TREATMENT AND REENTRY PRACTICES
FOR SEX OFFENDERS
An Overview of States

Reagan Daly
Vera Institute of Justice
September 2008

Suggested citation: Reagan Daly. Treatment and Reentry Practices for Sex Offenders: An Overview of States.
New York: Vera Institute of Justice, 2008.

This report was prepared by the Vera Institute of Justice under grant 2006-MU-BX-K018 awarded by the Bureau of
Justice Assistance. The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also
includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and
Delinquency Prevention, and the Office for Victims of Crime. Opinions expressed in this document are those of the
author and do not necessarily represent the official position or policies of the U.S. Department of Justice or the Vera
Institute of Justice. © 2008 Vera Institute of Justice. All rights reserved.
Additional copies can be obtained from the communications department of the Vera Institute of Justice, 233
Broadway, 12th floor, New York, New York, 10279,
(212) 334-1300. An electronic version of this report is available for download on Vera’s web site, www.vera.org.
Requests for additional information about the research described in this report should be directed to
contactvera@vera.org.

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice ii

Executive Summary

the ACUTE, are becoming more prevalent in
community supervision.

Over the past 15 years, the response of the criminal justice

•

No reentry initiatives were found that

system to people who have been convicted of a sex offense

specifically target sex offenders. Although

has become increasingly punitive, relying heavily on

eligible for general reentry programming in

incarceration. Yet, a consequent increase in criminal

most states, people convicted of a sexual

justice costs has led some states to reconsider their

offense have few, if any, options for reentry

response to sex offenders. Concerns about public safety

programming that addresses their unique needs.

and the protection of victims remain the primary focus, but

•

Correctional institutions and community

many states have also invested in treatment and reentry

supervision agencies in most states share

programs as alternatives to incarceration for some people.

information about the case histories and
treatment plans of sex offenders who are

Although the content and structure of treatment and
reentry programs vary considerably from one jurisdiction

returning to the community from prison.

to another, few if any resources provide criminal justice

Research suggests that this type of inter-agency

officials and policymakers an overview of these programs

communication can help reduce recidivism.

or a comparative assessment of their effectiveness. This

•

In general, community supervision agencies

report attempts to address these issues by providing an

manage risk and provide services. Research

overview and analysis of existing treatment and reentry

suggests that this is an effective approach to

practices for sex offenders who are involved with the

reducing recidivism.

criminal justice system. It focuses, specifically, on four

•

A limited number of states are conducting

broad areas of practice: treatment in prison, treatment

research on their own treatment, reentry, and

under community supervision, reentry programming, and

supervision initiatives. Almost no studies have

community supervision. Interviews with state officials and

examined these programs from a cost-benefit

treatment providers from 37 states that responded to our

perspective.

survey revealed several findings:
•

In both prison and community settings, the
treatment of sex offenders is generally
grounded in evidence-based practices,
especially cognitive-behavioral therapy. In
general, treatment is much more available in the
community than in institutional settings.

•

In most of the participating states, communitybased treatment for sex offenders is supported,
at least in part, by collecting fees from those in
treatment—a circumstance that may limit
access to these programs.

•

Standardized risk assessment tools such as the
STATIC-99 are now widely used nationally in
both prison- and community-based treatment
programs. Needs assessment tools, especially

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice iii

Acknowledgments
I would like to thank the following people for their
assistance in conducting this study: Robin Campbell,
Ashley Cannon, Tina Chiu, Jennifer Fratello, Jordie
Hannum, Alisa Klein, Abbi Leman, Scott Matson,
Charles Onley, Ruth Parlin, Maggie Peck, Carla Roa,
Christine Scott-Hayward, Neil Weiner, Dan Wilhelm,
and finally, all interview respondents.
Edited by Patrick Kelly.

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice iv

Table of Contents
Executive Summary ...................................................................................................... iii
Acknowledgments......................................................................................................... iv
Introduction and Background.......................................................................................... 1
Methodology ................................................................................................................. 2
Research on Treatment, Reentry, and Community Supervision Practices ............................ 3
Prison- and Community-Based Treatment ................................................................ 3
Reentry Programming ............................................................................................ 6
Community Supervision .......................................................................................... 7
Recent Trends in Treatment, Reentry, and Community Supervision Practices...................... 8
Prison-Based Treatment ......................................................................................... 8
Community-Based Treatment................................................................................ 11
Reentry Programming .......................................................................................... 12
Community Supervision ........................................................................................ 13
Conclusions................................................................................................................. 15
Bibliography ................................................................................................................ 16
Appendix A: State Overview Tables of Prison-Based Treatment ....................................... 18
Appendix B: State Overview Tables of Community-Based Treatment................................ 23
Appendix C: State Overview Tables of Reentry Programming .......................................... 26
Appendix D: State Overview Tables of Community Supervision Practices .......................... 28
Appendix E: Individual State Templates......................................................................... 30

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice v

Introduction and Background

release information to the public about known convicted
sex offenders, and has continued through the passage of

The sentencing and management of sex offenders is one

Jessica’s Law in 2006, which introduced stricter

of the most difficult and controversial issues facing the

penalties and restrictions for sex offenders.) Today, the

criminal justice system today. This is in large part due to

term sex offense can include everything from child

the brutal nature of many sex crimes and the fact that

molestation to public urination.
The increasing reliance on incarceration as a

many victims are children and other vulnerable people—
a combination that elicits highly emotional responses

response to sex offenses, together with expanded

from the public.

definitions of what constitutes a sex offense, has driven

Over the past 15 years, the criminal justice system’s

up criminal justice costs. This has led some states to

response to people who have been convicted of a sex

reconsider their response to sex offenders. While

offense has become increasingly punitive. In 2004, more

concerns of public safety and the protection of victims

than 150,000 people were incarcerated in state prisons

remain the primary focus, a number of states—especially

for sex offenses, compared with 142,000 in 2002 and

those with limited resources—have concluded that

1

110,000 in 1999. In many states, lengthy prison

incarceration is simply not a viable long-term solution, at

sentences are now the norm: according to one recent

least not for all sex offenders.

study, people who are incarcerated in connection with a

In fact, most people who are convicted of a sex

sex offense spend about twice as long in prison as those

offense will be placed under community supervision at

2

who serve time for other crimes. Also, an increasing

some point—either on probation immediately following

number of local and state laws impose strict registration

sentencing or on parole after having served a jail or

and residency requirements on people who have been

prison term. A 1997 study by the Bureau of Justice

convicted of a sex offense, even after they have served a

Statistics reports that of the approximately 234,000 adult

prison sentence. There are now more than 636,000

sex offenders who are under the custody or control of

registered sex offenders in the United States—one in 500

correctional agencies on any given day in the United

3

Americans. This number has doubled in the last
4

decade.

The punitive response of the past 15 years is not
limited to sentencing laws and stricter registration

States, almost 60 percent are under some form of
community supervision.5 Although there has been no
follow-up study in recent years, this number has likely
grown.

requirements: the definition of what constitutes a sex

To cope with the large number of sex offenders under

offense has also been greatly expanded. (The beginning

community supervision, a growing number of states are

of this expansion coincided with the 1993 passage of

investing in treatment programs. Increasingly, these

Megan’s Law, a federal regulation that directed states to

programs are also functioning as alternatives to
incarceration.
However, the content and structure of treatment and

1

W.J. Sabol, H. Couture, and P.M. Harrison, Prisoners in 2006
(Washington, DC: Bureau of Justice Statistics, 2006); P. M. Harrison
and A. J. Beck, Prisoners in 2004 (Washington, DC: Bureau of Justice
Statistics, 2004); A. J. Beck and P. M. Harrison, Prisoners in 2000
(Washington, DC: Bureau of Justice Statistics, 2000).
2
Lawrence A. Greenfield, Sex Offenses and Offenders: An Analysis of
Data on Rape and Sexual Assault (Washington, DC: Bureau of Justice
Statistics, 1997, NCJ 163392).
3
National Center for Missing & Exploited Children, Registered Sex
Offenders in the United States per 100,000 Population (map), March
25, 2008.
4
Devon B. Adams, Summary of State Sex Offender Registries
(Washington, DC: Bureau of Justice Statistics (Fact Sheet): March
2002, NCJ 192265).

Treatment and Reentry Practices for Sex Offenders

reentry programs vary considerably from one jurisdiction
to another, and there are few resources for criminal justice
officials and policymakers who would like an overview of
these programs nationwide. Both the Center for Sex
Offender Management and the Association for the
Treatment of Sexual Abusers, an international non-profit

5

Ibid.

Vera Institute of Justice 1

organization, have produced publications on the treatment

community supervision. We end with a discussion of

and management of sex offenders, but policymakers

overarching themes and conclusions.

seeking to optimize their use of resources would profit
from a survey of the programs that are currently in place
across the United States. Similarly, their policy decisions

Methodology

would benefit from a comparative assessment of the
effectiveness of current practices.

Vera researchers relied on qualitative methods to collect

This report attempts to address these issues by

and analyze data for this report. Data was collected over

providing an overview and analysis of existing treatment

a six-month study period through phone interviews with

and reentry practices for sex offenders involved with the

state officials and other policymakers who manage sex

criminal justice system (as opposed to those who are

offenders.

6

civilly committed). Drawing on information that was

For each of the four substantive areas mentioned

collected by Vera researchers from policymakers and

earlier (prison-based treatment, community-based

treatment providers in the 50 states and Washington, DC,

treatment, reentry, and community supervision), Vera

it emphasizes the structure, content, and availability of

researchers developed detailed interview questionnaires

those programs and, when applicable, compares current

and identified at least one potential respondent from each

practices to research findings. Specifically, it focuses on

state (for a minimum total of four contacts per state).

four broad areas of practice: treatment in prison,

Most respondents either worked in the Department of

treatment under community supervision, reentry

Corrections or another state agency or were treatment

7

programming, and community supervision.

providers. Interview questions were open ended.
The overall response rate for all four substantive

Note that this report does not provide an exhaustive
catalog of what each state is doing in terms of treatment,

areas categories across all 51 jurisdictions was 65

reentry, and community supervision, nor does it provide

percent.9 For each state, Vera researchers entered

a comprehensive overview of the legal context in which

information into an answer template that covered all four

8

these services are being delivered. Rather, it aims to

substantive areas. Once this answer template was

identify and analyze nationwide trends in treatment and

completed, it was sent back to the respondents to

reentry practices.

confirm that it was consistent with the information they

After a brief description of our methodology, we

had provided. The completed state templates are

begin with a review of the latest research on treatment,

included as appendices in this report. They provide

reentry, and community supervision practices for sex

detailed information on both the treatment and reentry

offenders. Then, we present and analyze our findings

practices themselves as well as the context in which they

from each of the four broad areas of practice, beginning

were developed.
To identify larger patterns, Vera researchers

with prison-based treatment and followed by
community-based treatment, reentry programming, and

conducted a qualitative data analysis. This qualitative
analysis consisted in reviewing each state template and

6

Civil commitment is the court-ordered confinement and treatment of
sex offenders who are deemed to represent a significant threat to
public safety.
7
Sex offenders in the community also receive treatment under civil
commitment. However, this study focuses exclusively on treatment in
the criminal justice context.
8
To gain a better understanding of state legislation governing sex
offender definitions, registration requirements, and sentencing
practices, the Vera Institute has also issued a companion report, The
Pursuit of Safety: Sex Offender Policy in the United States, that gives
a national overview of these issues.

Treatment and Reentry Practices for Sex Offenders

categorizing treatment and reentry practices according to
topics of general interest, such as whether statewide
standards exist or the number of treatment providers in a
given state. These state overviews are also included in
9

In social science research, a response rate above 50 percent is
considered adequate for analysis and publishing (see Babbie 2005 for
more information).

Vera Institute of Justice 2

the appendices. Categorizing treatment and reentry

makes it difficult to assess the financial impact of these

practices in this manner provided researchers with a

programs.

broad overview of the subjects.

There are, however, a number of methodological

This study has two methodological limitations. First,

issues associated with research on sex offenders that

as is true of any study that relies on interview responses,

limit the applicability of these findings. For one, it is

some of those we contacted chose not to participate, with

often difficult to find a control group with which to

the result that there are gaps in our data. Our discussion

compare program participants—a necessary step if one is

of national trends and patterns here reflects only those

to know for certain a program’s effect. Also, low

states that responded to requests for phone interviews.

baseline rates of sexual offense arrests and significant

Second, the trends identified in this report are based on

under-reporting of sexual offenses make it difficult for

information reported by state contacts. While Vera

researchers to demonstrate statistically significant

researchers made every effort to ensure that the

reductions in sexual offending as a result of treatment

information is accurate, this is a complex subject, and the

and reentry programs.10

open-ended nature of our interview questions left room
for interpretation and (possibly) error.

In the remainder of this section, we discuss in more
detail research as it relates to each of the four broad areas
of practice identified earlier: treatment in prison,

Research on Treatment, Reentry,
and Community Supervision
Practices

community-based treatment, reentry programming, and
community supervision.
PRISON- AND COMMUNITY-BASED TREATMENT

Treatment programs generally have three aims: First, they
In this section, we present an overview of recent research

aim to help offenders take responsibility for their actions.

on treatment (both in prison and in the community),

Second, they aim to prevent relapse. Third, they aim to

reentry, and community supervision practices for sex

rehabilitate people who have been convicted of a sex

offenders. The aim is to provide a context for the

offense.11 Different programs pursue these goals in a

assessment of current state practices described in

variety of ways, ranging from CBT to chemical castration

subsequent sections of this report.

(the use of a hormonal medication such as Depo-Provera to

Broadly, the research on treatment methods has

temporarily reduce testosterone levels) to education. The

consistently found that cognitive-behavioral therapy

appropriateness of any particular approach often depends

(CBT), a treatment that relies on changing thought

on the nature of a person’s offending behavior: a treatment

processes to help people understand and accept

that is geared toward pedophiles, for example, may not be

responsibility for their offenses, is the most effective

appropriate for an adult rapist who exhibits more general

approach to reducing sexual and overall recidivism.

criminal tendencies.

(This result applies to programs that provide CBT in
prison as well as those that provide it in other settings.)

Treatment across settings. A 2002 meta-analysis of 43

In addition, the research on reentry and supervision

studies on the psychological treatment of sex offenders

practices has uncovered two salient findings: social

found that the average rate of sexual recidivism for

support is key to making a successful transition back to

people in treatment (12.3 percent) was statistically

society, and supervision is most effective when
combined with specialized sex offender treatment
services. Unfortunately, there has been little cost-benefit
analysis of treatment and reentry programming, which
Treatment and Reentry Practices for Sex Offenders

10
It becomes increasingly difficult to establish statistically significant
differences as the number of outcome events decreases.
11
Kurt Bumby, Understanding Treatment for Adults and Juveniles
Who Have Committed Sex Offenses (Silver Spring, MD: Center for
Sex Offender Management, 2006).

Vera Institute of Justice 3

significantly lower than for those who did not receive
12

differences in risk assessment scores between those who

treatment (16.8 percent). The average rate of overall

completed the program and those who did not, it is

recidivism for those in treatment was also lower (27.9

impossible to know for certain whether factors other than

percent, compared with 39.2 percent for people who

treatment affected the observed outcomes.16

were not in treatment).13 Finally, the analysis found that

In contrast, there are several studies which have

CBT, which has become standard practice in almost

examined specific treatment programs and concluded

every state, is much more effective than the treatments

that they do not have a significant effect on recidivism

that were used before 1980. More recently, a review of

rates.17 Among these is a study in which prisoners who

69 controlled outcome evaluations of sex offender

had volunteered to participate in California’s Sex

treatment confirmed many documented earlier findings.

Offender Treatment and Evaluation Project (SOTEP)

It also found that treatment reduces sexual recidivism by

were randomly assigned to either SOTEP (which

an average of 37 percent and that hormonal therapy and

employed CBT and relapse prevention, a treatment that

CBT work best—although it was difficult to separate the

uses cognitive and behavioral techniques to help

14

effect of these treatments from other factors. The report

offenders identify and change negative behavioral

concluded that more rigorous studies were needed to

patterns) or a control group.18 Likewise, researchers from

determine the effectiveness of different treatments for

the Washington State Institute for Public Policy

different types of offenders.

(WSIPP), which is well-known for both its metaanalyses and its research on treatment for sex offenders,

Prison-based treatment. The research literature on the

found that a sex offender treatment program for inmates

effectiveness of treatment programs for incarcerated

had little effect on recidivism rates for sexual and violent

offenders is fairly inconclusive. A 2003 study of 195 sex

offenses—despite the fact that those who participated in

offenders who took part in a prison-based CBT program

the program did so voluntarily and were thus likely to be

in Vermont found that people who completed the

amenable to treatment.19

program were significantly less likely (5.4 percent) than

In spite of these inconclusive results regarding

those who dropped out (30.6 percent) or refused to

prison-based treatment in general, there is some evidence

participate (30.0 percent) to be charged with a sexual

that CBT in particular is effective for lowering

15

offense in a six-year follow-up period. It also found

recidivism rates. In addition to the Vermont study

that continuing with treatment after release from prison
was significantly associated with lower recidivism of
sexual offenses. However, this study did not use
randomly assigned treatment or control groups, so
despite the fact that researchers found no significant
12

Because meta-analyses incorporate numerous studies that measure
recidivism differently, it is not possible to define recidivism more
specifically.
13
R.K. Hanson, A. Gordon, A.J.R. Harris, J.K. Marques, W. Murphy,
V.L. Quinsey, and M.C. Seto, “First Report of the Collaborative
Outcome Data Project on the Effectiveness of Psychological
Treatment for Sex Offenders,” Sexual Abuse: A Journal of Research
and Treatment, 14 (2002): 169-194.
14
F. Lösel and M. Schmucker, “The Effectiveness of Treatment for
Sexual Offenders: A Comprehensive Meta-Analysis,” Journal of
Experimental Criminology 1(2005): 117-146.
15
R.J. McGrath, G. Cumming, J.A. Livingston, and S. Hoke,
“Outcome of a Treatment Program for Adult Sex Offenders: From
Prison to Community,” Journal of Interpersonal Violence 18, no 1
(2003): 3-17.

Treatment and Reentry Practices for Sex Offenders

16
The use of comparison groups allows researchers to assess whether
or not changes in outcomes following treatment would have occurred
in the absence of treatment as well. Random assignment to treatment
or comparison groups provides the strongest evidence of a treatment
effect because it creates two groups that are comparable except for the
treatment intervention.
17
A. Mander, M. Atrops, A. Barnes, and R. Munafo, Sex Offender
Treatment Program: Initial Recidivism Study (Anchorage, AK: Alaska
Department of Corrections, 1996); and V.L.E. Quinsey, G.T. Harris,
M.E. Rice, and C.A. Cormier, Violent Offenders: Appraising and
Managing Risk (Washington, DC: APA, 1998).
18
J.K. Marques, M. Wiederanders, D.M. Day, C. Nelson, and A. Van
Ommeren, “Effects of a Relapse Prevention Program on Sexual
Recidivism: Final Results from California’s Sex Offender Treatment
and Evaluation Project (SOTEP). Sexual Abuse: A Journal of
Research and Treatment 17 (2005): 79-107. Note that because random
assignment fully controls for competing influences on recidivism, the
absence of a significant difference between the two groups in this
study can be interpreted as strong evidence that there was in fact no
difference between them.
19
L. Song, and Roxanne Lieb, Washington State Sex Offenders:
Overview of Recidivism Studies (Olympia, WA: Washington State
Institute for Public Policy, 1995).

Vera Institute of Justice 4

mentioned above, a 2000 study of high-risk sex

$3,258 per participant. In contrast, treatment delivered to

offenders who volunteered for Canada’s Clearwater Sex

juveniles in an institutional setting saved an average of

Offender Treatment Program, which used both CBT and

$7,829 per participant.23 This was the only cost-benefit

a relapse prevention component, found that program

analysis we uncovered in our review.

participants had significantly lower reconviction rates
than those in a comparison group.20 Moreover, the

Community-based treatment. The research on

difference in conviction rates was much larger for sexual

community-based treatment programs for sex offenders

reconvictions than for nonsexual reconvictions.

suggests, fairly consistently, that these programs are

Similarly, in a comprehensive meta-analysis, WSIPP

effective in reducing recidivism. In one study of 1,400

researchers found that prison-based CBT reduced

sex offenders who were sentenced to probation in

21

recidivism by an average of 14.9 percent.

Therapeutic community programs, which emphasize

Minnesota, researchers found that re-arrest rates for
sexual offenses for those who completed treatment (5

group support in facilitating behavior change, have also

percent) were lower than for those who began but did not

been shown to exert a beneficial effect on sex offender

complete treatment (11 percent) and those who never

recidivism. In 2003, the Colorado Division of Criminal

entered treatment (11 percent).24 The Minnesota study

Justice found that sex offenders who participated in their

also found that offenders who completed treatment were

prison-based therapeutic community program were

less likely to be re-arrested for any new offense (13

significantly less likely than sex offenders who did not

percent versus 45 percent for those who began but did

participate in the program to recidivate across a number

not complete treatment, and 42 percent for those who

22

of measures. Moreover, the Colorado study found that
longer periods of treatment in the therapeutic community

never entered treatment).
In addition, there is evidence that treatment designed

led to lower recidivism rates upon release. Again,

to address deviant feelings and behaviors specifically

though, this evaluation did not use randomly assigned

related to sexual offending has an effect on both sexual

treatment and control groups, nor did it match people in

and nonsexual recidivism rates above and beyond the

the two groups on the basis of characteristics that may

effects of general treatment, which addresses more

have influenced their decision to enroll in treatment. As

general mental health and behavioral issues. For

a result, it is not possible to attribute the observed

example, a 1998 study found that probation supervision

outcomes to the program with any certainty.

combined with specialized sex offender treatment, as

With regard to the cost of prison-based treatment

compared with probation supervision combined with

programs, a cost-benefit analysis by the WSIPP found

only general mental health treatment, significantly

that these programs, when combined with aftercare,

reduced overall re-arrests (for both sexual and nonsexual

actually increase costs to taxpayers by an average of

offenses) among a group of sex offenders in rural
Vermont.25 However, neither the Minnesota nor the

20

J. Looman, J. Abracen, and T. Nicholaichuk, “Recidivism among
treated sexual offenders and matched controls,” Journal of
Interpersonal Violence 15, no. 3 (2000): 279-290; Polly Phipps, Kim
Korinek, Steve Aos, and Roxanne Lieb, Research Findings on Adult
Corrections Programs: A Review (Olympia, WA: Washington State
Institute for Public Policy, 1999). Throughout this section,
“significance” means statistical significance.
21
Steve Aos, Marna Miller, and Elizabeth Drake, Evidence-Based
Public Policy Options to Reduce Future Prison Construction,
Criminal Justice Costs, and Crime Rates (Olympia, WA: Washington
State Institute for Public Policy, 2006).
22
Kerry Lowden, Nicole Hetz, Linda Harrison, Diane Patrick, Kim
English, and Diane Pasini-Hill, Evaluation of Colorado’s Therapeutic
Community for Sex Offenders: A Report of Findings (Office of
Research and Statistics, Division of Criminal Justice, 2003).

Treatment and Reentry Practices for Sex Offenders

Vermont study used random assignment, so it is not
possible to conclude with any certainty that the

23
Aos, Miller, and Drake, Evidence-Based Public Policy Options to
Reduce Future Prison Construction, Criminal Justice Costs, and
Crime Rates, 2006.
24
Sex Offender Supervision: 2000 Report to the Legislature (St. Paul,
MN: Minnesota Department of Corrections, 2000).
25
R.J. McGrath, S.E. Hoke, and J.E. Vojtisek, “Cognitive-Behavioral
Treatment of Sex Offenders: A Treatment Comparison and LongTerm Follow-Up Study,” Criminal Justice and Behavior 25 (1998):
203-225.

Vera Institute of Justice 5

reductions in re-arrests were due to treatment rather than

studies that addresses the subject directly began by

other factors.

examining the general literature on successful reentry

With regard to specific treatments, there is

strategies for people convicted of a wide range of

considerable evidence, grounded in methodologically

offenses. Then, arguing that these reentry strategies can

sound research, that community-based CBT is effective

be applied to sex offenders so long as one takes the

in reducing overall recidivism. However, it remains

unique needs of sex offenders into account, it identified

unclear whether community-based CBT is effective in

several key factors in the successful reentry of sex

reducing sexual recidivism. In a systematic meta-

offenders:

analysis of sex offender programming that examined
only those evaluations that used a well-matched
comparison group, WSIPP researchers found that CBT
significantly reduces recidivism (by an average of 31.2
percent across studies) among low-risk sex offenders on
26

probation. The WSIPP study did not, however,
examine the impact of CBT on sexual recidivism.
It is difficult to assess the impact of medical
treatments on sexual offending. This is primarily due to

1. Institutional and community case managers
collaborate to maintain a consistent approach.
2. Manage sex offenders in prison in a way that
prepares them for release.
3. Consider the benefits of discretionary release
policies.
4. Have case managers actively involved in
facilitating the transition.

ethical restrictions that prevent researchers from

5. Recognize victims as important stakeholders.

randomly assigning people to procedures or treatments

6. Develop a community supervision approach for

that are either potentially harmful or invasive.

sex offenders that promotes successful outcomes

Nonetheless, there have been a handful of studies in this

in addition to risk management.29

area. One of these, a study based on a sample of mostly
pedophiles, found that people who volunteered for and

The Center for Sex Offender Management endorsed

were surgically castrated were significantly less likely to

these strategies in a 2007 report.

engage in recidivism of sexual offenses than volunteers
27

A handful of studies have examined the impact of

who were not castrated. In addition, a meta-analysis

specific reentry models on sex offenders leaving prison.

found that hormonal therapy was, on average, more

A 2005 study, for example, examined Circles of Support

effective in reducing sexual recidivism than psychosocial

and Accountability (COSA), a program that originated in

interventions—although other aspects of these programs

Canada and is becoming more prevalent in the United

28

may account for this effect.

States. COSA encourages high-risk offenders to develop
support networks in the community, consisting mostly of

REENTRY PROGRAMMING

volunteers from faith-based organizations who visit them

Reentry programming aims to help sex offenders make

on a regular basis, following their release from prison.

the transition back into the community after they are

The researchers found that sex offenders who

released from prison. Although reentry in general is a

participated in COSA recidivated at a rate that was 31.6

major topic in the field of corrections, there has been

percent lower than people in a matched group who did

relatively little research that focuses on the specific

not participate.30 Another study of COSA, this one from

needs of sex offenders leaving prison. One of the few
26

Steve Aos, Marna Miller, and Elizabeth Drake, Evidence-Based
Adult Corrections Programs: What Works and What Does Not
(Olympia, WA: Washington State Institute for Public Policy, 2006).
27
Ibid.
28
Lösel and Schmucker, 2005.

Treatment and Reentry Practices for Sex Offenders

29
K.M. Bumby, T.B. Talbot, and M.M. Carter, “Sex Offender
Reentry: Facilitating Public Safety through Successful Transition and
Community Reintegration,” Criminal Justice and Behavior (in press).
30
R.J. Wilson and J.E. Picheca, “Circles of Support and
Accountability: Engaging the Community in Sexual Offender
Management” in B.K. Schwartz (Ed.), The Sex Offender: Issues in
Assessment, Treatment, and Supervision of Adult and Juvenile

Vera Institute of Justice 6

2007, concluded that the program led to a 70 percent

ensure victim safety, and make reparation to

reduction in re-arrests for sexual offenses and a 57

victims.
31

percent reduction in re-arrests for violent offenses.

2. Sex offender management should rely on interagency coordination, interdisciplinary

Finally, a number of studies suggest that many sex
offenders leaving prison need community support to find

partnership, and job specialization to provide a

a place to live, as strict residency requirements often

unified approach.

32

3. Offenders should be held accountable through

make it difficult for them to find affordable housing.

individualized case management plans that use
COMMUNITY SUPERVISION

informal controls (which are learned and

Community supervision refers to those forms of

reinforced through treatment) as well as external

correctional supervision that do not involve

controls (in particular the active involvement of

incarceration, such as probation, parole, and community

family and law enforcement). Polygraphs should

corrections. (Community corrections involves

also be used to monitor these internal and

monitoring offenders independently of probation and

external controls.
4. State and local criminal justice agencies and

parole. In general, community corrections agencies
supervise offenders who have been diverted from prison

policymakers should work together to develop

but who represent a higher risk than people on

informed public policies.
5. Criminal justice agencies should develop quality

probation.) The research on community supervision is
similar to that on reentry in that it stresses the

control mechanisms to monitor the

importance of social bonds and community support in

implementation of these strategies and to assess

reducing recidivism and rehabilitating offenders.

their effectiveness over time.

One of the most promising models of community
supervision—and perhaps the most widely known in the

Each of these principles is grounded in the clinical

sex offender management community—is the

treatment literature, and research on the containment

containment model, an evidence-based model developed

model provides support for its effectiveness in reducing

by the Colorado Division of Criminal Justice in the

recidivism. Some of this research overlaps with the

1980s. The containment model is grounded in five key

treatment literature discussed earlier—for example, the

principles, all of which support the notion that sexual re-

Colorado therapeutic community program that was

offending can be minimized through internal and

found to reduce recidivism was grounded in the

33

external controls:

containment approach. In addition, a 2001 Oregon study
found that people on probation and parole who took part

1. The primary objectives of sex offender
management are to enhance public safety,

in a program that combined treatment, polygraph
monitoring, and specialized supervision were 40 percent
less likely to be convicted of a new felony than people
on probation and parole in a neighboring county who did

Populations (pp 13.1-13.21) (Kingston, NJ: Civic Research Institute,
2005).
31
R.J. Wilson, J.E. Picheca, and M. Prinzo, “Evaluating the
Effectiveness of Professionally Facilitated Volunteerism in the
Community-Based Management of High-Risk Sexual Offenders: Part
Two—A Comparison of Recidivism Rates, The Howard Journal, 46,
no. 4 (2007): 327-337.
32
Joan Petersilia, When Prisoners Come Home: Parole and Prisoner
Reentry (New York, NY: New York Open Society Institute, 2003).
33
K. English, S. Pullen, and L. Jones, Managing Adult Sex Offenders
in the Community: A Containment Approach (Washington, DC:
National Institute of Justice, Research in Brief, 1997).

Treatment and Reentry Practices for Sex Offenders

not receive the same combination of services.34 Other
state-specific analyses have found that sex offenders who
are supervised under the containment model have low

34

K.A. England, S. Olsen, T. Zakrajsek, P. Murray, and R. Ireson,
“Cognitive/Behavioral Treatment for Sexual Offenders: An
Examination of Recidivism,” Sexual Abuse: A Journal of Treatment
and Practice 13, no. 4 (2001): 223-231.

Vera Institute of Justice 7

felony re-arrest rates (6 percent in one study). However,

differences between the two groups with respect to the

none of these state-specific studies used comparison

number of people charged with sexual offenses; the

groups, so it is difficult to attribute this outcome with

number of people charged with sexual or violent

35

any certainty to the containment model.

offenses; or the number of people charged with criminal
offenses in general.39

Other research suggests that strong social support
can play a crucial role in preventing recidivism. For
example, a 2004 study of sex offenders sentenced to
probation for child molestation found that people who
had strong support from family and friends were less
likely to have their probation status revoked for either a

Recent Trends in Treatment,
Reentry, and Community
Supervision Practices

technical violation or a new arrest and that people with
strong support whose status was revoked generally lasted
36

This section summarizes recent trends in each of the four

longer on probation than people without such support.

substantive areas outlined earlier—prison-based

The study also found that people who were employed

treatment, community-based treatment, reentry, and

37

were less likely to violate the terms of probation. These

community supervision—as revealed by our survey.

findings are consistent with a body of research that

When applicable, we assess these trends in light of

highlights the shortcomings associated with a straight

extant research. A detailed, state-by-state overview of

risk management approach (that is, an approach that

current practices for each substantive area can be found

emphasizes monitoring offenders without attempting to

in the appendices.

address their needs). According to some studies, risk
management strategies have a negligible impact on

PRISON-BASED TREATMENT

recidivism rates among the general offender population

Our analysis of prison-based treatment indicates that

when they are used in isolation; additional research

while few states are able to provide treatment to all

suggests that this is true of sex offenders as well.38

imprisoned sex offenders who are eligible, the treatment

On a different note, a recent study in Vermont

services that are currently in place are grounded in

examined the impact of polygraph techniques on

evidence-based approaches such as CBT and relapse

recidivism rates among 208 adult male sex offenders

prevention. There is less emphasis on drug therapy and

who were both receiving treatment and under community

polygraph monitoring, which have not yet been

supervision. Half of the people in this sample group were

adequately evaluated by researchers. Our qualitative

subject to polygraph monitoring. Researchers found that

analysis of survey data identified four trends: the limited

although significantly fewer people in the group that was

availability of prison-based treatment; the widespread

subject to polygraph monitoring were charged with non-

use of evidence-based treatment; the growing use of

sexual violent offenses, there were no significant

treatment standards; and the widespread use of risk (but
not needs) assessments.

35

Division of Probation Services, Special Analysis (Denver, CO: State
Court Administrators Office, Judicial Branch, 2007); M. Walsh,
“Overview of the IPSO Program—Intensive Parole for Sex Offenders
– in Framingham Massachusetts, Presentation by the parole board
chair to the National Governors Association policy meeting on sexual
offenders. November 15, 2005. San Francisco, CA.
36
This includes revocations for technical violations and new arrests.
37
John R. Hepburn, and Marie L. Griffin, “The Effect of Social Bonds
on Successful Adjustment to Probation: An Event History Analysis,”
Criminal Justice Review, 29, no. 1 (2004).
38
Kurt Bumy, Tom Talbot, and Madeline Carter, Managing the
Challenges of Sex Offender Reentry (Silver Spring, MD: Center for
Sex Offender Management, 2007).

Treatment and Reentry Practices for Sex Offenders

Limited availability. Prison-based treatment for sex
offenders is available in most states. In general, though,
the treatment capacity of prisons and jails is quite

39

R.J. McGrath, G.E. Cumming, S.E. Hoke, and M.O. Bonn-Miller,
“Outcomes in a Community Sex Offender Treatment Program: A
Comparison Between Polygraphed and Matched Non-polygraphed
Offenders,” Sex Abuse 19 (2007): 381-393.

Vera Institute of Justice 8

limited, especially when compared with community-

Very few states employ drug therapy as part of

based programs. Across the 37 states that responded to

prison-based treatment on anything other than a case-by-

our survey of prison-based treatment, we found that the

case basis. Among those states that do administer drugs,

percentage of imprisoned sex offenders in treatment at

most use anti-depressants such as selective serotonin

any given time ranged from 1 to 33 percent. Interviews

reuptake inhibitors (SSRIs), as opposed to chemical

with policymakers and treatment providers suggest that

castration or other types of hormonal therapy—the types

limited institutional capacity was the primary reason

of drug therapy that are generally associated with

these figures were so low. Only one state (Pennsylvania)

medical treatment of sex offenders in the research

reported that treatment is available in all facilities; in

literature. Because very few studies have examined the

contrast, 13 states reported that treatment was either

role of anti-depressants in prison-based treatment for sex

unavailable altogether or available in only one facility.

offenders, it is difficult to draw conclusions about the

Our findings also suggest that it is especially difficult for

impact of current drug therapy practices.

female sex offenders to access treatment. Fewer than half

While polygraphs are more prevalent than drug

of the participating states reported that treatment is

therapy in the context of prison-based treatment, they are

available in at least one women’s prison. (We did not,

hardly widespread. Fewer than half of the states that

however, directly ask about the availability of treatment

responded to our survey reported using polygraphs in

in women’s prisons, so the actual number may be

some capacity in prison-based treatment programs.

higher.)

Unfortunately, as noted earlier, there is very little

In light of the limited availability of prison-based

research (as of spring 2008 we were unable to find a

treatment programs, it is not surprising that very few

single study) that examines the impact of polygraph

states require all incarcerated sex offenders to undergo

monitoring on sexual recidivism.

treatment. Indiana, Iowa, Missouri, and New Jersey were

A few states reported assigning people to different

the only states that reported mandatory treatment in

treatment programs based on their level of risk. This

prison without any qualifiers. (In other words, all

practice is consistent with criminological research, which

incarcerated sex offenders in those states are presumably

shows that, in the general population of offenders, those

required to undergo treatment.) Other states provide

who are higher risk achieve better outcomes when they

treatment to select groups of sex offenders, or offer

receive more intensive programming, and those who are

education that does not technically qualify as treatment.

lower risk do better in less intensive programming.41

Montana, for example, requires all people convicted of a

Finally, a number of states have treatment programs

sex offense to participate in a 15-week group educational

that employ either multiple treatment components or a

program with a sex therapist prior to being screened for

progressive series of phases (or both). Most multi-phase

further treatment; Ohio mandates treatment for all

programs begin with an educational component. The

medium- and high-risk sex offenders, as defined by

content and purpose of this educational component

40

scores on the STATIC-99 risk instrument.

varies from program to program: In Colorado and
Montana, for example, the first phase of treatment

Evidence-based treatment methods. Our survey

involves providing an overview of the program so that

indicates that most prison-based treatment programs rely

participants know what to expect before they begin. In

heavily on CBT, a treatment that, as noted earlier, is

Ohio, on the other hand, the first phase consists of a

supported by research.

“psychoeducation” program that explains to participants

40
The STATIC-99 is an actuarial risk assessment instrument that
predicts risk for sexual recidivism among adult males based on 10
factors that are stable over time.

41

D.A. Andrews and J. Bonta, The Psychology of Criminal Conduct.
3rd edition (Cincinnati, OH: Anderson, 2003).

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice 9

the nature of their mental illness to help them prevent

STATIC-99. In general, standardized instruments are

relapse.

more common than customized instruments, though it
remains unclear to what extent such standardized

Standards for treatment. Most states have standards

instruments have been validated for the particular uses

that define the parameters of treatment programming,

individual states put them to.

although only 15 of the 37 states that responded to our

Only five states (Colorado, Illinois, Utah, Vermont,

survey reported that their standards had been developed

and Wisconsin) reported having developed customized

by independent bodies outside of the department of

risk assessment tools based on statistical data drawn

corrections. The existence of treatment standards is

from local sex offender populations.43 Two of the most

significant because it creates a system of accountability

widely recognized customized state tools are the

among criminal justice agencies and providers and

Minnesota Sex Offender Screening Tool (MnSOST-R)

encourages them to use evidence-based techniques.

and the Vermont Assessment of Sex Offender Risk

Independent standards provide an additional level of

(VASOR), both of which are being used in a number of

oversight and, thus, encourage criminal justice agencies

other states.

and treatment providers to adopt responsible and

Although the use of risk assessment tools is fairly

effective approaches to treatment. Moreover, the fact that

widespread, only a few states use actuarial needs

independent standards are usually drafted by mental

assessments in prison. (The two types of instruments

health professionals and other authorities suggests that

serve very different purposes in the context of prison-

such standards are more likely to be effective than

based treatment: risk assessments are primarily used to

standards created by correctional officials. Among the

predict the likelihood that a sex offender will recidivate;

states with standards that were created by independent,

needs assessments provide information about “dynamic”

legislatively created bodies are Colorado, Connecticut,

factors—such as alcoholism and negative moods—that

42

Kentucky, and Texas. Several other states—among

change over time. Information about dynamic factors can

them Washington, Vermont, and Montana—have

then be used to craft individual treatment plans with

standards that were created by independent bodies that

targeted interventions that can be re-evaluated over

were not legislatively created.

time.) Only about one-quarter of states reported using a
standardized needs assessment instrument in prison

Risk and needs assessments. A great majority of

settings; Vermont is the only state that has developed its

participating states use at least one actuarial risk

own needs assessment instrument.44 The Vermont

assessment instrument for predicting sexual recidivism

instrument is distinct from other needs assessment

among people incarcerated for sex offenses. Such tools

instruments in that it can be used not only to identify

have the advantage of determining risk through statistical

possible interventions, but also to assess progress in

relationships, rather than through subjective clinical

treatment.

judgments. The most widely used risk assessment
instrument is a standardized instrument known as the

42
Both Delaware and New Mexico recently passed legislation to
create sex offender management boards (SOMB) for the purpose of
drafting treatment standards. In addition, California and West Virginia
are currently developing standards tied to legislative initiatives:
California has a SOMB and recently created a treatment committee,
which submitted a report to the state legislature in early 2008. In West
Virginia, the Department of Health and Human Resources is
developing standards to meet requirements of the 2006 Child
Protective Act.

Treatment and Reentry Practices for Sex Offenders

43
Minnesota has one as well—the MnSOST-R—but did not
participate in the study.
44
The MnSOST-R includes some dynamic factors, but in this report,
needs assessment instruments have been defined as those that contain
ACUTE dynamic factors. Among those that are commonly recognized
are the ACUTE, Vermont Treatment Needs and Progress Scale,
Multiphasic Sex Inventory (MSI), Psychological Inventory of
Criminal Thinking Styles (PICS), Sex Offender Need Assessment
Rating (SONAR), and COMPAS.

Vera Institute of Justice 10

COMMUNITY-BASED TREATMENT

programs than in prison-based programs. Thirty-two out

In most states, the treatment that is provided for sex

of 36 states that responded reported using polygraphs in

offenders under community supervision is, like that

some capacity for sex offenders on community

which is available for incarcerated sex offenders,

supervision. A few states reported using them for

grounded in evidence-based approaches such as CBT.

multiple purposes, including assessing the offender’s

Most states also reported efforts to ensure that consistent

ability to admit the full extent of his or her crime;

treatment is available for people returning home from

assessing the offender’s criminal history; obtaining

prison. In general, sex offenders in the community have

information about victims; and assessing the extent to

greater access to treatment than those in prison, although

which an offender is complying with treatment and

in many states access to treatment is at least partially

supervision requirements (the most common use). As

paid for by offender fees.

noted earlier, there is little evidence that polygraphs are

There are many different community-based
treatment programs for sex offenders. At the county

effective in reducing recidivism rates, so it is unclear
whether or not these practices should be expanded.

level, where most probation is administered, there can be
considerable variation in the content and structure of

Consistency between prison-based and community-

these programs. To simplify the process of gathering

based treatment programs. In most states, correctional

information on community-based treatment, we focused

institutions and community supervision agencies share

exclusively on programs at the state level, most of which

information about the case histories and treatment plans

target people on parole.

of sex offenders who are returning to the community
from prison. By communicating in this manner, these

Evidence-based treatment. As was the case for prison-

states aim to ensure that treatment is provided

based treatment programs, almost all community-based

consistently during the transition period—a goal that is

treatment programs use CBT to some extent; many also

consistent with the unified approach to sex offender

use relapse prevention, arousal control (a technique for

management emphasized in the containment model. The

reducing deviant sexual urges), and victim empathy (a

majority of states that took part in our survey reported

technique that helps sex offenders become aware of the

that even in cases where a person begins treatment in

impact of their actions on victims.) Again, the

prison but does not continue treatment under community

prevalence of CBT is consistent with research that shows

supervision, prison officials and community supervision

this method is effective in reducing recidivism.

officials communicate about the person’s prison-based

Community-based treatment programs are also

treatment. In Montana, for example, community

similar to prison-based treatment programs in their

treatment providers generally call prison case managers

reluctance to use drug therapy on anything other than a

to learn more about a person’s treatment while in prison,

case-by-case basis. Although officials in about half of

while in Colorado prison-based treatment providers send

the states that responded to our survey reported that drug

treatment records on to community-based providers as a

therapy is sometimes used for sex offenders under

part of the standard discharge procedure.

community supervision, most also noted that it is not a
standard component of treatment. A number of states

Greater availability but limited state funding. Our

reported using hormonal drug therapy in addition to

data also suggest that treatment is more readily available

chemical drug therapy—almost always only rarely or on

under community supervision than in institutional

a case-by-case basis.

settings. This is to be expected, given the higher risk of

On the other hand, the use of polygraph tests appears
to be much more prevalent in community-based
Treatment and Reentry Practices for Sex Offenders

recidivism among offenders who re-integrate into
society. All of the states that participated in our
Vera Institute of Justice 11

community treatment interview reported that treatment is

limited. Although sex offenders in most states are

available in some capacity for sex offenders under

eligible for general reentry programs, only about a third

community supervision; about two-thirds described the

of participating states reported that they have reentry

distribution of treatment providers as “statewide.”

programming that targets the specific needs of this

The number of treatment providers varied greatly

population. In addition, the role of faith-based

from one state to another, ranging from three (in both

organizations in providing reentry programs for sex

Arkansas and Washington, DC) to 427 (in Texas). There

offenders is not especially prominent. On the other hand,

was also a great deal of variation in treatment settings.

case managers—people assigned to help sex offenders

Most states contract with private providers in some

plan and carry out reentry plans—are becoming more

capacity; some states contract with a single provider,

common in prisons.

others work with an assortment of different providers.
An example of the former is Connecticut, which

Lack of sex-offender specific initiatives. Especially

contracts with the Connection Inc.’s Center for the

striking was the finding that many states do not have

Treatment of Problem Sexual Behavior (CTPSB) to

reentry initiatives for sex offenders.45 Most states

provide all treatment to people on probation and parole.

reported that they provide at least some services for

(CTPSB employs a staff of 30). Examples of the latter

offenders (including sex offenders) during reentry, but

include Washington and Ohio. In Washington, treatment

only around half reported having specific reentry

is provided by both the Department of Corrections and

initiatives to coordinate the delivery of those services.

private contractors. In Ohio, there are two types of

None reported having a reentry initiative specifically for

residential programming for sex offenders in the

sex offenders. Both Colorado and Ohio reported that

community: halfway houses that provide sex offender-

they use the COSA model (discussed earlier in the

specific programming (in addition to other types of

section on reentry programming), but because COSA

programming) for offenders on probation and parole, and

focuses on post-release support, it is not, technically

community-based correctional facilities, which provide

speaking, a reentry initiative. Finally, we found that in

diversionary programs for low-risk sex offenders on

most states that provide services to sex offenders at some

probation.

point during reentry, those services are available in all

For many community-based treatment programs,

prisons throughout the state.

funding appears to be a significant concern. Most states
reported that at least some funding comes directly from

Case managers in prison and community settings.

offenders; around one-quarter of states reported that

Our review also indicates that case managers—people

offender fees are the only source of funding for

assigned to help sex offenders plan and carry out

community-based treatment. In these states, access to

individual reentry plans—are almost as widely available

community-based treatment is at least partially

in prisons as they are in the community. This is a very

dependent on the sex offender’s ability to pay for it.

positive development; as mentioned earlier,
collaboration between institutional and community case

REENTRY PROGRAMMING

managers has been identified as one of the key

Given that most sex offenders who are sentenced to

components of successful reentry. About half of the

prison are eventually released into the community,

states we interviewed reported that some sort of case

reentry programming has recently become a topic of
significant interest in the field of sex offender
management. Yet, our review has revealed that reentry
programming for sex offenders in the United States is
Treatment and Reentry Practices for Sex Offenders

45
For the purposes of this report, a reentry initiative is distinct from
reentry programming in that it represents a comprehensive effort to
provide well-coordinated services to people who are making the
transition home from prison. In general, reentry initiatives regulate the
provision of services both before and after release.

Vera Institute of Justice 12

manager is assigned to offenders while they are still in

Washington reported that at least half of all nonprofit

prison. Our survey also indicates that this practice is not

reentry service providers are faith-based, and in

limited to states with a particular reentry initiative in

Michigan, faith-based organizations play a role in the

place. Montana, for example, does not have a reentry

development of reentry policy through county-level

initiative; nonetheless, probation officers begin working

reentry steering committees. In Delaware, nonprofit

with offenders to prepare them for reentry about 90 days

organizations generally do not provide services to sex

prior to release. In many states, the role of post-release

offenders; however, the few that do are faith-based.

case manager is filled by probation and/or parole
officers, although some states (such as Pennsylvania and

COMMUNITY SUPERVISION

Utah) employ specialized case managers for that

The last of the four substantive areas on which we

purpose.46 In Washington State, some service providers

surveyed policymakers and treatment providers was the

begin working with offenders six to twelve months

supervision of sex offenders in the community. As in

before release and continue working with them in the

previous sections, our discussion here is limited to

community.

supervision at the state level. In some states, that means
both probation and parole. In other states (such as

Role of faith-based organizations. Our data suggest

Kansas), it also means community corrections agencies

that in most jurisdictions, faith-based organizations do

separate from probation and parole. In still other states,

not play a central role in the provision of post-release

where probation is administered at the county-level, it

reentry services for the general population of offenders.

means parole alone. And in a few states (Pennsylvania is

While a number of states have adopted the COSA model,

an example), probation and parole are administered at

which, as discussed earlier, makes extensive use of

both the state and county level. In order to simplify our

volunteers from faith-based organizations to support and

discussion, we do not distinguish here between parole-

monitor sex offenders returning to the community, very

based practices and probation-based practices on the

few states cited COSA as a reentry initiative. Indeed, the

state level. For more information on these issues, please

role of faith-based organizations in reentry appears

refer to the individual state appendices.

difficult to measure. Most interview respondents could

Our review indicates that needs assessments are

only estimate the involvement of faith-based

increasingly being administered to sex offenders under

organizations in very general terms (e.g., some, limited),

community supervision. In addition, we found that in

and Vera researchers were unable to obtain precise data

most states, community supervision agencies pursue two

about the proportion of service providers that are faith-

goals: managing risk and providing services. Research

based. That said, respondents from a few states did

suggests that this is an effective approach to reducing

report that faith-based organizations either play or are

recidivism.

expected to begin to play a significant role in the
provision of reentry services. In Ohio, for example, a law

Increasing use of needs assessments. There is a

(HB 113) was recently passed that requires the

growing use of needs assessment instruments for sex

Department of Rehabilitation and Corrections to work

offenders under community supervision. One prominent

with faith-based organizations to develop prison-based

example is the ACUTE, which was adapted from the Sex

mentorship reentry programs. Respondents from

Offender Need Assessment Rating (another needs
assessment tool) and includes seven scales of acute

46

In both Pennsylvania and Utah, sex offenders are assigned to a
“transitional coordinator,” a parole agent charged with helping the
newly released person re-integrate into the community immediately
upon release from state prison. After 90 days, the person’s case is then
transferred to a general parole agent.

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice 13

dynamic factors, which change rapidly.47 As mentioned

sex offenders under community supervision. Specialized

earlier, the use of such tools is a positive development,

provisions are supervision conditions—such as

as they can track changes in dynamic risk factors over

restrictions on an offender’s contact with minors—that

time and modify supervision practices according to

apply specifically to sex offenders. In general, they aim

changes in risk levels. More than half of the states that

to enhance community supervision and reduce exposure

responded to our survey reported that they use actuarial

to cues that are likely to trigger deviant behavior. In

needs assessment tools to manage sex offenders under

many states, specialized provisions are reserved for

community supervision—a figure that is much higher

specialized caseloads that include only sex offenders.50

than the proportion of states that use these tools in prison

(Probation and parole officers who administer these

48

settings. As previously mentioned, Vermont has

caseloads have generally undergone specialized

developed a customized instrument that assesses both

training.)
In addition, more than half of the states that reported

needs and treatment progress, and this instrument has
recently been adopted in West Virginia as well.
In addition to needs assessments, almost all of the

back have lifetime supervision (mandatory supervision
for the rest of a person’s life). In most cases, this

states we surveyed administer at least one type of

sanction is only used for high-risk or violent sex

actuarial risk assessment to sex offenders under

offenders: In Iowa, for example, only people who are

community supervision. The STATIC-99 is the most

convicted of a Class C felony sex offense or higher are

prevalent risk assessment tool: 24 out of the 29 states we

eligible for lifetime supervision.
Our review does not indicate that specialized

interviewed reported using it in some capacity. Only
three states reported having developed customized risk

provisions, specialized caseloads, and lifetime

assessment tools for sex offenders under community

supervision have displaced efforts to provide services,

supervision, although customized tools are used more

however. As noted earlier, most of the states that

frequently in the community than in prison. The

responded to our survey reported that treatment has

customized risk assessment tools that were developed in

become an important part of community supervision.

Colorado and Vermont, as discussed earlier, are

This finding is consistent with research showing that

administered both in prison and to those under

community supervision that combines surveillance and

community supervision. Additionally, the Iowa

intensive supervision with treatment and rehabilitation

Department of Corrections is in the process of

services is more effective at reducing recidivism than

developing a customized tool called the ISORA 8 for sex

surveillance alone, both among the general offending

49

offenders on both probation and parole.

population and among sex offenders.51
50

Focus on treatment and monitoring. Our review also
revealed that most states have specialized provisions for

47
ACUTE dynamic factors are distinct from stable dynamic factors,
which change over longer periods of time.
48
Again, needs assessment instruments are defined as those that
contain ACUTE dynamic factors. These include the ACUTE,
Vermont Treatment Needs and Progress Scale, Multiphasic Sex
Inventory (MSI), Psychological Inventory of Criminal Thinking Styles
(PICS), Sex Offender Need Assessment Rating (SONAR), and
COMPAS.
49
Alabama; Kansas; Montana; Washington, DC; and Wyoming also
reported having customized risk assessment tools under community
supervision, but they described them as general risk assessment
instruments, rather than sex offender-specific.

Treatment and Reentry Practices for Sex Offenders

Some states do not have specialized caseloads for all sex offenders
under community supervision, but this is usually because not all
jurisdictions have enough sex offenders to warrant specialized
caseloads. Additionally, some states require only those sex offenders
who meet certain risk or offense criteria to be supervised on
specialized caseloads. For example, in Indiana, if an offender on
parole is originally convicted of or has a history of at least one of a
specific subset of offenses, including, rape, criminal deviant conduct,
molestation, or failure to register, he or she is required to be
supervised under the Sex Offender Management and Monitoring
Program.
51
S. Aos, P. Phipps, R. Barnoski, and R. Lieb, Evidence-Based Adult
Corrections Programs: What Works and What Does Not. Document
number 06-01-1201. (Olympia, WA: Washington State Institute for
Public Policy, 2006); R.J. McGrath, G.F. Cumming, J.A. Livingston,
and S.E. Hoke, “Outcome of a Treatment Program for Adult Sex
Offenders: From Prison to Community,” Journal of Interpersonal
Violence, 18 (2003): 3-17.

Vera Institute of Justice 14

Conclusions

Research suggests that this type of inter-agency
communication can help reduce recidivism.

Our findings can be summarized as follows:
•

•

both manage risk and provide services. Research

In both institutional (prison-based) and

suggests that this is an effective approach to

community settings, the treatment of sex
offenders is generally grounded in evidencebased practices, especially cognitive-behavioral
therapy (CBT). In general, treatment is much
more available in the community than in
institutional settings.
•

In a majority of participating states, community-

In general, community supervision agencies

reducing recidivism.
•

A limited number of states are conducting
research on their own treatment, reentry, and
supervision initiatives. There have been almost
no studies that examine these programs from a
cost-benefit perspective.

based treatment for sex offenders is supported,
at least in part, by collecting fees from those in
treatment—a circumstance that may limit access
to these programs.
•

Standardized risk assessment tools such as the
STATIC-99 are now widely used in both prisonbased and community-based treatment programs
across the nation. However, a lack of data
prevented us from determining the number of
states that have validated these tools for their
local populations.

•

Needs assessment tools, especially the ACUTE,
are becoming more prevalent in community
supervision.

•

We found no reentry initiatives that specifically
target sex offenders. Although sex offenders in
most states are eligible for general reentry
programming, there are few reentry programs
that address the unique needs of this population.
One exception is Circles of Support and
Accountability (COSA), a program that
encourages high-risk offenders to develop

The variety in treatment and reentry practices across
different states (and even from one jurisdiction to
another) makes it impractical to devise blanket
recommendations from these findings. However, the
need for more rigorous research on treatment and reentry
practices for sex offenders is clear. Although the current
body of research indicates that cognitive-behavioral
therapy and the containment model of supervision are
both effective in reducing recidivism, many questions
remain unanswered: Many of the practices described in
this report, for example, consist of multiple components,
but it is unclear how each of the individual components
affects recidivism or improves offender outcomes such
as reintegration. Furthermore, there is very little research
that provides a clear picture of what works for whom.
Finally, it bears repeating that there is a noticeable lack
of research on the cost-savings associated with treatment
and reentry programs. Finding answers to these
questions will help policymakers create more informed
and more effective policies for the treatment and
management of sex offenders.

support networks in the community. COSA has
been piloted in several states.
•

In most states, correctional institutions and
community supervision agencies share
information about the case histories and
treatment plans of sex offenders who are
returning to the community from prison.

Treatment and Reentry Practices for Sex Offenders

Vera Institute of Justice 15

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