Corrections

Policy, Practice and Research

ISSN: 2377-4657 (Print) 2377-4665 (Online) Journal homepage: http://www.tandfonline.com/loi/ucor20

Treatment Integrity and Recidivism among Sex

Offenders: The Relationship between CPC Scores
and Program Effectiveness

Matthew Makarios, Lori Brushman Lovins, Andrew J Myer & Edward Latessa

To cite this article: Matthew Makarios, Lori Brushman Lovins, Andrew J Myer & Edward Latessa
(2017): Treatment Integrity and Recidivism among Sex Offenders: The Relationship between CPC
Scores and Program Effectiveness, Corrections, DOI: 10.1080/23774657.2017.1389318

To link to this article: https://doi.org/10.1080/23774657.2017.1389318

Published online: 07 Nov 2017.

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CORRECTIONS: POLICY, PRACTICE AND RESEARCH
https://doi.org/10.1080/23774657.2017.1389318

Treatment Integrity and Recidivism among Sex Offenders: The

Relationship between CPC Scores and Program Effectiveness
Matthew Makariosa, Lori Brushman Lovinsb, Andrew J Myerc and Edward Latessad
a
Department of Sociology, Anthropology and Criminology, University of Northern Iowa, Cedar Falls, Iowa,
USA; bDepartment of Criminal Justice, University of Houston Downtown, Houston, Texas, USA; cDepartment of
Political Science and Criminal Justice, North Dakota State University, Fargo, North Dakota, USA; dSchool of
Criminal Justice, University of Cincinnati, Cincinnati, Ohio, USA

ABSTRACT KEYWORDS
Although a large body of research suggests that adherence to RNR Sex offending; treatment;
model is correlated with program outcome, only a small body of recidivism
research examines how it applies to programs that serve sex offenders.
The current study uses the Correctional Program Checklist (CPC) to
measure how well eight community correctional facilities that serve
sex offenders adhere to the Risk Need and Responsivity (RNR) model.
Outcome evaluations are then used to see whether scores on the CPC
are correlated with program effect size. The results find moderate to
strong correlations between CPC scores and program effect sizes.

A large body of research in the field of corrections has examined the effectiveness of different
types of correctional interventions at reducing recidivism. This body of research suggests
that there are specific types of interventions that are effective, others that are not, and even
some that increase recidivism (for an overview see Andrews & Bonta, 2010 or Cullen &
Gendreau, 2000). The programs that have most consistently demonstrated positive treat-
ment effects are based on the principles of effective intervention. These principles suggest
that effective correctional programs target dynamic risk factors (Andrews et al., 1990;
Lowenkamp Latessa, & Smith, 2006), in high-risk offenders (Lowenkamp, Latessa, &
Holsinger, 2006), while using a cognitive-behavioral or social learning approach
(Andrews et al., 1990; Drake, Aos, & Miller, 2009; Latessa, Brushman Lovins, Smith, &
Makarios, 2010). The principles of effective intervention largely dominate the literature on
evidence-based correctional programming (Cullen & Gendreau, 2000). An evidence-based
correctional approach suggests that programs should model interventions that have been
found to be effective in prior research and engage in ongoing evaluations to ensure that the
interventions are achieving their desired goals (MacKenzie, 2000).
The Evidence-Based Correctional Program Checklist (CPC) is a tool designed to assess
how well correctional programs align with “best practices” and the principles of effective
intervention. The CPC is an actuarial instrument that is administered as an in-depth
process evaluation and seeks to determine whether correctional programs ascribe to more
than 70 different items that are theoretically driven and have been shown to be correlated
to reductions in recidivism. Items in the CPC are grouped into five domains: leadership

CONTACT Matthew Makarios matthew.makarios@uni.edu Department of Sociology, Anthropology and

Criminology, University of Northern Iowa, Bartlett Hall 1111, Cedar Falls, IA 50614-0513, USA.
© 2017 Taylor & Francis
2 M. MAKARIOS ET AL.

and development, staff characteristics, assessment, treatment characteristics, and quality

assurance. Several studies conducted by researchers the University of Cincinnati were used
to develop and validate the indicators on the CPC. The results from these studies indicate
that the CPC yields strong correlations with recidivism (Holsinger, 1999; Lowenkamp,
2004; Lowenkamp & Latessa, 2003, 2005a, 2005b).
Although research on the CPC has shown that higher scores yield stronger treatment
effects, no research to date has examined whether this finding applies to correctional
interventions that serve sex offenders. The goal of the current research is to determine
whether scores on the CPC are correlated with reductions in recidivism using process and
outcome evaluations of community correctional facilities that serve sex offenders. The
data from the current research come from a large study that examined the processes and
outcomes of all community correctional facilities that received funding from the Ohio
Department of Rehabilitation and Correction. The larger study consisted of 64 different
community correctional facilities that sought to reduce offender recidivism. The current
study uses data gathered from eight of these programs that served sex offenders. As a
result, the current project extends prior research on evidence-based correctional programs
by focusing on the effectiveness of community correctional facilities that serve sex
offenders as well as the characteristics of successful programs.

Overview of risk, need, and responsivity model

The CPC is an actuarial instrument that is designed to determine how well treatment
programs ascribe to the principles of effective intervention. The principles of effective
intervention provide empirically based guidance to correctional agencies regarding who to
treat, what factors to target for change, and how to administer treatment. The risk, need,
and responsivity (RNR) principles are the focus of the principles of effective intervention.
The risk principle of effective intervention suggests that programs should avoid treating low-
risk cases and should instead target moderate to high-risk clientele (Andrews & Bonta, 2010;
Lowenkamp et al., 2006). This is because low-risk offenders have the least to gain because
their odds to engaging in recidivism are already low (Lowenkamp & Latessa, 2004). On the
other hand, moderate- and high-risk offenders are more likely to recidivate as they have
more dynamic risk factors driving criminal behavior, thereby making them more likely to
see reductions in recidivism when their risk factors are appropriately targeted.
The need principle provides insight as to what offender needs correctional interventions
should target. Targets for change should be dynamic risk factors, or criminogenic needs
(Andrews & Bonta, 2010; Cullen & Gendreau, 2000). These are risk factors that are related to
the odds of recidivism and, when changed, reduce the likelihood of further criminal behavior.
The strongest criminogenic needs include antisocial personality characteristics, criminal peers,
and antisocial attitudes; others risk factors include employment, family issues, and substance
abuse (Gendreau, Little, & Goggin, 1996). When dynamic risk factors are addressed in moder-
ate- or high-risk clientele they experience a subsequent decline in the odds of recidivating
because the factors that are encouraging their criminal behavior have been addressed (Labreque,
Smith, Lovins, & Latessa, 2014; Raynor, 2007; Vose, Lowenkamp, Smith, & Cullen, 2009).
The responsivity principle is concerned with how programs attempt to change dynamic
risk factors. It suggests that correctional interventions be responsive to how offenders
learn and address barriers to treatment (Andrews & Bonta, 2010). There are two
 CORRECTIONS: POLICY, PRACTICE AND RESEARCH 3

components to the responsivity principle: specific and general responsivity. General

responsivity is concerned with ensuring that correctional interventions engage in ther-
apeutic modalities that have been shown work with offending populations. In particular,
behavioral interventions that use social learning principles in group therapy have been
shown be an effective means of teaching offenders the skills they need to avoid recidivism
(Andrews et al., 1990; Lipsey, 2009). Specific responsivity is concerned with removing
barriers to treatment. Even evidence-based curricula will be ineffective at changing
behavior if there are barriers that keep individual offenders from engaging in treatment.
Responsivity factors such as language barriers, lack of transportation to treatment, lack of
day care for children, or mental health issues make it difficult for clients to become
engaged in treatment, thereby limiting the system’s ability to address criminogenic needs.

Effectiveness of sex offender treatment

Several major meta-analyses have been conducted that examine the impact of sex offender
treatment on recidivism. Furby, Weinrott, and Blackshaw’s (1989) early meta-analysis of
sex offender treatment programs found little evidence the programs in their review
reduced recidivism. Hall’s (1995) follow-up to this study included 12 sex offender treat-
ment studies and found a modest effect of treatment on recidivism. The research findings
revealed that the most effective forms of treatment were cognitive-behavioral and hormo-
nal treatments.
Hanson et al.’s (2002) research reported on the analysis of 43 treatment effects from the
Collaborative Outcome Data Project. They found a recidivism rate of 12% for treated
offenders and a recidivism rate of 17% for the control participants. Hanson et al. (2002)
confirmed Hall’s (1995) finding that cognitive-behavioral programs were more effective
than other forms of treatment.
More recently, Hanson, Bourgon, Helmus, and Hodgson (2009) conducted a meta-
analysis of 23 studies and found that the recidivism rates for treated sex offenders was
lower than that of the control participants for sexual recidivism, violent recidivism, and
general recidivism. They also found that cognitive-behavioral programming was asso-
ciated with increases in program effect sizes. Of interest, they coded the methodological
rigor of studies using a set of standardized criteria and found that larger effect sizes were
associated with weaker methodological designs.
Finally, Losel and Schmucker (2005) conducted the most comprehensive meta-analysis
of sex offender treatment studies by analyzing 69 different studies. The authors found a
mean odds ratio of 1.70 that translated into recidivism rates of 11% for the treatment
group and 18% for the control group. Losel and Schmucker (2005) also looked at the
impact of different treatment types of treatment. They found that surgical castration and
hormonal treatments were associated with the largest reductions in recidivism, followed
by cognitive-behavioral and classical conditioning approaches. Not related to reductions
in recidivism were insight-oriented talk therapies or therapeutic communities.

Effectiveness of the RNR model in treating sex offenders

Although there has been a good deal of research that has examined the effectiveness of sex
offender treatment, relatively little has examined the characteristics of effective programs.
4 M. MAKARIOS ET AL.

Olver, Wong, and Nicholaichuck (2009) examined the effectiveness of a high-intensity

inpatient sex offender treatment program that ascribed to the principles of effective
intervention. In particular, the program examined targeted moderate to high-risk sex
offenders while utilizing a cognitive-behavioral approach. Further, the program targeted
criminogenic needs such as antisocial attitudes and family dynamics and addressed
responsivity factors such as language ability and treatment readiness. Their results indicate
that the program was successful at reducing recidivism, with treated sex offenders less
likely to recidivate than controls.
Hanson et al. (2009) conducted a meta-analysis of 23 treatment programs for sex offenders.
They found that overall participants of the treatment programs were less likely to recidivate
than those in the control groups. Furthermore, programs that ascribed to the principles of
RNR were more effective than those that did not. Additionally, as programs adhered to more
of the principles, effect sizes increased. That is, there was a linear relationship between
ascribing to the principles of effective intervention and program effect size. These findings
suggest that a better understanding of sex offender program effects can be gleaned by
evaluating variation in program adherence to the principles of effective intervention. In
particular, these findings suggest that measures of a program’s adherence to the RNR model
may correlate with program effectiveness at reducing recidivism in sex offenders.

Overview of CPC
The CPC is an actuarial assessment instrument that is designed to determine how closely
correctional programs meet the principles of effective intervention. Studies by the University
of Cincinnati were used to construct and validate the CPC using adult and juvenile
treatment interventions. These studies found that individual items and domain areas of
the CPC maintained moderate to strong correlations with program effect size (Holsinger,
1999; Lowenkamp, 2004; Lowenkamp & Latessa, 2003, 2005a, 2005b; Shaffer, 2006).
The CPC is divided into two areas that contain a total of five domains. The capacity
area measures whether the treatment programs have the capability to deliver evidence-
based interventions for offenders. There are three domains in the capacity area: program
leadership and development, staff characteristics, and quality assurance. The content area
examines the substantive services that are provided by the program and focuses primarily
on whether the programs meets the principles of risk, need and responsivity. It includes
two domains: treatment and assessment.

Current study
Given the research that suggests that that the principles of effective intervention apply to
sex offender treatment, it is of interest as to whether the CPC is related to increases in
program effectiveness in programs that serve sex offenders. Although research on the CPC
has shown that it is related to significant reductions in recidivism at the program level
(Holsinger, 1999; Lowenkamp, 2004; Lowenkamp & Latessa, 2003, 2005a, 2005b; Shaffer,
2006), no research to date has examined whether it applies to correctional interventions
that serve sex offenders. The goal of the current research is to determine whether scores
on the CPC are correlated with reductions in recidivism using process and outcome
evaluations of eight halfway houses that serve sex offenders. As a result, the current
 CORRECTIONS: POLICY, PRACTICE AND RESEARCH 5

project extends prior research on evidence-based correctional programs by examining

whether factors that have been shown to be effective in general offending populations are
also effective at reducing recidivism in sex-offending populations.

Method
Sample and setting
The current research seeks to examine whether scores on the CPC are related to program
outcome. Data were gathered as part of a larger project that sought examine the process
and outcomes of all community correctional facilities in Ohio. The current research
utilizes a subset of the data and includes eight facilities that admitted sex offenders into
their program. All of the current programs reported providing sex offender treatment as a
major component of their program.
Separate outcome evaluations were conducted on eight community correctional facilities.
The outcome evaluations involved a quasi-experimental, matched pairs design and was used
to create program effect sizes. Measures from the CPC were gathered through process
evaluations that involved site visits to each of the programs. As a result, data from the process
evaluation provides scores on the CPC that can be used to predict program effect size.
Measures of program effect size were gathered using a quasi-experimental design that
matched a control group to a treatment group of sex offenders that were referred to the
programs. The larger project utilized a treatment group that consisted of all offenders referred
to the programs between February 1, 2006 and June 1, 2007. The current research utilizes only
those offenders in the treatment group that were convicted of a sex crime as the instant
offense. The control group consisted of sex offenders that were on community supervision
during the same time frame and were matched on county size, gender, race, and risk level.

Measures
Demographics
Demographic information was gathered for purposes of matching. These measures
include offense type, gender, race, county of conviction, and risk in the treatment and
comparison samples. These data, along with county size, were used to match the treatment
and comparison groups. As the reader can see from Table 1, matching was successful as
there were no differences across the groups for any of these measures. In total there are
266 treated offenders distributed across eight community correctional facilities. The
number of offenders in each program ranges from 10 to 72. Nearly three fourths of the
sample is White. Approximately 15% of the sample is low risk, three fourths of the sample
was considered moderate risk, and nearly 7% considered high risk. Table 1 also presents
validation statistics for the risk instrument. For low-, moderate-, and high-risk cases, 22%,
46%, and 67% of the sample was arrested, respectively. This stepwise increase in the rates
of recidivism produces a correlation of .21 with recidivism. Given the wide range of the
sample size for each program, the relationship between program effect size and sample
size was examined. These analyses revealed only weak and inconsistent relationships
between program effects and program size, suggesting that program size did not play a
role in the relationships examined here.
6 M. MAKARIOS ET AL.

Table 1. Descriptive statistics for the offender sample.

Tx Comp
Count (%) Count (%)
Halfway-House
Program A 66 (24.8) 66 (24.8)
Program B 20 (7.5) 20 (7.5)
Program C 18 (6.8) 18 (6.8)
Program D 72 (27.4) 72 (27.4)
Program E 57 (21.4) 57 (21.4)
Program F 13 (4.9) 13 (4.9)
Program G 10 (3.8) 10 (3.8)
Program H 10 (3.8) 10 (3.8)
Race
Black 71 (26.7) 71 (26.7)
White 195 (73.3) 195 (73.3)
Risk Level
Low 41 (15.4) 41 (15.4)
Moderate 207 (77.8) 207 (77.8)
High 18 (6.8) 18 (6.8)
Outcome
Arrest 100 (37.5) 144 (54.5)
χ2 = 14.65, r = .166
Incarceration 59 (22.1) 93 (34.9)
χ2 = 10.65, r = .141
Sex Offense 62 (23.3) 66 (24.8)
χ2 = .165, r = .018
Risk by Arrest Not Arrested Arrested
Low 64 (78) 18 (22.0)
Moderate 224 (54.1) 190 (45.9)
High 12 (33.3) 24 (66.7)
χ2 = 24.32, r = .214
Note. Tx = Treatment Group; Comp = Comparison Group.

CPC scores
Between August and December 2006 site visits and surveys were conducted at 64 of the
community correctional facilities for the larger Ohio study. CPC site visits entailed
conducting structured interviews with all treatment staff and administrators, observation
of group sessions, interviews of selected participants who attended programs, file review of
treatment cases, review of treatment protocols and review of program materials.
Researchers who conducted the site interviews held at least a master’s degree in a
human service profession and were trained on the administration of all data collection
instruments. During this process, information was gathered that was used to score the
programs on the CPC. Programs received overall scores as well as scores for each CPC
domain. Score percentages for the overall instrument and subdomains are then classified
into four categories: highly effective, effective, needs improvement, and ineffective. For
further information on the CPC, see Blair et al., (2016).
The first domain of the CPC is leadership and development. It consists of 14 items that
measure factors such as the experience and education of the program director, the stability of
funding, and whether the program is valued by stakeholders, to name a few. The domain of
staff characteristics consists of 11 items that measure factors such as the education and
experience of staff, frequency and consistency of staff meetings, and the amount of training
that staff receive. The domain of offender assessment consists of 13 items that measure the
programs assessment practices. Items include factors such as exclusionary criteria, the types of
risk and need factors assessed, and whether validated instruments are used to determine risk
 CORRECTIONS: POLICY, PRACTICE AND RESEARCH 7

and need level and responsivity concerns. The domain of treatment characteristics consists of
31 items that measure factors such as use of structured curricula, incorporation of rewards and
punishments, whether structured skill building is taking place, and whether the program has
aftercare as a component. The final domain of the CPC is quality assurance. It has eight items
that measure whether the program employs internal quality control mechanisms, whether it
engages in quality assurance for outside treatment providers, and whether it works with an
outside evaluator. Each domain of the CPC receives a rating based on the percentage of items
exhibited by the program. All domains are totaled to give the program an overall score.

Outcome
Upon release from the program, offenders were tracked for recidivism for 24 months.
Recidivism was measured in three ways: a new criminal arrest for any offense, a new
incarceration, and a new arrest for a sex offense. These three outcomes were chosen because
they were they were considered the most valid and reliable measures and follow previous
research (Maltz, 1984; Hanson et al., 2009; Lowenkamp, Flores, Holsinger, Makarios, &
Latessa, 2010). It is worth noting that 2 years is a relatively short follow-up period for sex
offenses, and the findings from the analyses that examine arrest for a sex offense should be
interpreted with this caveat in mind. The rates of recidivism of the entire sample (treatment
and control groups combined) is 46% for any arrest, 29% for incarceration, and 24% for sex
offense arrest. Table 1 provides the rates of recidivism for the treatment and control groups
separately. Chi-squared analysis suggest significant differences between the treatment and
control group in the percentage that experienced any arrest or incarceration. There is not a
significant chi-squared value for sex offense recidivism.

Effect sizes
After follow-up data were gathered, program level effect sizes were created by comparing
the recidivism rates between treatment and control groups. This was done to examine the
relationship between CPC items/domains and recidivism with sex offenders. Consistent
with prior research (e.g., Lowenkamp, Makarios et al., 2010), the effect size for the current
study represents the difference of the proportion of those offenders that recidivated
between the treatment and control groups. Average effect sizes for programs serving sex
offenders are compared by ratings on each CPC domain and by the overall CPC rating.
Bivariate correlations between the CPC scores and effect sizes are also examined.

Results
Overall effects
Table 2 presents mean effect sizes for all programs. The results for the arrest effect size
suggest that overall there was a 17 percentage point reduction in general recidivism for
community correctional programs that treated sex offenders. The confidence interval does
not fall around zero that suggests that this is a significant reduction in recidivism. For
incarceration the effect size of .128 suggests that the programs were modestly effective in
keeping offenders out of prison. Again the confidence interval for this effect size does not
include zero, which indicates that overall the programs were effective at reducing new
incarcerations. For arrests for a sexual offense, the effect size of .015 is small and the
8 M. MAKARIOS ET AL.

Table 2. Overall effect sizes.

Mean 95%
Effect Size Confidence Interval
Arrest .170 [.11, .32]
Incarceration .128 [.04, .21]
Sex offense arrest .015 [−.12, .19]

confidence interval does include zero that suggests that overall the programs did not
significantly reduce sex offense recidivism.
Figure 1 presents the effect sizes for each of the eight programs by recidivism measure.
This figure shows that six of the eight programs showed a positive treatment effect using
arrest as the recidivism measure. Likewise, just one of the eight programs showed a negative
treatment effect using incarceration as the recidivism measure; treatment effects did not
reach as high a level, but they consistently demonstrated a moderate treatment effect. Fewer
positive results were demonstrated when sex offense arrest was used as the recidivism
measure; just three of the eight programs demonstrated a positive treatment effect.

Effects by CPC domain rating

Table 3 presents effect sizes by CPC rating and correlations between rating categories and
effect size. Positive correlations indicate that increases in ratings are corresponding to
increases in effects size and negative correlations indicate increases in ratings are correspond-
ing with decreases in effect sizes. For the domain of leadership and development, the CPC
rating has moderate to strong correlations for all three effect sizes. For arrest, the correlation is
.482, for incarceration the correlation is .248, and for arrest for a sex offense the correlation is
.355. For the domain of staff characteristics, the effect size for arrest has a correlation of .371,

0.6

0.5

0.4

0.3
Effect Size

0.2

0.1

-0.1

-0.2

-0.3
A B C D E F G H
Arrest -0.03 0 0.06 0.13 0.14 0.15 0.4 0.5
Incarceration 0.15 -0.1 0.11 0.14 0.19 0.23 0.1 0.2
SO Arrest 0.08 -0.2 -0.17 0 0 0.15 0.4 0

Figure 1. Effect sizes for all programs.

Note. SO = Sex Offense.
 CORRECTIONS: POLICY, PRACTICE AND RESEARCH 9

Table 3. Effect sizes by Correctional Program Checklist (CPC) domain.

Number of Programs Arrest Incarceration Sex Offense Arrest
Leadership and Development
Highly effective 2 .228 .106 .117
Effective 3 .265 .208 .051
Needs improvement 3 .032 .064 −.041
Ineffective 0 — — —
r value 8 .482 .248 .355
Staff characteristics
Highly effective 6 .206 .114 .031
Effective 2 .055 .172 .038
Needs improvement 0 — — —
Ineffective 0 — — —
r value 8 .371 −.265 −.016
Quality assurance
Highly effective 2 .228 .106 .117
Effective 3 .208 .194 .077
Needs improvement 1 .140 .193 .000
Ineffective 2 .063 .019 −.100
r value 8 .365 .381 .467
Assessment practices
Highly effective 3 .203 .147 .129
Effective 2 .235 .176 .038
Needs improvement 0 — — —
Ineffective 3 .089 .077 −.067
r value 8 .315 .359 .477
Treatment practices
Highly effective 0 — — —
Effective 1 .500 .200 .000
Needs improvement 1 .056 .111 −.167
Ineffective 6 .132 .119 .072
r value 8 .564 .237 −.270
Overall rating
Highly effective 1 .056 .111 −.167
Effective 2 .450 .150 .200
Needs improvement 2 .062 .191 .115
Ineffective 3 .089 .077 −.067
r value 8 .390 .201 .157

however the correlation for incarceration and sex offense is –.265 and –.016, indicating that
for these latter two effects, increases in categorization resulted in reductions in effect size. For
the domain of quality assurance, correlations between CPC categorization and effect size are
all positive and moderate to strong. For arrest the correlation is .365, for incarceration the
correlation is .381, and for arrest for a sex offense the correlation is .467.
For the domain of assessment all of the correlations between CPC categorization and
program effect size are positive and moderate to strong. The correlation for arrest, is .315, the
correlation for incarceration is .359, and for arrest for a sex offense the correlation is .477. For
the domain of treatment practices, two of the correlations are positive and one is negative.
The correlation for arrest is .564, for incarceration the correlation is .237, but for sex offense
the correlation is –.270. It is worth noting that there is limited dispersion for the domain of
treatment characteristics. That is, six of the eight programs scored in the ineffective category.

Effects by overall CPC rating

The last series at the bottom of Table 3 presents effect sizes by overall CPC rating; Figure 2
presents a visual display of how the effect sizes vary by overall CPC rating. The
10 M. MAKARIOS ET AL.

0.5

0.4

0.3

Effect Size
0.2

0.1

-0.1

-0.2
Highly Needs
Effective Ineffective
Effective Improvement
Arrest 0.056 0.45 0.062 0.089
Incarceration 0.111 0.15 0.191 0.077
Sex Offense Arrest -0.167 0.2 0.115 -0.067

Figure 2. Effect size by overall rating.

correlations between CPC rating and effect size are all positive and modest to moderate in
strength. The correlation for arrest is .390, the correlation for incarceration is .201, and the
correlation for arrest for a sex offense is .157. Figure 2 indicates that except of for the
highly effective category, there are general increases in all three effect sizes as CPC rating
increases. That is, as programs increase from ineffective, to needs improvement, to
effective, program effect sizes also tend to increase. Worth noting, there was one program
that scored highly effective, and it did not produce effect sizes that were larger than the
programs that scored effective.

Discussion
Three important findings emerged from this research. The first finding is that the com-
munity correctional facilities that treated sex offenders displayed moderate reductions in
general recidivism and weak reductions in sex-offending recidivism. New arrests were
reduced on average by 16.8% overall, and new incarcerations were reduced by 12.8%. New
arrests for a sexual offense were only reduced by 3.3%.
The relatively small reductions in sex offense recidivism should be discussed. The
treatment group had just over three percentage points lower than their controls on
community supervision. This reduction in recidivism for community corrections facilities
is lower than those observed in other evaluations of sex offender treatment (see Hanson
et al., 2009; Losel & Schmucker, 2005). As noted in the Method section, the current study
had a follow-up time that was limited to 24 months. Other research that looks at sex
offending recidivism tend to have a longer follow-up (Hanson et al., report the median
follow-up time for programs in their meta-analysis as 4.7 years). Traditionally, studies of
sex offending tend to have a longer follow-up period than general offending because of the
longer time it takes for sexual offending to occur (Brake, 2011). That is, several studies
find that employing a follow-up period of fewer than 3 years finds very low recidivism
rates, and that increasing follow-up time substantially increases these recidivism rates (see,
e.g., Langan, Schmitt, & Rose, 2003). As a result most research suggest having follow-up
periods of at least 5 years (for a discussion, see Przybylski, 2006). The current research was
not able to use the longer follow-up times that prior research recommends, and this caveat
 CORRECTIONS: POLICY, PRACTICE AND RESEARCH 11

should be kept in mind when interpreting the results because it is possible that a longer
follow-up time could have yielded larger effect sizes.
The second noteworthy finding is that scores on the CPC were correlated with reduc-
tions in recidivism. Although the single program that scored highly effective only saw at
best modest reductions in recidivism, moving from ineffective to needs improvement to
effective was related to increases in program effect size. For example, for any arrest, the
reduction in recidivism was .45 for effective programs and .06 and .09 for needs improve-
ment and ineffective, respectively. The same results hold those arrested for a sex crime,
other than the highly effective category with one program, the sex offense effect sizes
decreases as overall rating improves. This suggests in most cases, that the CPC was able to
correctly classify programs in a manner that correlated with improved program outcome.
The above finding indicates that not only were the community correctional facilities in
this study able to reduce recidivism, but those that were rated as effective saw moderate to
large reductions in recidivism, those rated as needs improvement saw modest reductions
in recidivism, and those rated as ineffective saw at best weak reductions in recidivism. This
suggests that the positive relationship between CPC and outcome general treatment
programs found in prior research (Lowenkamp, 2004) can be generalized to community
correctional facilities that treat sex offenders. This is consistent with prior research that
has found that high fidelity, cognitive-behavior programming is effective at reducing
recidivism in sex offenders (see Olver et al., 2009). It also suggests that the CPC provides
a valid measure of the likely effectiveness of these programs.
The third and final noteworthy finding is that the domains of the CPC were found to have
varying correlations with recidivism. The domains of leadership and development, quality
assurance, and assessment practices were consistently found to have the strongest effects on
recidivism. For example, the domain of leadership and development was found to have a
correlation of .48 and .36 with the arrest and sex offense arrest effect sizes, respectively. Quality
assurance was correlated with arrest and sex offense arrest at .37 and .47, respectively. The
domain of assessment practices was correlated with arrest and sex offense arrest at .31 and .48,
respectively. The domain of treatment practices displayed some moderate to strong reductions
in recidivism but not as consistently. That is there was a correlation of .56 with arrest, and .24
with incarceration, but a –.27 with sex offense arrest. Finally the domain of staff characteristics
only displayed modest reductions in effect size for arrest (.37) and actually made things worse
with the other two effect sizes (incarceration = –.27 and sex offense arrest = –.16). It suggests
that in these data, the most predictive domains of the CPC were leadership and development,
quality assurance, and assessment practices.
The treatment domain is the largest on the CPC. Given this domain examines what
criminogenic needs are targeted in treatment and how these needs are targeted (i.e., the
model used, the services that support the program), it makes sense that when working
with sex offenders, predictors of sexual recidivism should be targeted as part of the
program if the hope is to reduce likelihood of sexual recidivism. Furthermore, given
that most programs scored in the ineffective range, the bulk of programs in this study not
only failed to incorporate aspects of RNR effectively, but may have also failed to incorpo-
rate sex offender specific targets and treatment strategies.
Caution should also be taken in the interpretation of the findings for the domain of
staff characteristics and treatment practices because both domains were marked by a
reduced dispersion of cases. In the staff characteristics domain, only two categorizations
12 M. MAKARIOS ET AL.

are used (highly effective and effective), and most cases fall into only one (highly effective).
The limited distribution of cases here may be the reason for the unstable/inconsistent
estimates observed. The same holds for the domain of treatment practices, except the
distribution is at the other end of the CPC categorization. As noted, six of the programs
scored ineffective, only one scored needs improvement, and one effective. It could be that
the negative effect size observed for sex offense arrest is due to having so many programs
scoring poorly and few scoring very well, because it created unbalanced estimates for the
programs that did well.
It is though important to note that the program that scored the highest did not have the
largest reductions in recidivism. That is, one program scored highly effective and yet only
produced weak effects on recidivism. There are two possible reasons for this. First, it could
be that the CPC is flawed and does not do a good job at ranking programs by effectiveness.
This is unlikely given the findings from this research. Rankings of all other programs did
produce moderate to strong corrleations with recidivism and there were stepwise changes
in effect sizes for the other categories of the CPC. The second possibility is that the
outcome evaluation did not produce accurate estimates of the program’s effectiveness. It is
worth noting that the sample size for this program was small (N = 36). It is reasonable to
expect that if there were more cases included in the evaluation that the program effect size
could substantially change. As a result, future research should seek to examine the
relationship between CPC scores and programs that serve sex offenders using larger
sample sizes.
Although the above findings are notable, it is also important to note the limitations of
this research. The first limitation is the external validity or generalizability of this study.
This research clearly identifies the population of offenders for this research as sex
offenders that attended treatment in a community correctional facility in Ohio during
the study period. As a result, replications of this research should be conducted in other
areas, states, and regions before generalizations are made beyond those observed here. The
findings of this research should be limited to sex offenders that attended community
corrections facilities in Ohio.
Another limitation to the study findings are the small sample sizes observed here, in the
number of programs, and in the some instances, the number of participants within each
program. There are a total of eight community correctional facilities examined in the current
study. Although this study is smaller than most major meta-analyses that report findings, it is
important to remember that this analysis of eight individual programs is a substantial
addition to the literature. It is also worth noting that in four of the programs, there are
fewer than 20 treatment cases examined. The small sample size of these programs may bias
the estimates, though no sample sizes with fewer than 10 treatment cases were allowed in this
study. Although the findings from the current research are compelling, future research
should seek to include more community correctional facilities with larger sample sizes.
It is also worth noting the quantitative nature of the data used for the current study.
The CPC is an actuarial instrument that gathers largely quantitative data. Although
quantitative data are necessary for the current analyses to examine correlations between
program effect size and CPC score, qualitative data would be helpful to tease out more
subtle differences between the programs and the services that they provide. Supplemental
qualitative analyses could help to better understand differences between effective and
ineffective programs and future research should seek to incorporate qualitative and
 CORRECTIONS: POLICY, PRACTICE AND RESEARCH 13

quantitative data to get a better picture of the differences between effective and ineffective
programs that serve sex offenders.
Despite these limitations, the findings from this research indicate that the community
correctional facilities in this study were able to reduce recidivism, and they performed the
best when they scored in the effective range on the CPC. As a valid indicator of program
success, the CPC thus provides agencies with an assessment which measures adherence to
evidenced based practices, identifying areas where the programs are doing well and areas
where there is need of improvement. Thus, from a program level, it provides an important
baseline for programs, helping to guide action planning and determine future priorities.

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