Patience is no virtue on MSOP injustice

A federal judge seems willing to give the state more time. There's scant evidence it will be used well.

Guest essay by D. J. Tice, Minnesota Star Tribune*

For many years, critics of the Minnesota Sex Offender Program have worried that this state may be guilty of cruel injustices.

They’ve worried that Minnesota’s sweeping, inconsistent system for dumping sex offenders who have completed prison sentences into so-called “treatment centers” may be imposing retroactive life sentences on some “clients” who pose no serious threat to the public, while giving them no effective treatment.

As of this summer, this is no longer a worry.

Now it’s a fact.

It took experts appointed by a federal court about two months to find what Minnesota officialdom has been unable to find in two decades — people buried alive in MSOP who have no earthly business there and should be released or transferred to another program.

And they’ve barely begun to look.

Unfortunately, a combination of legal complexities and deference toward state officials has caused even U.S. District Judge Donovan Frank to let injustice continue awhile longer. Earlier this month,Frank declined to release or transfer the MSOP inmates his experts had asked him to liberate. Instead, he ordered an expedited trial of class-action claims that the entire MSOP program is unconstitutional.

About 20 states have “civil commitment” programs like Minnesota’s. Most were enacted in the crime-plagued early 1990s out of legitimate fears that some habitual sex offenders are too dangerous to be released. But many of the other states with such programs regularly review clients’ cases and have developed less-restrictive forms of supervision for offenders who are less dangerous or are making progress in treatment.

In Minnesota, attempts to contain or reform MSOP have repeatedly become politicized. The result is that the state boasts the largest per-capita population of committed offenders in the nation (nearly 700, costing about $120,000 a year each), in a program offering nothing but prison-like incarceration and no serious path toward success in treatment and release. Just two clients have emerged in the program’s whole history.

Only last winter, Gov. Mark Dayton released a letter to his Department of Human Services, which runs MSOP, noting that he likes the program just fine the way it is and ordering the department to abandon its efforts to move some clients toward release. He cited “gamesmanship” by his political opponents as the reason.

Judge Frank seems rather less sanguine about MSOP. In February, as part of the class-action suit challenging the program’s constitutionality, he put four experts to work examining MSOP — including a sample of individual client files. They quickly brought forward two cases they wanted the judge to see right away.

One involves 24-year-old Eric Terhaar, who has been in MSOP for five years on the basis of offenses committed before he was 15. Insisting that a juvenile record of this kind should be viewed differently than adult sex crimes, the court experts unanimously insisted that “there is little evidence to suggest that Mr. Terhaar is a dangerous sexual offender … .” He should be “unconditionally discharged,” they said.

The other case brought to the judge is that of Rhonda Bailey, 48, locked inside MSOP since 1993 as the program’s only woman. Suffering an “intellectual disability,” a deeply troubled victim of abuse and trauma since childhood, Bailey, the judge wrote, is being “housed on the St. Peter campus of MSOP as the only female on a unit of all male high risk sexual offenders.”

The court’s experts, unanimously, have “exceptionally grave concerns” about Bailey’s “current housing and treatment scenario.” They declare her situation “unprecedented in contemporary sexual offender treatment and management … .”

This “unprecedented” achievement isn’t the sort of distinction Minnesota usually boasts of. The experts have a notion that Bailey, while clearly needing treatment and supervision, might do better in “a facility where she can receive care and treatment that is sensitive to both her gender and her clinical presentation.”

Suddenly, the state seems to think so, too. Confronted with the Bailey and Terhaar cases in hearings before Frank this summer, state officials are now apparently scrambling to find an alternative treatment setting for Bailey and to move Terhaar toward provisional release. (It’s also worth noting that lately state courts have been scrutinizing MSOP commitments more rigorously.)

For now, Judge Frank seems willing to be patient while the state’s processes unfold. On Aug. 11, he declined to find continued confinement of Terhaar and Bailey unconstitutional, but said he would revisit the questions if the state’s efforts prove inadequate.

Meanwhile, Frank wants to get on with the trial in the broader class-action case. Last week, he set Feb. 9 as the trial date.

“It is obvious,” Frank wrote in his Aug. 11 order, “that but for this litigation, Terhaar … would likely have languished for years in the prison-like environment of MSOP-Moose Lake without any realistic hope of gaining his freedom. And of course it is of great concern to the Court that this may not be an aberrant case [but] symptomatic of a larger systemic problem. … This concern is heightened by the experts’ opinion about the grossly inadequate — even shocking — treatment of Bailey … .”

There is as yet no explanation, the judge wrote, of “how this troubling state of affairs came about.”

That one’s easy, your honor. It came about because too many judges over too many years have been too patient waiting for Minnesota’s politicians to do the right thing.

* * * * *

*D. J. Tice is Commentary Editor for the Star Tribune, and is a member of the newspaper's Editorial Board. He has been a writer, editor and publisher in Twin Cities journalism for more than 30 years. A former political editor, he is the author of two books of popular history. This essay originally appeared in the Star Tribune on August 26, 2014 and was reprinted with the written permission of Mr. Tice. 

Previous guest coverage of the Minnesota civil commitment crisis by Minnesota social worker Jon Brandt can be found HERE.

Federal judge calls Minnesota civil commitment program “draconian”

State lawmakers remain in paralysis as judge threatens action

This is one in a series of on-the-ground reports from clinician Jon Brandt of Minnesota on the high-profile legal battle over the civil commitment of sex offenders in his state, a battle with potentially national repercussions. 

 

Guest post by Jon Brandt, MSW, LICSW*

Three weeks ago, a federal judge issued his long-awaited ruling in a civil rights case brought by civil detainees over the constitutionality of the Minnesota Sex Offender Program (MSOP). Although stopping short, for now, of declaring the program unconstitutional, the judge ordered new procedures to make release attainable for the 700 detainees. He warned that he may ultimately find the program to be unconstitutional if he determines that it is essentially punitive or if it confines men who are no longer dangerous. “The time for legislative action is now," wrote US District Judge Donovan Frank.

Now, in mid-March, with about eight weeks left in a short legislative session, Minnesota lawmakers are indicating that they are not likely to find bipartisan support to accomplish the reforms demanded by the federal court. If the state legislature adjourns without taking action, it seems likely that the US District Court will impose federal oversight.

Withholding "unconstitutional"

Fully aware that he is knee-deep in constitutional law and up to his neck in public antipathy, Judge Frank’s Feb. 20 ruling in Karsjens v. Jesson is a demonstration of judicial restraint. Judge Frank expressed several times in his 75-page decision that it is too early, in what will be protracted litigation, to rule on the constitutionality of any part of MSOP. However, his ruling leaves little doubt that he will hold the status quo to be an unconstitutional encroachment on civil liberties:

"[I]t appears that MSOP may very well be serving the constitutionally impermissible purposes of retribution and deterrence. … If, with the benefit of discovery, [the detainees] are able to demonstrate that the commitment statutes are systematically applied in such a way as to indefinitely commit individual class members who are no longer dangerous, or that MSOP is administered as a punitive system despite its statutory treatment purpose, Plaintiffs will likely prove up their claims."

Over the past two decades, more than 700 sexual offenders, deemed dangerous by state courts, have been sent to the program for treatment. Once there, detainees complain, disingenuous treatment and onerous program goals make release virtually impossible.

Judge Frank’s ruling appears to vindicate widespread complaints over conditions of confinement and concerns of civil liberties violations. Noted the judge:

"Whether or not the system is constitutionally infirm, without prompt action on the part of the legislature and [the state Department of Human Services], MSOP’s reputation as one of the most draconian sex offender programs in existence will continue."

Right to treatment?

Detainee at Moose Lake detention facility in Minnesota

If the position of the detainees can be reduced to the maxim that “no one has ever gotten out,” perhaps the State’s (defendant’s) position can be oversimplified to, “MSOP clients have no constitutional right to treatment.”   Judge Frank begged to differ with this latter position, expressing that legitimate treatment is, by judicial precedent, one of the essential constitutional underpinnings of civil detention programs for sex offenders (as distinct from criminal punishment). Judge Frank more than hinted at an ultimate finding in support of the detainees’ position, saying:

"Given the prison-like conditions described by Plaintiffs, and the lack of treatment and essentially no-exit regime alleged in this case, it may well be that, with a fully developed record, the Court will find the totality of the MSOP system to be unacceptably and unconstitutionally punitive."

He noted that it would be unconstitutional, under existing U.S. Supreme Court rulings, to operate a civil commitment program under the guise of providing treatment, if this is just “a sham or mere pretext,” and the true purpose is to punish.

Landmark ruling

Judge Donovan Frank

In his ruling, Judge Frank issued a landmark change, effectively shifting the burden of proof on how clients exit civil detention. Prior to this ruling, in order to gain release, detainees had to clear several tall hurdles. They had to prove they had completed the treatment program, demonstrate their readiness for community re-entry, and get the green light for release from two review panels. Under that scheme, in 20 years only two of more than 700 men gained even a conditional release. Citing substantial case law and programs in other states, Judge Frank turned that process upside down:

“It is unquestionable that commitment, at the outset, must be justified by law. Similarly, … continued commitment must also be justified. A statute that -- as written, as applied, or as implemented -- renders discharge from a sex offender civil commitment program more onerous than admission to it, such that individuals who no longer meet commitment criteria remain confined, raises grave due process questions. In that regard, the Court expresses serious doubts as to the constitutionality of Minnesota’s sex offender commitment statutes and their implementation through MSOP.

“Today, the Court finds that it is constitutionally mandated that only individuals who constitute a “real, continuing, and serious danger to society” may continue to be civilly committed to MSOP. See Hendricks, 521 U.S. at 372 (Kennedy, J., concurring). If the evidence demonstrates that MSOP systematically continues to confine individuals who are not 'a real, continuing, and serious danger to society,' then such confinement will be held unconstitutional."

State government paralyzed

A powerful amicus brief filed jointly by law professor Eric Janus and the ACLU of Minnesota is highly critical of the Minnesota program. Laying out relevant case law, the Brief claims that all three branches of Minnesota’s government have abdicated responsibilities for ensuring the program’s tenuous promises. The Brief observes that after the Federal Court advised the State Legislature in 2012 that urgent changes were needed, the 2013 Legislature failed to act; by executive order, the last two Minnesota Governors put constitutionally questionable moratoriums on releases; and state appellate courts have repeatedly failed to correct program deficiencies. 

Citing “massive deprivations of liberties,” and accumulating evidence that civil detention is punitive in nature, the Brief refers to the Minnesota experiment as an “utter betrayal.” If -- as now appears likely -- another legislative session expires without lawmakers taking action, there is little doubt that the federal court will intervene, perhaps as it did in the State of Washington .

Change coming to MSOP

To reassure, it is not the intent of this legal challenge that dangerous individuals be released into the community. Reforming MSOP is clearly a forensic minefield and Judge Frank has been deliberate in navigating solutions. Drawing on a critical 2011 report from the Minnesota Office of the Legislative Auditor, he appointed experts to conduct an initial review of MSOP. He also ordered the state’s Department of Human Services to assemble a Task Force of prominent stakeholders to explore program challenges and make recommendations. The Task Force issued their first report in December 2012 and their second report in December 2013.

In December 2013, in anticipation of his ruling, Judge Frank wisely appointed a team of four nationally recognized experts (identified in this previous blog) to help credibly guide the process. He asked both parties to the lawsuit, and the experts themselves, to identify the tasks and goals to which the “dream team” should endeavor, and then, leaving no doubt that change is coming to MSOP, Judge Frank’s order exceeded the cumulative list, and established priorities.

In addition to a complete review of the MSOP program, Judge Frank indicated that all current detainees will be reevaluated by independent experts to determine whether they currently meet criteria for civil commitment and, if so, whether they could be treated in less restrictive settings. He ordered reevaluations to begin with those likely to be most eligible for a reduction in custody. He even threw a bone to the 100 or so discouraged (or obstinate) detainees who have withdrawn from treatment:

“It defies reason that individuals who are comatose or otherwise completely incapacitated would be considered so dangerous as to require continued confinement in a secure, prison-like facility. Moreover, an individual who refuses to participate in treatment, but is no longer dangerous, cannot constitutionally continue to be confined in such a facility. See Foucha, 504 U.S. at 77.”

Judge Frank directed his final admonition to state administrators and the Minnesota Legislature, which just convened its 2014 session, stating that the time for “substantial changes” is now:

“If the evidence requires it, the Court will act. But it is the Minnesota Legislature that is best equipped to develop policies and pass laws -- within the limits of the Constitution -- that both protect public safety and preserve the rights of the class. The time for legislative action is now. Time and again, professional assessments have identified grave deficiencies in the program. Regardless of the claims raised in this case, and irrespective of the Court’s ultimate rulings on any constitutional questions with which it is presented, the interests of justice require that substantial changes be made to Minnesota’s sex offender civil commitment scheme.

“The program’s systemic problems will only worsen as hundreds of additional detainees are driven into MSOP over the next few years. The politicians of this great State must now ask themselves if they will act to revise a system that is clearly broken, or stand idly by and do nothing, simply awaiting Court intervention.”

In reserving a ruling of “unconstitutional,” Judge Frank has been shrewd in attempting to force Minnesota’s government leadership to the table.   If state leaders acknowledge the federal court directives, seize good research, understand the limits of forensic psychology, and muster the professional courage to marshal bold legislative initiatives, Minnesota could potentially develop a national model for the civil commitment of sex offenders. If not, Judge Frank has left little doubt that the US District Court for Minnesota will rebalance legitimate concerns of public safety, effective treatment, and civil liberties for those under civil commitment.

Either way, these proceedings are likely to contribute to the national debate about whether civil commitment can be effectively reconciled with sound public policy and constitutional law, or whether civil commitment schemes, now in place in 20 U.S. states, are fundamentally “preventive detention,” derived from “society’s opprobrium” of sexual offenders.

* * * * *

Judge Frank’s  ruling (HERE) is a compelling read for anyone interested in the civil commitment of sex offenders.

*Jon Brandt is a clinical social worker in Minnesota, for 35 years working in the prevention of sexual abuse. He provides evaluations, treatment, and supervision to sexual offenders, and professional consultation and training to colleagues. His previous post on this case, a report on the December 2013 federal court hearing, can be found HERE. To contact Mr. Brandt, click HERE. 

Research review II: Sexual predator controversies

Following up on last week’s research review, here are some new articles from the ever-controversial practice niche of sexually violent predator cases:

Facts? Who cares about the facts?!

Once a jury is empaneled to decide whether someone with a prior sex offense conviction is so dangerous to the public that he should be civilly detained, the verdict is a foregone conclusion. Dangerousness is presumed based on the prior conviction, rather than having to be proven.

Researchers Nicholas Scurich and Daniel Krauss confirmed this by giving jury-eligible citizens varying degrees of information in a Sexually Violent Predator (SVP) case and asking them to vote. Some mock jurors were told only that the person had a prior conviction for a sex offense. Others were also given information that the person had a mental abnormality that made him likely to engage in future acts of sexual aggression.

It mattered not a whit. The mock jurors voted to civilly commit at the same rate, whether or not they had heard evidence of current dangerousness.

“The mere fact that a respondent had been referred for an SVP proceeding was sufficient for a majority of participants to authorize commitment,’ the researchers found. “These findings raise concerns about whether the constitutionally required due process occurs in SVP commitment proceedings.”

No surprise, really. In this practice niche more than others, fear and hype often overshadow reason. Sex offenders are not the most appealing human beings, and no one wants to shoulder the responsibility of voting to release someone who could go out and rape or molest again.

The study is:

The presumption of dangerousness in sexually violent predator commitment proceedings, Nicholas Scurich and Daniel A. Krauss, Law, Probability and Risk. A copy may be requested from the first author (HERE).

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Sexual disorder diagnoses not reliable

Meanwhile, even when jurors do hear evidence of mental abnormality, it is not especially accurate.

Examining the diagnoses given to 375 sex offenders referred for civil commitment in New Jersey, researchers found “questionable” diagnostic reliability to be a widespread problem across the range of clinicians.

Pedophilia was the only diagnosis in which two evaluators were likely to agree at a level above chance. The rates of agreement were far worse for other disorders that are typically rendered in SVP cases, including “Paraphilia Not Otherwise Specified,” Sexual Sadism, Antisocial Personality Disorder and Exhibitionism. In fact, among the six cases in which Exhibitionism was diagnosed, there was not a single case in which both clinicians agreed.

The study, by Anthony Perillo of John Jay College and colleagues, adds to a burgeoning body of literature (some of which I’ve previously reported on) suggesting that psychiatric diagnoses in SVP evaluations are often dubious and not to be trusted.

The article is:

Examining the scope of questionable diagnostic reliability in Sexually Violent Predator(SVP) evaluations, Anthony D. Perillo, Ashley H. Spada, Cynthia Calkins and Elizabeth L. Jeglic, International Journal of Law and Psychiatry. A copy may be requested from the first author (HERE).

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Race bias in actuarial risk prediction

Okay, so the diagnoses aren’t reliable. But we’ve still got another tool of science up our sleeves -- actuarial risk assessment.

Not so fast.

As I’ve previously reported, the predictive accuracy of actuarial risk assessment tools is pretty wimpy. And now, researchers from Sam Houston State University are finding that the most widely used actuarial tool, the Static-99, doesn’t work at all with Latino offenders.

The findings are based on research with a large sample of about 2,000 sex offenders, almost 600 of whom were Latino.

“Findings have implications for fairness in testing and highlight the need for continuedresearch regarding the potentially moderating role of offender race/ethnicity in risk research,” note researchers Jorge Varela and colleagues.

The study is:

Do the Static-99 and Static-99R Perform Similarly for White, Black, and Latino Sexual Offenders? Jorge G. Varela , Marcus T. Boccaccini, Daniel C. Murrie, Jennifer D. Caperton and Ernie Gonzalez Jr. International Journal of Forensic Mental Health. To request a copy from the first author, click HERE.

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How to lie with statistics: “The Area Under the Curve”

Listen to any defender of actuarial risk prediction for a few minutes, and you will likely hear "Receiver Operating Characteristics” and “The Area Under the Curve” touted as indicators of statistical accuracy.

But in a new study in the Journal of Threat Assessment, two European scholars argue that these arguments are “fundamentally misleading.” Using the Risk Matrix 2000 instrument -- widely deployed in the United Kingdom -- as an exemplar, they found that a prediction of reoffense for an offender who scored in the “Very High Risk” range will be wrong an astounding 93 percent of the time.

“The numbers necessary to detain in order to prevent one instance of recidivism are large,” write David Cooke and Christine Michie. “On further reflection, from a statistical rather than a psychological perspective, should we be surprised? It has long been recognized that low-frequency events are hard to predict.”

The authors argue that the weak performance of actuarials is being systematically camouflaged by “statistical rituals” that are confusing and non-transparent, raising fundamental questions of fairness in legal decision-making.

The article is:

The Generalizability of the Risk Matrix 2000: On Model Shrinkage and the Misinterpretation of the Area Under the Curve. David Cooke and Christine Michie. Journal of Threat Assessment and Management. To request a copy from the first author, click HERE.

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Counterpoint

Not everyone agrees with Cooke and Michie’s analysis. One detractor is Douglas Mossman, of the Department of Psychiatry at the University of Cincinnati College of Medicine. Using a fictional scenario, he attempts to illustrate how "group data have an obvious application to individual decisions.” His paper goes on to argue that “misinterpretations of mathematical concepts and misunderstanding of the aims of risk assessment have led to mistakes about the applicability of group data to individual instances.”

The paper is:

From Group Data to Useful Probabilities: The Relevance of Actuarial Risk Assessment in Individual Instances. (Unpublished.) Douglas Mossman. Paper available online (HERE).

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Who is minding the store?

If nothing else, the above research snippets demonstrate the high level of controversy and complexity in the implementation of Sexually Violent Predator laws. If psychologists -- who must master psychometrics and statistics in order to earn our PhD’s -- have a hard time with these concepts, imagine how difficult it is for attorneys. With people’s lives at stake, do they have the knowledge base necessary to avoid being hoodwinked, and to educate jurors and judges?

In a new paper, prolific legal scholars Heather Cucolo and Michael L. Perlin of the New York School of Law argue that more stringent standards for representation are necessary for effective assistance of counsel in SVP cases.

They propose that counsel should be required to “demonstrate a familiarity with the psychometric tests regularly employed at such hearings, and with relevant expert witnesses who could assist in the representation of the client.” Furthermore, they argue for a pool of court-appointed experts who could be appointed at no cost, similar to those provided in insanity cases.

“There is no question that the population in question is the most despised group of individuals in the nation. Society’s general revulsion towards this population is shared by judges, jurors and lawyers. Although the bar pays lip service to the bromide that counsel is available for all, no matter how unpopular the cause, the reality is that there are few volunteers for the job of representing these individuals, and that the public's enmity has a chilling effect on the vigorous of representation in this area.”

The paper is:

'Far from the Turbulent Space': Considering the Adequacy of Counsel in the Representation of Individuals Accused of Being Sexually Violent Predators. Heather Cucolo and Michael L. Perlin. It is available online HERE.

Putting the Cart Before the Horse: The Forensic Application of the SRA-FV

As the developers of actuarial instruments such as the Static-99R acknowledge that their original norms inflated the risk of re-offense for sex offenders, a brand-new method is cropping up to preserve those inflated risk estimates in sexually violent predator civil commitment trials. The method introduces a new instrument, the “SRA-FV,” in order to bootstrap special “high-risk” norms on the Static-99R. Curious about the scientific support for this novel approach, I asked forensic psychologist and statistics expert Brian Abbott to weigh in.

Guest post by Brian Abbott, PhD*

NEWS FLASH: Results from the first peer-reviewed study about the Structured Risk Assessment: Forensic Version (“SRA-FV”), published in Sexual Abuse: Journal of Research and Treatment (“SAJRT”), demonstrate the instrument is not all that it’s cracked up to be.

Promotional material for an SRA-FV training

For the past three years, the SRA-FV developer has promoted the instrument for clinical and forensic use despite the absence of peer-reviewed, published research supporting it validity, reliability, and generalizability. Accordingly, some clinicians who have attended SRA-FV trainings around the country routinely apply the SRA-FV in sexually violent predator risk assessments and testify about its results in court as if the instrument has been proven to measure what it intends to assess, has known error rates, retains validity when applied to other groups of sexual offenders, and produces trustworthy results.

Illustrating this rush to acceptance most starkly, within just three months of its informal release (February 2011) and with an absence of any peer-reviewed research, the state of California incredibly decided to adopt the SRA-FV as its statewide mandated dynamic risk measure for assessing sexual offenders in the criminal justice system. This decision was rescinded in September 2013, with the SRA-FV replaced with a similar instrument, the Stable-2007.

The SRA-FV consists of 10 items that purportedly measure “long-term vulnerabilities” associated with sexual recidivism risk. The items are distributed among three risk domains and are assessed using either standardized rating criteria devised by the developer or by scoring certain items on the Psychopathy Checklist-Revised (PCL-R). Scores on the SRA-FV range from zero to six. Some examples of the items from the instrument include: sexual interest in children, lack of emotionally intimate relationships with adults, callousness, and internal grievance thinking. Patients from the Massachusetts Treatment Center in Bridgewater, Massachusetts who were evaluated as sexually dangerous persons between 1959 and 1984 served as members of the SRA-FV construction group (unknown number) and validation sample (N = 418). It was released for use by Dr. David Thornton, a co-developer of the Static-99R, Static-2002R, and SRA-FV and research director at the SVP treatment program in Wisconsin, in December 2010 during training held in Atascadero, California. Since then, Dr. Thornton has held similar trainings around the nation where he asserts that the SRA-FV is valid for predicting sexual recidivism risk, achieves incremental validity over the Static-99R, and can be used to choose among Static-99R reference groups.

A primary focus of the trainings is a novel system in which the total score on the SRA-FV is used to select one Static-99R “reference group” among three available options. The developer describes the statistical modeling underlying this procedure, which he claims increases predictive validity and power over using the Static-99R alone. However, reliability data is not offered to support this claim. In the December 2010 training, several colleagues and I asked for the inter-rater agreement rate but Dr. Thornton refused to provide it.

I was astounded but not surprised when some government evaluators in California started to apply the SRA-FV in sexually violent predator risk assessments within 30 days after the December 2010 training. This trend blossomed in other jurisdictions with sexually violent predator civil confinement laws. Typically, government evaluators applied the SRA-FV to select Static-99R reference groups, invariably choosing to compare offenders with the “High Risk High Needs” sample with the highest re-offense rates. A minority of clinicians stated in reports and court testimony that the SRA-FV increased predictive accuracy over the Static-99R alone but they were unable to quantify this effect. The same clinicians have argued that the pending publication of the Thornton and Knight study was sufficient to justify its use in civil confinement risk assessments for sexually violent predators. They appeared to imply that the mere fact that a construction and validation study had been accepted for publication was an imprimatur that the instrument was reliable and valid for its intended purposes. Now that the research has been peer-reviewed and published, the results reflect that these government evaluators apparently put the proverbial cart before the horse.

David Thornton and Raymond Knight penned an article that documents the construction and validation of the SRA-FV. The publication is a step in the right direction, but by no means do the results justify widespread application of the SRA-FV in sexual offender risk assessment in general or sexually violent predator proceedings in particular. Rather, the results of the study only apply to the group upon which the research was conducted and do not generalize to other groups of sexual offenders. Before discussing the limitations of the research, I would like to point out some encouraging results.

The SRA-FV did, as its developer claimed, account for more sources of sexual recidivism risk than the Static-99R alone. However, it remains unknown which of the SRA-FV’s ten items contribute to risk prediction. The study also found that the combination of the Static-99R and SRA-FV increased predictive power. This improved predictive accuracy, however, must be replicated to determine whether the combination of the two instruments will perform similarly in other groups of sexual offenders. This is especially important when considering that the SRA-FV was constructed and validated on individuals from the Bridgewater sample from Massachusetts who are not representative of contemporary groups of sexual offenders. Thornton and Knight concede this point when discussing how the management of sexual offenders through all levels of the criminal justice system in Massachusetts between 1959 and 1984 was remarkably lenient compared to contemporary times. Such historical artifacts likely compromise any reliable generalization from patients at Bridgewater to present-day sexual offenders.

Training materials presented four months before
State of California rescinded use of the SRA-FV

Probably the most crucial finding from the study is the SRA-FV’s poor inter-rater reliability. The authors categorize the 64 percent rate of agreement as “fair.” It is well known that inter-rater agreement in research studies is typically higher than in real-world applications. This has been addressed previously in this blog in regard to the PCL-R. A field reliability study of the SRA-FV among 19 government psychologists rating 69 sexually violent predators in Wisconsin (Sachsenmaier, Thornton, & Olson, 2011) found an inter-rater agreement rate of only 55 percent for the SRA-FV total score, which is considered as poor reliability. These data illustrate that 36 percent to 45 percent of an SRA-FV score constitutes error, raising serious concerns over the trustworthiness of the instrument. To their credit, Thornton and Knight acknowledge this as an issue and note that steps should be taken to increase reliable scoring. Nonetheless, the current inter-rater reliability falls far short of the 80 percent floor recommended for forensic practice (Heilbrun, 1992). Unless steps are taken to dramatically improve reliability, the claims that the SRA-FV increases predictive accuracy either alone or in combination with the Static-99R, and that it should be used to select Static-99R reference groups, are moot.

It is also important to note that, although Thornton and Knight confuse the terms validation and cross validation in their article, this study represents a validation methodology. Cross-validation is a process by which the statistical properties found in a validation sample (such as reliability, validity, and item correlations) are tested in a separate group to see whether they hold up. In contrast, Thornton and Knight first considered the available research data from a small number of individuals from the Bridgewater group to determine what items would be included in the SRA-FV. This group is referred to as the construction sample. The statistical properties of the newly conceived measure were studied on 418 Bridgewater patients who constitute the validation sample. The psychometric properties of the validation group have not been tested on other contemporary sexual offender groups. Absent such cross-validation studies, we simply have no confidence that the SRA-FV works at it has been designed for groups other than the sample upon which it was validated. To their credit, Thornton and Knight acknowledge this limitation and warn readers not to generalize the validation research to contemporary groups of sexual offenders.

The data on incremental predictive validity, while interesting, have little practical value at this point for two reasons. One, it is unknown whether the results will replicate in contemporary groups of sexual offenders. Two, no data are provided to quantify the increased predictive power. The study does not provide an experience table of probability estimates at each score on the Static-99R after taking into account the effect of the SRA-FV scores. It seems disingenuous, if not misleading, to inform the trier of fact that the combined measures increase predictive power but to fail to quantify the result and the associated error rate.

In my practice, I have seen the SRA-FV used most often to select among three Static-99R reference groups. Invariably, government evaluators in sexually violent predator risk assessments assign SRA-FV total scores consistent with the selection of the Static-99R High Risk High Needs reference group. Only the risk estimates associated with the highest Static-99R scores in this reference group are sufficient to support an opinion that an individual meets the statutory level of sexual dangerousness necessary to justify civil confinement. Government evaluators who have used the SRA-FV for this purpose cannot cite research demonstrating that the procedure works as intended or that it produces a reliable match to the group representing the individual being assessed. Unfortunately, Thornton and Knight are silent on this application of the SRA-FV.

In a recently published article, I tested the use of the SRA-FV for selecting Static-99R reference groups. In brief, Dr. Thornton used statistical modeling based solely on data from the Bridgewater sample to devise this model. The reference group selection method was not based on the actual scores of members from each of the three reference groups. Rather, it was hypothetical, presuming that members of a Static-99R reference group will exhibit a certain range of SRA-FV score that do not overlap with any of the other two reference groups. To the contrary, I found that the hypothetical SRA-FV reference group system did not work as designed, as the SRA-FV scores between reference groups overlapped by wide margins. In other words, the SRA-FV total score would likely be consistent with selecting two if not all three Static-99R reference groups. In light of these findings, it is incumbent upon the developer to provide research using actual subjects to prove that the SRA-FV total score is a valid method by which to select a single Static-99R reference group and that the procedure can be applied reliably. At this point, credible support does not exist for using the SRA-FV to select Static-99R reference groups.

The design, development, validation, and replication of psychological instruments is guided by the Standard for Educational and Psychological Testing (“SEPT” -- American Educational Research Association et al., 1999). When comparing the Thornton and Knight study to the framework provided by SEPT, it is apparent the SRA-FV is in the infancy stage of development. At best, the SRA-FV is a work in progress that needs substantially more research to improve its psychometric properties. Aside from its low reliability and inability to generalize the validation research to other groups of sexual offenders, other important statistical properties await examination, including but not limited to:

1. standard error of measurement
2. factor analysis of whether items within each of the three risk domains significantly load in their respective domains
3. the extent of the correlation between each SRA-FV item and sexual recidivism
4. which SRA-FV items add incremental validity beyond the Static-99R or may be redundant with it; and proving each item has construct validity. 

It is reasonable to conclude that at its current stage of development the use of the SRA-FV in forensic proceedings is premature and scientifically indefensible. In closing , in their eagerness to improve the accuracy of their risk assessments, clinicians relied upon Dr. Thornton’s claim in the absence of peer-reviewed research demonstrating that the SRA-FV achieved generally accepted levels of reliability and validity. The history of forensic evaluators deploying the SRA-FV before the publication of the construction and validation study raises significant ethical and legal questions:

• Should clinicians be accountable to vet the research presented in trainings by an instrument’s developer before applying a tool in forensic practice? 

• What responsibility do clinicians have to rectify testimony where they presented the SRA-FV as if the results were reliable and valid?

•  How many individuals have been civilly committed as sexually violent predators based on testimony that the findings from the SRA-FV were consistent with individuals meeting the legal threshold for sexual dangerousness, when the published data does not support this conclusion?

Answers to these questions and others go beyond the scope of this blog. However, in a recent appellate decision, a Washington Appeals Court questions the admissibility of the SRA-FV in the civil confinement trial of Steven Ritter. The appellate court determined that the application of the SRA-FV was critical to the government evaluator’s opinion that Mr. Ritter met the statutory threshold for sexual dangerousness. Since the SRA-FV is considered a novel scientific procedure, the appeals court reasoned that the trial court erred by not holding a defense-requested evidentiary hearing to decide whether the SRA-FV was admissible evidence for the jury to hear. The appeals court remanded the issue to the trial court to hold a Kelly-Frye hearing on the SRA-FV. Stay tuned!

References

Abbott, B.R. (2013). The Utility of Assessing “External Risk Factors” When Selecting Static-99R Reference Groups. Open Access Journal of Forensic Psychology, 5, 89-118.

American Educational Research Association, American Psychological Association and National Council on Measurement in Education. (1999). Standards for Educational and Psychological Testing. Washington, DC: American Educational Research Association.

Heilbrun, K. (1992). The role of psychological testing in forensic assessment. Law and Human Behavior, 16, 257-272. doi: 10.1007/BF01044769.

In Re the Detention of Steven Ritter. (2013, November). In the Appeals Court of the State of Washington, Division III. 

Sachsenmaier, S., Thornton, D., & Olson, G. (2011, November). Structured risk assessment forensic version (SRA-FV): Score distribution, inter-rater reliability, and margin of error in an SVP population. Presentation at the 30th Annual Research and Treatment Conference of the Association for the Treatment of Sexual Abusers, Toronto, Canada.

Thornton, D. & Knight, R.A. (2013). Construction and validation of the SRA-FV Need Assessment. Sexual Abuse: A Journal of Research and Treatment. Published online December 30, 2013. doi: 10.1177/ 1079063213511120. 

* * *

*Brian R. Abbott is licensed psychologist in California and Washington who has evaluated and treated sexual offenders for more than 35 years. Among his areas of forensic expertise, Dr. Abbott has worked with sexually violent predators in various jurisdictions within the United States, where he performs psychological examinations, trains professionals, consults on psychological and legal issues, offers expert testimony, and publishes papers and peer-reviewed articles.

(c) Copyright 2013 - All rights reserved

Legal challenge may force changes to Minnesota civil commitment

Guest post by Jon Brandt, MSW, LICSW

It has been 16 years since the U.S. Supreme Court narrowly upheld the constitutionality of controversial preventive detention schemes for dangerous sex offenders. Now, with 20 U.S. states incarcerating many thousands of men at an annual cost of more than $500 million, Minnesota has become Ground Zero for a new round of legal challenges alleging that the state’s treatment program is a sham from which no one is ever released. In this guest post, Jon Brandt gives a first-person report on last week’s momentous federal hearing.

U.S. District Court Judge Donovan Frank

SAINT PAUL, MINNESOTA -- On December 18 at the Federal District Courthouse, Judge Donovan Frank heard motions in a federal lawsuit that promises to dramatically change the civil commitment landscape in Minnesota and, by extension, around the country.

The case began modestly two years ago as a pro se complaint by about a dozen detainees at the Minnesota Sex Offender Program (MSOP).* The Federal District Court for Minnesota determined the case had merit, appointed counsel, and in 2012 Judge Frank certified it as a class action.  At a hearing last Wednesday, Dan Gustafson, lead attorney for the plaintiffs, argued motions alleging that civil commitment as administered in Minnesota is unconstitutional. 

An inauspicious start

When the court convened there was a sparse audience that included a few families of MSOP clients, a handful of reporters, and several professional stakeholders. Conspicuously absent were any plaintiffs.   Perhaps there’s some irony in the fact that, in 20 years, not only has no one ever been fully discharged from MSOP, apparently all current clients are too dangerous for any of them to be shackled and accompanied by security personnel to a federal courtroom to hear arguments on the conditions of their own confinement. Given that courtrooms are designed to contain dangerous people, whether the decision to exclude clients was made by executive or judicial authorities, it seems like a missed opportunity to allow some representative plaintiffs to bear direct witness to the wheels of justice.   

The hearing had an inauspicious start for the 698 plaintiffs civilly detained 90 miles away – the audio feed via phone lines failed. So, after waiting 15 years for the courts to reconsider their plight, the plaintiffs missed the first hour of legal arguments.   When the audio connection was finally restored, Judge Frank assured wary plaintiffs that the technical problems were not deliberate, and personally took responsibility.
The hearing began with attorney Gustafson arguing for “declaratory judgment,” or a legal finding that the state’s civil commitment program is operating in an unconstitutional manner.   He cited case law that clients have a constitutional right to rehabilitation and claimed that the program breaches civil liberties and offers neither adequate rehabilitation nor acceptable living conditions.

No one ever released

Detainee at Moose Lake MSOP facility

The state’s attorney, Assistant Attorney General Nate Brennaman, countered that the program does provide appropriate treatment, that there is no constitutional right to treatment, and that the plaintiffs are basing their entire case on a single fact, “That no one has ever gotten out.”

Gustafson seemed amused that the defense was making his case. The fact that no one is released is strong evidence, he asserted. He pointed out that nearby states have far better track records. Wisconsin, with demographics nearly identical to Minnesota’s, has civilly committed only 351 people, and nearly half are now on either conditional or full release. Iowa has committed only about 103 people, and about 30 of those have been provisionally or fully released. He pointed out that treatment which was originally estimated to be completed in 32 months is now anticipated to last eight to nine years. Not a single one of the more than 700 individuals (including one female) who have been detained has ever completed the treatment program, and only one is on conditional release.

The plaintiff next argued for a court order mandating that each detainee be individually evaluated to determine whether he might safely be released to a “less restrictive alternative,” or LRA.

Judge Frank peppered the hearing with comments and questions that frequently interrupted attorneys on both legal teams, and also gave clues to his persuasion.   Noting that Justice Kennedy was the swing vote in the 5-4 ruling in Kansas v. Hendricks, he read a passage from Kennedy’s concurring opinion whereby Kennedy cautioned that “an improvident plea bargain” by the criminal justice system cannot be remedied by the civil commitment system, and that retribution is exclusively within the domain of criminal justice. Judge Frank also raised concerns about 18 infirmed clients (one who is 91) who require assisted living and questioned the “dangerousness” of such relatively incapacitated clients. He also questioned conditions of confinement that mimic prison. When the state’s attorney argued that conditions of criminal versus civil confinement had been decided by the US Supreme Court in the 1982 Youngberg v. Romeo case, Judge Frank interrupted with, “No, it wasn’t… but continue.”

Judge Frank expressed concern that most of the clients at the MSOP were still in the first phase of treatment, and twice pointed to his understanding that treatment progress is not only slow but that some clients are apparently sent back to redo previous phases. He also seemed concerned that detainees get less treatment than sexual offenders incarcerated in state prisons. He pondered rhetorically, “How much treatment is enough,” and questioned how the “Youngberg standard” of professional judgment might determine completion of treatment.

Motion for federal oversight

Moose Lake

The plaintiffs’ third motion was for the appointment of a “special master” and federal supervision of both the facility and the system. A special master is an administrator who would oversee MSOP operations and implement federal court directives. The state’s attorney responded that clients are getting effective treatment at MSOP, that treatment is subject to quarterly reviews, which is more stringent than other states that only require annual reviews, that MSOP has filled most of its open clinical positions, and that there is nothing that a special master could do that isn’t either already being done, or that DHS couldn’t manage if so directed by the federal court.

If Judge Frank grants the first motion, finding conditions unconstitutional, the other two motions might be automatic -- MSOP could be put under federal supervision in a similar manner as the state of Washington from 1994 to 2007. 

Judge Frank confirmed that on December 6 he appointed four sex offender treatment experts to guide the proceedings, under Federal Court Rule 706 . The four experts are: 

• Mike Miner, Professor and Research Director of the Program in Human Sexuality at the University of Minnesota Medical School

• Naomi Freeman, who leads New York’s unit for Strict and Intensive Supervision and Treatment that manages civilly committed individuals outside of secure facilities

• Deborah McCulloch, director of Wisconsin’s sex offender civil commitment program, and 

• Robin Wilson, former clinical director at the Florida sex offender civil commitment program from 2006 to 2011, during which time there was a class action and settlement

Judge Frank seems to have exercised judicial restraint over the two years since the original complaint was filed. In an effort to prod state government, in 2012 he ordered the establishment of a special task force  to make recommendations to the state legislature. The Task Force held several hearings and collected relevant documents. It issued its first report in December 2012, with general recommendations for public-private partnerships to establish a statewide network of less restrictive alternatives. The report echoed critical findings by the Minnesota Office of the Legislative Auditor in 2011. Unfortunately the state legislature adjourned in May 2013 without enacting legislative changes. 

Events may force action

Wednesday’s motions, the critical reports, and two other events in 2013 will likely force Judge Frank to act soon. Last summer Dr. Grant Duwe, chief researcher for the Minnesota Department of Corrections, published research that challenges the government’s foundational claim that civil detainees are “highly likely” to reoffend. Duwe’s research indicates that most of the detainees are highly likely to NOT reoffend.   

Then, last month, Minnesota Governor Mark Dayton issued an executive order that continued the eight-year moratorium of his predecessor -- that there will be no further releases of clients from MSOP, except by court order. With this abdication of executive oversight, all three branches of the state government seem to be in perpetual paralysis. 

Minnesota’s government is managing the Sex Offender Civil Commitment program (SOCC)  like holding a wolf by the ears -- don’t want to hold on and afraid to let go.   Modest reforms that are in progress at MSOP are being sabotaged by systemic failures. Clinical staff have the impossible job of trying to maintain the integrity of endless treatment goals for clients trapped in a treatment paradox and have come to realize that the promise of rehabilitation is disingenuous.

Legal scholar Eric Janus

One of the highly principled critics of SOCC who is likely to be vindicated by imminent rulings from Judge Frank is Eric Janus. Janus is the President and Dean of the William Mitchell College of Law, and author of, “Failure to Protect; America’s Sexual Predator Laws and the Rise of the Preventive State” (Cornell University Press, 2006). Janus led an unsuccessful challenge to SOCC before the Minnesota Supreme Court in the 1990s. Since then, he has been warning that the SOCC, as public policy, is deceptively enticing, deeply flawed, and destined to overreach its stated intent. Janus was also a member of the Minnesota SOCC Task Force. 

Judge Frank indicated that he will accept a joint amicus brief from Janus and the ACLU, due Dec. 27, and will rule on the motions within 60 days.

My take is that the federal courts can no longer ignore repeated judicial admonishments; if the SOCC begins to look like retribution or prison in disguise, the courts will intervene. With precedence in the state of Washington, Judge Frank seems poised to put MSOP under federal supervision. Depending on the strength of any finding of “unconstitutional,” the ruling could have far-reaching implications that echo around the United States.    

Relevant legal cases:

*Karsjens, et al. v. MN Department of Human Services, et al., CV 11-3659 DWF/JJK

Foucha v. Louisiana, (90-5844), 504 U.S. 71 (1992).

Strutton v. Meade, (10–2029) 668 F.3d 549, US Court of Appeals for the Eighth Circuit (2012)

Youngberg v. Romeo, (80-1429) 457 U.S. 307 (1982)

Call v. Gomez, 535 N.W.2d 312, Supreme Court of Minnesota (1995)

Seling v. Young (99-1185) 531 U.S. 250 (2001)

Jon Brandt is a clinical social worker in Minnesota, for 35 years working in the prevention of sexual abuse. He has provided evaluations, treatment, and supervision to several hundred sexual offenders, and provided professional consultation and training to colleagues. He is a Clinical Member of the Association for the Treatment of Sexual Abusers (ATSA) and is a blogger for ATSA’s website, Sexual Abuse: A Journal of Research and Treatment.   In February 2012 his post, “Doubts about SVP Programs,” was re-blogged here.