The current study investigated the effect on recidivism of treatment aimed at juveniles who have sexually offended. It also assessed the potential moderating effect of type of recidivism, and several treatment, participant and study characteristics. In total, 14 published and unpublished primary studies, making use of a comparison group and reporting on official recidivism rates, were included in a multilevel meta-analysis. This resulted in the use of 77 effect sizes, and 1726 participants. A three-level meta-analytic model was used to calculate the combined effect sizes (Cohens d) and to perform moderator analyses. Study quality was assessed with the EPHPP Quality Assessment Tool for Quantitative Studies. A moderate effect size was found (d = 0.37), indicating that the treatment groups achieved an estimated relative reduction in recidivism of 20.5% as compared to comparison groups. However, after controlling for publication bias, a significant treatment effect was no longer found. Type of recidivism did not moderate the effect of treatment, indicating that treatment groups were equally effective for all types of recidivism. Also, no moderating effects of participant or treatment characteristics were found. Regarding study characteristics, a shorter follow up time showed a trend for larger effect sizes, and the effect size calculation based on proportions yielded larger effect sizes than calculation via mean frequency of offending. Implications for future research and clinical practice are discussed.
This multilevel meta-analysis examined the effects of treatment for juveniles with harmful sexual behavior on psychosocial functioning, and the potential moderating effects of outcome, treatment, participant, and study characteristics. In total, 23 studies, comprising 31 independent samples and 1342 participants, yielded 362 effect sizes (Cohen's d). A moderate overall effect size was found of d = 0.60, indicating that groups receiving treatment achieved an estimated relative improvement in psychosocial functioning of 33%. Type of outcome did moderate the effect of treatment, indicating that effects on atypical sexual arousal and empathy (a trend) were smaller, compared to effects on other outcomes. Most prominently, studies of weak quality produced larger effect sizes. Unexpectedly, non-established treatments had more effect than did established treatments, which may be explained by the use of less rigorous study designs. Treatment groups with a higher percentage of juveniles with similar age victims or mixed type problem behavior also yielded larger effect sizes. Lastly, evaluation of treatment effects by professionals produced higher effect sizes, compared to other sources of information (e.g., adolescent self-report). Although only a marginal to no indication was found for publication bias by means of funnel plot analysis of the distribution of effect sizes, articles published in peer reviewed journals showed relatively large effect sizes. Implications for future research and clinical practice are discussed.
The aim of this study was to compare results of and develop guidelines for mandatory allocation of sexually transgressive juveniles to Multisystemic Therapy - Problem Sexual Behavior (MST-PSB), Secure Youth Care (SYC), or Forensic Youth Care (FYC), based on the risk-need-responsivity model. Results of current allocation showed a population with relatively less treatment needs to receive community-based MST-PSB, compared with populations receiving residential SYC and FYC. Furthermore, estimated recidivism risk levels did not always support the need for risk reduction by the imposition of limitation of freedom of movement and maximum supervision, provided by all three treatment modalities. Based on the assessed sexual recidivism risk, 38% of the juveniles in FYC, 7% in SYC, and 24% in MST-PSB received treatment that was too intensive, which is considered detrimental to motivation and development. Future allocation practices could benefit from assessing treatment needs and recidivism risk, by use of an actuarial tool.
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