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CLINICIANS’ PERCEPTIONS OF DEGREE OF DIFFICULTY IN TREATING
DIFFERENT TYPES OF SEX OFF ENDERS AND THEIR ATTITUDES TOWARD
THE TREATMENT OF SEX OFFENDERS
-- A COMPARATIVE RESEARCH BETWEEN TAIWAN AND MICHIGAN

By

Min-chieh Lin

A THESIS
Submitted to
Michigan State University

in partial fulfillment of the requirements

for the degree of

MASTER OF SCIENCE

School of Criminal Justice

1998

ABSTRACT

CLINICIANS’ PERCEPTIONS OF DEGREE OF DIFFICULTY IN TREATING
DIFFERENT TYPES OF SEX OFFENDERS AND THEIR ATTITUDES TOWARD
THE TREATMENT OF SEX OFFENDERS
-- A COMPARATIVE RESEARCH BETWEEN TAIWAN AND MICHIGAN
By
Min-chieh Lin

This study compares the clinicians of sex offender treatment programs in Taiwan and
Michigan treatment programs in terms of their perceptions of treating sex offenders. and
their attitudes toward the current treatment programs as well as how their attitudes affect
the clinicians’ supportiveness of the program.

The objectives of this research are to: (I) understand the differences in clinicians’
perceptions of the degree of difficulty in treating different types of sex offenders in Taiwan
and Michigan; (2) understand the relationship between the treating experiences and the
attitudes toward the treatment of sex offenders; (3) understand the relationship between
the clinicians‘ attitudes toward the treatment of sex offenders and their supportiveness of
the program; (4) understand clinicians‘ opinions on the three current controversial
policies-— indefinite confinement, chemical castration, and Megan’s Law; (5) understand
clinicians’ treating philosophy. theoretical approaches. and perceptions of successful

treatment factors in Taiwan and Michigan.

In Memory of My dead father and mother

iii

ACKNOWLEDGMENTS

Being an international student, I have a lot of things that need to adjust. This process is
frustrated sometimes, but exciting sometimes. Having the mission to bring back to Taiwan
a brand new knowledge, sex offender treatment program. I have a lot of work to do, in
addition to the study. This process to me is the same as above.

I could not make it without the following people’s help, and here I would like to
express my appreciation to all of them sincerely. Professor Dr. Sheila Maxwell, chairperson
of my thesis committee, gave me many instructions and help which helped this thesis go
smoothly. Professor Dr. Vincent Hoffman and Professor Dr. Charles Corley always helped
me with kindness. Clinical Psychology Professor Dr. Andrew Barclay instructed me the
clinical knowledge from the very beginning of my study at MSU.

My deepest gratitude also give to Dr. John Rushbrook, Psychological Director at
Michigan Department of Corrections, Dr. Clayton Strassaske, Psychological Director at
South Michigan prisons. Mr. Stan Bolt. Chief of Psychological Service Unit at Cotton
Correctional Facility, and Mr. Zhigang Wang, psychologist at Cotton. Without their help, I
can not have the internship at Cotton and get the best training on the treatment program.
Especially Dr. John Rushbrook allowed me doing my survey in the training conference.
And all of them let the Taiwan Delegation to visit here come true in late 1997!

In Taiwan. Psychology Professor Dr. Joe-chang Roda Chen. Criminology Professor

Dr. F u-yuan Huang, and Criminology Professor Dr. Chen-ou Chou encouraged me study
this field further. Mr. Zi-ming Wang, an official in Taipei Prison, coordinated for this
survey. They are really wonderful. My boss F or-wey Long, director of Psychiatric
Department at 802 Military General Hospital, applied a scholarship for me enthusiastically
to let my dream come true!

Meng-li Yang, a graduating Ph. D student of educational statistics at MSU
suggested me on the statistical work and grammar no matter that she is so busy. Amber
Mushinske, my peer, helped me recognize some terrible handwriting on the questionnaires.

Moreover all the respondent clinicians in the survey no matter where in Michigan or
Taiwan are so important for this study. I would like to appreciate all of them. And all the
clinicians in both ereas deserve my highest respect. because they are in the first line of the
treatment program and they are making the socitey safer!

Finally I need to thank all of the above people again, and say I will miss all of you all

the time!

TABLE OF CONTENTS

Chapter 1
INTRODUCTION ‘
Introduction ........................................................................................................ 1
Objectives of the Research ................................................................................... 1
Chapter 2
LITERATURE REVIEW
Typological Research of Sex Offenders ................................................................ 3
Researches on Degree of Treating Difficulty-- Relapse Rate and Treatment
Effectiveness ............................................ . ............................................................. 7
Current Sex Offender Treatment Programs in Taiwan and Michigan ..................... 11
Three Controversial Policies about Treating Sex Offenders in America ................. 24
Chapter 3
METHODOLOGY
Hypotheses of the Research ................................................................................. 26
Design of the Research ......................................................................................... 26
Chapter 4
ANALYSIS
Demographic Analysis of Participating Clinicians in Michigan and Taiwan ........... 30
Comparing four Clinical Experiences in Both Areas .............................................. 33

Comparing Means of Percentage of Different Types of Sex Offenders Perceived

Clinicians in Both Areas ...................................................................................... 36

Comparing Means on Degree of Difficulty of Treating Different Types of Sex
Offenders Perceived by Clinicians in Both Areas .................................................. 38

vi

Checking the Relationship Between 3 Independent Variables and 3 Dependent

Variables ............................................................................................................. 40
Checking the Relationship Between 3 Dependent Variables and “Support” .......... 50
Crosstabulation and Open-ended Answers of Support ......................................... 52
Clinicians’ Response on Suggestions for the Current Treatment Program ............ 56
Clinicians’ Response on 3 Controversial Policies ................................................. 59

Analysis of Clinicians’ Philosophy, Theoretical Approaches, and Perception of

Successful Treatment Factors in the Two Areas ................................................... 65
Chapter 5
SUMMARY AND CONCLUSIONS
Summary of This Research .................................................................................. 72
Conclusions of This Research ............................................................................. 75
Appendix
Appendix A: Questionnaire ...................................................................................... 80
B: Sex Offender Program Chronology (in Michigan) ................................. 86
REFERENCES .............................................................................................................. 9O

vii

Table 1
Table 2
Table 3
Table 4
Table 5
Table 6
Table 7

Table 8

Table 9

LIST OF TABLES

California‘s Atascadero Research Program .................................................... 10
Vermont‘s Sex Offender Program, Prison and Community Involvement ........ 11

Sex offense Rate in United State, Michigan, and Taiwan ................................ 18
Sex Offender Proportion in Michigan and Taiwan Prison ............................... 18
Numbers of Response and Population in Michigan ......................................... 30
Numbers of Respondent and Population in Northern and Southern Taiwan ....30

Clinical Position, Gender, and Educational Background of Samples in Both

Areas ........................................................................................................... 32
Average Treating Terms in Different Clinicians of Northern and Southern

Taiwan ......................................................................................................... 35
Main Treatment Modalities of Clinicians in Both Areas .................................. 36

Table 10 Proportion of Child and Adult Sex Offense in Sex Offense in US. and Taiwan..38

Table l 1

Table 12

Table 13

Table 14
Table 15

Table 16

Table 17

Proportions of Different Types of Sex Offenders Perceived by Clinicians in

the Two Areas ............................................................................................. 38
Clinicians’ Perception of Degree of Difficulty on Treating Different Types of
Sex Offenders in the Two Areas (based on 7-level Likert Scale) .................... 40
Comparing Means of 3 Dependent Variables in the Two Areas (based on
7-level Likert Scale) ..................................................................................... 4l
Bivariate Relationship within the Three Dependent Variables ....................... 42

Predicting "Deserve" by "Attending Length", "Numbers of Clients", and
"Treating Term" ........................................................................................... 42

Predict "Feel Effective" by "Attending Length". "Numbers of Clients". and
"Treating Term" ..................... . .................................................................... 43

Predict "Technique F amiliarity" by "Attending Length”, "Numbers of Clients",

viii

Table 18
Table 19
Table 20
Table 21

Table 22
Table 23

Table 24

Table 26

and "Treating Term" .................................................................................... 43
Bivariate Correlation within 3 Independent Variables ................................... 45
Factor Analysis within "Attending Length" and "Numbers of Clients" ........... 46

......... 46
Predict "Deserve", "Feel Effective", and “Technique Familiarity” by FACTOR

Factor Analysis within "Attending Length" and "Numbers of Clients"

a2 and "Treating Term" ................................................................................ 46
Predict 3 Dependent Variables by 3 Independent Variables in Michigan ........ 48
Predict 3 Dependent Variables by FACTOR m1 and "Treating Term" in

Michigan ...................................................................................................... 48
Predict 3 Dependent Variables by 3 Independent Variables in Taiwan ........... 50

Table 25 Predict 3 Dependent Variables by FACTORtl and "Treating Term"in Taiwan .50
Comparing Means of "Supportiveness" in the Two Areas ............................. 50
Predict "Supportiveness" by 2 Independent Variables in the Combined,

Table 27

Table 28

Table 29

Table 30

Table 31

Table 32

Table 33

Table 34

Michigan, and Taiwan .................................................................................. 51
Predict "Supportiveness" by 3 Independent Variables in the Combined,
Michigan, and Taiwan .................................................................................. 52
Predict "Supportiveness" by Factor (abstracted from "attending length" and
"numbers of clients") and "Treating Term" in the Combined, Michigan, and
Taiwan ......................................................................................................... S2
Crosstabulation and Comparing Means of Clinicians’ Degree of Support on the
Current Program in Michigan and Taiwan ..................................................... 53
Crosstabulation and Comparing Means of Clinicians’ Degree of Support on the
Current Program in Northern and Southern Taiwan ...................................... 54
Clinicians’ Response on Suggestions for the Current Treatment Program in
Michigan and Taiwan ................................................................................... 57
Crosstabulation and Comparing Means of Clinicians’ Response on Indefinite
Confinement in Michigan and Taiwan ........................................................... 6O

Crosstabulation and Comparing Means of Clinicians’ Response on Chemical

Castration in Michigan and Taiwan .............................................................. 62

Table 35 Crosstabulation and Comparing Means of Clinicians’ Response on Megan’s
Law in Michigan and Taiwan ...................................................................... 64

Table 36 Clinicians’ Perceptions of Successful Treatment Factors in Michigan and

Taiwan ........................................................................................................ 70

LIST OF FIGURES

Figure 1 Sex Offender Treatment Model in Taiwan Prisons ........................................ 14
Figure 2 Sex Offender Treatment Model in Michigan Prisons ..................................... 21
Figure 3 Scatter Plot and Regression Lines of Predicting "deserve" by

"attending length" in Michigan and Taiwan ................................................. 44
Figure 4 Scatter Plot and Regression Lines of Predicting "deserve" by

"treating term" in Michigan and Taiwan ...................................................... 44

xi

Chapter 1

INTERDUCTION

In r i n

In early 1994, the Legislative Yuan in Taiwan amended the Criminal Code and
required sex Offenders not get paroled unless they accept psychotherapy. This researcher
was a psychiatric social worker in Taiwan and participated in the treatment program then. I
have always wanted to study the sex ofl’ender treatment programs. Recently some
newspapers in Taiwan reported that the program is mostly useless by citing several
participating psychiatrists’ comments (Wan, 1995). Therefore, the researcher decided to
do research by comparing the clinicians in Taiwan and Michigan treatment program in
terms of their perceptions of treating sex offenders, and their attitudes toward current
treatment program as well as how they affect the clinicians’ degree of supportiveness of the

program.

'ive th h

1. Understand the differences in clinicians‘ perceptions of the degree of difficulty in
treating different types of sex ofl’enders in Taiwan and in Michigan

2. Understand the relationship between the treating experience and the attitude toward the

treatment of sex offenders

3. Understand the relationship between the clinicians’ attitude toward the treatment of sex
offenders and their supportiveness of the program

4. Understand clinicians’ opinions on the three current controversial policies- indefinite
confinement, chemical castration, and Megan’s Law

5. Understand clinicians’ treating philosophy, theoretical approach, and perception of

successfirl treatment factors in the two areas

Chapter 2

LITERATURE REVIEW

Typological Regargh gf Sex Offenders

Several typological researches about sex ofi’enders were developed in the last two decades.
Following are the main ones.

I l . E .
(1) Groth: Groth is a clinical psychologist who provided psychotherapy for sex offenders in
Connecticut and Massachusetts. Groth’s most famous comment on sex offenders is that
“ rape is a pseudosexual act, complex and multidetermined, but addressing issues of
hostility (anger) and control (power) more than passion (sexuality).”(1981, pp2) He gave
two types of classifications in 1977 and 1979.

I. 1977: He and A. W. Burgess submitted that sex offenders could be divided into two
main types and four subtypes. The two main types are power type ( power
reassurance type and power assertive type) and anger type ( anger retaliation type
and anger excitation type).

(A) Power Type: In this type of assault, the offender seeks power and control
over his victim through intimidation by means of a weapon, physical force,

threat of bodily harm. Physical aggression is used to overpower and subdue

4

the victim. The aim of the assault usually is to effect sexual intercourse as
evidence of conquest. This type of sex offender often shows little skill in
negotiating interpersonal relationships and feels inadequate in both sexual and
nonsexual areas of his life. So rape is the means by which he reassures himself
of sexual adequacy and identity, and of his strength and potency.
(a) power-assertive rapist: They mentioned as the followings:
The power-assertive rapist regards rape as an expression of his virility and
master and dominance. He feels entitled to “ take it ” or see sexual
domination as a way of keeping “his” woman in line. The rape is a reflection
of inadequacy he experiences in terms of his sense of identity and
effectiveness. (Groth, Burgess, & Holrnstrom, 1977)
(b) power-reassurance rapist: They mentioned as the following:
The power-reassurance rapist commits the ofi‘ense in an effort to resolve
disturbing doubts about his sexual adequacy and masculinity. He wants to
place a woman in a helpless, controlled position in which she can not refuse
or reject him, thereby shoring up his failing sense of worth and adequacy.
(Groth et al. )

(B) Anger Type: This type of sex offender ofien expresses anger, rage, contempt,
and hatred for his victim by beating her, sexually assaulting her, and forcing
her to perform or submit to additional degrading acts. He often uses more
force than would be necessary simply to subdue his victim, and uses profane
and abusive language. The victims ofien get more serious hurts and trauma
such as physical and psychological hurts.

(a) anger-retaliation rapist:
The anger-retaliation rapist commits rape as an expression of his hostility

and rage towards women. His motive is revenge and his aim is degradation
and humiliation. ( Groth et al.)

 

(b) anger-excitement rapist:

The anger-excitation rapist finds pleasure, thrills, and excitation in
sufl’ering of his victim. He is sadistic and his aim is to punish, hurt, and
torture his victim. His aggression is eroticized. (Groth et al.)

11. 1979: Two years latter in 1979, Groth and Bimbaum submitted another similar
typology of sex offenders. It includes the anger type (40%), the power type
(55%), and the sadistic type (5%). He combined the two power subtypes
into “power type” in the newer typology, changed the anger-retaliation type
to a new name- “anger type”, and changed anger-excitement type to a new
name- “sadistic type” (Groth & Bimbaum, 1979)

(2) Cohen & Seghorn(1980): They have clinically inspected twenty-seven rapists in the
Massachusetts Treatment Center, and found that based on the offensive motivation,
rapists’ characteristics fall several dimensions as serial dispersion. They tried to
classify rapists according to the homogeneous and heterogeneous crime behavior and
life history. The typology of their research seems to focus on the issue of sexual and
assaultive motivation, and different from Groth’s focusing on the issue of power and
anger. The following four types of rapists were classified by them (Hsiu & Ma, 1994).

(a) Compensatory rapists: This type of rapist is pretty close to the Groth's power
assurance type, for the ofl’ender wants to get some confirmation of his competency.
The ofi’ender often seems not to have sufficient social ability, and lower social status,
but the offense always is not so serious.

(b) Displaced aggressive rapists: This type of rapists is very close to the Groth’s anger-

retaliation rapists. They always had bad experience with their girlfiiends, wives, or

6

mothers, and this induced the intention to hurt females by transferring their hostility.

(c) Sex-aggression-firsion rapists: Similar to Groth‘s anger-excitement rapists, they
seem to have some assaultive and social-path personality. Their offenses are often
serious and crude, and get gravitation from the hurting instead of the sex. Sometimes
they even seriously hurt or kill the victims.

(d) Impulsive rapists: Groth did not have this type in his typology. Cohen et al.
mentioned that this rapist‘s offense always is based on the psychological impulse and
dose not seem to be related to sex and assault. The sex ofi’ense behavior often follows
the other crime behaviors, such as burglary and robbery. The nature is opportunity,
and impulse. This type of offenders often do not have crime records in childhood.

(3) Knight and Prentky(1992) developed a statistically based typology for rapists, which is
used by Massachusetts Treatment Center for many years. After three revisions, they
settled on a typology consisting of nine types derived from four basic categories--
opportunistic, pervasively angry, sexual, and vindictive. The eight types are called
Type 1 to Tapes 8.

WWW
There are several important researches about child sex offenders including the
following:

( l) Groth (1979): Based on the two dimensions, Groth divided pedophiles into the
following types : (1) Based on the psychological needs, be divided F ixated Type and
Regression Type. (2) Based on the degree to which behavior is entrenched: sex-

pressure type, sex-force type, and sadistic type. According to Groth’s typology, there

7

are six types of pedophiles were submitted. As the researcher’s clinical experience, the
dimension of fixated and regressed is a good to recognize the pedophiles’
psychological characteristics . And the fixated offenders are always diflicult to treat.
(2) FBI : This typology was developed by Lanning in 1986, and based loosely on Groth’s
typology. It divided the child sex ofl‘enders into two main types and seven subtypes.
The two main types are :
1. Opportunistic Child Molesters: This is very close to Groth’s regressed type. They
often do not have a defined sexual preference for children. It contains four subtype --
regressed, morally indiscriminate, sexually indiscriminate, and inadequate.
2. Preferential Child Molesters: This type is close to Groth’s fixated ofi’enders. They
show a strong sexual preference for children, which characterizes their sexual
attraction pattern throughout their lives. It contains three subtypes— seduction,

introverted, and sadistic. (Schwartz, 1996)

Re h n Da: 4; fTr .. -_'n Drffials - R to; ’ ._ e .. . Tr... n Efl’vmiv a:
The relapse rate of sex offenders is always an issue. Detroit News mentioned that 75
to 80 percent of untreated sex ofl’enders will strike again, compared to a general recidivism
rate of about 35 percent, citing the description of an officer of Safer Society Program in
Vermont washeda & Hoffman, Jan. 29, 1995). But the more careful researches have
always revealed the opposite situation, that is, the sex offenders are generally found to
have relatively low rate of recidivism when compared to other types of offenders (Tracy,

Donnelly, Morgenbesser, & Macdonald, 1983)

8

Treatment effectiveness is another attractive subject. Many researches revealed the
optimistic results in this decade (Marques, Day, Nelson, & West, 1994; Whitaker &
Wodarski, 1989; Smith & Wolfe, 1989). There are still pessimistic findings in addition to
the optimistic ones in the researches.

P . . .

As regard to the pessimisitic aspect, as early as 1989, Furby, Weinrott, and
Blackshaw reviewed existing studies of sex offender recidivism and concluded that “there
is as yet no evidence that clinical treatment reduces rates of sex reoffenses in general and
no appropriate data for assessing whether it may be differentially effective for different
types of ofl’enders”(p.27). Subsequently, numerous reviewers refuted these findings,
pointing out serious methodological flaws in this study. Some reviewers noted that most of
the programs surveyed by F urby, et al., did not employ currently accepted treatment
methods. Most of the programs in the study have not survived.( Steele, 1995). But some
researchers in institutional settings are skeptical of the ability of treatment to reduce
recidivism (Quinsey, Harris, Rice, & Lalumiere, 1993)

With regard to the optimistic aspect, G. Hall (1995) identified 12 studies of sex
ofl’ender treatment since Furby et al.(1989) reported the recidivism rates of treatment and
comparison groups of sex offenders could be included in a meta-analysis. In contrast to
Furby et al. (1989), G. Hall (1995) concluded that treatment was more effective than no
treatment or comparison treatments.

In Hall‘s meta-analysis review, three behavioral treatment programs reduced deviant

9

sexual arousal among sexually aggressive men. But none of these programs was

significantly more effective in reducing sexually aggressive behavior than the no treatment

or comparison treatment groups. In fact, these behavioral programs were slightly less
effective (i.e. , resulted in slightly higher rates of recidivism) (Hall, 1995). G. Hall also
found that antiandrogen hormonal treatment programs were more efi’ective in reducing
sexually aggressive behavior than behavior treatment programs or no treatment. (Hall,

1995). In addition to the above, cognitive-behavioral treatments were found efi’ective in

reducing sexually aggressive behavior than behavioral treatment programs or no treatment,

but are not significantly more effective than hormonal treatment programs in the findings of

Hall‘s meta-analysis review. However, cognitive-behavioral treatment programs may be

more effective than hormonal treatments for a wider range of sexual aggressors, while

compared the comprehensive nature of cognitive behavioral programs and the compliant

problems with hormonal treatment.(Hall, 1996).

Continuously, two important researches of sex offender treatment programs are
revealed as the following:

1. California‘s Atascadero Research Project: The project, Sex Offender Treatment and
Evaluation Project (SOTEP), has a series of outcome studies since 1988 (Marques, Day,
Nelson, & West, 1994). The project combined inpatient and outpatient services for their
clients. It started in 1985 for imprisoned sex offenders who volunteered to receive
treatment two years before their release fi'om prison.

The evaluation was based on the comparison of three groups: (1) Treatment group:

sex offenders who volunteered and were randomly selected for the treatment program.

IO

(2) Vohmteer control group: sex offenders volunteered to be in control group, and were
matched to the treatment subjects on the basis of age, type of offense, and criminal
history. (3) Nonvolunteer control group: sex offenders who qualified for the program
but chose not to participate in both groups. They were also matched as above.

The procedure for this research were: (1) Treatment group was transferred to
Atascadero State Hospital, where they remain about 2 years ( 14-30 months). (2)
Treatment group participated in l-year aftercare program in community after their
parole. (3) All 3 groups were traced on oflicial record data within 5 years after their
release. Treatment program here provided a cognitive-behavioral approach. In the
hospital, participants attended group therapy and individual therapy per week. The
therapies contain relaxation training, sex education, human sexuality, social skill training,
stress and anger management, and preparation for release. In community, participants
attend aftercare program by clinicians trained by this research group. All the treatments
were conducted according to the manuals. The results are shown in Table 1 (Steele,
1995)

Table 1 California‘s Atascadero Research Program (1993)

 

Treatment Voluntary Nonvoluntary
control group 1 control group 2
(N=11Q (N=126) (N=121)

Time at risk 38 months 38 months 38 months
Rapists 23.0% 48.0% 28.5%
(N=78)
Child molesters 7.8% 1 1.0% 13.8%
(N=285)
Total (N=363) 11.2% 19.0% 14.9%

According to the explanation of the researchers, there are some important findings in

II

the research: (1)the estimated risk for new sex ofi’enses was lower for treatment subjects
than for the control groups, but the difference was not statistically significant; (2)
Rapists have no significant difference in the survival analyses between treated and
untreated groups, though the apparently large difference on their sexual or their violent
reoffense; (3) Treated child molesters were found to be at significantly lower risk for
other violent offenses than was the volunteer control group (p<0. 5) (Marques et al.,
1994). On the other hand, the attrition were also highlighted, 21% of their clients failed
to complete the program: 15% dropped out and 6% were removed for disciplinary
reasons and all of them committed new sex offenses(Steele, 1995).

. Vermont‘s Sex Offender Program: It was another continuous institution-based program

like the former one, but the follow-up term is 1-8 years. The result was revealed as the

 

following table:
Table 2 Vermont‘s Sex Offender Program, Prison and Community Involvement
(1992)

Type of Offender Number of Ofi’enders % New Sex Ofi’ense
Pedophiles 195 7%
Incest Offenders 190 3%
Rapists 53 19%
Untreated - 38%

There are some problems to determine what percentage of the sex offenders failed
the institutional or in community phase and what their recidivism was. But the result of
this program are consistent with other studies in that the incest offenders have a low
recidivism rate (Steele, 1995).

n x n r Tr m Pr ' T ' Mi hi

Tg'wan.

12
(1)Background
In November of 1993, a female university student was sexually murdered. It raised a
heated discussion about having sex offenders receive more rigid punishment. A female
legislator held a hearing in the morning of January 18,1994 , and then she submitted the
script of Criminal Law revision in the latest conference of the Legislative Yuan. The script

was passed on the same day (Wan, 1995).

(2)Legislative Origin
The original Criminal Law in Taiwan does not specifically rule how to treat sex

offenders in prisons, but only rules that people with mental disorder could be put in
appropriate institutes for security care (like the civil commitment in the US). In the above
discussion, everyone thought that it is the rapist who should receive more rigid treatment,
but the revised code was changed to “Persons who violate ‘the violating moral custom
chapter’ of Criminal Law should not be paroled unless they have passed the obligatory
diagnosis and treatment.”

What the researcher should explain firrther here is that criminals contained in the
violating moral custom chapter are not only sex offenders, but also persons who dealt with
prostitution or erotic publishing. S. Wan mentioned that only about halfof moral custom

ofl’enders are sex ofi’enders (Wan, 1995).

(3 )Program of Sex offender Treatment

After passing the revision of the Criminal Law, the Ministry of Law Afi‘air submitted

l3

“ Executive Order of Obligatory Diagnosis and Treatment for Inmate Breach ‘Vrolating
Moral Custom Chapter’ ”
In that order, there are several steps below (see figure 1) :

' Move such inmates to the instructed prisons( inmates in northern Taiwan go to Taipei

Prison; those in the south go to Kaohsiung Prison)

- Instructed prisons should contract with hospitals, and request psychiatrists and clinic

psychologists provide sex ofi’enders diagnosis and treatment.( In contract, it also
contains psychiatric social workers and clinical nurses.)

- Intake team in prison should screen all of such inmates and decide on who might have
mental disorders and refer these to mental health professionals. Inmates without mental
problems should continuously receive the prison mentors’ counseling.

- Instructed prisons should hold the evaluative conference of diagnosis and treatment, and
evaluative conference of counseling. (In contract, the conference should be held very
three months.)

- Such inmates‘ evaluation for parole should firstly pass through one of these two
conferences and then the parole committee.

- In budget, the payment for practitioners under the contract are (based on each time their
treatment in prison’s clinic): psychiatrist NT $5000 (US $180),and the others NT $1000
(US $3 6).

(4)Practical Situations

° Real numbers of sex ofi’enders in prison who received psychiatric treatment:

United News in Taiwan (Wan, 1995) reported that fi'om March 1994 to October

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1995, altogether 1191 moral custom offenders were moved to Taipei Prison. After
screening, generally the nonsexual offenders would be excluded, 542 moral custom
ofi’enders of the 1191 were suspected of mental disorders and were transferred to
psychiatric diagnosis and treatment. After the psychiatrists’ diagnosis, only 56 moral
custom ofi’enders really needed psychiatric treatment-- that is, 4.9 percent of all moral
custom offenders.

- Real screening and process

Taiwan Ministry of Law Affair held a conference discussing whether it is necessary
to have all moral custom offenders receive psychiatric treatment, and they finally decided
that some types of these offenders need to be directly excluded, such as dealers of
prostitution and erotic publishing. A prison officer said that would exclude half of such
inmates. A psychiatrist said that according to his experience, 90 percent of moral custom
ofi‘enders do not have psychiatric problem. Besides he said it should not say there is no
one should accept the psychiatric therapy, and pedophilia, for example, should receive

therapy , but it is very rare (Wan, 1995).

(5)1mportant Issues from Different Sections of Society
There were several important criticisms of the new law from the society: (1) Rushed
law making: It took only half a day to submit the legislative script and for it to pass at the
whole conference of Legislative Yuan. All the procedures were not carefirl enough. It
ignored the more serious sex offenses- rape combined with robbery or rape in the

Military Criminal Law. (2) Goal of the law was not clear: What was the real goal, and

16

how to achieve it were not clear by stated. (3) Suddenly delaying parole resulted in
unstable moods of inmates who offended moral customs.( A little collective roaring was
happened in Taipei Prison while the law began to be efi’ective.) (4) Low quality of
treatment: There are too many sex offenders in prison, but the willing psychiatrists are
very rare. (5) High expense and ambiguous outcome: C. Chiu, the chief of Health
Division in Kaohsiung Prison, said that the officials of Ministry of Law Affair want to
reconsider the contract system because it is too expensive, and he agreed with this

(personal communication, May 14, 1996).

Michigm.
(1) Origin and Sex Offense Rate
According to a Memorandum submitted by the Michigan Department of Corrections
in July 6, 1994 ( see in Appendix A), the following are the origins of sex offender
treatment in Michigan:

- 1971-72 Implementation of residential sex ofl’ender treatment program in Top 6 of

SPSM (a reception and guidance center in Jackson Prison Complex, noted
by author ) reception center (under auspices of Psychiatric Services)

. 1975 Reception and Guidance Center(R&GC) Psychological Service Unit staff

begin operating sex offender program therapy groups at SPSM

- 1979 ...as prison facilities opened across the state and Psychological Services

staff were allocated, sex offender program therapy groups were

implemented at those sites housing sex offenders

17
° 2/25/1993 Recommendations of Psychological Services Advisory Committee (PSAC)
regarding standardization and revision of sex offender program(the product
of a series of meeting in 1992)

- 11/19/1993 Proposed implementation plan and program statement for standardized sex

offender program (two-year program) submitted

- 5/17/1994 Deputy Director Jabe approves 1 1/19/93 sex offender program proposal and
addendum(which outlines the accelerated sex offender program designed to
accommodate the waiting list sex offenders within 24 months of ERD)
(ERD is acronym of earliest release date. Author noted.)

So sex offender treatment program in Michigan began in some prison and gradually
was developed to most prisons in Michigan. \Vrthin the last four years, the Michigan
Department of Corrections was devoted to standardize and accommodate the sex
offender treatment program.

Sex offense rate in Michigan, United States, and Taiwan and sex offender proportion
in Michigan and Taiwan prisons are organized as the succeeding tables in order to know
the differences between the two areas firrther. From 1996, the sex offense rate in Michigan
(57/ 100,000) is 8.38 times of that in Taiwan (68/100,000). But we should note the
“hidden” numbers (dark figure) of sex offenses. Generally speaking, sex offense has very
serious dark figure problem, as the victims of sex offense may be unwilling to report to the
police. This also happens in the both areas. In Taiwan, several non-ofiical researches
revealed that sex offense rates are much higher than those of omcial statistics are. The

range of sex offense rates in these non-ofiical researches is between 0.6% to 4.2%, both of

18

the researches were done in 1993 (Taiwan Ministry of Justice, 1995). The latter research
conducted by Joe-Chang Roda Chen (1993). Using female university students in Taiwan

Table 3 Sex offense Rate in United State, Michigan, and Taiwan.

 

 

 

 

 

United States Michigan Taiwan
1996 36.1 57.0 6.5
1995 37.1 62.0 4.3
1990 41.2 78.0 2.9
1985 36.6 67.6 4.0

 

 

 

 

 

Note. All the rates are based on 1/ 10,000,000. The rates in the United State and Michigan
are fi'om Uniform Crime Report. The rates in Taiwan are from Taiwan Crime Statistics.

Table 4 Sex Offender Proportion in Michigan and Taiwan Prisons

 

Michigan(sex offender/ prison population)ITaiwan(sex offender/ prison population)

 

 

1995 18.71% (7271/ 38854) NA

 

1994 14.48% (5633/ 38896) 1.06% (380/ 36043)

 

 

 

 

_N_Q_t§. The data in Michigan are from Sourcebook of Criminal Justice Statistics, edited by
US. Department of Corrections. Because the data in Taiwan are from Crime Situation and
Its Analysis and it provides the proportion of moral custom offenders instead of sex
offender. In 1994,it reports 2.11% of inmates, totally 36043, are moral custom offenders. S.
Wan mentioned the about half of moral custom offenders are sex ofi’enders (Wan, 1995).
Therefore, the research used half of the proportion (2.11%), 1.06%, as the proportion of
sex offenders in Taiwan prisons.

as the sample, she found 4.2% (4200/ 100,000) of them had the experience of being
sexually abused on the third degree (namely rape) behavior. Finkelhor and his colleagues
(1990) conducted the comparable research in the US. They used the female and male

population as the sample in nationwide survey, and found 14.6% (14600/100,000) female

 

19

population had the experience of sexual intercourse by offenders (namely rape).

(2)Program

A program process data is attached in the Sex Offender Program Implementation

Plan , which contains the Sex Offender Program- Program Statement.(Bureau of Health

Care Services [BHCS]in Michigan Department of Corrections, Nov. 1, 1993) It details the

whole process as below (see figure 2) :

Step 1. At reception center, incoming sex ofi’enders receive routine intake
psychological screening.

Step 2. Reception center psychologist employs revised screening criteria to identify sex
offenders who (a) are recommended for subsequent sex offender assessment or
(b) do not receive such recommendations.

Step 3. The results of this initial screening are recorded on “transcase forms” modified
to reflect changes in screening criteria and process.

Step 4. Prisoners with recommendations for subsequent sex offender assessment are
maintained on an automated tracking list by earliest release date (ERD).

Step 5. When ERD for prisoner brings him/her to top of tracking list (ideally 2 to 2.5
years prior to actual ERD).

Step 6 Prisoner completes Multiphasic Sex Inventory (M81) in group test
administration (approximately 2 hours in duration) .

Step 7 Prisoner completes standardized sex offender program questionnaire prior to
assessment interview.

Step 8 A two-person team of psychologists reviews the prisoner‘s sex ofi'ender program

20

questionnaire and MSI results, interviews the prisoner and makes decision for (a)
sex offender program continuation or (b) termination.

Step 9 Prisoners continuing on in the sex ofi’ender program begin a standardized 6-
month psychoeducational intervention delivered to classes of 16 sex offenders
and employing reusable workbooks / participant manuals, videotapes, etc.

Step 10 Upon completion of the psychoeducational phase, sex offenders are
recommended for (a) specialized group psychotherapy or (b) termination from
the sex ofi’ender program. Sex offender group psychotherapy entails one group
therapy session per week with 10 sex offenders per group for 6 to 18 months.

Step 11 Post-program assessment of sex offenders by Psychological Services to measure
degree of program progress.

Step 12 Sex ofi’ender program progress report is completed for prisoner using
standardized format and including recommendations for any required
community-based supervision or program involvement.

However, according to the section of correctional psychological service in Michigan
Statewide Annual Report-1996 , there are almost two thirds (68.09%) of joining treatment
sex offenders (totally 1006 people) in above two-year program, but the rest ones (31.91%)
in the accelerated treatment program. J. Rushbrook, the psychological service director of
Michigan Department of Corrections, mentioned the accelerated program is a one-year
program was developed in 1994 to reduce the more and more inmates in waiting list. The
program has the same frequency and treatment context as the 2-year program (personal

communication, Feb. 23, 1998).

21

 

 

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22

(3)some important traits of this program:

- The treatment is voluntary for sex offenders in Michigan prison, but every volunteer
should firstly meet the program screening criteria. The criteria below was effective in
June, 1993 (Bureau of Health Care Service in Michigan Department of Corrections,
1993):

l. The prisoner is currently serving a sentence for one or more of the following
ofi‘enses Rape, Criminal Sexual Conduct ( lst, 2nd, 3rd, 4th Degree, and 2nd
offense), and assault with Criminal Sexual Conduct, lst or 2nd Degree. (includes
attempts )

2. The prisoner has no more than two (included two) documented prior adult felony
convictions, not counting the instant offense(s).

3. The prisoner has an Earliest Release Date ( ERD ) other than life.

On the other hand, the program is not applicable to all sex offenders. It is selectively
directed at offenders with identified characteristics which enable them to effectively
participate in and benefit from the program. Poor program candidates unlikely to and
benefit fiom the program involvement will be screened out.

o It has uniform assessment methods. The Program Statement mentions that the required

assessment tests contain MMPI-Z, MSI ( Multiphasic Sex Inventory ), and a composite
sex ofl’ender program questionnaire.

- It has uniform treatment methods. The program also contains psychoeducational

interventions ( it briefly mentioned how to do and can use the USCfill materials or

videotapes etc.) and group psychotherapy ( it briefly mentioned group should be

23

organized by different gender and typology, and needs to be supplemented peer
counseling , support group, behavioral techniques, individual psychotherapy, and
family counseling, etc.)

° It has community-based treatment after release. Community psychologists were
contracted to provide supervision for parole sex offender, and encourage them
participate in community- based treatment.

- It mainly provides the prisoners within 24 months of Earliest Release Date, so as to the

highest priority in terms of program access will be sex offenders housing at Level I, H,
and III.

(4)Practical Issues

Some practical situations are worthy mentioning as below:

- In addition to treating sex offenders, Michigan psychologists also provide the one-year

grouptherapy to assaultive offenders, interpret the psychological testing, and once a
week emergency spell.

- All of the psychological treatment providers are psychologists and few clinical social

workers. However, if a sex offender diagnosed with serious mental disorder should be
transferred to prison hospital being as an outpatient or inpatient, and receive the
treatment provided by the psychiatrists or psychiatric social workers.

- Considering the high expense of health care professionals, Michigan Department of

Corrections have been planing to replace the original personnel by the health care
professionals employed by outside hospitals contracting with the Department in the last

three years in order to save the budget. Currently the Department has been doing the

24

system in few prisons under the experimental stage and evaluating it.

Six states in America have the laws to allow state oflicials the right to indefinitely
confine sex ofi‘enders: Arizona, California, Minnesota, Washington, \Vrsconsin, and Kansas
(Mishra, 1997). All of these states consider the potential objects as sexual violent predators
or sex offenders as having psychopathic personalities, because they are considered to pose
a severe danger to the community. Whatever they are called, the definition of the objects
have raised controversies in legal and clinical fields fi'om the beginning, especially on the
substantial due process issue, civil commitment process issue, and an issue that “sex
offenders- even diagnosed pedophiles- had never been classified as mental illness; they
are thought to have mental abnormalities.” (Cohen, 1997; Nfishra, 1997).

h ' ti n.

In medical technique, antiandrogens, main ingredient in female hormone, can be used
to reduce the sexual drive in male. The most famous drug of antiandrogens is
medroxyprogesterone acetate (MPA or Depo-Provera). MPA was first used with sex
offenders in 1966 by John Money, then it was followed by a series of related researches.
It was found to be effective on the subjects such as XXY sexual deviant males,
homosexual pedophiles, heterosexual pedophiles, and rapists in reducing sexual drive
and sexual violence, but there are still some controversies as to whether it reduces the

sexual fantasy or not (Bradford, 1990; Land, 1995; Pallone, 1993). The other main

25

reason MPA raises legal controversies is that Depo-Provera at times are referred to as
chemical castration, which is thought similar to surgical castration- an inhumane
punishment especially for sex offenders in the past or in some countries (Cohen, 1995).

Megan’s Law.

Megan’s Law is named after Megan Kanka, a New Jersey seven-year old girl who
was sexually killed by a paroled sex offender in July 1994. It made the public angry and a
law was quickly passed to require paroled sex offenders to register to the community in
New Jersey. Before this murder, only five states had similar laws. Shortly after that,
more states and even the federal government have enacted this law. The federal law even
pushed the other states to enact a registration of sex offender or risk the loss of 10% of
federal funding for local and state law enforcement. After Massachusetts passed the law
in August 1996, all of the states in America have passed the registration laws, although
there are several differences among the states, such as differences of registration places,
and whether notifying the community is further required or not (Walsh, 1997). In
Michigan, the law requires sex offenders be registered to local police without notifying
the community, but encourages the community people to check about the information to
protect their safety. This Law also causes the controversies among the offenders, jurists,
clinicians, and the public on legal, clinical , and public safety issues. The critiques
generally include that there is no proof that this law actually reduces recidivism and that
the law might inhibit offenders from seeking treatment after parole or even make them

feel more fi'ustrated and reofi‘end (Walsh, 1997).

Chapter 3

METHODOLOGY

H h th h

1. There are no differences in perceptions of the degrees of difliculty in treating different
types of sex offenders between clinicians in Taiwan and Michigan.

2. There is no significant relationship between clinicians’ treating experience (such as years
of experience, numbers of clients, and length of the treatment) and the attitudes on the
treatment of sex offenders (such as attitudes toward the sex ofl‘enders’ deserving to be
treated, the efi‘ectiveness of treatment, and familiarity of treating techniques).

3. There is no significant relationship between the clinicians’ attitudes toward the treatment

of sex offenders and their supportiveness of sex offender treatment program.

WW
1. Questionnaire design
(1) In addition to the demographic questions, the questionnaire contains five main parts:
the treating experience (including three items- Item 1(2): the length of participating
in treating sex offenders; Item 2(1): the number of treating sex ofi‘enders; Item 3: the

average length of treating every sex offenders), the perceptions of the degree of

26

27

dificulty in treating different types of sex offenders (Item 5), the perceptions of the
degree of difficulty in treating sex offenders in general (Item 6) , the clinicians’
attitudes toward the treatment of sex offenders (including three items- Item 7: the
degree of agreement on sex offenders deserving to be treated; Item8: the degree of
agreement on treating sex offenders being effective; Item9: the degree of familiarity
on the techniques of treating sex offenders), the clinicians’ supportiveness of the
program (Item 10), and the clinicians’ suggestions in improving the program (Item
1 1).

(2) The items about the perceptions and attitudes are based on the 7-level Likert Scale.

(3) A brief introduction of Groth’s Typology for Sex Offenders was provided on a
separate page attached on the questionnaire.

(4) There were three open-ended questions pertaining to the following treatment issues:
treatment philosophy (Item 12), specific theoretical approach (Item 13), and
successful treatment factors (Item 14).

(5) There were three open-ended questions pertaining to the three controversial policies
in the America. They are indefinite confinement (Item 15), chemical castration (Item
16), and Megan’s Law (Item 17). Respondents were asked their degree of support
on the policies, the reason of their degree of support, and what their suggestions are
if the policies passed as law.

2. Sampling process
( l) Clinicians in Taiwan: There are about 40 clinicians participating in the sex offender

treatment program in Taiwan. They include psychiatrists, clinical psychologists,

28

psychiatric social workers, and clinical nurses. The researcher requested all of them
to complete the questionnaires.

(2) Clinicians in Michigan: There are about 90 clinicians participating in the sex
ofl’ender treatment program in Michigan. All of them are psychologists except few
clinical social workers. The researchers handed out the questionnaires at an annual
training conference by the permission of the Authority where all of the psychologists
were present, and requested all of them to complete it.

3. Methods of the Analysis

( l) The researcher used two-sample t-test to test the significance of difference between
the two areas’ different perceptions on the degree of difficulty in treating different
types of sex offenders (Because the sample sizes in the two areas are different, the
researcher would use “pooled t-test” mainly).

(2) The researcher tested the significance of the relationship between clinicians’ treating
experience (such as years of experience, numbers of clients, and length of the
treatment Item 1(2), 2(1), and 3) and their attitudes toward the treatment of sex
offenders- Item 7, 8, and 9)

# If Items 7, 8, and 9 are tested to be related to each other, using MAN OVA to test
the significance of correlation on Hypothesis 2 would be tried.
# If Items 7, 8, and 9 are tested to be not related to each other, the Multiple
Regression Analysis for every one of them would be used.
(3) The researcher tested the significance of relationship between the three clinicians’

attitudes toward the treatment of sex offenders (Items 7, 8, and 9) and clinicians’

29

supportiveness of the program (Item 10) by the method of multiple correlation.
(4) The suggestions toward current treatment program (Item 1 1) would be analyzed by
the number of approved items as priority of clinicians’ suggestions.
(5) The open-ended questions would be analyzed by the numbers of similar responses,
and tried to keep their original meaning.
4. Tools of Analysis
All the above close-ended questions in this research were analyzed by the software

of SPSS 6.0- Statistical Package for Social Science 6th edition.

QSE'QQ'QD of the Samples in Michigan and Tang
E l l . .

Chapter 4

ANALYSIS

In Michigan, the researcher obtained 33 responses, all of which are USCfil]. The

response rate is 34.74% (33/ 95= .3474). In Taiwan, the researcher obtained 34 responses.

One of them is useless, because of insufficient amount of information provided. The

response rate is 91.66% (33/ 36 = .9166). The followings are tables of the response rates

(response/ population) in Michigan and Taiwan.

Table 5 Numbers of Response and Population in Michigan

 

(types of clinicians)

response/ population (rate )

 

 

Michigan

 

 

 

psychologist 30/ 87 (.34)
clinical social worker 3 / 4 (.75)
(total) 33/ 91 (.36)

 

 

Table 6 Numbers of Respondent and Population in Northern and Southern Taiwan

 

 

 

 

 

 

(types of clinicians)l 818 Military Taoyuan psychiatric Taipei Psychiatric response! po-
Hospital Center Center pulatiorKrate)
Northern psychiatrist 7 / 8 1 / l l / l 9/ IO (.90)
Taiwan psychologist 5 / 5 O/ 1 O/ l 5/ 7 (.71)
clinical social worker 0 / 0 0 / O 0 / 0 0/ 0
(total) 12/13 1/2 1/2 14/17
(.92) ( 50) £50) (.82)

 

 

 

 

 

 

30

 

 

31

 

 

 

 

 

 

 

 

 

 

 

(types of clinicians) 802 Military Kai-suan Psychiatric Kaohsirmg Hospital W P0-
Hospital Hospital
pulation(rate)
Southern psychiatrist 5 / 5 1 / 3 l / 1 7/ 9 (.78)
Taiwan psychologist 5 / 6 6 / 7 1 / 1 12/14(.86)
clinical social worker 0/ 1 O / O l / 1 1/ 2 (.50)
(total) 10/ 12 7/10 3 /3 20/ 25
(.83) (.70) (1.00) (.80)

 

Types of glinig'ans.

In Michigan, most clinicians are psychologists. Of the valid responses, 30 (90.9%) are
psychologists. The other three are clinical social workers (9.1 %).

But the situation is quite different in Taiwan. Of the sample, 16 clinicians are
psychiatrists (45.5%) , 16 are psychologists (48.5%), and l is a clinical social worker (3%).
As mentioned before, all of the participating clinicians work in community hospitals and
provide treatments to sex offenders once a week in prisons by contract with the prisons.
Therefore, all of them are in the psychiatric teams, and psychiatrists are the leaders of the
teams. The difi‘erence in the proportions of clinician types between the two areas is
significant (Chi-square= 21.26, significance= 00*").

.GLndm
The proportion of male clinicians to female clinicians in Michigan is 72.7%: 27.3%,
and 66.7%: 33.3% in Taiwan. The difl‘erence is not significant (chi-square= .29, sig.= .59).

In this study, male clinicians constitute around 70% of the sample both in Taiwan and in

Michigan.

 

 

32

Table 7 Clinical Position, Gender, and Educational Background of Samples in Both

 

Areas
Michigan Taiwan Total

Clinical position
psychiatrist 0 16 (48.5%) 16
psychologist 30 (90.9%) 16 (48.5%) 46
clinical social worker 3 (9.1%) l (3%) 4
(chi-square= 21.26, significance= 00*")

Gender of clinicians
Male 24 (72.7%) 22 (66.7%) 46 (69.7%)
female 9 (27.3%) 11 (33.3%) 20 (30.3%)
(chi-square= .29, significance= .59)

Educational background
medical degree - 0 (0%) 15 (45%) 15
doctoral degree 11 (34.4%) 1 (3%) 12
master degree 21 (65.6%) 7 (21.2%) 28
bachelor degree 0 (0%) 11 (30.3%) 11
associate degree 0 (0%) 0 (0%) 0
missing 1 0 l

 

(chi-square= 40.33, significance= 00*")
Note. The chi-square tests conducted here may not be reliable, because numbers in several
cells are less than 5. For more information, please see McNemar (1962, p218).

 

Educationalbaskgmm

In Michigan, all of clinicians for treating sex ofi’enders are psychologists and social
workers. 63.6% of them have master’s degree, and 33.3 of them have doctoral degree (one
missed this item).

The qualifications for being a clinician are also very different between the two areas.
In Taiwan, social works and nurses with a bachelor’s or associate degree are allowed to
involve in mental health practice. However, only a bachelor’s degree or higher is offered
for psychologist. 1 1 (33.3%) clinicians have bachelor’s degrees, and 7 (21%) have master’s

degrees (all of them are psychologists). The other 16 are psychiatrists (They are considered

33

to have medical degrees, but one of them getting a doctor degree are considered as doctor
degree). The difl‘erence between the two areas is significant (chi-square= 40.33,
sig.= 00*").

Age.
The average age of clinicians in Michigan is 44.67, and 35.66 in Taiwan. The difference
between them reaches significance (significance of t-test is 00*"). This might be because
most Taiwan clinicians are at military hospitals, the places psychiatrists might apply
retirement earlier than other hospitals’ and psychologists might be more younger than other
hospitals’. On the other hand, Michigan has been running the correctional psychological
service for decades, which might be the reason why the correctional psychologists in

Michigan are generally older than those in Taiwan have.

Comparing four Clinicfl Exm’engs in Both Argus

Four items concern about “generalized clinical experience” in this research. They are
attending length, numbers of clients, treating term, and main treating from of clinicians.
They are analyzed as the following.

A in l

The average of attending length of clinicians in Michigan is 89.52 months and that in
Taiwan is 17.04 months. Furthermore, there are 7 missing values in Taiwan, and three of
them responded they just provide assessment or diagnosis instead of treatment in the
questionnaires. After the researcher consulted Northern Taiwan clinicians, they mentioned

all of them just provided assessment or diagnosis for sex offenders, that is very difl’erent

34

from Southern Taiwan (It will be explained latter in this study). Moreover, the difference
reaches significance (sig.= 00*").

Numbgs Qf clients.

The average of client numbers in Michigan’s clinicians is 194.18 , and that in Taiwan
is 30.85. The two averages are significantly different (significance of t-test = 00*").

Miriam

The average of clinicians’ treating term (or treatment length) for sex ofl‘enders in
Michigan is 19.81 months, and 1.30 in Taiwan. Again, the difi’erence is significant
(significance of t-test=.00***). The treating terms between northern and southern Taiwan
also differ as shown in the following table. The average treating terms in Northern Taiwan
is .71 month, and 1.85 months in Southern Taiwan. The difference between the two is
significant based on 90% level of confidence ( significance of t-test = .09 *). The
researcher reviewed the response of clinicians in Northern Taiwan and consulted some of
them. It turns out that all Northern Taiwan clinicians have been doing is just interviewing
sex offender in prison for one time and then giving them diagnosis. They do not provide
any treatment at all. This is very different from Southern Taiwan. In southern Taiwan,
although most of the psychologists mentioned they only provided psychological assessment,
most clinicians gave psychotherapy for sex offenders in prison.

After a discussion with Director of Adult Psychiatry Department in 818 Military
Psychiatric Center and Psychological Service Department in Kai-suan Psychiatric Hospital,
it was agreed .25 month would be the treating term for those who only provided

assessment or only gave diagnosis for sex offenders in prisons, because the researcher

35

using the “treating term” in the questionnaire seemingly confused them and some of them

 

 

 

 

 

 

 

 

 

 

 

left it blank.
Table 8 Average Treating Terms in Different Clinicians of Northern and Southern
Taiwan
means or treating term (month) means of treating tetm(month)1response/ population
Northern Psychiatrist .97 mo. 9 / 10

Taiwan Psychologist .25 mo. .71 mo. 5 / 7
Southern Psychiatrist 3.05 mo. 7 / 9

Taiwan Psychologist 1.05 mo. 1.85 mo. 12 / 14
clinical social worker 3 mo. 1 / 2

Taiwan 1.30 mo. 34 / 42

 

 

 

 

 

(sig. T of difference between Northern and Southern Taiwan: .075“)

Man treatmgrt modaliu.

The treatment modalities in Michigan and Taiwan are also very different. As

mentioned before, there is a regulation in Michigan that the clinicians provided group

psychotherapy for 2 years. But there is no such rule in Taiwan. The difference reaches

significance (chi-square= 38.34, significance= 00*“) (see Table 9).

The main treatment modalities in Northern and Southern Taiwan are also

significantly different- more grouptherapy been used in the South, and more individual

interventions been used in the North (All of the interventions in the North are assessment

by psychologists or diagnosis by psychiatrists, as mentioned before), as the following table

reveals (significance of chi-square: .02").

 

36

Table 9 Main Treatment Modalities of Clinicians in Both Areas

 

 

 

 

Michigan Taiwan Northern Southern
Taiwan Taiwan
Missing 0 (0%) 5(15.2%) 3 (21%) 2 (10.5%)
only group 22(66.7%) 1(4.3%) 0 (0%) 1 (5.3%)

 

lmost group&some individual 11(33.3%) 13(39.4%) 204.3%) 11 (57.9%)

 

 

 

only individual 0 (0%) 4(12.1%) l (7.1%) 3 (15.8%)
most individual & some group 0 (0%) 10(30%) 8 (57.1%) 2 (10.5%)
(column total) 33(100%) 33( 100%) 14 (100%) 19 (100%)

 

 

 

(Sig. 0f chi-square= 00*“) (Sig of chi-squarc=..021 lit)

 

 

 

 

 

omo rin M :L fP g 2.18 foDiff ' t T u s f ex Ofl" or P I: a! o
lini ' in h

The proportions of difi‘erent types of sex offenders perceived by clinicians in the two
areas are very different. The average of perceived percentage of rapists is 28.09% in
Michigan and 70.92% in Taiwan. On the other hand, that of child molesters is 71.91% in
Michigan and 25.84% in Taiwan. The phenomenon in Michigan was also detected by the
researcher while doing an internship in Michigan state prison at the summer of 1997.
However, the ranks of proportions of the subtypes in rapists and child molesters in the two
areas are the same, though the proportions of them are somewhat different (table I 1).
Groth and his colleagues estimated that in the rapist population, the proportion of power
type rapists is 55%, anger type rapists 40%, and sadistic type rapists 5% (Groth, 1979) ; in

the child molester population, the proportion of regressed type child molesters is 49% and

37

fixated type child molesters 51% (Groth, 1978). The reasons why the perceived
proportions of rapists and child molesters in the two areas are very different might result
fiom the following reasons: (1) difference in treatment programs: Every sex offender in
Taiwan is required by law to receive mandatory diagnosis and treatment before they
parole, but in Michigan sex ofi’enders will be recommended by prison psychologists two
years before the offenders’ early release date and they have the right to decide whether
they will be treated or not. S. Bolt, the director of psychological service unit in Cotton
Correctional Facility at Jackson, Michigan, said that generally fewer rapists want to join
the therapy sessions than child molesters, and that the former also more likely to withdraw
fiom the group even when they joined the group, because of their higher tendency to denial
(personal communication, June 12, 1997). (2) difference of child abuse report system: E.
Bojdos, a psychologist in Cotton Correctional Facility, said that the better child abuse
report systems would always get more reports than the worse ones (personal
communication, July 20, 1997). As the researcher know, the child abuse report system in
Taiwan is worse than the US. (3) different compositions of sex offense rates: The
composition of sex offenses in the United States and Taiwan are very different as the
researcher found in oficial statistics reports. The proportion of child sex abuse cases in sex
offense cases in Taiwan generally is generally in the range between 10% to 20%, but about

46% in the United States (table 10).

38

Table 10 Proportion of Child and Adult Sex Offense in Sex Offense in US. and Taiwan

 

 

 

 

United States Taiwan
(child sex abuse: adult sex offense) (child sex abuse: adult sex offense)
1996 NA 10% : 90%
1995 46.86% : 53.14% NA
1990 NA 20% : 80%

 

 

 

 

 

1&9 Of the US. data, the proportions of victims above 12 and victims below 12 are
calculated fi'om Sourcebook of Criminal Justice Statistics -- 1996 (edited by US.
Department of Justice). The Taiwan proportions are from Taiwan Crime Statistics (edited
by Taiwan Criminal Investigation Bureau). The cutpoints of child and adult in both areas

here are 12 years old.

 

 

 

 

 

 

 

 

 

Table 11 Proportions of Different Types of Sex Offenders perceived by clinicians in the
, Two Areas
l Michigan Taiwan (sig. T of difference)
)Rapist 28.09% 70.92% .oo***

power type 51.15% 64.25% 06*

anger type 42.56% 23.80% 00*“

sadistic type 8.15% 15.70% .1 1
Child Molester 71.91% 25.84% 00*"

regressed type 72.1 1% 65.06% .44

fixated type 27.89% 30.78% .75

 

 

 

 

 

 

 

Note. *p<.l; ***p<.01

om» 'n_Mn. onD_ -- fDim 15 oth: in Diffren Tn: of- x Ofi‘ 1.-

Pr'v linii in h

The ranks of clinicians’ perception of degree of difficulty on treating different types of

39

sex offenders in Michigan and Taiwan are totally the same. From the most difficult to the
easiest, they are sadistic type rapists, fixated type child molesters, power type rapists, anger
type rapists, and regressed type child molesters. None of the degrees of difficulty in
treating every type of sex offenders reach the significant difference between the two areas
(Table 12). Therefore, the first hypothesis of this research, there are no difi’erences in
perceptions of the degrees of difficulty in treating different types of sex offenders between
clinicians in Taiwan and Michigan, was met. The reason of this result might be the clinical
intuition of two areas’ clinicians is very close. Moreover, because the majority of Taiwan
clinicians did not know the Groth’s typology, there was an appendix explaining every types
of sex offender in Groth’s typology attached to every copy of questionnaire in order to
help Taiwan clinicians understand this typology and respond the questions by their clinical
experience or clinical intuition. Groth did not specify the degree of difiiculty on treating
different types of sex offenders, but he submitted some of important assessment guides
such as family background, childhood history, medical history, military history,
interpersonal development, occupatiOnal history, criminal history, means of the offense etc
(Groth & Bimbaum, 1979). However, some researches revealed that if juvenile sex
ofi’enders were not effectively treated, they might develop into fixated pedophiles,
incestuous fathers (Thomas & Rogers, 1983) or perpetrators of other increasingly deviant
and dangerous behaviors (Freeman-Longo & McFadin,1981). Generally if the sex
offenders with tortured childhood, early developed deviant sexual fantasy, or antisocial
personality disorder (namely psychopathic personality), they should be very difficult to be

efi’ectively treated (S. Bolt, personal communication, July 10, 1997; R. Walter, personal

40

communication, Feb. 21, 1998).

Table 12 Clinicians’ Perception of Degree of Difiiculty on Treating Different Types of
Sex Offenders in the Two Areas (based on 7-1evel Likert Scale)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Michigan Taiwan (sig. T of differencefl

power type 4.74 4.85 sig=.77
Rapist angertype 4.63 4.64 sig=.33
sadistic type 6.48 6.08 sig=. 16
Child regressive type 4.09 4.41 sig=.30
Molester fixated type 6.06 5.88 sig=.46
general sex offenders 5.00 5.33 sig=. 14

h kin_ th R1 in hi r ~31no-r en V nol- .. Q3Da0' r V 2,019»

Comparing means for the dependent variables should be done before checking the
relationship between independent variables and dependent variables.

[2 . E l 3 l l . l l

The following three dependent variables are obtained from a 7-point Likert Scale
with higher score representing higher degree of agreement with the statements or higher
familiarity with the techniques (thus midpoint 4 means “so so” on the items, and scores
below 4 would mean disagree and unfamiliar).
1. Deserving to be treated (labeled “deserve” in the statistics)

It means the degree of agreement on the statement “all sex offenders deserve to be

treated”. Michigan clinicians responses have a mean of 4.30 point on the item, close to

the midpoint, “so so”, on the scale. Taiwan clinicians responses’ mean is 3.47, a little bit

41
close the side of disagreement. The difference of the two areas is not yet significant (sig.
T of difference= .10).

Table 13 Comparing Means of 3 Dependent Variables in the two areas (based on
7-level Likert Scale)

 

Michigan Taiwan (sig. T of difference)

 

 

 

deserve 4.30 3.47 sig=.10
effective 4.94 4.21 sig=.03**
technique familiarity 5.30 3.32 sig=.00"*

 

 

 

 

 

 

2. Treating sex offender is effective (labeled “effective” in the statistics)

It means the degree of agreement on the statement “treating sex ofi’ender is
effective”. Average Michigan clinicians response is 4.94, more than that of Taiwan
clinicians’ response 4.21. Both areas are on the positive side. The difference of the two
areas is significant(sig. T of difference= .03").

3. Degree of familiarity with the techniques of treating sex offender (labeled “technique
familiarity” in the statistics)

It means the degree of agreement on the statement “the degree of familiarity on the
techniques of treating sex ofl‘ender”. Average Michigan clinicians response is 5.30 (on
the familiar side), higher than that of Taiwan clinicians‘ response 323-- on the unfamiliar
side. The difference of the two areas is significant (sig. T of difference= 00*").

h kin biv 't rlati nhi wihinh 3d en nv '1
If there is significant relationship within the three dependent variables, it is better to

use Multiple Analysis of Variance (MANOVA). But if not, then Multiple Regression

42

should be used instead. After checking the bivariate relationship (see the following table),

only one significant relationship exists- between “effective” and “technique familiarity”.

Therefore, using Multiple Regression is necessary.

Table 14 Bivariate Relationship within the Three Dependent Variables

 

 

 

 

 

 

 

 

 

I deserve feel effective technique familiarity
Reserve 1 .20 -.01
-. l 3 p=. 99
feel efi’ective 1 .39
p=.oo***
[technique familiarity 1
Multiple regtessipn.

1. Predicting “deserve” by 3 independent variables in both areas

The following table is the result of multiple regression. Only “treating term” can

significantly predict “deserve”, and the slope is .06, a mild positive slope- which means the

longer the treating term is, the more likely the clinician is to agree that “sex offender

deserve to be treated”.

Table 15 Predicting "deserve" by "attending length", "numbers of clients", and

 

"treating term"
Multiple R .36
R Square .13
Variable B SE B SM
"attending length" -.01 1 .01 .13
"numbers of clients" -.00 .00 .98
”treating term" .062 .03 .04"
(Constant) 4.07 .45 .00

After making two scatter plots of predicting "deserve" by "attending length" and

predicting "deserve" by "treating term" in both Michigan and Taiwan for a try (Figure 3

43

and 4), the researcher found that the spread of the data points in the two areas are very
different, so analyzing the two areas separately is inevitable in this research.
2. Predict "feel efi‘ective" by 3 independent variables
The following table is the result of multiple regression. There is no significant
slope in it, that means none of the three independent variables can predict "feel effective".

Table 16 Predict "F eel Effective" by "Attending Length", "Numbers of Clients", and
"Treating Term"

 

Multiple R .22

R Square .05

Variable B SE B SM
”attending length" .00 .00 .97
"numbers of climts" .00 .00 .44
"treating term“ .01 .02 .67
(Constant) 4.38 .32 .00

3. Predict technique familiarity by 3 independent variables
The following table is the result of multiple regression. Only "treating term" can
significantly predict technique familiarity. The slope is .05, a mild positive slope. That
means the longer the treating term, the more familiar to the techniques of treating sex

offenders.

Table 17 Predicting "Technique Familiarity" by " Attending Length", "Numbers of
Clients", and "Treating Term"

 

Multiple R .59

R Square .35

Vgg'able B SE B Stg._I
”attending length" .00 .00 .51
"numbers of clients" .00 .00 .15
"treating term" .05 .02 .03”

(Constant) 3.33 .32 .00

44

 

which area's clinici
* Taiwan

 

feel sex offender deserve to be trez

 

 

 

1 I u 0 at o TMichigan

\ _
0 _ fl \ _ Total Population
-100 0 100 \ .200 300

months of attending treating sex offender

Figure 3 Scatter Plot and Regression Lines of Predicting "deserve" by
"attending length" in Michigan and Taiwan

 

which area's clinici
* Taiwan
- Michigan

0 _ _ _ _ Total Population
-1 0 0 10 20‘ 30 40

 

 

 

feel sex offender deserve to be trez

 

 

 

average treatment term

Figure 4 Scatter Plot and Regression Lines of Predicting "deserve" by
"treating term“ in Michigan and Taiwan

45

4. Running factor analysis on 3 independent variables, and running multiple
regression
Because there are few significant predictions in the above multiple regressions and
the three multiple Rs (multiple correlation coefficient) are still high (.36, .22, and .59), it is
a reasonable doubt that there might be high correlation within the three independent
variables. The following table (Table 18) reveals all of the three bivariate correlations are
significant. It is worthy to check whether there is a factor within them.

Table 18 Bivariate Correlation within 3 Independent Variables

”attending length” “numbers of clients” ”treating term"

"attending length" 1.00 .79 .48
( 59) ( 57) ( 54)
P=. P= .00‘" P= .00‘"
"numbers of clients" .79 1.00 .34
( 57) ( S9) ( 55)
P= .00’” P=. P= .01“
"treating term" .48 .34 1.00
( 54) ( 55) ( 61)
P: .00‘" P: .01" P=.

After factor analysis on 3 independent variables being done, one factor (named
FACTOR a1) is revealed. Obviously, "attending length" and "numbers of clients" have
heavier loading than "treating term" on FACTOR a1, so it can be presumed to contain the
meaning of “extensive clinical experience” (see Table 19). On the other hand, treating term
can be meant as “deep clinical experience. Afier doing factor analysis within "attending
length" and "numbers of clients" further, the loading is obviously heavier on a factor,

named FACTOR a2 (see Table 20).

46

Table I9 Factor Analysis within "Attending Length" and "Numbers of Clients"

 

 

 

Variable Comrmmalitv ‘ Mm Eigenvalue Pet of Var. Cum Pct
“attending length" .87 ‘ l 2.09 69.6
"numbers of clients” .77 ’
”treating term" .45 '
Factor Matrix] Pagor l
”attending length" .93
"numbers of clients“ .88
"treating term" .67
Table 20 Factor Analysis within "Attending Length" and "Numbers of Clients"

 

 

 

 

Variable Comrnunality ' Factor Eigenvalue Pct of Var. Cm Pct
'attarding length" 1.00 ' l 1.79 89.6

”numbers of clients” 1.00 ’ 2 .21 10.4

Factor Matrix / F a_c_t_or l

"attending length" .95

”numbers of clients" .95 '

(1) predicting "deserve" by FACTOR a2 and "treating term"

Both FACTOR a2 and "treating term" can significantly predict "deserve" (see

Table 21). The interesting finding here is the slope of the former is negative (slope = -.68),

that means the more “extensive clinical experience” the clinician has, the less he/she would

agree that “sex offenders deserve to be treated”.

Table 21 Predicting "Deserve", "Feel Efi’ective", and “Technique Familiarity” by

FACTOR a2 and "Treating Term"

 

 

 

 

 

 

 

 

 

 

 

 

 

deserve feel efi’ective Technique familiarity
B sig. T B sig. T B sig. T
FACTOR a2 —.68 .03" .25 .23 .66 00*"
treating term .06 .06* .01 .72 .05 .03"
(Multiple R) .34 .22
(R square) .12 .05

 

Npte. B means regression coefficient; sig. T means significance of t-test.

 

47

(2) predicting "feel efi’ective" by FACTOR a2 and "treating term"

Either FACTOR a2 or "treating term" can not significantly predict "feel
effective" (see Table 21).

(3) predicting "technique familiarity" by FACTOR a2 and "treating term"

Both FACTOR a2 and "treating term" can significantly predict "technique
familiarity". Especially, the slope of former is very high (.66), that means the more
“extensive clinical experience” the clinician has, the more he/she would be familiar with the
techniques of treating sex offenders.

5. Running factor analysis on 3 independent variables, and running multiple
regression in Michigan and Taiwan separately
Because the three independent variables are significantly difi‘erent in both areas as
found before, the researcher ran the above again in Michigan and Taiwan separately to
check whether there is further difference.
(1) Michigan
None of the three independent variables can significantly predict the three dependent
variables in Michigan (see Table 22). But FACTOR ml (abstracted from factor analysis
on "attending length" and "numbers of clients" in Michigan, and meaning “extensive
clinical experience) can significantly predict "deserve" and "technique familiarity". The
slope of the former is severely negative (-.8508), that means the more “extensive clinical
experience” the clinician has, the far less he/she would agree that “sex offender deserve
to be treated” (see Table 23). The reasonable explanations might be the burn-out effect

of clinicians (A. M. Barclay; personal communication, Jan. 27, 1998) or considerable

48

proportion of sex offenders might be impossible to be treated well (R Walter; personal

communication, Feb. 21,1998). J. Rushbrook, the psychological service director of

Michigan Department of Corrections, interpreted that it might result fiom the burn-out

efi’ect and feeling not good on the political issue, the State and politicians always want to

cut down the money on the expense of health care and prison (personal communication,

 

 

 

 

 

 

 

 

 

 

Feb. 23, 1998).
Table 22 Predictin r 3 Dependent Variables by 3 Independent Variables in Michigan
dell var- \ indep- W- deserve feel effective Technique familiarity
B -sig. T B sig. T B sig. T
Attending length -.01 .20 .00 .80 .00 .46
Numbers of clients -.00 .64 .00 .74 .00 .49
treating term .01 .88 -.03 .51 -.02 .67
(Multiple R) .44 .21 .37
(quuare) .19 .04 .14

 

 

 

 

 

Table 23 Predicting 3 Dependent Variables by FACTOR ml and "Treating Term" in

 

 

 

 

 

 

 

 

 

 

 

 

 

Michigan
dep- var. \ indep- W- deserve feel effective Technique familiarity
B sig. T B sig. T B Sig. T
FACTOR ml -.85 .02" .22 .40 .56 .04"
treating term .00 .98 -.03 -.51 -.02 .66
(Multiple R) .43 .21 .37
(quuare) .18 .04 .14

 

 

 

(2) Taiwan

49

None of the three independent variables can significantly predict the three dependent

variables in Taiwan (see Table 24). Also FACTOR t1 (abstracted from factor analysis on

"attending length" and "numbers of clients" in Taiwan) and "treating term" cannot

significantly predict the three dependent variables (see Table 25). It might be caused by the

Table 24 Predicting 3 Dependent Variables by 3 Independent Variables in Taiwan

 

 

 

 

 

 

 

 

 

 

Hep. var- \ indep- var. deserve feel effective Supportiveness
B sig. T B sig. T B sig. T
attending length -.07 .21 -.03 .38 .02 .51
numbers ofclients .01 .41 .01 .36 .01 .35
treating term .27 .29 .21 .16 .20 .15
(Multiple R) .39 .42 .50
(R square) .15 .18 .25

 

 

 

 

 

Table 25 Predicting 3 Dependent Variables by FACTOR t1 and "Treating Term" in

 

 

 

 

 

 

 

 

 

Taiwan
(den var- \ indep- var- "deserve" "feel effective" "technique familiarity"
B sig. T B sig. T B sig. T
FACTOR t1 -.22 .63 .01 .96 .44 .ll
treating term .26 .30 .21 .16 .20 .14
(Multiple R) .27 .35 .50
(R square) .08 .12 .25

 

 

 

 

 

 

 

50

attending length, numbers of clients, and treating term of Taiwan clinicians is too small in
quantitative to significantly predict the three dependent variables; that is the spread of the
three independent variables is too narrow for the slopes to significantly predict the three

dependent variables. Both Figure 1 and Figure 2 can prove this situation.

hakin_ h Rlun,_h1. .- een 3 Dar 1‘ 2 Miles 1 n “1-0 . 9 'v ' s"
1. Comparing means of "supportiveness" (in Michigan and Taiwan)
"Supportiveness“, the degree of support on the current sex offender treatment
program, was obtained from a 5-level Likert Scale with higher score representing higher
degree of supportiveness (thus midpoint 3 means “so so” on the item, and scores below 3
would mean unsupportiveness on the program).

The average Michigan clinicians’ response is higher than that of Taiwan. Both areas
are in the positive side, though Taiwan clinicians’ response is closer to the midpoint 3, “so
so” The difference of the two areas is significant (see Table 26). Crosstabulation and
open-ended answers would be analyzed later.

Table 26 Comparing Means of "Supportiveness" in the Two Areas
Michigan Taiwan

 

 

means of "supportiveness" 3.64 3 .03

 

 

sig. T of difference= .03"

 

 

 

 

2. Predicting "supportiveness" by 3 independent variables (Combined, Michigan, and
Taiwan)

The researcher wanted to understand which variable might affect the degree of

51

supportiveness on the current sex ofi‘ender treatment program. Therefore, predicting
"supportiveness" by three independent variables and three dependent variables through
multiple regression was done as in the following two tables. In the former multiple
regression in the Combined, Michigan, and Taiwan, none can significantly predict
"supportiveness", except "treating term" in Taiwan (sig. T=.08*)(see Table 27).

Table 27 Predicting "Supportiveness" by 2 Independent Variables in the Combined,
Michigan, and Taiwan

 

 

 

 

 

 

 

 

 

Combined Michigan Taiwan
B sig. T B Sig. T B sig. T
factor(extensive clinical experience) .05 .87 -.07 .70 -. 16 .53
treating term .04 .15 -.01 .78 .25 .08*
(Multiple R) .24 .09 .45
(R square) .06 .01 .20

 

 

 

 

 

 

3. Predicting "supportiveness" by 3 dependent variables (Combined, Michigan, and
Taiwan)

In predicting "supportiveness“ by three dependent variables in the Combined,
Michigan, and Taiwan, only "feel effective" can significantly predict "supportiveness“ in
the Combined and Taiwan. Overviewing these two tables, the researcher found the 3
independent variables and the 3 dependent variables can explain .21 and .30 percent of

variation of "supportiveness" in Taiwan, and they are far higher than Michigan.

52

Table 28 Predicting "Supportiveness" by 3 Independent Variables in the Combined,
Michigan, and Taiwan

 

 

 

 

 

 

 

 

 

 

Combined Michigan Taiwan

B sig. T B sig. T B sig. T
Deserve .10 .13 .08 .40 .09 .38
feel efl‘ective .20 .07* .11 .43 .37 .05”
Technique familiarity .14 .11 .05 .68 .27 .18
(Multiple R) .45 .25 .55
(R square) .20 .07 .30

 

 

 

 

 

 

Table 29 Predicting "Supportiveness" by Factor (abstracted from "attending length" and
"numbers of clients") and "Treating Term" in the Combined, Michigan, and

 

 

 

 

 

 

 

 

 

Taiwan
Combined Michigan Taiwan
B sig. T B sig. T B sig. T
Factor .43 .00" .20 .28
Deserve .10 .13 .08 .35
(Multiple R) .45 .25
(R square) .20 .06

 

 

 

 

 

Note. In Taiwan, there is no significant relationship between ”feel effective" and "technique familiarity“, but the
Combined and Michigan have. Also, a factor could be abstracted from the Combined and Michigan, and it might
contain the meaning of feeling treatment effective and familiar to treating technique.

r l i n d - An w f " iv e s"
An i f " i n "
1. Comparison of Michigan and Taiwan

The clinicians’ degrees of supportiveness on current treatment program in Michigan

 

53

and Taiwan are significantly different in the comparing means (sig. T of difl’erence = .
025"), though they do not reach significantly difference in crosstabulation as the
following table shows. The clinicians in Michigan generally tend to be more supportive on

the current treatment program than the ones in Taiwan do.

Table 30 Crosstabulation and Comparing Means of Clinicians’ Degree of Support on the
Current Program in Michigan and Taiwan

 

 

Michigan Taiwan
not supportive at all 0 (0%) 2 (6.5%)
not supportive 6 (18.2%) 9 (29.0%)
so so 7 (21.2%) 8 (25.8%)
Supportive 13 (39.4%) 10 (32.3%)
very supportive 7 (21.2%) 2 (6.5%)
(total) 33 (100%) 31 (100%)

Chi-square= 5.78, sig.= .22

 

means of "supportiveness" 3.64 3.03
sig. T of difference = .03"

 

 

 

Npte. 2 missing values, both in Taiwan.

2. Comparison of Northern Taiwan and Southern Taiwan

The clinicians’ degrees of supportiveness on the current program in Northern and
Southern Taiwan are significantly different as the following comparing means table shows
(sig. T of difference = .03“). The clinicians in Southern Taiwan generally tend to be

more supportive the current treatment program than the clinicians in Northern Taiwan do.

ngt-gnded stpr gpajysis pf "sttppogtivgpess".

The question in this item is “ If you answered the above question as ‘not satisfied’
and ‘not satisfied at all’, would you explain why?” The followings are the responses:

1. Michigan: Of the negative reposes, including “not supportive” or “not supportive

54

Table 31 Crosstabulation and Comparing Means of Clinicians’ Degree of Support on the
Current Program in Northern and Southern Taiwan

 

 

Northern Taiwan Southern Taiwan
not supportive at all 2 (16.7%) 0 (0%)
not supportive 5 (41.7%) 4 (21.1%)
soso 2 (16.7%) 6(31.6%)
supportive 3 (25.0%) 7 (36.8%)
very supportive 0 (0%) 2 (10.5%)
(total) 12 (100%) 19 (100%)

chi-square= 6.46, sig.= .17

 

means of "supportiveness" 2.50 3.37
sig. T of difference = .03"

 

 

 

Not; 2 missing values, both in Northern Taiwan.

at all”, 6 clinicians responded “not supportive” in this question, and all of them wrote

down the reasons of their responses, totally ten reasons, been classified as the following.

(1) four (40%) relating to treating term: Three (30% of negative responses) are not
satisfied with short time, and one (10%) is not satisfied with infrequency. They are
“ I am not satisfied with accelerated program” (ml), “ program is overly structural
and too short” (m18), “ too restrictive in time” (m24), and “infrequency of therapy”
(m27).

( 2) two (20%) relating to treating format: Two (20%) of the negative responses
relate to treating format, one (10%) for cognitive behavioral approach and the
another one (10%) for too structure.

(3) the others (each for 7.69%): Because they might provide some clues for the

policy makers, the researcher prefer to leave them. They are “ parole review

55

process allowed to impair therapy alliance” (m25), “ time limits beginning at time
incarcerated” (m27), “lack of training and expertise of most clinicians” (m27), and
“people who are not clinicians tend to develop programming” (m27).

2. Taiwan: Of the negative responses, 9 clinicians responded “ not supportive” and 2
clinicians responded “ not supportive at all”. There are 13 reasons of their responses been
classified as the following.

( 1) Four (30.77% of negative responses) are “We just do the diagnosis instead of

treatment currently.” (t2,3,6, 12)

(2) two (15.38%) relating to treating objects. They are “the one lost control after
drunk should be excluded” (t2), and “It is wrong that every sex offender should get
the mandatory treatment.” (t23).

(3) the others (each for 7.69%): They are as the followings: “Screening high risk
factors needs to be established.” (t5), “That every sex offender needs to see medical
doctor limits other clinicians’ professional intervention.” (t7), “1 do not feel there
is any sex offender treatment program.” (t10), “Eligible professionals and
manpower are not enough.” (t12), “The program with only outside clinicians and
without professionals in prisons might get half the result with twice the effort.”

(t l 6), “Sex offenders should be intervened according to the individual situation.
Not only psychiatric treatment, but also psychotherapy and family therapy should
be included.” (t28), and “It is mere formalism, because the program can not be

really fillfilled.” (t29)

56

Clinigiang’ Rpsppng pn Sugggtipng fpr the Current Trtgtmmt Prpgtapt

In order to understand what are the clinicians’ suggestions on the current
program in the two areas, the researcher asked the following question in the
questionnaire. The choice items were from the suggestions of clinicians in Cotton
Correctional Facility and Southern Michigan Correctional Psychology Director, in
addition to my clinical experience in Taiwan. The seven items, including the two blank
items, are named as suggestion #1 to suggestion #7 in the table and latter descriptions.
This question was asked as the following:

What would be your suggestions to improve the eficiency of treating sex offenders
in the current system? (Please choose at least two items from the followings. If the
choices are not so suitable for you, please write it/them down.)

suggest #1 1] continuing the community treatment program after being paroled

suggest #2 [1 providing meetings or seminars to improve the professional techniques

suggest #3 El clarifying which kind(s) of sex offenders deserve to be treated

suggest #4 1] making the length of the treatment at least one or two years

suggest #5 El concentrating the sex ofi’enders to exclusive prisons in order to provide

more treatments
suggest #6 [1
suggest #7 D

 

 

Because this question is multiple choice, the testee can choose as many as they want,
but at least two items. Including the responding on the blank items, there are 111
responses in Michigan, and 104 in Taiwan. From the total responses of the following
table (table 32), it reveals the priority in the two areas seems somewhat difi’erent.
Suggestion #1 is the highest priority in the two areas. 96.97% of Michigan clinicians
chose Suggestion #1 and 86.21% of Taiwan clinicians. This reveals the clinicians in both
areas mostly agree that “continuing the treatment program after being paroled” is

extremely important. Suggestion #2 is the other highest priority in Taiwan (86.21%),

57

and the third priority in Michigan (51.52%). It indicates that the on-work training is also
very important. Suggestion #3, clarifying which kind(s) of sex offenders deserve to be
treated, is the third priority in Taiwan (79.31%) but not in Michigan (24.24%).
Suggestion #4, making the length of treatment at least one or two years, is the second
priority in Michigan (54.55%), and the fourth priority in Taiwan (48.28). Suggestion #5,
concentrating the sex offenders to exclusive prisons in order to provide more treatments,

are the third priority in Michigan (51.52%), and the fourth priority in Taiwan (41.38%).

Table 32 Clinicians’ Response on Suggestions for the Current Treatment Program in

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Michigan and Taiwan
Michigan Taiwan (column total)
(33 pe0ple (29 people (62 people
responded) responded) responded)
mo. of approve proportion of mo. of approve proportion of no. of approve Epmponion of
approve mve mire
suggestion #I 32 96.97% 25 86.21% 57 91.94%
suggestion #2 17 51.52% 25 86.21% 42 67.74%
suggestion #3 8 24.24% 23 79.3 1% 3 1 50.00%
suggestion #4 18 54.55% 14 48.28% 32 51.61%
suggestion #5 17 51.52% 12 41.38% 29 46.77%
[suggestion #6(blank) 15 45.45% 5 17.24% 20 32.26%
Isuggestion #7(blank) 4 12.12% 0 0.00% 4 6.45%
l (row total) 1 1 1 104 215

 

 

 

 

 

Relating to the open-ended suggestions (suggestion #6 and #7), there are totally 24

responses in the two items, 19 in Michigan and 5 in Taiwan. They are sorted as the

58
following:

( 1) three relating to the treating term: They are “having termination related to
criteria rather than arbitrary i.e. 1 year and you are out” (m2), “increasing the
quality, substance, and length of involvement with arbitrary time limits” (m3 ), and
“three years of treatment prior to parole” (m21).

(2) three relating to the training for the clinicians: It is similar to Suggestion #2, but
it is still been emphasized in the two blank items. They are “more training” (m20,
l8), and “training of the therapists should be professional” (t2).

(3) two relating to the qualification of the clinicians: They are “credentialing sex
offender therapists” (m9), and “The qualification of the therapists should be limited
and their professional standard should be identified” (t3).

(4) three relating to the beginning time of the treatment: All suggest the treatment
should be provided as soon as possible. They are “beginning treatment soon after
prosecution” (m9), “address the issue when inmates are first imprisonment” (m10),
and “Therapy and assessment should be done as soon as the client is sentenced...”
(t6).

(5) others: The following suggestions are provided as their original sentences in
order to keep the meaning of them.

A. Michigan: They are as the followings: “( l) clarify risk assessment issues; (2)
develop a standard procedure for dealing with denials. (m1); “ ( 1) better data kept
on who fails on parole and conjoin it to the specific of their treatment; (2) also

“

examine who is successfill to treatment and what factor account for it (m16);

59

(2) fitting the treatment to the offenders instead of the offenders to the treatment-
- behaviorally, culturally, intellectually etc. (m 1 8); “distance the parole board”
(m25); “(1) hiring clinicians who are the most skilled rather than the least; (2)
support by the Department for clinicians to provide most effective treatment”
( m27); “ofi’er mandatory substance abuse treatment for dual diagnosis” (m29);
“personally no treatment can be completed without a spiritual dimension
involved” (m31); “divide rapists and child molesters into separate groups” (m32).
B. Taiwan: They are as the following: “...besides it is necessary to evaluate the
efi’ect of treatment periodically” (t2); “ Ministry of Legal Affair needs to provide
the budget for the related researches, such as the research of reoffense criteria, so
the research outcome can direct the clinical approaches.” (t8); “The prisons
should have the full time psychologists and clinical social workers in order to do
the individual, psychological, familial, and environmental assessment and

treatment and do the appropriate transference if necessary.” (tl6).

Clinipim’ Rgsppnsg pa 3 Contrpvpr_sigl Pplicjes

Inggfinitg gpnfinmmt.
l. Crosstabualtion in the two areas

It can be found that the responses concentrate on both sides in both areas, although
the disagree sides are lower. 69.7% (23) of Michigan clinicians agree or totally agree
indefinite confinement, but 51.7% (15) of Taiwan clinicians do. On the other hand, there

are 21.2% (7) of Michigan clinicians disagree or totally disagree indefinite confinement, but

60

31.0% (9) of Taiwan clinicians do (Table 33).

Table 33 Crosstabulation and Comparing Means of Clinicians’ Response on Indefinite
Confinement in Michigan and Taiwan

 

 

 

 

 

 

Michigan Taiwan (row total)
Total disagree 3 1 4
9.1% 3.4% 6.5%
lDisagree 4 8 12
12.1% 27.6% 19.4%
Hso so 3 5 8
9.1% 17.2% 12.9%
Agree 6 14 20
18.2% 48.3% 32.3%
Total agree 17 l 18
51.5% 3.4% 29.0%
(column total) 33(100%) 29(100%) 62(100%)
chi-square=20.08Lsig. of chi-square=.00***, contingency coefiicienct=49
Means of indefinite 3.91 3.21
confinement
sig. T= .03"

 

 

Npte. There are 4 missing values, all in Taiwan.

2. Comparing means in the two areas
The averages of degree of agreement in the two areas are significantly different. The
mean in Taiwan is 3.21, and Michigan 3.91 (Table 33). Clinicians in Michigan tend to agree
with indefinite confinement than those in Taiwan.
3. Analysis of open-ended questions
(1) The reasons of the above responses:
a. negative comments on indefinite confinement: They can be sorted to three
categories as the following: it is against the law-- citizens can only be confined for
the criminal acts (m16, 17, 24; US, 16, 21, 24); this can not solve the original

problems (t2, 3); finishing serving the sentence means completing the punishment

(m16, 21).

61

b. positive comments on indefinite confinement: They can be sorted as the following:
some offenders are unable or unwilling to change their behavior, such as
psychopathic or fixated offenders (m2, 3, 4, 5, 7, 8, 9, 10, 13, 20, 21, 22, 23, 25,
26, 27, 29, 30, 31, 33; t8, 14, 15, 18, 27, 33); concerning public safety, the system
is necessary (m2, 12; t4, 6); if the treatment is not successfill in prison, continuing
the treatment is necessary (t25, 26).

(2) “If indefinite confinement for sex ofi’enders is passed as law, what is/are your
suggestion(s) to enforce it?”: The answers can be sorted as the three followings:
criteria for qualified indefinite confinement should be established (m4, 13, 17; t2,
13, 18, 19, 21); it better to change the imprisonment of sex offenders longer instead
of indefinite confinement (ml, 14, 18; t21); indefinite confinement should also

combine with treatment (m12, 14, 17).

h ' l i n

1. Crosstabulation in both areas
The following crosstabulation reveals less clinicians in Michigan agree or totally
agree with chemical castration than in Taiwan, but the difference is not significant.
42.5% (14) of Michigan clinicians agree or total agree with it, and 72.4% (21) in
Taiwan (Table 34).

2. Comparing means in both areas
The averages of degree of agreement in the two areas are significantly difi’erent. The

mean in Taiwan is 3.76, and Michigan 3.15 (Table 34). It reveals Michigan clinicians tend

62
to be neutral toward the chemical castration while Taiwan clinicians are a little more
supportive.

Table 34 Crosstabulation and Comparing Means of Clinicians’ Response on Chemical
Castration in Michigan and Taiwan

 

 

Michigan Taiwan (row total)
ltotal disagree 6 1 7
18.2% 3.4% 11.3%
iDisagree 2 2 4
6.1% 6.9% 6.5%
so so 11 5 16
33.3% 17.2% 25.8%
agree 9 16 25
27.3% 55.2% 40.3%
otal agree 5 5 10
15.2% 17.2% 16.1%
(column total) 33 (100%) 29(100%) 62(100%)
chi-square=7.56, sig. of chi-square=. 11
means of chemical 3.15 3.76
castration
sig. T=. 04"

 

15191;. There are 4 missing values, all in Taiwan.
3. Analysis of open-ended questions
(1) The reasons of the above responses:

a. negative comments on chemical castration: They can be sorted as the three
followings: chemical castration is not addressing the behavioral problem (m2, 10, 17,
26, 27, 28, 30); this treatment can not reduce the offenders’ assault by other methods
or tools. (m2; t1, 3, 21, 23); there would be massive abuse of civil rights. (mlS)

b. positive comments on chemical castration: They can be sorted as the five followings:
chemical castration may work small minority of sex offenders (m1, 8, 12, 18; t19);
only if we had provide series of positive treatment and the prognosis is still bad, we

might consider this kind of treatment. (t6, 8, 16); this treatment would increase the

 

63

possibility of behavioral control (t12, 27); some sex offender are happy about it (ml 8,
31); biological factor is one of the clients’ problem, so the treatment could work (t25,
33).

(2) “If chemical castration is passed as law, what is/are your suggestion(s) to enforce
it?”: The suggestions can be sorted as the four followings: this treatment should be
voluntary (m7, 14, 19, 31; t4, 23, 25, 26, 27); accurate diagnosis of those who require
chemical castration, and classifying sex offenders (m1; t4, 5, 17, 19, 20, 21, 22, 26, 27,
33); this treatment should be ruled the receivable clients should have commit at least
three time of reoifense and have received at two years of professional treatment. (t 1 6,
25); use in conjunction with lie detector and penile plethymography (m26).

9

W

l. Crosstabulation in both areas

It can be found more clinicians in Taiwan agree with the Megan’s Law than in
Michigan, but the difference is not significant. 72.4% (21) of Taiwan clinicians agree or
totally agree with the law, and 57.6% (19) in Michigan. On the other hand, 3.4% ( 1)
Taiwan clinicians disagree or totally disagree with the law, but 21.2% (7) in Michigan
(Table 35).

2. Comparing means in both areas
The averages of degree of agreement in the two areas are not significantly different.
The averages in Taiwan is 3.90, and Michigan 3.64 (Table 35). It reveals that more Taiwan

clinicians tend to agree with Megan’s Law than Michigan clinicians do.

64

Table 35 Crosstabulation and Comparing Means of Clinicians’ Response on Megan’s Law
in Michigan and Taiwan

 

 

 

 

[ Michigan Taiwan (row total)
otal disagree 1 0 1
3.0% 0.0% 1.6%
disagree 6 1 7
18.2% 3.4% 11.3%
so so 7 7 14
21.2% 24.1% 22.6%
agree 9 15 24
27.3% 51.7% 38.7%
otal agree 10 6 16
30.3% 20.7% 25.8%
(column total) 33 (100%) 29(100%) 62 (100%)
chi-square=6.84, sig. of chi-square=.l4_,p>. 10
means of Megan’s 3.64 3.90
Law
sig. T= .32, p>.10 (not significant enough)

 

 

Npte. There are 4 missing values, all in Taiwan.
3. Analysis of open-ended questions
(1) The reasons of the above responses:

a. negative comments on Megan’s Law: They can be sorted as the following six
comments: this system will isolate the ofi’enders, and leads their committing
reofl’ense cycle (m10; t27); it can be a good way of implementing supervision if it is
not the only thing being done (ml); the courts need to recognize their responsibility
to define the term of incarceration. (m6); encourages a ‘intch hunt” mentally (m14);
we need to have effective deterrents that before the crime not after. I am not
convinced that public safety if enhanced as a resort. (m29); it’s not being enforced
secretly-- implicated wrong people (by address) and misses appreciate ends

sometimes (m3 2).

b. positive comments on Megan’s Law: They can be sorted as the following:

65

community pe0ple have the right to know whether a sex offender lives nearby, and
protect themselves (m7, 15, 16, 22, 28, 33; t17, 23); the protection of the
community people is more important than the right of ofl‘enders (m24, 33; t3, 21, 22);
to save children and women from predators (m24; t1).

(2) “What is/are your suggestion(s) to enforce the Megan’s Law?”
The responses can be sorted as the followings: agree with registration, but disagree
with notification (ml7, 18, 27; t14, 20, 24, 25, 26, 27); continuing treatment afier

release (t5, 12, 14, 17).

11.1. ‘1‘ f lini ' ’Philonh Thur-lice ‘nl'oaJ'rs‘ e 9 P 150 'n Of; 1;. 1
Trpatment Fagprs in thg Twp Argg
Clinig'ggs’ philgflphy of film.

Personal philosophy always affect a person’s work attitude and interpersonal
interaction. This surely includes the clinicians. Clinicians’ philosophy of therapy might
come from what they learned, their clinical experience, or even their personal experience.
The question asking clinicians’ philosophy in the questionnaire is “ what philosophy
underlies your treatment of sex offenders such as ‘ Do you think they can be cured?’ and
‘Why treat them?’ ” . The following are the analyses of the two sub-questions. (2 Michigan
clinicians and 7 Taiwanese missed this question)

1. “Do you think they can be cured?”
There is no consensus in the sub-question as the following reveal. The reason of non-

consensus might mainly come fiom the very different treating experience of two areas’

66

clinicians, surely including the intensive and extensive clinical experience. They are as

the followings: 51.6% (16) of Michigan clinicians and no Taiwan clinician responded

“Sex ofi‘ender can not be cured”. The reasons for the above response firrther provided

by five respondents can be sorted into three types- sex offense is a behavior not an

illness (9.68% (3) of Michigan respondents), sex offender can only be managed

(3.22%(1)), and sex ofi’ender may be taught to control his behavior (3.22%(1)); 30.7%

(10) of Taiwan clinicians and none Michigan clinicians responded “It depends”. The

reasons they described firrther can be sorted into two types-- 30.77% (8) said it

depends on the typology, and 7.69% (2) believed it depends on the motivation to be
treated.
2. “Why treat them?”

The reasons of treating sex offenders can be mainly sorted into the following categories:
5 8.06% (18) of Mchigan clinicians and 11.54% (3) of Taiwanese wanted to provide
sex ofi‘enders opportunity to change behavior and learn coping skills. 19.35% (6) of
Michigan clinicians and 11.54% (3) of Taiwanese responded “no more victim”,
“protecting society”, or “reducing recidivism”. 11.54% (3) Taiwan clinicians responded
“If we understand the offenders’ motivation of crime, we might know the ways to take
prevention”. 11.54% (3) Taiwan clinicians responded “Therapy is necessary for the sex

offenders with mental illness”

TM

The question asking the clinicians’ theoretical approach in the questionnaire is “Do you

67

have a particular theoretical position that underlies your treatment? What is it? How

successful is it in providing the particular treatment you use?”. The following are the

analysis of the responses (3 Michigan clinicians and 7 Taiwanese missed this question).

(1) cognitive behavioral approach: 56.67% (17) of Michigan clinicians and 23.08% (6) of
Taiwan clinicians chose cognitive behavioral approach as their theoretic base. The
comments given by clinicians are: (a)Primarily cognition-behavioral. However, I’m a
believer in offering as many resources and techniques to treat sex offenders. They don’t
respond to just one form of therapy (m l). (b) Cognitive behavioral techniques to avoid
relapse (m13). (c) I combine the dynamics of cognitive- behavioral treatment (via Safer
Society) with 12-step dynamics with emphasis on development of a strong spiritual base
(m29). (d) It has been successful on recidivism rate of 4 to 10 % (m30). (e) After some
discussion, I give them chance to correct some wrong cognition, discuss some risky
situations with them, and how to positively coping with these situations. That might help
them keep away from reofi’ense (t8). (1) I do not want to deal with their sexual impulse,
but I guide their expression of sexual impulse to an acceptable way, and help them
produce the newly replacing behavior. That can satisfy the sexual desire and keep them
fi'om doing harm to the society (t1 1). (g) That can help inmate restructure the cognition,
and train social skill and anger control (t26).

(2) relapse prevention approach: 16.67% (4) of Michigan clinicians and none of Taiwanese
chose relapse prevention approach as their theoretical base. Two of them combined it
with cognitive behavioral approach. The given are: Utilize model from Safer Society

Press, and I believe it to be effective (m28); relapse prevention plan with many cases the

68

inculcation of strong sense of a religious conviction which inmate has before but weak in
some degree (m31).

(3) psychodynamic or psychoanalysis approach: 13.33% (4) of Michigan clinicians and
7.69% (2) of Taiwanese chose psychodynamic approach. The reasons to submitted it as
the following: It is very helpful to in understanding, and helps most people with an
average IQ or above (m18, 27); It is positive in emphasizing the elements of trust and
love (m25); It helps clinicians understand clients’ history and dynamic of criminal
behavior, then it can also help clients induce the insight (t1 3).

(4) cognitive approach: 11.54% (3) of Taiwan clinicians and none of Michigan clinician
chose cognitive approach. One described that he used the cognitive therapy (or rational
emotion therapy) to deal with the offenders’ interpersonal relationship problems and
impulse control problems through grouptherapy (t21).

(5) rational emotional therapy (RET) approach: 3.33% (1) of Michigan clinicians and
3.85% (1) of Taiwan clinicians chose RET developed by Ellis.

(6) reality therapy approach: 3.33% (1) of Michigan clinicians and 3.85% (1) Taiwanese
submitted reality therapy approach. Neither of them explained filrther.

(7) fits clients’ need: 10% (3) of Michigan clinicians and 3.85% (1) of Taiwanese said it is
better to fit the clients’ need. The reasons being explained further are the following: (a)
Being skilled enough and flexible enough to a number of relevant, multiple model
approaches dependent on clients‘ personality, specific pathology, and behavioral needs,
and history (m3). (b) Each offender is different and requires a treatment plan and therapy

goals and objectives to his/her needs (m12). (c) If the underlying causes of offenses is

69

personality disorder, impulse control problem or any kind of psychotic disease, it is a
good way to provide therapy according to these underlying causes. But if sexual impulse
is the main cause, punishment should be enforced. The justification of law is more
important than criminals’ right (t3).

' (8) spiritual refining (12-step) approach: 3.33% (l) of Michigan clinicians and 3.85% (1)
of Taiwan clinicians mention about the spirit. The former said he combines cognitive
behavioral treatment with 12-step dynamics, with emphasis on development of a strong
spiritual base (m29). The latter mentioned it is a way to let sex ofi'enders’ molded spirit
be exposed to sun, and bask in the sunshine, then the molded part of their spirit will be
gone gradually and naturally (t25).

(9) no specific therapeutic approach: 34.62% (9) of Taiwan clinicians and none Michigan
clinicians said they have no specific therapeutic approach.

(10) inducing empathy to victim impact: 3 .33% (1) of Michigan clinicians and none
Taiwanese emphasized the empathy to victim impact is very important, and said when
the offenders began to know victim impact, they see the change sometimes (m10).

(11) others: Each of the following four approaches were mentioned by 3 85% (1) of
Taiwan clinicians-- behavioral approach, supportive psychotherapy, biological therapy,
and interpersonal approach. The one submitted supportive psychotherapy mentioned he
only did diagnosis in one session, but sometimes he provides supportive psychotherapy
to sex offender at the same session (t6). The one submitted biological therapy mentioned

biological treatment can be used if clients’ motivation is not strong enough (tl4).

Pr inf lr nf rs.

 

70

The question asking the perception of successfirl treatment factors in the questionnaire is
“What do you think constitutes a successful course of treatment? How do you know when
a sex offender is done being treated?” The following are the analyses of the two sub-
questions. (2 Michigan clinicians and 10 Taiwanese missed this question)

1. What do you think constitutes a successful course of treatment?

The response were summerized as the following table: It can be easily found that most of
the items submitted by the clinicians in the two areas are strongly oppisite. That might
reveal that the clinical experiences of clinicians in both areas are very different. From the
researcher’s point of view, the main reason of this outcome might come from Taiwan
clinicians’ clinical experience far less than Michigan clinicians’.

Table 36 Clinicians’ Perception of Seccessfirl Treatment Factors in Michigan and Taiwan

 

Michigan Taiwan Total
1- having developed skills to prevent relapse 8 (25.81%) 3 (13.04%) 1 I (20.37%)
2- WWW cognitive distortion OfOHCSCIf 5 (16.13%) 4 (17.39%) 9 (16.67%)
3. taking responsibility on offense 7 (22.58%) 2 (8.70%) 9 (16.67%)
4. developing empathy for others! victims 7 (22.58%) 1 (4.35%) 8 (14.81%)
5. willingness to change 1 (3.23%) 7 (30.43%) 8 (14.81%)
6. never ending ongoing tenure of treatment 4 (12.90%) 1 (4.3 5%) 5 (9.26%)
7. no more sex assault 3 (9.68%) 2 (8.70%) 5 (9.25%)
8. understanding relapse cycle 3 (9.68%) 1 (3 23%) 4 (7.41%)
9. depending on clinicians’ data collection, evaluation, 0 (0%) 4 (17.39%) 4 (7.41%)
and classifying their problem

 

 

 

71

2. How do you know when a sex offender is done being treated?

The answers can be sorted into the following: (1) “They are never done”: Totally 8
clinicians answered and all of them (25.81%) are Michigan clinicians. (2) “I am not
sure”: Totally 5 clinicians answered, and all ofthem (21.74%) are in Taiwan. (3) “It is
hard to say they will never relapse after release”: Totally 4 clinicians answered. All of
them (17.39%) are in Taiwan.

From the response of the subquestion, a total disparity phenomenon between Taiwan
and Michigan was revealed, such as many Michigan clinicians said they are never done, but
no Taiwan clinicians said it. This might result from the very different treating experience

between areas.

 

Chapter 5
SUMMARY AND CONCLUSIONS
W
The summary of this research is as the following:

1. finding about demography in the two areas: Educational background, types, and ages of

 

clinicians between Michigan and Taiwan are significantly different but gender of the
clinicians not. Most Michigan clnicians are psychologists. Two third of them have
master degrees, and one third have doctoral degrees. But Taiwan clincians include
psychiatrists, psychologists, and social workers. Psychiatrists have medical degrees, and
the other clinicians have either master degrees or bachelor degrees. The ages of
Michigan clinicians are generally older than Taiwan clinicians.

2. finding about clinical experience in the two areas: Four factors are considered as factors
of clinical experience— attending length, numbers of clients, treating term, and treating
form. All of them reach significant difl’erence between Michigan and Taiwan. Even
treating term and treating form are also significantly different between northern and
southern Taiwan.

3. finding about the proportions of different types of sex offenders in the two areas: The
proportions of different types of sex offenders are very different. The percentage of

rapists is 28.09% in Michigan and 70.92% in Taiwan. On the other hand, the percentage

73

of child molesters is 71.91% in Michigan and 25.84% in Taiwan. The ranks of
proportions of the subtypes in rapists and child molesters in the two areas are the same,
though the proportions of them are somewhat different.

. finding about clinicians’ perception of degree of difficulty on treating different types of
sex ofi‘enders in the two areas: The ranks of clinicians’ perception of degree of difficulty
on treating different types of sex offenders in Michigan and Taiwan are totally the same.
From the most dificult to the easiest, they are sadistic type rapists, fixated type child
molesters, power type rapists, anger type rapists, and regressed type child molesters.
The reason of this result might be the clinical intuition of two areas’ clinicians is very
close.

. finding about relationship between three kinds of clinical experience and three kinds of
perception of treating sex offenders: In Taiwan, there is not any one significant
relationship between them. But in Michigan, the extensive clinical experience (including
the length of attending treatment and the number of clients) have a significant
relationship with sex offender deserving to be treated (slope is sever negative) and with
the familiarity of treatment technique (the slope is positive). The former means the
longer the Michigan clinicians provide treatment to sex offenders, the less they think sex
offenders deserve to be treated. The reasonable interpretations might be the burn-out
effect of clinicians or considerable proportion of sex ofi’enders might be impossible to be
treated well.

. finding about clinicians’ degree of support to the current treatment program and its

reasons: The average degree of support to the current treatment program in Mchigan is

 

 

74

significantly stronger than that of Taiwan. But only the degree of support in Taiwan can
be significantly predicted by treating term and confidence on treating effect, and both
slopes are positive.

. finding reasons why some of clinicians do not support the current treatment program: In
Michigan, the main reasons are treatment is too short and too structural; In Taiwan, the
main reasons are only doing the diagnosis instead of treatment and not every sex
offender needs to be treated.

. finding about the clinicians’ suggestions for the current treatment program: Though the
priority is somewhat different, the three most favorite suggestions in both areas are
continuing community treatment program after being paroled, providing training to
clinicians, and clarifying which kind(s) of sex offenders deserve to be treated.

. finding about the clinicians’ attitudes on three controversial policies: The three
controversial policies are indefinite confinement, chemical castration, and Megan’s Law.
In addition to the society, all of the three also have bipolar comments in the clinicians in
Michigan or even in Taiwan. There are significant differences in indefinite confinement
and chemical castration between the responses of Nfichigan and Taiwan, but not in
Megan’s Law. (1) indifinite confinement: 69.7% of Michigan clinicians agree or totally
agree indefinite confinement, but 51.7% of Taiwan clinicians do. On the other hand,
there are 21.2% of Michigan clinicians disagree or totally disagree indefinite
confinement, but 31.0% of Taiwan clinicians do. (2) chemical castration: 42.5% of
Michigan clinicians agree or totally agree with it, and 72.4% in Taiwan, but the

difference is not significant. However, the comparing means in both areas reaches

 

75

significant difference. (3) Megan’s Law: 72.4% of Taiwan clinicians agree or totally
agree with the law, and 57.6% in Michigan. On the other hand, 3.4% Taiwan clinicians
disagree or totally disagree with the law, but 21.2% in Michigan. The difi‘erence above is
not significant and the comparing means is the same.

10. finding about clinicians’ philosophy, theoretical approaches, and personal perception of
successfill treatment factors in the two areas: The most favorites will be provided as the
following. (1) clinicians’ philosophy: About half (5 l 61%) of Michigan clinicians said
sex offenders can not be cured. On the other hand, about one third (3 0.77%) of Taiwan
clinicians said whether or not the sex offenders can be cured depends on the typology. (2)
theoretical approach: Over half (56.67%) of Michigan clinicians chose cognitive
behavioral approach as their favorite, but over one third (34.62%) of Taiwan clinicians
mentioned they have no specific theoretical approach. (3) personal perception of
successfirl treatment factors: The first three factors chose by Michigan clinicians are
having developed skills to prevent relapse, taking responsibility on the offense, and
developing empathy for victims, but by Taiwan clinicians are willingness to change,
understanding self cognition distortion, depending on the data collection, evaluation, and

classifying their problems.

Qppplpsippp pf This Resggrgh

Sex ofl’enses are often scaring and even horrible in the society, especially to female
population. Dealing with sex offenders is always very complicated in most countries in the

world, because community people, human right groups, politicians, or even offenders

76

always try to intervene the related policy-making, in addition to the suggestions of criminal
justice professionals and mental health professionals. Sex offenders in criminal justice
system, no matter in correctional facilities or in communities, are also likely to cause the
administrative problems, such as the followings: they are more likely to be harassed by
other inmates in prisons should the treatment be mandatory? how effective is the treatment?
what are the criteria to get parole? will the paroled sex ofi‘enders never reofi‘end in the
community? are the registration or notification hurt the offenders’ privacy? etc.

All of the above problems need to be dealt with. This research tries to understand
what are the clinicians’ perspectives in dealing with sex ofi'enders. The information
revealed in this research might be helpfirl for the criminal justice practitioners, mental
health clinicians, policy-makers, legislators or anyone who is concerned about sex offender
treatment. However, there are several strengths and limitations in this research.

Willem

This research have the following advantages:

1. Comparative research between two difi‘erent countries: It is very rare in this field to do
comparative research between two countries, especially comparing America to an Asia
country. Taiwan is the first and the only one country to provide psychological treatment
to sex offenders by law in Asia, though North America have been doing it for decades.

2. Research about clinicians’ perceptions: The researches dealing with clinicians’
perceptions on treating different types of sex offenders, current treatment program,
successful treatment, treatment philosophy, or even the three controversial policies are

still very few in this field. Even though Safer Society Foundation has been doing the

77

consecutive nationwide survey for treatment providers every two years since 1986
(F reeman-Longo, Bird, Stevenson, & Fiske, 1995), it only focuses on treatment
program context and treatment Modalities currently used by the treatment providers.
. Understanding the degree of difficulty in treating different types of sex offenders: After
Groth developed the sound typology of sex ofl’enders in 1979, little research has been
done on understanding the degree of difficulty in treating different types of sex ofi’enders,
as the researcher knows.
. Providing comments and suggestions to current treatment program based on clinicians’
opinions: Clinicians participating treatment programs are in the first line to treat
incarcerated sex offenders. They should understand the psychological characteristics of
sex ofl’enders better than others, including community people and legislators. Therefore
no matter in which countries or states the policy-makers should not disregard clinicians’
related opinions, in addition to community people’s perception. After this treatment
programs been run for years in the two areas, it is time to evaluate them, especially in
Taiwan, a country just began this treatment program for four years. This research can be
an important part, surely not an only one part, in evaluating current treatment program,
because the respondents are the main actors to fillfill the treatment programs.

There are several disadvantages:
. Having limitation to generalize to all states in America: Because the researcher only
chose Michigan clinicians as the sample in the America, this research results cannot

generalize to every state of America, besides there are several differences in the

78

treatment program and policies within every American state such as treatment processes
and modalities in correctional facilities or communities, tracking systems, and even
public perceptions.

2. Not enough understanding about the practical situation in northern Taiwan: Originally
the researcher thought the treatment situation in northern Taiwan should be the same as
in southern Taiwan, providing psychotherapy followed by doing psychosocial diagnosis
by the psychiatric team. But while the researcher administrated the questionnaires in

northern Taiwan, all northern Taiwan clinicians said they did not do any treatment

 

except diagnosis for one time, besides the psychologists in northern Taiwan only did the
psychological testing for one time then provided to psychiatrists to do the diagnosis.
This caused low response rate in these some questions.

3. Not clear in one question: There is one ambiguous question in the English edition of the
questionnaire. Five Michigan respondents noted or hinted that they get confilsed on
the “What is/are your suggestion(s) to ‘enforce’ it?” in the later open-ended
questions which are about the three controversial policies. This might cause

relatively low responses compared to other questions in Michigan respondents.

Implicatipm pf F pmrg Researph

After writing this research, the researcher felt that several implications of research in
the filture need to be addressed as the following:
( 1) It is worthy doing the researches about the relapse rate in different types of sex

offenders by Groth’s typology. Until now, most of the evaluation researches are only

79

based on rougher classification such as dividing sex offenders into rapists, incestuous
offenders, and child molesters, but even rapists can be further divided into several
subtypes.

(2) The survey of clinicians’ opinions on treating offenders or current program is very
important to the policy-making, but it is few that their opinions to be taken into serious
account. It is necessary that more related researches to be done. The related researches
might include how to improve the treatment emciency, what are their suggestions on
the community registration and treatment, and what are the criteria to screen whether
the sex offenders get parole or not etc.

(3) According to some suggestions of the respondents, it is necessary to establish a
standardized screening scale to screen a high risk reoffensive group before parole. To
protect the society, this kind of screening scale deserves to be researched, developed,
and established.

(4) Evaluation of sex offender treatment program had been done in several other states
except Michigan. Evaluation could be a good way to understand whether the current
program work or not, though it is a very sensitive issue. Facing the same
circumstances— budget constrains, expectation of public safety, and overcrowded
prisons etc., hopefillly Taiwan and Michigan have their own program evaluation done
by interested clinicians or scholars in the near filture to show the way improving the

treatment effectiveness and protecting the public safety in the two areas.

 

 

Appendix A: Questionnaire 81

Questionnaire for Clinicians of Sex Off'enders‘ Treatment— English edition

 

" The following questions will ask about your attitudes toward treatment of sex ofi’enders.
Please answer honestly. Your answer will be kept strictly confidential.

0. Demographic Dataztplace “x” in front of items that apply; Almipglmpjmpfljt)
(1) Gender: _ male; _female
(2) Highest Educational Level: _Bachelor; _Master: _Doctor; _Medical Degree
(3) How old are you? years old
1. Clinical Background
(1) Which kind of clinician are you: _ psychiatrist; _ psychologist: _ clinical social worker;
_clinical nurse

(2) How long have you been treating sex offenders?
__ year(s) __ month(s)

 

 

 

2. The population and percents of the sex offenders you have treated:
(1) Approximately, how many sex offenders you have treated ?
About persons.

(2) I. What percent are rapists? About % (” fl 11 h OO°/ )
(a. The sum of following subtypes is 100%: power type %, anger type %, sadistic type %.)

Il.What percent percent are child molesters (including incestuous offenders)? About °/o
(a. The sum of following subtypes is 100%: regressed type %, fixated type %)

3. Generally. how long do you take to treat sex offenders. on the average?

year(s) month(s) (’If there is any special course, please note:

4. Which form is your main treatment for sex offenders ? (Choose one of the followings)
__ group therapy only; __ mostly group therapy with some individual therapy;

_ mostly individual therapy with some group therapy; individual therapy only

5. Scales of your perceptions on the degree of difficulty for treating different types of sex offenders

 

 

extremely extremely

(based on Groth ‘s Typology) easy average difficult
(1) about rapists 1 2 3 4 5 6 7

A. Power type Cl :1 13 13 D D C]

B. Anger type D 3 1 l E l 1.1 D 1]

C. Sadistic type [3 C1 171 17.1 1] D [1

 

 

Ii

 

 

 

 

 

 

 

 

82
(2) about child molesters 1 2 3 4 5 6 7
A. Regressed type [3 D D D D D C1
B. Fixated type D U U D D 8 Cl
6. What do you believe the degree extremely extremely
of difiiculty is in treating sex easy average dificult
ofi’enders in general? 1 2 3 4 5 6 7
D D I] D D D [1
7. Do you agree the all sex totally totally
ofi’enders deserve to be treated? agree average disagree
1 2 3 4 5 6 7
D D D D D E El
8.Do you agree that treating sex totally totally
offenders is efl’ective? agree average disagree
1 2 3 4 5 6 7
D D n D D [1 Cl
9. How familiar do you think pretty pretty
you are with techniques of familiar average unfamiliar
of treating sex ofl’enders? l 2 3 4 5 6 7
D D D D D D C]

 

10. How supportive are you with the current sex ofi’ender treatment program?
_pretty supportive; _supportive; _so so; _not supportive; _ not supportive at all
10.1 If you answered the above question as “not satisfied” and “not satisfied at all”,
would you explain why?

 

 

 

l 1. What would be your suggestions to improve the eficiency of treating sex offenders in the
current system? (Please choose at least two items from the followings. If the choices are not so
suitable for you, please write itfthem down.)

[1 continuing the community treatment program after being paroled
El providing meetings or seminars to improve the professional techniques

83

D clarifing which kind(s) of sex ofl’enders deserve to be treated

El makingthe length ofthe treatmentatleast one or two years

[1 concentrating the sex offenders to exclusive prisons in order to provide more treatments
[1

El

 

 

(“ Please feel free to write the following items as much as you want !)

12. What philosophy underlies your treatment of sex offenders such as “ Do you think they can be
cured?” and “Why treat them? ”

 

 

 

 

 

 

13. Do you have a particular theoretical position that underlies your treatment? What is it? How
successful is it in providing the particular treatment you use?

 

 

 

 

14. What do you think constitutes a successful course of treatment? How do you know when a
sex offender is done being treated?

 

 

 

 

15. Do you agree that some sex ofl‘enders could be indefinitely confined, even when their terms are
up, because they pose a danger to society?
_ totally agree; _ agree; __ so so; _ disagree; _ totally disagree
15.1 Why do you have the above answer?

 

 

 

 

15.2 If indefinite confinement for sex offenders is passed as law, what is/are your suggestion(s) to
enforce it?

 

 

 

16. Do you agree that chemical castration could be used on some sex offenders in order to make
relapse prevention more effective?
_ totally agree; _ agree; _ so so; _ disagree; _ totally disagree
16.] Why do you have the above answer?

 

 

 

 

16.2 If chemical castration is passed as law, what is/are your suggestion(s) to enforce it?

 

 

 

17. Do you agree with the Magan’s Law (The paroled sex offenders should be registered or the
police should nortify the community if paroled sex offeneders move in.) ?
__ totally agree; _ agree; __ so so; _ disagree; _ totally disagree
17.1 Why do you have the above answer?

 

 

 

17.2 What is/are your suggestion(s) to enforce the Magan’s Law?

 

 

 

(Thank you for your helpl! I appreciate it by heart! 1)

 

85

Appendix: Introduction for Groth‘s Typology of Sex Offenders

Groth (1979) mainly divided the sex ofi’enders into two types, rapists and child
molesters, and also divided them into the following subtypes:
1. Rapists (The victims are usually those at the age after puberty):

(1) power type: They think that rape serves a means of exercising dominance, mastery,
strength, authority, and control over the victim. There is little to use the
excessively offensive violence, but more about the compulsively sexual
fantasies or reafirming their sexual potency.

(2) anger type: They more intend to hurt, debase, and contempt for the victim and is
marked by suddenly gratuitous violence. They might think rape is a good way
to punish and disgrace the women, and is a outlet to discharge their fi'ustration
either associated with the victim or utilizing the victim as a scapegoat.

(3) sadistic type: They might usually cause most seriously physical hurt to the victim or
even death. The ritual of torturing the victim and perceptions of sufl’ering and
degradation become erotized, and as the assailant‘s arousal builds, so may the
violence of his acts , progressing in some cases to lust murder. The pattern of
the assault and the characteristics of the victim are repetitious and symbolic of
something he wants to humiliate and destroy.

2. Child molesters or Pedophiles (The victims are always at the age of puberty or
before.) ("Ms also could be fallen into the below subtypes.)

(l) regressed type: They have related sexually to appropriate peers at some time in their
lives. However, a variety of situation stressors (such as long unemployment,
physically impair, or disputed by female adult especially on sex) may
undermine their confidence in them as a man. Then they transfer their sex
gratification to the underage individual who are less threatening.

(2) fixated type: They have been attracted to children throughout their lives and been
unable to attain degree of psychosexual maturity. Groth found that this type of
molesters might relate to physical abuse or even sex abuse in their childhood,
and that causes them can not develop the trust relationship with adult.
Therefore they transfer to getting close with children, and even regard the sex
offense as an expression for the child.

Reference

Groth, A. N. (1981). Men who rape: the psychology of the oflender. NY: Plenum.

Schwartz, Barbara K. (1995). Characteristics and Typologies of Sex Offenders. In B. K.
Schwartz and H. R. Cellini (ED), The sex ofi’ender: corrections, treatment and
legal practice (pp. 3-1~ 3-36). New Jersey: Civic Research Institute.

86

Appendix B

DATE:
TO:

FROM:

Appendix B 37

Michigan Department of Corrections
Memorandum

July 6, 1994

Franklyn Giarnpa, Ph.D./BHCS

John c. Rushbrook, Pan, Chief of Psychology ? ”V

Bureau of Health Care Services

SUBJECT: Sex Offender Program; Chronology

As requested, here is a chronology of the most significant dates related to the implementation
and development of the sex offender program within the Department of Corrections.

 

1971-72

1975

"1979

5/17/87

11/87

9/9/91

Implementation of residential sex offender treatment program in Top 6 of SPSM
reception center (under auspices of Psychiatric Services)

Reception and Guidance Center (R&GC) Psychological Services Unit staff begin
Operating sex offender program therapy groups at SPSM

Riverside Reception Center opens at Riverside Correctional Facility in Ionia;
Psychological Services Unit staff begin operating sex oriender program therapy
groups. firscat Michigan Reformatory and then orher Ionia correctional facilities
as Psychological Services Staff are hired, as prison facilities opened across the snare
and Psychological Services staff were allocated, sex offender prOgram theraov
groups were immcmented at those sites housing sex offenders

DOC staff, including current BHCS Chief of Psychology, attend National Academy

of Corrections training: The Sex Offender: Strategies for Treatment (Thirty-six
hours)

BHCS Chief of Psychology position filled, among Other tasks, assuming overall
programmatic direction for department's sex offender program: program primarily
consisted of . group psychotherapy interventions delivered by staff psychologist and
social workers employed by DOC Psychological Services Units at those sites
housrng sex offenders; program was relatively unstructured and non-specialized

with therapy groups conducted at the professional discretion of the involved
psychologist/social worker

More selecrive criteria for reception center sex offender program recommendations

 

 

 

1218/92

3123/92

3127/92

1128/93

2193

218193

2125/93

3115/93

4121/93

6122/93

1016/93

88

and general sex offender program eligibility were implemented (an attempt to

“manage" program waiting list size by culling out “low risk“ sex offenders with
less apparent need for the program)

Meeting of sex offender program review committee: Richard McKeon, William
Burghardt, Dan Bolden, Franklyn Giampa, Tom Patten and Lynn Green

BHCS Chief of Psychology and other staff attend National Academy of Corrections
training: Developing and Administering Sex Offender Programs (Thirty-Six hours)

Approval to begin implementation of pilot sex offender program at Muskegon
Temporary Correctional Facility

Meeting of sex offender program review committee: Director McGinnis,

Richard McKeon, William Burghardt, Robert Steinman, Gary Gabry, Lynn Green,
Richard Russell and Greg Owen

Implementation of residential sex offender program in one housing unit at MTF

Informational meeting with Parole Board chair regarding psychological report
terminology, program waiting lists and reception center recommendauons

Recommendations of Psychological Services Advisory Committee (PSAC) regarding

standardizationand revision of sex offender program (the product of a series of
meetings in 1992)

Sex offender program proposal submitted to sex offender program review
committee review and comments; proposal .outlined history of proposed
options/strategies forJeducing sex offender'p'rog’ram waiting li§i numbers lC-gu
more restrictive program screening criteria, redeployment! reassrgnment of aiming
staff, use of staff overtime and transfers of program-eligible prisoners) andarelated

problems .(growth in prisoner/sex offender populations, staff vacancies and work
force reduction)

Meeting of same committee to discuss 3/15/93 sex offender program proposal

Implementation of revised sex offender program screening criteria for determining
which sex offenders are recommended for further assessment and continued

program involvement: CHI ~251 form). Notice of Sex Offender Program Screenmg
used to document screening

Recommendation to incorporate proposed penile plethysmography on a ptht test

basis into the Muskegon Temporary Correcuonal Facility pilot sex oftender
program

Page 2

11119193

115/94

3129/94

4126/94

513/94

514/94

519/94

5/ 16194

51 17/ 94

616/94

6121/94

cc: File

89

Proposed implementation plan and program statement for standardized sex

offender program (two-year program) submitted ‘ ‘

11119193 sex offender program proposal submitted to Deputy Directors Steinman
and Bolden and M. Van Ochten for review and comment

BHCS allocated an additional 4.6 psychologist and 2.0 secretarial positions
dedicated to sex offender program activities at Specific sites; stage is set for transfer
of sex offenders to these sites for program participation as needed

Directive from Gayle Lafferty to proceed with implementation of proposed
accelerated sex offender program

Proposed addendumto 11/19/93 sex offender program proposal to Deputy Director
Jabe for approval; addendum modifies the sex offender program into an accelerated

program (six- to nine-month program) designed to accommodate sex offenders on
the waiting list within 24 months of earliest possible release date (ERD)

Lafferty directive to medical directors/clinical administrators regarding denial of
medical clearances for transfer for prisoners involved in sex offender program

Demarse Academy training of staff related to assessment instruments to be used

in accelerated sex offender program; assessment materials for the accelerated sex
offender program distributed to regional psychologists

BHCS central office decision to forestall trial implementation of penile

plethysmography at Muskegon Temporary Correctional Facility until review of
related liability and legal issues is completed

Deputy Director Jabe approves 11l19/93 sex offender program proposal and
addendum (which outlines the accelerated sex offender program designed to
accommodate the waiting list sex offenders within 24 months of ERD)

Psychoeducational materials (Safer Society workbooks) for the accelerated sex
offender program distributed to regional psychologists

Following suggestions from M. Van Ochten and with input from Lafferty and
Giampa, work groups recommended to (a) draft a sex offender program policy
directive, (b) collect documentation supporting the reliability/validity/efficacy of
penile plethysmography, (c) explore other state prison systems' experience with

the use of penile plethysmographs and (d) gather materials for central office review
of proposed plethysmograph stimulus materials

Page 3

90

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