February 11, 2010

Skeem to give psychopathy training in Oregon

Save the date: Friday, April 9

On the heels of a hugely successful training featuring Stephen Hart of Simon Fraser University on sex offender risk assessment, Alexander Millkey and Michelle Guyton at Northwest Forensic Institute in Portland are doing it again. This time, they've scored Jennifer Skeem of the University of California at Irvine, who will provide advanced training on the controversial construct of psychopathy.

As many of you know, Dr. Skeem is an eminent scholar who has received the prestigious Saleem Shah Award for Early Career Excellence from the American Psychology-Law Society (APA Div 41) and the Distinguished Assistant Professor Award for Research at UC Irvine. She has published more than 70 scientific articles, chapters, and books, and is co-editor and an author of the excellent new book, Psychological Science in the Courtroom: Consensus and Controversy. Her research areas include psychopathy, violence risk assessment, and effective supervision strategies for individuals mandated for psychiatric care.

In this training, she will challenge prevailing assumptions that psychopathy is a unitary and homogeneous construct or something that can be reduced to a score on the Psychopathy Checklist-Revised (PCL-R). She will also present data challenging the deeply entrenched idea that people with psychopathic traits are incurable cases that should be diverted from treatment settings to environments where their behavior can merely be monitored and controlled.

The all-day training is on Friday, April 9 at Portland State University, and is followed by a networking reception with Dr. Skeem. Registrants will receive six hours of continuing education credits. The cost is only $175, or $75 for students.

For more information and to register, go to the Institute's website.

February 9, 2010

DSM-V: Get ready, get set . . . here it comes!

The American Psychiatric Association plans to launch its new DSM-V website tomorrow, February 10, publicly airing the long-anticipated diagnostic revision proposals and their criteria. I understand that two of the controversial forensic-related diagnoses I have blogged about extensively -- paraphilic coercive disorder and pedohebephilia -- are among those that made the draft manual.

Simultaneously, controversies grow on multiple fronts. On the one hand, we've got psychiatrists arguing that it's time to wrest the discipline back from all of those pesky non-psychiatrist interlopers. Writing over at the Psychiatric Times, Steven Moffic says the DSM-V should include an express clause saying only psychiatrists are qualified to use the manual.

Don't hold your breath. As long as psychiatrists keep charging many times the fees of other mental health practitioners, I guarantee that economic forces will keep Dr. Moffic's wish from coming true. Talk about trying to close the barn door after the horses are long gone!

Meanwhile, on the other side of the fence, the Association for Women in Psychology is saying, "Who wants it?" The Association has launched a new web site devoted to concerns about bias in the DSM-V diagnostic system. The site features a veritable link fest of criticisms, with articles on specific areas of diagnostic bias that will inordinately affect women, including anorexia nervosa, borderline personality disorder, female sexual dysfunction, and gender identity disorder.

Of particular relevance to forensic practitioners is an article critiquing parental alienation syndrome, proposed for the DSM-V, as well as articles on racism and social class bias in the diagnostic system.

Check it all out, folks. And if you disagree with anything you see, be sure to speak up now, before it's too late. The new manual, originally slated for publication in 2012, has been pushed back to May 2013, which may seem far away. But you only have two short months -- until April 20, 2010 -- to view the draft and make comments; after that, the website "will be available for viewing only." So much pseudoscience, so little time.

It's easy to register and make your comments. Whether the psychiatric gurus will listen is another story. But if you don't try, you'll never know.

Related resources:

Peter Aldhous, the award-winning science reporter covering the DSM debacle for New Scientist magazine, will be following up on his widely disseminated article, Psychiatry's Civil War, with a critical report on the latest developments. He is the guest on Michael Krasny's Forum on KQED radio on Wednesday (February 10); you can download the audio of "Updating Psychiatry's Bible" HERE.

February 3, 2010

What is a gang?

A group of violent thugs? A social club? Troubled, homeless losers who are "hard to love"?

And what is gang membership? Is it a fixed identity, or something fluid, which urban youngsters claim or don't claim according to external circumstances and the flow of their lives?

How can we explain why, even in the roughest neighborhoods, at most 10 percent of youths belong to street gangs? Who are the other nine out of ten, and how do they negotiate survival without affiliation?

For answers to these complex questions, and more, I recommend a new book from New York University Press, Who You Claim, written by John Jay College of Criminal Justice sociology professor Robert Garot based on ethnographic researcher at a continuation school in Southern Calfornia.

Garot's nuanced analysis is a refreshing antidote to the kind of simplistic categorization that we see in corrections and in forensic practice, where young people being processed through the system are treated as if the label of gang member explains everything that we need to know about them.

His bottom-line message: Beware reifying gangs as fixed and essential components of identity, when even their members do not see them as such. As urban centers create increasingly fluid possibilities for identity -- exemplified by Polish-Brazilian and Mexican-Korean cuisines -- identity is becoming much more malleable and flexible than such a narrow and pejorative focus would lead us to believe.

My complete review, at Amazon, is HERE.

January 31, 2010

The "juvenile sex offender": Myth in the making?

Book describes harmful effects of labeling and treatment

In the past 30 years, a vast cottage industry has sprung up to treat and warehouse juvenile sex offenders. Whereas in 1982 the United States had 20 programs to treat such youths, by 2002 that number had skyrocketed to upwards of 1,300 specialized programs, most of them private, for-profit residential centers. What is especially startling about the continuing expansion of this fledgling industry is that rates of serious offending, including sex offending, by juveniles is staying steady or even declining.

In The Perversion of Youth, forensic psychologist Frank DiCataldo says this new field may be harming both youth and society, by labeling typical delinquents as sexual monsters and thereby forcing them down a deviant path from which there is little hope of escape. In other words, our very process of labeling and treatment may breathe life into the bogeyman of our cultural imagination.

Like many failed social experiments, this one is driven by good intentions. But its underlying premises are based not on scientific evidence but on misguided faith and lore. DiCataldo, a psychology professor at Roger Williams University, meticulously presents the empirical evidence suggesting that the "juvenile sex offender" is not a natural category distinct from other delinquents. Rather, youths so labeled are typical delinquents whose offending happens to include a sex offense. And their sex offenses stem not from sexual deviance, but from a panoply of developmental factors, including sexual experimentation, thrill-seeking, poor social skills, emotional neediness, and rigid gender scripts that encourage sexual conquest as proof of masculinity.

In the past, many of the so-called sex offenses for which even young children are now being locked up and subjected to treatment would have been regarded as sex play, experimentation, or -- more seriously -- evidence of general criminality. In the overwhelming majority of cases, the natural course is for youths to mature out of sexual misconduct and other delinquency as they become adults, the data show.

Since only a tiny handful of youths who commit a sex offense are budding sexual deviants, the dominant treatment -- a one-size-fits-all, deviancy focused relapse prevention model -- is not helpful. In fact, by labeling normal adolescent boys as deviants, it may be very harmful, encouraging them to see themselves as the very monsters that the label makes them out to be.

DiCataldo is not peering down from an ivory tower. Long-time director of the Forensic Evaluation Service for the Massachusetts Department of Youth Services, he devotes special attention to the practices in the treatment trenches. Instead of taking the time to really see the individual adolescent for who he is, well-intentioned but dogmatic clinicians administer manualized treatment based on a “mind-boggling” array of unsupported global beliefs:
All adolescents who have committed an inappropriate sex act must receive this particular form of treatment; all juvenile sex offenders have a history of sexual victimization, and if you look deep enough, you will find it; adolescents must admit that their sexual abuse was traumatic and damaging; their denial must be broken down with persistent in-your-face confrontation; they must admit to deviant fantasies or hidden perversions and are provided fantasy logs in which to record them; … they must make their offense fit a stock, prefabricated dynamic involving the need for power and control or the presence of perversion or deviancy; they must face the fact that they have an incurable condition, like a chronic disease….
Ironically, he points out, the only empirically supported treatment for juvenile sex offenders, Multisystemic Treatment (MST), does not endorse these unproven tenets. Indeed, it does not even directly address sexual deviancy, instead focusing on client strengths and environmental supports in the family and community.

Like the misguided treatment programs, efforts to design instruments that will accurately predict which juvenile will go on to reoffend are also doomed to failure. It is not the fault of the instruments themselves, the author contends. Rather, because the base rates of sexual recidivism are so low (an estimated 5% to 15% across many studies), the most reliable prediction for any individual boy is that he will NOT commit a future sex offense.

In warning of the siren call of the sex offender narrative, DiCataldo echoes scholars such as James Kincaid and Philip Jenkins who have written about its alluring promise to simplify simplify the world and safely contain its dangers. But unlike in previous historical cycles of moral panic and sexual hysteria, he points out, this time around the pathologizing discourse of deviance is more securely embedded in systems such as the schools and the juvenile justice system. The ever-expanding and lucrative cottage industry devoted to juvenile sex offending has so firmly entrenched itself as a part of modern culture that, absent some serious attention to the lack of underlying science, it is unlikely to fade away anytime soon.

The author could have benefited from a good editor, as the presentation becomes repetitive. Still, in meticulously summarizing virtually all of the existing research and case law pertaining to juvenile sex offending, this well-researched book is an essential one-stop resource for anyone interested in understanding the contemporary phenomenon of juvenile sex offending.

So, here's a modest idea:

In recent years, a small-scale civil rights movement has emerged among mental patients, former mental patients, and their allies. One of their aims is to remove mental illness as the core construct of a person's identity. As such, they recommend not using terms such as "schizophrenic" as nouns to describe a person. Rather than calling someone "a schizophrenic," they would say: "A person with schizophrenia" or, even better, "a woman who has had some bouts of psychosis." I would love to see this applied in the sex offender field. Instead of calling a child "a juvenile sex offender," why not call him "a 15-year-old who engaged in sexual misconduct" or "a boy with a sex offense arrest"? As DiCataldo so thoroughly explains, within the current legal and treatment climate, the mere act of labeling a child as "A SEX OFFENDER" can effectively derail that person's life, potentially forever.

* * * * *

And, finally, I leave you with a related book recommendation:

The Trauma Myth, by Susan Clancy. The New York Times book review is HERE.

Related Amazon book reviews:

Photo credit: SOL Research

January 27, 2010

California training: Complex issues in SVP evaluations

California's Department of Mental Health has just announced an exciting training featuring several prominent psychologists in the sex offender field. The two-day training, March 9-10 in beautiful Seaside (by Monterey), features:

Dr. Robert Prentky, a psychology professor at Fairleigh Dickinson University in New Jersey and a leading researcher and practitioner in the field of sex offender risk

Dr. Howard Barbaree, Clinical Director of the Law and Mental Health Program at the Centre for Addiction and Mental Health in Toronto, a pioneer in the study of the mitigating effects of aging and treatment on sex offender risk

Dr. Richard Wollert, a sex offender evaluator and treatment provider in Washington State who has published cutting-edge work on the application of mathematical principles (such as base rates, probability theory and Bayes' Theorem) to risk assessment

Dr. Brian Abbott, a forensic psychologist in San Jose, California, whose recent published work critiques the scientific reliability and validity of actuarial tools used to assess sex offender recidivism risk

More information and online registration is available through the event's cosponsor, the College of Continuing Education at the California State University in Sacramento. The fee is a bargain -- only $100 including lunch, and they've negotiated a steeply discounted hotel rate as well. If you’re a psychologist, it's a great way to get up to speed on recent developments in sex offender risk assessment while earning six units of CE credits.

Kudos to the Sex Offender Commitment Program of the Department of Mental Health for organizing such an exciting training!

Click HERE for more information.

Also coming up in Seaside:

By the way, while I'm promoting conferences at the Embassy Suites in Seaside (pictured above), don't forget the Forensic Mental Health Association's annual conference there on March 24-26. I will be giving a training on "Ethical Considerations in Psychiatric Diagnoses in Forensic and Correctional Settings." They've also got an entire track on Competency to Stand Trial. The brochure and registration information are online HERE.

January 24, 2010

Whatever happened to the War on Drugs?

Can you believe that the War on Drugs has been raging for more than 40 years, ever since President Richard M. Nixon launched it way back in 1969? Talk about a war without end! And talk about casualties -- a massive prison industry that shoulders at least some of the blame for the current economic crisis here, where 46 out of 50 U.S. states are on the verge of bankruptcy.

Now, says Hugh O'Shaughnessy in an insightful article in the Independent of UK, the War on Drugs is quietly "being buried in the same fashion as it was born -- amid bloodshed, confusion, corruption and scandal."

The article, entitled, US waves white flag in disastrous 'war on drugs,' focuses on the disastrous consequences to Latin America of this long-running and unwinnable war, but it also points out the war's devastating economic impacts and suggests some positive uses for the billions of dollars currently being wasted on fruitless drug control efforts.
... US agents are being pulled from South America; Washington is putting its narcotics policy under review, and a newly confident region is no longer prepared to swallow its fatal Prohibition error. Indeed, after the expenditure of billions of dollars and the violent deaths of tens of thousands of people, a suitable epitaph for America's longest "war" may well be the plan, in Bolivia, for every family to be given the right to grow coca in its own backyard….

Prospects in the new decade are thus opening up for vast amounts of useless government expenditure being reassigned to the treatment of addicts instead of their capture and imprisonment. And, no less important, the ever-expanding balloon of corruption that the "war" has brought to heads of government, armies and police forces wherever it has been waged may slowly start to deflate.

Prepare to shed a tear over the loss of revenue that eventual decriminalisation of narcotics could bring to the traffickers, large and small, and to the contractors who have been making good money building and running the new prisons that help to bankrupt governments -- in the US in particular, where drug offenders – principally small retailers and seldom the rich and important wholesalers -- have helped to push the prison population to 1,600,000.….

Part of the reason for the slow US retreat from the "war" is that the strategy of fighting it in foreign lands and not at home has proved valueless. Along the already sensitive frontier with Mexico the effect of US attempts to enforce a hard line by blasting drug dealers away has been bloody.... In the areas of Mexico closest to the US frontier the toll of deaths in drug-related violence exceeded 7,000 people in 2009.... This takes the death toll over three years to above 16,000, figures far in excess of US fatalities in Afghanistan.….

As far back as last May, Gil Kerlikowske, the former police chief of Seattle who was named head of the US Office of National Drug Control Policy and thus boss of the campaign, announced he would not be using the term "war on drugs" any more. A few weeks earlier, former Latin American presidents of the centre and right … had told the new US President that the "war" had failed and appealed for greater emphasis on cutting drug consumption and the decriminalisation of cannabis.

For the lives and sanity of millions, the seeing of the light is decidedly late. The conditions of the 1920s, when the US Congress outlawed alcohol and allowed Al Capone and his kin to make massive fortunes, have been re-created up and down Latin America….

This year should be the year that common sense vanquishes the mailed fist in an unwinnable war against an invisible enemy.
Now, my main question is, Why am I reading about this in a British newspaper? Why isn't it front-page news here at home?

The entire Independent article, well worth reading, is online HERE. A 2008 Independent article, "Mexico’s war on drugs: Journey into a lawless land," is also online, excerpted from Richard Grant's book, Bandit Roads.

Photo credit: The Independent (2008)