescent treatment world.  The increased vulnerability of juveniles and adolescents, the worry that more harm than benefit may result from their perception of the process, and the focus on developmental rather than offending issues per se changes the tone of PCSOT from what it is when used with adults.  Indeed, it is not even clear that polygraphy works in the same way as it does in adults given differences in brain maturity and psychological development.  Whereas PCSOT in adult offenders has a steadily thickening evidence base, the same cannot be said for adolescent testing.  But while even critics like Chaffin (2011), who consider the ethical concerns relating to adolescent testing to be “substantial”, don’t go so far to say that it is unethical, they rightly argue for more evidence about the impact of its use in young people.  Until this evidence is produced it is almost certainly right that PCSOT should be used with great caution in young people, with decisions made on a case by case basis (in the UK we do not test those under 18 years of age at all), but care must be taken not to entangle the specific issues associated with testing young people with polygraph testing more generally.
None of the ethical objections referred to above would appear to be fundamental to PCSOT but to how it is delivered.  Which brings us to the more practical aspects of the process. 
In the US the prevailing approach to PCSOT is the Containment Model based on a triangle formed by treatment provider, offender supervisor and polygraph examiner.  While it has clear attractions from a public protection perspective, and helpfully stresses the need for communication between those working with offenders, it implies that all sex offenders require high levels of external control to keep them from reoffending.   Some offenders, however, genuinely seek to improve their internal controls and engage with treatment and supervision, and for them the emphasis on containment risks impairing internal longer term change.  For them the containment model may not be right, but nor is it the only show in town.  PCSOT can have a different focus.  Remembering that test outcome and disclosure are complementary, in those who are working with us polygraphy can function as a truth facilitator, encouraging them to discuss problematic thoughts and behaviors and provide reassurance that their risk is stable.  And though some argue that disclosures simply represent a ‘bogus pipeline’ effect resulting from the false belief that the polygraph is a 100% lie detector and is lost once an offender learns otherwise, all the evidence shows that disclosures continue regardless.  Indeed, rather than denigrating the increase in disclosure obtained in PCSOT we should be looking for ways to enhance the effect. 
There are associated concerns that the largely controlling approach of the Containment Model, and by implication PCSOT more generally, may impact negatively on both therapeutic and supervisory relationships. Arguments to this effect, however, are based on theoretical rather than empirical grounds.  What evidence there is suggests that PCSOT can in fact improve relationships.  It does not have to carry with it the implication that sex offenders are not to be trusted.  It should be remembered that polygraphy also catches offenders telling the truth; one should not underestimate the benefits for an offender who is able to demonstrate that he is being honest in his dealings with those working with him, and the positive impact this can have on his relationship with them. 
David Prescott stresses the importance of establishing a treatment culture “in which honesty and commitment are valued more than the appearance of compliance with expectations”.  There is no reason why PCSOT, when used properly, cannot contribute to this.  He asks, “What level of disclosure is good enough for treatment to be effective?” (which can just as well be asked about supervision).  This is not just a question for PCSOT, but whatever the answer is it should be the level of disclosure sought by therapists, supervisors, and PCSOT examiners alike.  The need for ‘complete confession’ or ‘full disclosure’, while perhaps a feature of some PCSOT programs, does not have to be what PCSOT is about.
Then there are those who argue that there is little evidence for the efficacy of PCSOT, noting few studies into reconviction rates.  Is recidivism, however, the right outcome with which to judge PCSOT.  PCSOT is about providing information, the nature of which is determined by therapists and supervisors and which they believe is important for supervision and treatment generally.  If this information does not contribute to treatment or supervision, and ultimately a reduction in recidivism, then either the wrong questions are being asked, or the answers are not being employed effectively.  The blame should not be placed at PCSOT’s door.  It seems odd to want it both ways – to argue that the information provided by PCSOT lacks value and does not reduce recidivism, but nonetheless we seek it in other ways. 
If PCSOT is not to be judged by recidivism rates, how should it be evaluated?  As it is about information gain surely attention should be focused instead on the value of the information provided – the frequency and content of disclosures, the impact of test outcome on decision making, and actions taken after a polygraph test can all form part of a cost-value analysis to determine the value added by PCSOT compared with the cost of administering it.  In other words, to what extent does PCSOT better enable probation officers to monitor risk and initiate timely interventions, and allow therapists to more accurately identify and address treatment targets?
Where the critics have it right is their observation that the process depends on competent polygraph examiners and well-designed and governed PCSOT programs.  Examiners must be properly trained and supervised, the protocols they work to sound, and their work subject to rigorous quality control.  The tendency to go for those with the cheapest rates or the flashiest websites needs to be resisted, and there lies the basis of potential problems.
In the end, one might ask whether it is unethical not to use PCSOT in the treatment and supervision of sex offenders.  If the information obtained during a polygraph examination adds significantly to what is otherwise known about treatment need and risk, is it right to deny the potential benefits of PCSOT to an offender?  If PCSOT does reduce risk, how can one explain to a future victim why it did not form part of the offender’s treatment and supervision package?  While the evidence for PCSOT is supportive rather than conclusive, objections tend to rely on opinion rather than fact. 
Those who make use of PCSOT must know the right questions to ask of it, how much weight to give its results, and how to integrate it with everything else they do with an offender.  More thought needs to be directed to which offenders are most likely to benefit, the needs that can best be targeted in those offenders, and whether modifications are necessary depending on the characteristics of the individual taking part (sounds a bit like the ‘risk-needs-responsivity’ principle).  In the end, that is an argument for enhancement, not abandonment. 
Don Grubin MD FRCPsych

Chaffin, M. (2011). The case of juvenile polygraphy as a clinical ethics dilemma.  Sexual Abuse: A Journal of Research and Treatment, 22:314-328.

Friday, November 20, 2015

Good Things Are Happening in Australia and New Zealand

ATSA has long enjoyed a friendship with the Australia and New Zealand Association for the Treatment of Sexual Abuse (ANZATSA). I had the honor of attending their biannual conference this month, and wanted to share some impressions in the event that it is useful.
There is a saying among historians that “Happy is the nation that has no history.” In other words, it can be painful to reflect on the history of one’s country, and this couldn’t be more true in the case of Australia and New Zealand (and elsewhere). At a time when so much of the world is grappling with problems related to human migration, the ANZATSA conference began with traditional greetings from an Elder of the Wurundjeri people (caretakers of the land on which the conference took place) and a Maori delegate from New Zealand. It is one thing to hear about this kind of opening and another to experience it. It was an important way to open the conference, as in many places in Australia, aboriginal people made up 2-3% of the general population and 70-80% of of incarcerated people. Addressing abuse in this context cannot be meaningful without explicit discussion of the systematic racism that occurs in these and other countries, including the USA and Canada. One ANZATSA attendee related to me that she could only become an Australian citizen at the age of seven because, as an Aboriginal, she had “fallen under the Plants and Animals Act.”
The first keynote addressed more immediate problems facing aboriginal people in that part of the world, before the conference turned to practice matters such as research and practice related to therapeutic engagement. Nicola Gavey, a Professor of Psychology at the University of Auckland, New Zealand, spoke on the topic of rape culture, focusing on the incidents and subsequent media coverage in Steubenville, Ohio, and the Roast Busters scandal of 2013 in New Zealand. The conference program noted that her 2005 book Just Sex? The cultural scaffolding of rape received a Distinguished Publication Award from the Association for Women in Psychology. Her current project ‘Pornography in the Public Eye’, raises questions about the gender and sexual politics of mainstream pornography.
Arguably, the most stunning presentation was by Louise Nicholas, who has established herself as a national treasure in New Zealand. She is a National Sexual Violence Survivor Advocate in New Zealand. She is a survivor of child and adult rape, perpetrated against her by rogue members of the New Zealand Police. While there are many people who have survived sexual abuse and gone on to tell their stories via books and lectures, Mrs. Nicholas stands out. Her presentation was passionately heartfelt and authentic. It was clear that she had come to tell the truth from her first words: “Some names have been changed due to suppression orders by the court.” Mrs. Nicholas’ persistence in seeking justice for herself and others is remarkable. There is now a wing of the New Zealand police named after her. In April 2015 she was awarded the Governor General's Anzac award and later same year (June) she was made an Officer of the NZ Order of Merit in the Queens Birthday Honours. Louise co-wrote the bestselling book Louise Nicholas – My Story, which was later made into a film.
Tony Ward followed with an exceptional keynote derived from a special issue of Psychology, Crime, and Law that he is editing with Clare-Ann Fortune. In essence, he argued that the current state of our understanding of dynamic risk factors (and by extension, protective factors) risks bring our field to a dead end unless research can better separate correlation and causation, and develop more explanatory models. He illustrated his point using the risk factor of emotional congruence with children, and outlining different ways it could result in sexual abuse. Without a keener eye turned to the nature of explanatory forces, he argued, our understanding of risk factors is less helpful than we are capable of, and the factors themselves reified constructs without explanatory power. As one might expect, Tony was passionate in his style. The special issue certainly promises to be as provocative as it is thoughtful.
The ANZATSA workshops were also very worthwhile. Caroline Burrowes presented on a 10-week trauma-focused curriculum using Acceptance and Commitment Therapy, while Fernanda Mottin gave an engaging talk on how she anchors her practice in Dan Siegel’s interpersonal neurobiology. All in all, the conference was an excellent experience, and the setting of Melbourne made it a great time for all. Good things are happening in Australia and New Zealand!
David S. Prescott, LICSW

Friday, November 13, 2015

What Makes a “Good” Risk Assessment? A Note on the Importance of Quality Control

The Issue

Most risk assessment scales are developed and validated by researchers based on file information scored by research assistants, who may have extensive training in the behavioural sciences, but no field experience. An essential question is whether the accuracy of these research studies will be similar to the results of real cases assessed by front-line staff. In other words, how can we implement a scale so that it works with similar (or even better) accuracy as research studies? Before delving into concrete recommendations for conducting high quality assessments, I will first use an illustrative example and summary of research to demonstrate that the commitment of individual staff members and organizations can make a huge difference in how well a risk assessment scale will work.


Illustrative Example: A Tale of Two States

Static-99 (and its revised version, Static-99R) is the most commonly used sex offender risk scale and there are over 60 studies of the scale, which have found that on average, it has moderate predictive accuracy. Unfortunately though, there are very few studies of how it works in field settings.


Among many states to mandate the use of Static-99/R for imprisoned sex offenders are Texas and California. Texas found low predictive accuracy – their results were lower than most studies of the scale. In contrast, California found remarkably high levels of predictive accuracy – their results were among the best of all studies conducted on the scale, or any other risk scale.


How could two American jurisdictions implementing the same risk scale achieve such remarkably different results?


There are many methodological or policy differences that could affect these findings, but at least part of the difference likely has to do with the quality of implementation. The study from Texas provides no information on how the correctional system maintains the quality of their risk assessments. In contrast, California has a remarkably rigorous implementation and quality control system. All staff who use the scale must be trained by someone certified by the Static-99R developers or a ‘super trainer’ who is certified by a certified trainer and has at least two years of scoring experience. All staff receives training from a detailed, standardized curriculum and by law, they must be retrained in the scale every two years. Additionally, they must pass scoring tests after training, and ideally, their first 10-20 cases are reviewed by a super trainer. Novice users are also encouraged to work with a mentor to maintain the quality of their assessments. With such diligent attention paid to the quality of their risk scale implementation, it is not surprising that California has found some of the highest predictive accuracy ever obtained in a field setting for a risk assessment scale.


What Does Research Tell us About Risk Assessment Quality?

In previous research, quality of risk scale implementation, defined either as involvement of the scale’s developer to (hopefully) help ensure fidelity to the scale or whether community supervision officers completed all the steps that were requested of them, was associated with substantial increases in predictive accuracy. Additionally, quality of training has also been linked to quality of risk scores.


What Can Staff and Organizations Do to Promote High Quality Assessments?

The jurisdiction examples and research discussed above show that it is not enough merely to implement a risk assessment scale. Care should be taken to ensure the assessments are done well. This is particularly important given that any risk assessment conducted can be challenged in court.


Below is a list of policy and procedures that are recommended by the developers of the STABLE-2007 (Fernandez, Harris, Hanson, & Sparks, 2014) to keep quality high. This list was modified to be applicable to all risk scales, and is included with permission of the scale authors.


All risk assessment practices should have most, if not all, of the following components in place:

1. A Bring Forward system to cue when it is time to re-assess scorings, ensuring regular scorings (applicable for dynamic risk assessment scales).

2. A system of peer reviews so that everyone is working towards scoring calibration (i.e., all scoring the same case alike). Colleagues should meet on a regular basis and present their scorings to each other and discuss the scorings, working towards consensus.

3. Clinical supervision by a very experienced assessor so that those scoring have access to a resource person for tricky questions (this person may well organize the peer review sessions).

4. Mentorships with those who are more experienced in using the measure so that novice scorers have an identified person with whom they can discuss their cases and their risk scoring.

5. Participation in inter-rater reliability trials where about 10% of the cases are scored by more than one rater and the scores are compared. This technique leads to better calibration of scoring.

6. Your agency may wish to consider participating in webinars about scoring and other risk assessment issues.

7. When scoring risk assessments on any offender a jurisdiction should have a quality control process in place, either through regular professional development days, internal supervision by senior employees who are committed to the risk assessment process or possible “scoring clinics” run cooperatively within organizations.


L. Maaike Helmus, Ph.D., Forensic Assessment Group, Ottawa, ON, Canada


Friday, November 6, 2015

A discussion about the development and implementation of the Active Risk Management System (ARMS) in the UK

 Since 2009, National Police Chiefs’ Council (NPCC) –previously known as ACPO and the National Offender Management Service (NOMS) have been developing a dynamic risk assessment framework, to assist offender managers in both organisations to manage sex offenders. It has strengthened the Police’s ability to manage registered sex offenders (RSO’s) more effectively and efficiently. Highlighting the risk they pose at the here and now, together with the historic risk they had been assessed at.

Active Risk Management System (ARMS) was primarily developed to address the gap in England and Wales created by the lack of an agreed and consistent approach to evaluating dynamic risk and protective factors in adult male sex offenders so that a defensible risk management strategy or case formulation can be completed. Learning from research and current understanding of the role played by these factors and combining outcomes into a case formulation that measures progress in the management of the offender, which has been one of the core aims in the development of ARMS.

ARMS guides offender managers through the risk assessment process and into a case formulation for each offender. The framework focuses on the current evidence for these factors which are derived from information from the offender, environment, agencies and third party sources.

ARMS has 11 factors which are broken down into 7 risk indicators and 4 protective factors, these cover areas like opportunity to offend, sexual preoccupation, offence related sexual interest, positive routine, social investment and commitment to desist.

Rather than labelling the offender with a risk level the Police have identified the priority for work to be given to reduce the risk and strengthen the protective elements of the management of the offender that will guide the assessor in arriving at a general level of priority for work to be completed.  Once assessed the professional is required to consider the Risk Matrix 2000 assessment of re-conviction and by combining these two assessments arrive at the general level of risk management.  It is this general level of risk management that will guide the timetabling of future engagements with the offender.

The re-defining of the concept of risk is argued will provide something more meaningful and have a direct relationship with work, action and investigation.

A particular strength of ARMS has been its ability to draw these assessments together to arrive at a risk management strategy that over time will measure the effectiveness of the Police’s and National Probation Service actions and provide the framework for intervention.
The Police have been using ARMS since October 2014 and have completed thousands of assessments across England and Wales. ARMS is used in every Police Force by the MOSOVO (Management of Sex Offenders Violent Offenders) officers. These officers now conduct a more thorough, intrusive and challenging conversation with offenders so they can obtain the most complete assessment that is possible in the circumstances. This has involved better training for officers to understand the complexities of such conversations by asking more in depth questions about their behaviour, thoughts and plans.

When officers started to use ARMS and change the way they had conversations with offenders, some found it a real challenge. This represented a cultural change for the Police to understand that to assist an offender from reoffending they had to engage in a more meaningful and sometimes intrusive way to fully recognise what an offender was thinking, fantasying and planning to do. This has led to more comprehensive assessments of offenders which has allowed officers to adjust the overall level of risk. The result of this is that resources are now more effectively and efficiently managed with fewer RSO’s being managed at very high and high risk without effecting public safety. This has been a very successful change in Police’s management of RSO’s and represents the biggest single change in practice since this area pf work started in the late 1990’s.

Research based upon the ARMS pilot was published in 2014:

Duncan Sheppard

If you have any further queries please contact DCC Skeer’s staff officer T/Insp Helen Harkins, Mark Blandford, ARMS developer for National College of Policing, or DCI Duncan Sheppard –MAPPA National Policy lead for Police in England and Wales.