Discussion: treatment outcome models in the field


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Scenario 1:

A woman was released from prison after completing a 24-month outpatient sex offender treatment program. She was required to participate in this treatment after she was convicted of sexually abusing a child. Three weeks after she was released from prison, she returned to the prison setting for violating conditions of her parole after she was found guilty of shoplifting. Because of this new conviction, her parole was deemed a failure, and in eight months she would again appear before the parole board.

Scenario 2:

A man was on probation for the conviction of theft by deception (writing bad checks). As a component of his probation, he was required to check in with his probation officer and comply with mandated substance abuse treatment for a possible drinking problem. During the sixth week of treatment, he was arrested for and later convicted of flagrant nonsupport (failure to pay child support).

Scenario 3:

A male juvenile completed a 16-week outpatient sex offender treatment program after he was convicted of sexual assault. Shortly after he completed the program, he was arrested for and convicted of rape under adult sentencing guidelines.

On the surface, it certainly appears that the above scenarios portray treatment failures rather than treatment successes. But maybe not. How would you determine whether a treatment or treatment program is successful? How would you select from the various treatment outcome models to ensure better treatment success? This week, you delve into these questions in a search for answers.

Before beginning treatment, practitioners are required to address treatment goals. Goals can be specific or broad and range from cessation of substance abuse and regularly checking in with authorities to compliance with medication requirements and avoiding specific locations and environments. Goals are usually developed in collaboration, with input from legal authorities, mental health professionals, and patients. Patient and community safety need to be taken into consideration as well. Goals for treatment are referred to as “outcomes.” Outcomes need to be considered during treatment, during review of professional literature, and when evaluating the efficacy of treatments.

The three treatment outcome models are recidivism, relapse, and harm-reduction. Each type of outcome exists independently of the others. For example, a person may be considered a treatment success in the harm-reduction model even though he or she has had a relapse and has returned to the criminal justice system. Determining the success of treatment depends on the goals and desired treatment outcomes agreed upon at the onset of practice. Additionally, in professional literature, treatment outcomes often are indirectly defined. To comprehend the research in your field and to be an effective practitioner, it is essential to understand treatment outcome models and discern how these models are used.

As a forensic treatment practitioner, you work to prepare individuals for their return to a more normal life with a reduced likelihood of future problems. Your understanding of treatment outcomes affects how you formulate your treatment plan. It also affects discussing treatment alternatives with interested parties, designing treatment programs for various types of offenders, and communication with criminal justice officials. You are ethically obligated to explain to interested parties the benefits of treatment as well as the limitations of what you are able to offer. For this very reason, the forensic treatment provider must have a well-established understanding of treatment outcome models. Central to that understanding is a familiarity with current literature in the forensic treatment field and an ability to discern how it relates to your professional practice. That being said, treatment outcome has more to do with services in the forensic setting than just professional journal articles. Treatment outcome has serious implications for the individual, society, and the professional planning of services.

To prepare for this Discussion:

· Review the Treatment Outcome Models document, and select one of the three treatment outcome models that is of particular interest to you for use with this Discussion.

· Conduct an academic search in the Walden Library, and select at least one scholarly article from a peer-reviewed journal that uses the treatment outcome model (recidivism, relapse, or harm-reduction) you selected.

· Reflect on the results of the study in terms of the outcome model you selected.

· Consider how the results of the study might be different if one of the other two treatment outcome models had been used. Think about how the outcomes might change.

· With these thoughts in mind:

· By Day 5

· Post a brief summary of the research article you selected, including an identification of the treatment outcome model used in the study. Then explain how the study might have been affected and how the outcomes might have changed if one of the other treatment outcome models had been used.

· Be sure to support your postings and responses with specific references to the resources.



Barnett, G. D., & Howard, F. F. (2018). What doesn’t work to reduce reoffending? A review of reviews of ineffective interventions for adults convicted of crimes. European Psychologist, 23(2), 111–129.

Hachtel, H., Vogel T., & Huber, C.G. (2019). Mandated treatment and its impact on therapeutic process and outcome factors. Frontiers In Psychiatry, 10, 219.

Howard, M. V. A., de Almeida Neto, A. C., & Galouzis, J.J. (2019). Relationships between treatment delivery, program attrition, and reoffending outcomes in an intensive custodial sex offender program. Sexual Abuse, 31(4) 477–499.

Note: You will access this article from the Walden Library databases.

Hsieh, M.-L., Hamilton, Z., & Zgoba, K. M. (n.d.). Prison experience and reoffending: Exploring the relationship between prison terms, institutional treatment, infractions, and recidivism for sex offenders. Sexual abuse-a journal of research and treatment, 30(5), 556–575. 

Vandiver, D. M., Braithwaite, J., & Stafford, M. C. (2019). An assessment of recidivism of female sexual offenders: Comparing recidivists to non-recidivists over multiple years. American Journal of Criminal Justice, 44(2), 211-229. 

Document: Treatment Outcome Models (PDF) 

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