The working alliance has been extensively studied and consistently linked to improved treatment outcomes; however, existing reviews have almost exclusively focused on non-forensic samples, which differ significantly in client characteristics, treatment goals, and settings. Therefore, prior reviews may not generalize to forensic contexts. Seeking to fill this gap in the literature, a meta-analysis of the working alliance in forensic treatment contexts was conducted and its relationship to risk-relevant treatment outcomes was examined featuring k = 21 unique studies. All three treatment outcomes examined-treatment dropout (d = 0.390), institutional misconduct (d = 0.374), and community recidivism (d = 0.196)-were significantly and negatively associated with the working alliance. These findings demonstrate the working alliance as a meaningful predictor of treatment outcomes in forensic contexts. Implications for research and practice are discussed to promote more favorable treatment outcomes for forensic clients.

Voyeurism has been, and continues to be, a growing problem worldwide, particularly with the rise of technology. Yet, unlike many other sexual offences, the characteristics and risk factors associated with voyeurism remain underexplored. Using a sample of UK men (N = 492), Study 1 examined sexual arousal, proclivity, and engagement in voyeurism in the general population. Results indicated that 32.30% reported engaging in voyeurism, supporting the suitability of the sample for further investigation. Study 2 sampled UK men (N = 513) and categorised participants into three groups: (1) no desire or engagement, (2) desire without engagement, and (3) engagement in voyeurism. Groups differed across several psychological measures. A structural equation model demonstrated that sexual interest in voyeurism strongly predicted engagement, with sexual compulsivity and socio-relational factors (loneliness, self-efficacy in romantic relationships, and resilient coping) also playing important roles. Findings are discussed in relation to the aetiology of sexual offending and implications for practice. PRACTICE IMPACT STATEMENT Findings suggest that sexual interest in voyeurism may be a key factor in engagement, with sexual compulsivity and socio-relational variables (e.g. loneliness, relationship self-efficacy and coping) also playing a role. Practitioners may wish to consider these factors in assessment and intervention, while recognising that further research is needed to confirm their clinical utility.

This study examined the discrimination and calibration properties of Violence Risk Appraisal Guide-Revised (VRAG-R) scores and risk bins in a sample of 124 forensic psychiatric inpatients found Not Criminally Responsible on Account of Mental Disorder (NCRMD) or Unfit to Stand Trial (UST), admitted under Saskatchewan Review Board jurisdiction during a 38-year catchment period. The VRAG-R was scored on all NCR and UST individuals from file, and recidivism data were obtained via official criminal records. The VRAG-R demonstrated strong discrimination properties for general and violent recidivism over 3-year, 5-year, and overall follow-ups. Calibration analyses revealed that VRAG-R recidivism norms tended to estimate higher rates of recidivism than actually observed. Overall, the results supported the use of the VRAG-R for psychological risk assessments with a population of persons found NCRMD; however, it should be a multi-measure process that involves other empirically validated tools.

The present study examined the development of updated risk levels and recidivism rates for the Violence Risk Scale-Youth Version (VRS-YV), a dynamic violence risk assessment and treatment planning tool, in a diverse Canadian sample of 404 court-adjudicated youth followed up an average of 8.6 years in the community. VRS-YV scores and those from a set of convergent measures of risk and protection were obtained from Court and Treatment file ratings; recidivism outcomes were obtained from criminal records. The distribution, discrimination, and calibration properties of VRS-YV scores were examined among Indigenous ethnoracial and gender groups to inform the development of evidence-based risk levels and violent recidivism rates associated with VRS-YV scores, applying the common language five-level framework. VRS-YV dynamic and total scores demonstrated good discrimination with medium to large effects in the prediction of violent and general recidivism across Gender × Ethnoracial groups. VRS-YV score percentile ranks and hazard ratios were used to identify numeric score cutoffs to inform risk categories, while violent recidivism rates associated with VRS-YV score categories were generated from logistic regression. Discrimination findings suggested common numeric score risk band cutoffs across gender and ethnoracial groups, while calibration findings suggested gender stratified violent recidivism norms and minor variations in labeling the uppermost risk categories for female youth. Convergent validity analyses supported the construct validity of the five risk levels. Implications for using the common language-based framework with the VRS-YV to drive risk management and violent prevention efforts as a function of gender and ethnocultural heritage are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The Hare Psychopathy Checklist (PCL-R) is the most widely used tool for the clinical assessment of psychopathy, and Robert Hare has contributed importantly in championing evidence informed treatment and risk management approaches for this population. We critically examine the treatment of psychopathy both in terms of what works and what has been shown not to work, through the lens of the PCL-R. We argue that a coherent and reliable operationalization of psychopathy, vis-à-vis the Hare PCL-R, has facilitated identifying the population of interest to be targeted for treatment services and has also aided the identification of the primary treatment objectives and approaches for this population. We begin by reviewing historical pessimism regarding the treatment of psychopathy and early seminal reviews. We then turn our attention to an integration of the Risk, Need, Responsivity principles and PCL-R measured psychopathy—termed the 2-Component Model as first introduced by Wong et al. (2012)—for the treatment of psychopathy and what treatment strategies may work for psychopathic correctional and forensic mental health populations. Extant research findings, current clinical practices, and future directions for the incorporation of the PCL-R into RNR-based treatment of psychopathy are discussed.

The present study examined the psychopathy-substance abuse nexus in a diverse Canadian sample of 420 justice-involved youth. The Psychopathy Checklist Youth: Version (PCL: YV) and a series of clinical and criminogenic substance abuse variables-assembled into a composite score that was corrected for missing indicators-were rated from court and treatment files and community recidivism was captured from criminal records. PCL: YV total, lifestyle, and antisocial facet scores showed strong convergence with clinical and criminogenic substance abuse indicators. Cox regression survival analyses demonstrated that certain indicators and the corrected composite incrementally predicted violent and general recidivism, controlling for PCL: YV total score across gender and ethnoracial groups. Kaplan-Meier survival analyses demonstrated that high psychopathy youth with medium or high substance-related concerns had steeper recidivism trajectories than low psychopathy youth with similar substance concerns. Results underscore the clinical and risk relevance of substance abuse and its intersection with juvenile psychopathy.

The present study examined the intersection of risk and protective factors and their associations with sexual, violent, and general recidivism in a treated multisite correctional sample of men (N = 405) with sexual offense conviction histories. Three measures of protective factors-Structured Assessment of Protective Factors, Protective Factors List, and Structured Assessment of Protective Factors-Sexual Offence version-were rated at pre- and posttreatment from detailed institutional files. Violence Risk Scale-Sexual Offense version and Static-99R were examined for incremental predictive validity analyses. Protection measure scores showed good convergence with dynamic risk and change scores and significantly predicted decreased recidivism. Incremental predictive validity analyses, however, demonstrated that Violence Risk Scale-Sexual Offense version dynamic risk and change scores uniquely predicted sexual and violent recidivism in their expected directions, while protection measure baseline and change scores generally did not. Clinical applications of protective factors in sexual violence risk assessment and management are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The present study examined the interrelations of psychopathy cognitive ability, achievement, and school engagement variables to recidivism in a diverse sample of 417 justice-involved youth court referred for assessment and/or treatment services. The Psychopathy Checklist Youth: Version (PCL: YV) and a set of criminogenic, education, and developmental variables were rated from file; recidivism data were obtained from criminal records. PCL: YV total and most facet scores were inversely related to verbal IQ, unrelated to academic achievement, and strongly associated with school disengagement; however, interpersonal facet scores showed the opposite pattern among male youth. Cox regression survival analyses demonstrated that composite variables reflecting global achievement and school engagement concerns incrementally predicted recidivism outcomes controlling for PCL: YV scores; higher achievement and school engagement appeared to mitigate risk. By contrast, while global cognitive ability similarly mitigated risk among male youth, it was associated with increased recidivism among female youth after controlling for baseline psychopathy. The results underscore the risk, need, and responsivity (RNR) relevance of cognitive ability, achievement, and school engagement in reducing risk for future crime and violence.

We present an evaluation of a strength-based, cognitive-behavioral therapy program provided to individuals with a serious mental illness who had committed a sexual offense. Utilizing an intent-to-treat design, individuals who participated in treatment were compared with a group of untreated men on treatment-relevant measures and recidivism. Individuals who completed treatment demonstrated greater change in perceptions of working alliance and dynamically assessed risk to re-offend compared to noncompleters. During the 18-month fixed follow-up period, 3.7% re-offended sexually, 20.4% re-offended violently, and 39.8% re-offended generally. After controlling for baseline risk, participation in treatment was significantly associated with an approximate two-thirds decrease in the hazard of future violent (including sexual) recidivism. High-risk, untreated men in our sample showed significantly higher rates of violent recidivism than the treated groups. Results support the utility of a strength-based approach among men residing in an institutional setting and presenting with a serious mental illness.

The use of risk assessment instruments is essential for the assessment, treatment, and management of violence risk; it is thus critical to examine their properties when implemented in novel settings with diverse forensic subpopulations. This study evaluated the convergent and predictive properties of three risk assessment instruments in a sample of 109 forensic patients found Not Criminally Responsible on Account of Mental Disorder (NCR). A retrospective longitudinal cohort design was employed to examine the Historical Clinical Risk Management-20 Version 3 (HCR-20V3), Revised Violence Risk Appraisal Guide (VRAG-R), and Level of Service/Case Management Inventory (LS/CMI) rated from archived hospital records. LS/CMI risk scores and risk bands predicted general (area under the curve [AUC] = .70-.73) and violent (AUC = .76-.91) recidivism with moderate to large effects and performed similarly to the VRAG-R and HCR-20V3. Calibration analyses demonstrated that LS/CMI scores overpredicted the risk of general recidivism in Moderate to Very High risk bands. Results supported the convergent validity and discrimination properties of study measures; however, mixed evidence was found for the calibration properties of the LS/CMI. The potential utility of risk instruments in the appraisal and management of offending behavior among forensic mental health patients is discussed.

The Structured Assessment of Protective Factors (SAPROF) is a measure of protective factors intended to augment violence risk assessment. While prior research supports the predictive validity of SAPROF ratings, factorial and convergent validity have been underexamined, each of which is required to ensure that the instrument measures intended targeted constructs and converges with test scores from established measures. We evaluated the structural and convergent properties of SAPROF ratings through examining its factor structure and convergence with measures of relevant constructs, as a function of ethnocultural heritage, in a treated sample of 461 men with sexual offense conviction histories. The SAPROF was rated from institutional files pre-and posttreatment. Results of exploratory structural equation modeling (ESEM) of pre and post SAPROF item ratings identified a temporally stable three-factor model that was invariant across ethnocultural groups; however, it departed from the developers' original subscale structure-the factors were termed Internal-Prosocial, Motivational-Lifestyle, and External-to reflect continuity with, yet departure from, the current subscale structure. SAPROF ratings were correlated in theoretically and clinically meaningful ways with scores on relevant risk-need-responsivity (RNR) measures. The results support the structural and convergent validity of SAPROF ratings and identified a slightly modified subscale structure in the present sample.

Sexual coercion is a form of sexual aggression that involves the use of verbal persuasion tactics to convince an individual to participate in sexual acts against their will, and is of particular concern on university campuses. Informed by Seto's Motivation-Facilitation-Model (MFM), the present study examined pathways to sexual coercion as motivated via paraphilic fantasy and sexual compulsivity, and facilitated by physical aggression and attitudes supportive of sexual offending. A university sample of staff and students (N = 938) completed an online self-report battery measuring sexual fantasy, attitudes, aggression, hypersexuality and lifetime reported atypical sexual behaviours. Results of multigroup-structural equation modelling revealed that a latent sexual deviance variable (derived from sexual compulsivity and paraphilia) predicted atypical sexual behaviours and specifically, sexual coercion, across genders and that physical aggression formed a unique pathway to sexual coercion in males. The results may inform the development of targeted sexual assault prevention efforts within the general population.

We examined the intersection of juvenile psychopathy with protective factors, dynamic violence risk, and recidivism in a court adjudicated Canadian sample of 257 male and female, ethnoracially diverse youth. The Psychopathy Checklist: Youth Version (PCL:YV) and measures of dynamic violence risk (Violence Risk Scale–Youth Version; VRS-YV) and protective factors (Structured Assessment of Protective Factors–Youth Version; SAPROF-YV) were rated from court and treatment files. Recidivism information was obtained from official criminal records. PCL:YV scores were associated with fewer protective factors and predicted recidivism across gender and ethnoracial (Indigenous vs non-Indigenous) groups; however, PCL:YV scores did not incrementally predict future crime and violence when controlling for violence risk and/or protective factors scores, while both of the latter measures did. Juvenile psychopathy is a clinically relevant construct for justice-involved youth but it does not equate to a lack of protective factors or inability to make treatment-related changes in risk.

We review the methodological issues, controversies, and main findings from the sexual offense treatment program (SOTP) outcome literature through a meta-meta-analysis (MMA) of SOTP meta-analyses with sexual offense recidivism as the primary outcome variable. The results of MMA of 21 meta-analyses demonstrated a broad treatment effect for the reduction of sexual recidivism relative to comparison controls by approximately 33

There has been little study of animal sexual abuse (ASA). Subsequently, little is known about veterinary medical professionals' (e.g., Veterinarians, Veterinary Technicians, Veterinary Nurses) knowledge of ASA and how they may contribute to the prevention of ASA. Thus, the objective of this paper is to comprehensively study ASA in a sample of veterinary medical professionals. Eighty-eight professionals were recruited through professional associations and posts on social media to take part in a survey examining non-sexual animal abuse, ASA, and criminal justice perceptions. Results indicated that, levels of knowledge and training were much lower for ASA than non-sexual abuse. Professionals also responded punitively toward individuals who have committed sexual abuse against animals and supported long prison sentences and registries for offenders. Veterinary medical professionals were supportive of mandatory reporting of all types of abuse but did not feel prepared to testify in these cases should they go to court. These results have implications for practice as they indicate that veterinary medical professionals are not receiving enough training on abuse - particularly ASA - which could put their patients at risk of continued harm.

Purpose of Review The overrepresentation of certain racial/ethnic groups in criminal legal systems raises concerns about the cross-cultural application of risk assessment tools. We provide a framework for conceptualizing and measuring racial bias/fairness and review research for three tools assessing risk of sexual recidivism: Static-99R, STABLE-2007, and VRS-SO. Recent Findings Most cross-cultural research examines Static-99R and generally supports its use with Black, White, Hispanic, and Asian men. Preliminary research also supports STABLE-2007 with Asian men. Findings are most concerning for Indigenous men, where Static-99R and STABLE-2007 significantly predict sexual recidivism, but with significantly and meaningfully lower accuracy compared to White men. For the VRS-SO and the combined Static-99R/STABLE-2007 risk levels, predictive accuracy was not significantly lower for Indigenous men, for which we discuss several possible explanations. Summary We offer considerations for risk scale selection with Indigenous men and highlight recent guidance produced for cross-cultural risk assessment.

The present study examined the convergent, structural, and predictive properties of Violence Risk Scale-Sexual Offense version (VRS-SO) scores in a sample of 200 men on community supervision for sexual offenses, attending forensic community outpatient services and followed up an average 8.6 years. The VRS-SO and two additional dynamic sexual recidivism risk measures-STABLE 2007 and Sex Offender Treatment Intervention and Progress Scale (SOTIPS)-were coded archivally from clinic files; Static-99R ratings were extracted. Recidivism data were captured from Royal Canadian Mounted Police records. VRS-SO static, dynamic, and total scores demonstrated expected patterns of convergence with total and subscale scores of the risk measures. Moreover, a confirmatory factor analysis of the VRS-SO dynamic item scores demonstrated acceptable model fit for a correlated three-factor solution consistent with prior confirmatory factor analyses. Discrimination analyses demonstrated that VRS-SO dynamic and total scores and STABLE 2007 scores had large prediction effects for 5-year sexual recidivism (area under the curves [AUCs] = .71-.72) while SOTIPS had a medium effect for this outcome (AUC = .67); the measures yielded medium to large effects for nonsexual recidivism. Cox regression survival analyses demonstrated that VRS-SO dynamic, Sexual Deviance factor, and SOTIPS scores each incrementally predicted sexual recidivism controlling for Static-99R or VRS-SO static factor scores. VRS-SO calibration analyses demonstrated that expected or predicted 5-year sexual recidivism rates showed generally close correspondence to the rates predicted or observed in the present community sample. Results support the psychometric properties of the VRS-SO, a sexual violence risk assessment and treatment planning measure, to a community outpatient sample. (PsycInfo Database Record (c) 2024 APA, all rights reserved).