Module 9: Mentally Disordered Offenders

Lecture 2: Case Study: Vince Li

• On July 30th, 2008, Tim Mclean was killed while a passenger on a greyhound bus going to
Winnipeg
• He was sitting at the back of the bus sleeping when a fellow passenger stabbed him in
the neck and chest
• The attacker was 40 year old vince li who had immigrated to Canada from china in 2001
• The bus driver pulled the bus to the side of the road and passengers exited the vehicle
• At this time, li beheaded mclean, continued to cut and stab the victim and started
consuming his flesh (cannibalism)
• The RCMP arrived on scene and called for negotiators and a tactical team
• Li tried to escape the bus through a window and the RCMP arrested him
• At his trial in 2009, Li pled not criminally responsible on account of mental disorder
• A psychiatrist that assessed Li said that Li heard voices from God telling him to execute
Mclean
• Li was found not criminally responsible for the offender on account of mental disorder
(schizophrenia)
• Li was remanded to the Selkirk Mental Health Centre in Selkirk Manitoba
• Li was gradually allowed more freedom given that he was responding well to treatment
• Short term supervised visits to local community were phased into short term
unsupervised visits
• After spending time in group homes in the community, Li was given permission to live
independently in 2016
Lecture 3: Defining Mental Disorder
• What is mental disorder
o A mental disorder is
§ A syndrome characterized by a clinically significant disturbance to
cognition, emotions and behaviors
§ Reflects dysfunction of the psychological, biological or developmental
processes underlying mental functioning
§ Is usually associated with significant distress in one’s life (e.g., in social,
occupational, or other important activities)
§ Is not short-lived, but persists in an individual’s life for some time
• Diagnosing mental disorder
o Most common approach for diagnosing mental disorder is to us a diagnostic
manual (e.g. ICD or DSM)
o ICD is the International Statistical Classification of Diseases; DSM is the
Diagnostic and Statistical Manual of Mental Disorder
o The DSM is widely used in North America and is currently in its 5th edition
o The DSM is designed to facilitate the diagnosis of mental disorder and collect
prevalence data
o Developed by APA (PSYCHIATRIC ASSOCIATION NOT PSYCHOLOGICAL)
o The DSM has historically used a multi-axial system:
 § Axis 1
• Clinical disorders (e.g. schizophrenia); impact an individual’s
perception of reality, very serious impact on an individual’s life
§ Axis 2
• Mental retardation and personality disorders (e.g., antisocial
personality disorder)
§ Axis 3
• General medical condition
§ Axis 4
• Psychosocial and environmental factors (e.g., family problems)
§ Axis 5
• General Functioning
§ System was dropped in DSM-5, but still forensically useful
§ Why?
• Axis 1 disorders may be more relevant because they impact an
individual’s ability to form criminal intent
• Axis 1 disorder symptoms are more overt and therefore, police,
court and corrections better able to detect
Lecture 4: Interaction with the police and the Courts
• CJS and Mental Disorder
o Individuals suffering from mental disorders come into contact with the CJS
o Over-represent in terms of contact with the police, the courts and the
correctional system
o Over time, contact with the CJS appears to have increased
• Contact with the police
o De-instutionalization (1960-80) is one factor that has resulted in more contacts
between mentally ill individuals and police
§ 4 beds per 1000 population in 1964
§ 1 bed per 1000 population in 1979
o Police are now the “informal first responders of our mental health system”
(Adelman, 2003)
o Stigma around mental illness leads to the increasing involvement of police
o Consider the following
§ 2/5 people with mental illness have been arrested
§ 1/7 referrals to emergency services involve police
§ 1/20 dispatches/encounters involve mental health issues
§ 2/5 encounters with mentally ill don’t involve crime
§ Over-represented in shootings, taser incidents and deaths
§ (Brink et al., 2011)
o Conclusion
§ Most people with mental illness do not commit crimes
§ However, contat with police is common
 o Given limited training and resources, police are not always equipped to deal with
this; training and resources can make a positive difference (Brink et al, 2011)
• Contact with the courts
o Increased contact with the police usually means increased contact with the court
system
o Mentally disordered individuals who come into contact with the courts fall in 3
categories
§ Mentally disordered offenders (MDOs)
§ Those found unfit to stand trial
§ Offenders found not criminally responsible (NCRMD)
o Mentally disordered offenders (MDO) found unfit to stand trial or NCRMD do not
enter the criminal justice system
o They enter the mental health system if they go anywhere (they can be also given
absolute or conditional discharges)
COMMUNITY

POLICE

RELEASE PSYCHIATRIC FORENSIC RELEASE

COURT
EMERG ASSESS
CC
D G
CRM
DO/LTO
T/N
COMMUNITY UFS PROBATION

RELEASE PRISON/ RELEASE

HOSPITAL
RTC PEN

MENTAL HEALTH PAROLE

CRIM CODE
REVIEW/ PAROLE
REVIEW
APPEAL BOARD
BOARD

RELEASE RELEASE RELEASE

CIVIL MENTAL FORENSIC MENTAL CRIMINAL
HEALTH SYSTEM HEALTH SYSTEM JUSTICE SYSTEM
o (CMHS) (FMHS) (CJS)

Lecture 5: Fitness to Stand Trial and NCRMD

• Fitness to stand trial
o Involves an assessment of the current mental condition of the accused
o Goal is to determine whether condition interferes with ability to perform legal
tasks
o Evaluated at time of trial, only delays trial, doesn’t take away from
sentencing/being tried
o Section 2 of the criminal code
§ Unable, on account of having a mental disorder, to understand nature of
the proceedings, understand consequences of the proceedings or
communicate with counsel
o Mental disorder is necessary but not sufficient
o Assessment tools focus on section 2 issues
o Fitness Interview Test – Revised
§ Understanding the nature or object of the proceedings
§ Understanding possible consequences of the proceedings
§ Communication with counsel
• NCRMD
 o Insanity or responsibility is a legal concept not a medical or psychological one
o Definition is standard in Canada, but varies in other jurisdiction (e.g. the US)
o Retrospective assessment has to be conducted of the offenders’ state of mind –
assessment is done to look at the state of mind at the time of the offence
o R v. Swain (1991)
§ Not legally responsible while suffering from a mental disorder that
renders the person incapable of appreciating the nature of the act or
incapable of knowing the act was wrong
§ Mental disorder is necessary but not sufficient
o Assessment tools focus on retrospective responsibility
o Rogers Criminal Responsibility Assessment Scales
§ Patient reliability
§ Organicity (brain damage, mental retardation)
§ Psychiatric disorder (Axis 1)
§ Cognitive control (Awareness, abilities, planning)
§ Behavioral control
o If found NCRMD, three options – (Latimer & Lawrence, 2006)
§ Absolute discharge (13%)
§ Conditional Discharge (35%)
§ Detention within hospital (52%)
• How common is NCRMD
o What do we know about NCRMD in Canada? (Miladinovic & Lukassen, 2014)
§ NCRMD cases are very rare in Canada (<1%)
§ The rate of NCRMD cases has remained stable
§ Most (60%) NCRMD cases involve interpersonal crimes
§ Most common crime is major assault (20%)
§ Court case completion takes longer for NCRMD cases
• Features of NCRMD?
o Other features associated with NCRMD: - (Latimer & Lawrence, 2014)
§ 84% are male
§ Median age is 35
§ 42% have no prior convictions
§ 90% have no prior fitness or NCRMD issues
§ Most common disorder is schizophrenia (52%)
Lecture 6: Prevalence of Mental Disorders
• Contact with prisons
o Increased contact with police and courts, inevitably leads to increased contact
with correction system
o Teplin (1990) argues jail have become “a repository of the severely mentally ill”
o Data suggests that mental health issues are a concern in the correction system
• Mental disorder in Prisons
o Prevalence rates for mental disorders are higher in prison samples compared to
the community
 Prevalence of Mental Disorders in Federal Adult Males Mental Disorders in Prison vs. Community
Disorder Lifetime Within 1 Year Within 2 Weeks Disorder Current (1 month) Lifetime Community
Organic 0.1 n/a n/a (n=64) (n=138)
Psychotic 7.7 5.0 3.6 Mood 8.4% 21.8% 7.1%
Depressive 21.5 9.9 5.4 Schizophrenia/psychotic 3.5% 5.0% 0.5%
Anxiety 44.1 27.0 11.8 Anxiety 17.3% 1.0% 8.7%
Psychosexual 21.1 n/a n/a Substance abuse 5.9% 69.8% 32.5%
Antisocial 56.9 n/a n/a Adjustment 4.0% 0% -
Drug abuse/depend 40.9 13.1 3.0 (Brink, Doherty, & Boer, 2001; Structured Clinical Interview of DSM-IV; Canadian sample of federal offenders)

Alcohol abuse/depend 47.2 9.8 0.5

•
(Motiuk & Porporino, 1991; Diagnostic Interview Schedule; Canadian data)

Lifetime Prevalence of Mental Disorders by Type of Crime

Co-Morbidity of Mental Disorders
Disorder Homicide Manslaughter Robbery Sex Drugs Other
(337) (98) (498) (103) (105) (1044) Disorder None 1-2 >2
Organic 0.03 0.0 0.0 0.0 0.0 0.2 Schizophrenia 7.9% 36.8% 55.3%
Psychotic 10.7 11.2 8.0 5.8 3.8 9.2 Bipolar 5.9% 29.4% 64.7%
Depressive 29.1 30.6 19.3 36.9 12.4 21.1 Depression 5.5% 50.6% 43.8%
Anxiety 41.3 46.9 44.6 47.6 29.5 45.2 APD 10.9% 72.6% 16.5%
Psychosexual 23.7 26.5 18.5 31.1 15.2 22.7 Alcohol abuse 14.8% 68.8% 16.3%
Antisocial 45.4 44.9 71.5 42.7 36.2 41.7 Drug abuse 7.5% 70.5% 22.0%
Drug abuse 30.0 36.7 54.6 22.3 36.2 41.7 (Cote & Hodgins, 1990; n=1018; Diagnostic Interview Schedule; Quebec offenders)

Alcohol abuse 46.1 46.9 51.0 36.9 29.5 50.3

(Motiuk & Porporino, 1991; Canadian federal adult male offenders)

Personality Disorders in Prison by Gender

Mental Health Indicators in Federal Prisons (at Admission) Disorder Male Offenders Female Offenders
Disorder Women Men Total Paranoid 27% 27%
# % # % # % Schizoid 7% 5%
Prior diagnosis 52 21.8 394 10.4 446 11.1 Antisocial 65% 43%
Prescribed psychiatric medication 783 33.2 772 20.6 850 21.3 Borderline 18% 24%
Past psychiatric hospitalization 72 30.1 547 14.5 619 15.5 Histrionic 1% 4%
Psychiatric outpatient care in past 21 8.7 225 5.9 246 6.1 Narcissistic 10% 10%
(Public Safety Canada, 2009) Avoidant 9% 14%
Dependent 1% 4%
Obsessive-compulsive 7% 15%
(Roberts et al., 2008: UK male violent offenders; Warrant et al., 2002: US max security female offenders)

• Suicide in Prisons
o Prison can be v. stressful, especially intake
o Suicide is a serious problem in canadian prisons
o From 19994 to 2014, 211 suicides among federal inmates
o About 10 suicides/year in federal prisons
o Leading cause of un-natural death in prisons
o Most common method of suicide is hanging/suffocation
Lecture 7: Mental Illness and Violence
• Mental illness and violence
o Debate about the relationship between mental illness and violence
o At various points in the history of psychology researchers have argued both sides
o Based on current research literature, what can we say about this relationship
o The majority of individuals with mental health issues do not engage in violence
o Factors that predict violence in non-MDOs predict risk in MDOs (APD, Criminal
history, substance abuse)
o Some mental health issues might be protective factors rather than risk factors
o MDOs might be at higher risk compared to community, but lower risk compared
to non-MDOs
o Certain combinations, on mental health issues raise risk, particularly APD and
substance abuse
 o MDOs at heightened risk of engaging in violence when suffering from active
psychosis (vs. lifetime diagnosis)
o Certain symptoms are likely to increase risk of violence including threat/control
override delusions
Lecture 8: Assessment of Mentally Disordered Offenders
• Assessment
o Five areas of assessment are important
§ Fitness to stand trial (previous slides)
§ NCRMD
§ Mental health in prison
§ Suicide
§ Risk for violence
• Mental health assessment
o Many organizations use a two-stage approach for assessing mental health issues,
consisting of
§ Initial screening
§ More extensive evaluation if screening items are present
o Brief Jail Mental Health Screen
§ Do you currently believe someone can control your mind by putting
thoughts in your head or taking thoughts out of your head
§ Do you currently feel that other people know your thoughts and can read
your mind?
§ Are you currently taking any medication prescribed for you by a physician
for any emotional or mental health problems
§ … ect
• Suicide assessment
o Many agencies conduct suicide assessment at intake
§ Offender has made previous suicide attempts
§ Offender has undergone recent psych intervention
§ Offender has experienced recent loss (e.g., spouse)
§ Offender is experiencing major problems (e..g, legal)
§ Offender is currently intoxicated or high
§ Offender shows signs of depression
§ Offender has expressed suicidal ideation
§ Offender has a suicide plan
• Risk Assessment
o Various SPJ Assessment tools exist
§ HCR-20 (AUC > .70)
§ Short term Assessment of Risk and Treatability (START) (AUC > .80)
§ Structured Assessment of Protective Factors for Violence Risk (SAPROF)
(Accurately predicts non-recidivism)
o Similar factors predict risk in MDOs and non-MDOs
o Consider a meta-analysis conducted by Bontal et al, (2013) that compared the
predictive power of
 General personality and cognitive social learning variables (e.g. criminal
§
history)
§ Clinical variables (e.g. schizophrenia)
o Effect size associated with predictors of recidivism
Effect Sizes Associated with Predictors of Recidivism
Personality/Social d Clinical d
Variables Gen/Viol Variables Gen/Viol
Criminal history .34/.50* Psychosis .03/.09
Antisocial personality .41/.57* Schizophrenia -.14/.04
Antisocial attitudes .37/.51* Mood disorder -.16/-.08
Family/marital .38/.25* Intelligence .15/.00
Education/employment .28/.14* APD .54/.66*
Substance abuse .51/.20* MDO/non-MDO -.09/-.06
§ (Bonta et al., 2013; 126 studies from 1959-2011)

Very few of clinical variables were relevant, all social variables were
§
relevant (stars = relevant/large)
Lecture 9: Treatment of Mentally Disordered Offenders
• Some information is available about the sort of treatments being provided to MDOs
• Very limited research on treatment effectiveness for MDOs
• Meta-analytic research beginning to emerge on treatment elements and treatment
outcomes
• Treatment elements
o Heilburn et al, 1992, conducted survey of US forensic mental health institutions
(115 institutions contacted; 71% response rate)
§ What treatments do you use for specific disorders?
§ What % of patients receive particular treatments?
% of Institutions Reporting Treatments for Different Disorders % of Institutions Reporting Treatment (by Gender)
Disorders Treatment Male Female
Treatment Mental/ Violence/ Self- Sexual Substance
Emotional Aggression Injury Deviance Abuse Drugs 73.0% 71.0%
Drugs 92% 92% 84% 24% 43%
Social skills 47.7% 46.6%
Social skills 65% 57% 57% 51% 43%
CBT 35% 35% 38% 41% 24% CBT 30.6% 26.2%
Aversion 0% 3% 0% 16% 3%
Aversion 2.3% 0.5%
Anger control 16% 62% 32% 22% 22%
Individual therapy 78% 81% 84% 70% 70% Individual counseling 55.0% 61.7%
Group therapy 81% 68% 65% 65% 62%
Group therapy 68.5% 66.4%
AA 27% 14% 14% 16% 68%
o (Heilbrun et al., 1992) (Heilbrun et al., 1992)

o Conclusions
§ Some treatments are variably delivered based on nature of disorder (E.G.
AA for substance abuse)
§ Other treatments are delivered in a constant fashion across disorders
(e.g. CBT)
§ Delivery % varies dramatically (drugs common: aversion therapy rare);
consistent across all genders
• Treatment outcomes
o Morgan et al, (2012) conducted a meta-analysis on 26 studies obtained from a
review of 12,154 documents
o Examined a range of issues, including impact of treatment on various outcomes
o Results suggest that treatment of MDOs can result in positive outcomes
 Effect Sizes Associated with Various Treatment Outcomes
Outcome k ES 95%CI Effect
General mental health outcomes 15 .87 0.64-1.11 Strong
Coping 6 1.32 0.56-2.07 Very strong
Institutional adjustment 6 .57 0.34-0.80 Moderate
Criminal recidivism 4 .11 -0.47-0.69 Inconclusive*
Psychiatric recidivism 3 .42 -0.84-1.69 Inconclusive*
• (Morgan et al., 2012; * influenced by 1 large study with a negative outcomes)

• Other results
o Targeting both criminality and mental illness results in more positive effects than
treating either in isolation
o Treatments with open admission policy result in more positive effects than
closes admission policy
o The use of homework in treatment results in more positive effects than not using
homework
o Right sort of treatment and delievered in the right way (important – typology
and delivery)

Module 10: Female Offenders

Lecture 1: Female Offender Case Study
• Case Study: Ashley Smith
o Died of self-inflicted strangulation in 2007 while on suicide watch in federal
prison, 19 years old at the time
o She was on 24/7 suicide watch, at the time of her suicide
o Staff fired/charged with homicide (withdrawn late)
o Lawsuit, inquest, media interest (fifth estate)
• Ashley Smith’s Background
o Adopted, no reported childhood adversity
o Age 13/14 behavioral problems emerge, by age 15 appears before courts 14
times for minor offence
o Multiple school suspensions, multiple diagnoses (ADHD, learning disorder,
borderline, narcissistic)
o While in youth justice system, were 150 reported incidents of self-harm,
transferred to adult system when she turned 18, spent most of her time in
segregation, multiple transfers
• Typical female offender
o Abused/traumatized as child and or as adult
o Suffers from internalizing mental health problems (depression, anxiety, self-
harming behavior)
o But also has traditional criminogenic needs
o Lower risk to re-offend than male counterpart particularly in terms of violence
Lecture 2: Why should we care about Female Offenders?
• Low prevalence (females account for 2-9% of prison population worldwide), masks any
potential uniqueness eclipsed by the male majority (Blanchette & Brown, in press)
• Increasing numbers within prison system worldwide
 o Since 2000, 50% increase for women vs. 18% increase for men (Blanchette &
Brown, in press)
• To address sexist scholarship
o “even the female criminal is monotonous and uniform compared with her male
companion, just as the general woman is inferior to man … due to her being
atavistically nearer to her origin than the male” (Lombroso, 1895)
• Policy and Law Says we must:
o “women shall not automatically be excluded from research solely on the basis
of sex or reproductive capacity (Tri-council policy statement: Ethical Conduct for
Research Involving Humans)
o The corrections and conditional release act says “ the service shall… provide
programs designed particularly to address the needs of female offenders”
(Section 77, CCRA)
Lecture 3: The Nature of Female Criminal Conduct
• The Gender Gap in Crime – The nature of female criminal conduct (Brown, Blanchette,
Thapa, in press)
o The Gender Gap in crime – males account for vast majority of crime, particularly
violent crime
o Gender gap is widest for violent crimes
§ Homicides, robbery, rape, weapon offenders (9/10 are male offenders);
85% of serial killers are male
o Gender gap is most narrow for non-violent crimes
§ Shoplifting & writing bad checks (1/2 are female); welfare fraud ¾ are
females
• The nature of female-perpetrated violence
o Rare but when it occurs …
o Relational in nature (Again someone they know well)
o More often motivated by intense emotions (anger, jealousy, revenge) rather
than instrumental reasons (money)
• Filicide (the killing of one’s child)
o Filicide is commited equally by males and females
o But as age of victim decreases the likelihood that the mother perpetrated the
offence increases (younger the child = more change of mother having done it)
o Reasons: mental illness, single/young, low income
• Girls: No longer sugard and spice?
o Teen [15 year old girl] guilty of first degree murder in death of Stefanie Renger,
14” (CBC news, 2009)
o “Medicine hat man plotted with girlfriend [12 years old] to kill family” (CBC
news, 2008)
o “See Jane Hit: Why girls are growing more violent and what we can do about it”
• Are girls getting more violent?
o No
o Media sensationalizes rare and shocking cases
 o Victimization data does not support the media or official police data that shows
an increase in some areas (Assault)
§ Behavioural vs policy change hypothesis
Lecture 4: Theories of Female Offending
• Generalist theories vs. female-specific theories

Theories of Female Offending

Gender Female-
neutral specific

Relational
Learning & Evolutionary Pathways
cultural
psychodynamic /biology theory
theory

Generalist theories vs. female-specific theories

o
• Female specific theories
o Arose from feminist critiques of mainstream criminology
§ Sexist (biological explanations more important for women; environment
more important for men)
§ Women are invisible
o Grounded in feminist ideology, qualitative research and the “gender-difference”
hypothesis
• Pathway’s theory
o Childhood adversity/trauma leads to
§ Maladaptive coping strategies (running away, internalizing disorder,
substance abuse)
§ ‘survivalist’ coping strategies that are criminalized (prostitution, drug
dealing, robbery)
§ Inability to form and maintain healthy relationships
o Methodology matters – participant voice is critical
• The evidence says?
o Quantitative support for gender neutral theories
§ Correlated and predictors
o Qualitative support for female specific theories
§ Correlates and prevalence studies
o Emerging quantitative support for an integrated model
• Gender neutral vs female specific
o Gender neutral
§ Grounded in Social learning theory
§ Risk-Need-Responsivity (RNR)
§ Central 8
• Attitudes, Associates, history, personality, substance abuse,
marital/family, education/employment, leisure
§ What works: Meta’s
o Female Specific
 § Grounded in Pathways theory
§ Trauma informed
§ Central 9
• Abuse/trauma, addictions, relational dysfunction, mental health,
poverty, low self-worth, parental stress, safety concerns, female-
specific physical needs
§ What works: qualitative
o Recent trend: Less polarization, more integration
Lecture 5: Female Offender Risk Assessment
• Female Offender risk assessment issues
o Few tolls built from the ground up for females but growing:
§ SPIN- Service Planning Inventory for Women (SPIN-W Orbis Partners,
2007) – canadian consulting firm
§ Women Risk Need Assessment (WRNA; VanVoorhis, 2013)
o Do existing gender-neutral tools ‘work’ just as well?
§ Work pretty well, when using predictive accuracy as the bench mark for
success
• How do existing gender neutral risk assessment tools perform?
o Very well
o Meta-analysis of the Level of Service and its variant (Olver, Stockdale & Wormith,
2014)
§ 121 studies, 151 samples, 137 931 offenders (26 896 females)
§ LSI total score predicted accurately for both gender, in fact the total risk
score generated on the LSI predicted slightly better for women.
§ More specifically
• LSI total score predicts equally well for both genders
• Domain level differences
o Substance abuse and ‘personal/emotional’ are slightly
stronger predictors of recidivism for females
o Antisocial personality pattern predicts slightly better for
males
• Domal level similarities
o Education/employment, family/marital, financial,
accommodations, friends, leisure, attitudes
o Criticisms levied against gender-neutral tools:
§ Risk over-estimation: high risk female does not equal a high-risk male
§ Context is not captured – why is she high risk?
§ Following factors not sufficiently weighed:
• Family dynamics
• Transient living – group homes, streets
• Older, male peers/romantic partners
• Mental health factors (Anxiety/depression)
• Safety issues/children
 § LSI centric world limits female-specificity tests
• How are the SPIN-W and the WRNA performing?
o SPIN-W (AUC = .73, Robinson et al, 2012)
§ Sample gender-responsive items: child custody/ domestic violence issues
o WRNA (AUC= .70, VanVoorhis et al., 2013)
§ Sample gender-responsive items: self-efficacy, anxiety
Lecture 6: Female Offender Treatment
• Female offender treatment issues
o Gender responsive criticisms levied against the RNR model
o What does gender responsive mean?
o Risk need responsivity model vs gender-responsive model
§ Which one works best with female offenders
• RNR Criticisms (Blanchette & Brown, 2006)
o Cognitive behaviourism individualizes and decontextualizes women
o Responsivity principle is empirically derived (Meta’s)
o White middle-class men developed cognitive behaviourism
o Cognitive behaviourism dehumanizes women
o RNR model lacks conceptual resources
• Gender Responsive (GR) Models: Key Elements
o Holistic approach (criminogenic and non-criminogenic factors addressed
simultaneously)
§ Target addictions, be skills-based, enhance self-efficacy whilst dealing
with internalizing mental health issues
o Greater emphasis placed on ‘responsivity’ issues
§ Trauma informed, relational, female-only, strengths
§ Parental stress, empowerment focus, safety issues
o Multiple outcomes: recidivism reduction, healthy relationships restored
• What works? RNR or GR?
o Recent Meta-analysis (Gobeil, Blanchette & Stewart, 2016)
§ 37 treatment outcome studies, 22,000 women offenders
o Results
§ Odds of recidivism were 22 to 35% less likely for women who participated
in correctional treatment vs. those who did not
§ Findings were the same for programs classified as GR or Gender Neutral
(i.e. cognitive behavioural), BUT…
§ BUT... there was a moderator
• Methodological rigour
• Analysis of methodological rigorous studies only illustrated that
GR programs outperformed GN programs
• Caveat: several GR programs targeted substance abuse and
incorporated elements of cognitive behaviourism
• The message?
o The evidence supports an integrated approach rather than an either of strategy
• Remaining debate
o Most gender responsive scholars support the risk and specific responsivity
principles (mixed support for cognitive behaviourism)
o The big debate: what need factors should be targeted?
§ Gender responsive scholars-relational dysfunction, addictions,
abuse/trauma, mental health, empowerment
§ Gender neutral scholars – criminal attitudes and criminal associated