The Effectiveness of a Strength-Based Sexual Offending Treatment Program for Men With Serious Mental Illness: Evaluation of Therapeutic Change and Recidivism

We present an evaluation of a strength-based, cognitive-behavioral therapy program provided to individuals with a serious mental illness who had committed a sexual offense. Utilizing an intent-to-treat design, individuals who participated in treatment were compared with a group of untreated men on treatment-relevant measures and recidivism. Individuals who completed treatment demonstrated greater change in perceptions of working alliance and dynamically assessed risk to re-offend compared to noncompleters. During the 18-month fixed follow-up period, 3.7% re-offended sexually, 20.4% re-offended violently, and 39.8% re-offended generally. After controlling for baseline risk, participation in treatment was significantly associated with an approximate two-thirds decrease in the hazard of future violent (including sexual) recidivism. High-risk, untreated men in our sample showed significantly higher rates of violent recidivism than the treated groups. Results support the utility of a strength-based approach among men residing in an institutional setting and presenting with a serious mental illness.