Florida’s Civil Commitment Center

Topic
The effectiveness of the civil commitment center for sexually violent offenders n Florida and some of the issues pertaining to the treatment facility.

Introduction
Americans have a prominent fear of crime, especially sexual offenders. Sex offenders are known to have multiple victims and higher rates of recidivism rates (Texas Council on Sex Offender Treatment, TCSOT, 2003, Hanson, 2002, Becker, et. al., 2003, Phillips, 2003). As a result of recent high profile cases and America’s renewed fear of sex offenders the legislature has created new laws to address this public concern. These new laws allow sexual offenders to be involuntarily committed to a civil commitment program or civil commitment center for treatment, if a judge or jury feels that the offender poses a further threat to society or public safety (Logan, 1999). All states have had legislation in place to deal with repeat offenders; only a select few have decided to take this to the next level by creating civil commitment centers or programs to further monitor the sex offender (Logan, 1999).

Florida’s approach is one of the most restrictive. Restrictive in the means of detaining all offenders, those awaiting commitment and those who have been successfully committed by trial, in a secure facility until they have completed a program to significantly alter their behavioral patterns so that they are no longer a threat to society (National Center for Prosecution of Child Abuse, NCPCA, 2003). Proponents of this current policy feel that it is the best system in place in that it keeps society safe by detaining the offender away from society and eliminates any potential for re-offending. Persons in support of the policy also point to the recidivism rates of sex offenders and their potential dangerousness. Other states have taken preventative measures to control this group of offenders, some with better outcomes for all parties involved. Florida has polluted the court systems with rights violations, (e.g. the current treatment program, the facility status, treatment of offenders) for the current policy in place and the treatment being provided at the facility. The Florida policy has chosen the most financially exhaustive means of detaining and dealing with offenders, which drains tax monies and pulls these resources from other public services. As a result of this program of complete detention, the facility itself has numerous problems, e.g. overcrowding which in turn has created a new problem, release vouchers. The facility promotes on going sexual offenses among the detainees and is not the best option for treatment of sexual offenders.

Program
In Florida commitment eligibility includes any person convicted, adjudicated, or not found guilty by reason of insanity for committing a sexually violent offense. The commitment is based on a standard of future dangerousness to public safety. In Florida this is measured by having a mental abnormality or personality disorder that makes the offender “likely”, or a high risk to re-offend if they are not detained in a secure facility. The determination of civil commitment is done by a judge or jury trial, if a jury is requested. The standard burden of proof lies upon the state by “clear and convincing” evidence. Once committed to the facility they are detained on an indeterminate sentence until they have successfully completed the treatment program or the disorder has changed and they no longer pose a threat to society (American Prosecutors Research Institute, APRI, 2003).

Program description
In Florida, the civil commitment center has an outline of the program treatment all in exception for the final stage of completing therapy; or an integration phase slowly transitioning the offender back into the community setting (Florida Department of Children and Family Services, FDCFS, 2001). The program requires the offenders consent to treatment and complete cooperation from the offender in each phase of therapy (FDCFS, 2001). The program requires acknowledgement of the crime that they committed and the offender must accept responsibility for their crime(s). The offender goes through numerous evaluations; psychological, medical, educational, etc. They are assessed on vocational, recreational and social work skills. They are also assessed for substance abuse (FDCFS, 2001).

The FDCFS (2001) allows for the program to include different therapy approaches. One approach is Rational Self-Counseling. This portion is to aid the offender in identifying and dealing with their irrational feelings and behaviors. This approach includes group therapy and regular sessions. Another therapy attempt is with the sexual auto biography; in a group of specific types of offenders they read their biographies to each other. This gives the offender the ability to graphically explain their feelings and reasons on paper to share with the group. This step also allows for the offender to openly share his feelings with a group that is more likely to understand and perhaps is one step to getting better by realizing that the offender is not alone in their struggle.

From this point the offender attends Psycho-educational groups. These groups are also sex offender specific comprising only of the same types of sexual offenders (FDCFS, 2001). Here they again present their auto biographies to the group and further discuss their inappropriate behavior and discuss community issues and other relevant topics, during this time they also maintain journals or fantasy logs, describing their thoughts. They attend counseling on an individual basis during this time as well. The next steps are to focus on relapse prevention, rational self counseling, and victim awareness, to fully understand the many aspects of each of these areas (FDCFS, 2001). The program also focuses on anger management, leisure education, stress management, and relaxation, substance abuse awareness, human sexuality, introductions to feelings, values, attitudes and beliefs (FDCFS, 2001). The treatment might also include vocational, educational, and other rehabilitative means. The treatment program provides a small detail of all the teachings involved in each area (FDCFS, 2001). (See Appendix A)
The number currently being detained in the Florida facility, as it is the only facility to detain the offender until they are determined by trial to be civilly committed to the program or released, but the facility currently houses 431 offenders; only 145 of the detainees currently undergoing treatment (Martin, 2003). Office of Program Policy Analysis and Government Accountability, OPPAGA (2004) states that the Florida facility has detained 294 offenders and has only committed 140 individuals, bringing the total held in the facility to only 434.

Recidivism
The current Jimmy Ryce law in Florida allows for the detention of offenders in a secure facility until they have been through a trial to determine whether or not they should be civilly committed and kept in the Arcadia facility for an indeterminate sentence. Supporters of the policy point to the fact that it prevents recidivism, as they are confined and this protects the public’s safety. In support of this policy, the “supporter” will provide that although there is difficulty in predicting recidivism rates accurately; it is noted that recidivism rates of sexual offenders increase with the length of time that they are studied, that shorter studies yield lower rates (Wood, et.al., 2002, Phillips, 2003, Hanson, et.al., 1995, Sample and Bray, 2003, Hanson and Bussiere, 1998). In a recent publication Hanson (2002) states that dealing with sex offenders (rapists, and child molesters-inter-familial and extra familial) revealed that there are age differences in recidivism rates. That rapists tend to be younger with the highest age group being 18-24 and they tend to have more non-sexual criminal histories (Hanson and Bussiere, 1998), but the recidivism rates decline with age; relatively few after the age 60 (Hanson, 2002). Child molesters who target family members (inter-familial or incest) have consistently lower rates of recidivism than any other type of sexual offender (Hanson and Bussiere, 1998), perhaps due to the lack of available victims or lack of opportunity (Hanson, 2002). Incest sexual offenders showed the highest peak age to be consistent with rapists at 18-24 (Hanson, 2002). The study also showed that extra-familial child molesters have a higher rates of recidivism than rapists (Hanson, 2002, and Becker, et.al., 2003). It also states that the high risk age group for this type of sexual offender if 25-35 and that the recidivism rates a re consistent with age, that it showed little to no decline until after the age 50 (Hanson, 2002). Recidivism rates can also be affected by the time that the offender spends incarcerated for prior offenses, as this reduces their opportunities to re-offend and that different sex offenses have different sentencing guidelines (Sample and Bray, 2003).

Also in support of such policy as complete detention that is practiced here in Florida, is that there in no way to accurately know the precise number of sexual offenses that occur. As many sexual offenses are not reported, thus it is hard to count recidivism rates based only on the offenders who get caught by the system and to not count the victims who do not come forward. Sex offenders can repeatedly re-offend before the system catches up with the offender initially or for their second offense (TCSOT, 2003). Phillips (2003) noted in his publication that male sex offenders exhibit patterns of behaviors that entail extensive histories of sexual assaults and that these offenders have numerous victims; significantly more than what are accounted for on their records. He also cited a Colorado study using polygraph examinations that found that “on average each offender admitted to committing 521 sex offenses on 182 victims in the years before they were caught” (Phillips, 2003). These kinds of studies re-affirm what the National Victimization Surveys report, that there are many sex offenses that go unreported to officials. Sample and Bray (2003) also acknowledge the limitations of available statistical data in that it only represents those offenses that are reported or come to the attention of officials. Current victim surveys only represent some of the offenses; they eliminate children under the age of 12 from being counted. Becker et.al., (2003) cited in their study that 32.5% of offenders stated that they had victimized children between the ages of 0-12, also that an additional 21% stated that their victims were under the age of 18.

In opposition to this policy, one would present more factual information pertaining to recidivism and how statistical data can be manipulated. One would also show the current problems with the definition of recidivism. That recidivism rates are different across the board due to the various ways that recidivism is defined and measured. As a result of this changing definition it is hard to accurately determine what is being measured (Hanson and Bussiere, 1998). Thus, that any statistical data presented on sexual recidivism rates will have fallacies. Recidivism can be measured by repeating a sexual offense, or committing a non-sexual offense, or measured by the arrest only, or the conviction only, or incarceration only of either a sexual offense or a non-sexual offense, or a combination of any of the above when gathering data to determine recidivism. Much of this same information coming from the same resources that the “supporting” side used for their argument. Sample and Bray (2003) also cite data suggesting that evaluating states individually that sex offenders had a lower percentage of arrests than did other categories of offenders for committing the same offense they were originally caught for (6.5%) and re-arrest for any offense was (41.5%), suggesting that a large percentage of sex offenders were not re-arrested for committing another sexual offense. Another problem with determining sex offender recidivism if that states use different language in composing their statutes to define what a sexual offender is and what determines a sexually violent predator is (NCPCA, 2003). Sample and Bray (2003) suggest that for measuring in respect to recidivism that arrest data which more accurately resembles the crime committed, would be ideal in that it eliminates the possibility for plea bargaining and or charge reductions and cases and or charges that are dropped due to lack of witness participation. However, this number would account for the persons falsely accused (though this is not very common), nor are the un reported sexual offenses represented here.

Another problem pertaining to recidivism and the current Florida policy in place is the idea of “predicting” recidivism. Civil commitment centers are based on the prediction of dangerousness or potential high risk of recidivism the offender poses. To keep the offender locked up and keep the public safe, as is the Florida philosophy. Hanson and Bussiere (1998) noted in their meta-analysis of recidivism studies that there are a very limited number of variables that attach to any majority of sexual offenders. In the area of demographic variables the two researchers noted that age and marital status were the most common influencing factors. In another study the demographics noted age, race, and education levels (as cited by Becker, et.al., 2003). It was also noted that criminal lifestyle or criminal history was a significant factor in predicting recidivism (Hanson and Busssiere, 2003, and Becker, et.al., 2003). The only psychological factor mentioned by the two studies anti-social and or a personality disorder. Becker et.al. (2003) cites a study that shows that a significant number (approximately 93%) of offenders met criteria for Axis I disorders and about 60% also fell into Axis II diagnosis as well. The highest predictor of a specific type of sexual offender through sexual deviance was child molesters (Hanson and Bussiere, 1998). Two very notable factors inducted from their research was that a negative relationship with the mother during developmental stages was a common factor in a number of cases and that being sexually abused in child hood was not a significant factor in the prediction; which has been a popular theory in predicting the cause of child sexual abuse (Hanson and Bussiere,1998). Becker, et.al. (2003) provides that in their review about one third of sexual offenders reported a history of physical abuse, and a slightly higher percentage reported having been sexually abused. Hanson (2002) states that low self control, opportunity, and sexual drive and or deviant sexual interests accompanied with the age of offenders can aid in predicting recidivism rates of certain types of sexual offenders. Wakefield and Underwager (1998) look at various types of prediction of recidivism tests and check lists composed by various qualified groups and individuals but, still note that there is no one test that can provide a sure prediction and that no one test should be used in trying to determine the risk of recidivism. That it is in fact not an exact science and there in no real way to determine which offender will recidivate, not enough to warrant the application of an indeterminate sentence (possibly for the rest of their lives) in a secure facility.

The Current Policy and Treatment
Supporters of the current policy will have you look to the various types of treatment and therapy options available to the offender and the detailed steps and phases that are outlined, creating easy steps for the offender to follow through with the treatment. They would also point out the numerous other areas that the program addresses in treatment, e.g. job skill training, educational skills, addressing beliefs, values; all to aid the offender in their treatment and personal advancement. Florida is overseen by Liberty Behavioral Health Corp, who contracts 31 psychologists and one psychiatrist for the assessment of sexual offenders to determine commitment eligibility. In a OPPAGA (2000) report it provides that all the evaluators are state licensed and have met the educational requirements. Many of the contractors have sufficient prior experience and have dealt with such likeliness, although none have worked extensively with sexual offenders, for any good length. This would be due to the fact that the program is newer and that sex offenders have not been grouped together previously for professional to have an extensive history. Supporters would also point out that they have hired an independent company to do the evaluations removing any chance of prejudices. Even after addressing many of the problems associated with recidivism and prediction thereof and the evidence suggested by the studies; even if one could conclude that sex offenders are less likely to recidivate than the general population of other criminals they are still a much loathed group that society has deemed must be controlled, because one offense is just too much. No person would want to take the chance of their child being violated by a sexual offender, so preventative measures have been taken.

Persons looking at the bigger picture would notice a few flaws in the treatment program employed at the Florida facility and with the staff. The treatment has yet to create a final transitional and supervised phase integrating the offender back into the community; e.g. slowly releasing the offender back into the community setting while being supervised and aided to reduce any chances of relapse and or aid in the troubling factors associated with life and the additional stressors that were not present in the secure treatment setting while reinforcing therapy goals (Krause, 2003). The program specifically states that disruptiveness, lack of motivation or failure to successfully adjust to the “therapeutic” environment will result in the suspension from going on to the second phase of therapy. However, there is nothing therapeutic about that old prison facility, in fact it is greatly deteriorated, rundown and overcrowded. It states that lack of motivation will result in their being moved back to the previous level of therapy or complete removal from therapy. This statement is absurd, every one going through therapy is expected to have troubled moments and have depression or numerous other factors that could slow down the treatment progress, but setting the offender back a whole level or removing them is even more detrimental to their recovery making them feel more disappointment and further the feelings. So, instead of progressively treating the offender’s issues as they arise as a natural part of therapy, the offender is set back or removed from treatment. Where as other policies in other states implementing civil commitment programs deal with these problems as they arise, not demoralizing the offenders efforts and or punishing them. These actions do not promote advancement and continually set the offender back in the treatment or completely neglect him further treatment, creating contempt for the treatment providers and creating a stressful environment and a sense of helplessness.

Another factor pertaining to the treatment being provided is that it makes no mention to the use of Plethysmograph assessments or regular Polygraph assessments, which other treatment programs attest is a key factor in determining compliance and evaluating the progress. The treatment provided as the Florida facility as mentioned before makes no mention of after care. This step should reinforce the therapy and assess the progress of the offender and ongoing “booster” therapy sessions, and aid in recognizing potential offender relapse. The Biomedical approach is another area not mentioned by the treatment outline. In many states they have recognized the value of such methods in reducing recidivism, the use of psychopharmacological agents, e.g. depo-provera and other medication(s) that treat conditions, to reduce deviant arousal and behavior may be necessary in the offenders treatment and ongoing condition when the offender is released. Also, in opposition to the current policy and treatment being provided one would have to mention that there is a higher success rate for offenders treated in outpatient programs have a 50% higher success rate, that treatment conducted in a secure facility does not transfer easily to the community setting, when the offender is left with new challenges and no help. Lastly, that residential programs are considerably more costly than some of the other options available, and little resources are afforded to the treatment and supervision, which increases community risks when the offender is released. Florida’s facility being complete detention and even housing the offenders who have not yet been committed to the program is the most financially exhaustive option out there.

The current policy is also faltered in that is it a gender biased policy. Phillips (2003) recognizes that there is a need to address the female population of sex offenders , that is too often over looked. He states that female sex offenses may account for up to 13% of other female abuse and up to 24% of abuse to males He asserts that sexual offender laws need to address this female population of offenders (Phillips, 2003). Last year a female sex offender, labeled a sexually violent predator was released from prison on an indeterminate sentence due to the fact that there is little research on the topic (Shur, 2003). The problem is not wide spread, but not holding a “sexually violent predator” to the same set of standards due to their gender leaves a huge policy bias. Becker, et.al, *(2003) acknowledges that in their review of sexual offenders 11.5% reported being sexually abused by their mothers. The TCSOT (2003). Recognizes the female population and cites that approximately 20% of the sexual offenses committed against children are committed by a woman. So, if Florida is providing treatment in the name of public safety, then why does it leave out such a group of offenders.

Both the Jimmy Ryce Act and the program guidelines or requirements for the contracted help. OPPAGS (2002) states in a report evaluating the staff , that prior to their contracted work that many of these individuals had never used the risk assessment instruments; which is key in determining commitment eligibility, also that the staff would benefit from further training and education. The Florida legislature noted in the report that the Office of Program Policy Analysis and Government Accountability, OPPAGA (2000) recognized that the facility had numerous errors, and that the program was not time efficient, that it should keep track of recidivism (meaning that it had not been keeping track of this valuable information), and that the program was in need of a formal selection criteria for the evaluators that are contracted (meaning that they did not have such criteria in place). These situation are a large problem with the current policy.

A little more in reference to the staff provided at the facility, many accusations of mistreatment, lack of treatment, miss management and disruption have been located in my literary review. As a result there have been numerous cases filed by the detainees against the staff and the director of the facility, in which the detainees have won (Pesci, 2003 and Gangi, 2003). Martin (2003) claims that the facility is poorly run, deteriorated, is a haven for drug use and homosexuality, and overall a hostile environment. There has also been mentions of the director of the facility manipulating evaluations and having evaluators change their original statements for numerous reasons (Martin, 2003). A quote from a psychiatrist who had treated offenders in the facility stated that “not enough treatment is going on for the facility to be considered a rehabilitative facility” (LaPeter, 2003). This statement is backed by the cases the detainees have won, the known condition of the ancient facility, and letters from evaluators pertaining to the facility director. Having been there and asked a few question about these issues it is hardly refutable that these issues are a valid concern.

Opposition to the policy would also present the current cost associated with the complete detention (as lightly mentioned earlier) and the other more resourceful options available. One has to admit that any sex offender treatment is cost effective if it reduces victimization which in turn would reduce costs in: state investigations, trials, appeals, incarceration, supervision, and counseling needed for the victim and the offender (TCSOT, 2003). But looking at the bigger picture here the Florida facility is too financially exhaustive to really be effective as a treatment program for the state to continue. The TCSOT (2003) provides a state by state comparison of the cost analysis of states currently providing sex offender treatments under civil commitment and this outline provides that the cost of Texas outpatient treatment ($15,000 per client, per year) is much more efficient and cost effective than Florida’s residential treatment ($97,000 per client, per year) [not quite sure what they used to obtain these figures]. According to the OPPAGA (2004) report for the 2003-04 fiscal tear the sex offender treatment program only received $23,700,484. If the latter is true (which seems relatively small) then the cost per client per year in $54,000, which is still considerable higher than the projections provided by outpatient treatment. It is also a known fact that outpatient is more cost effective.

In the Florida facility there are few problems that are not experienced by other programs, that effects the effectiveness of the current treatment and policy, when the offender is released for administrative reasons (release vouchers) as opposed to being effectively treated (Wood, et.al, 2000). The overcrowding problem that the facility is experiencing has created the necessity for certain counties to offer program vouchers (Krause, 2003 and Martin, 2003). These vouchers are offered to sex offenders to avoid commitment to the Arcadia facility; the states agrees to put the commitment in limbo, typically five years to allow the offender to obtain, at their own expense, treatment while residing in the community, if the offender waives their right to trial (Krause, 2003 and Martin, 2003), basically allowing the offender to go free with out treatment right back into the community; contradicting the original purpose of the civil commitment policy. Martin(2003) also states that currently approximately 30 of these vouchers have been signed, meaning there are 30 offenders out roaming the streets posing a possible threat to society; completely undermining the basic principles of the policy. The contracts are some what supervised releases, and if the offender fails to complete treatment they will be committed automatically (Martin, 2003), the only good out come of the vouchers is that they are not allowed to tie up the court systems with trials and appeals(although this is sure to follow, as no contract even civil ones are not protected from being subject to validity in referencing the law). These vouchers allow for a supervised release and polygraph testing (Krause, 2003) which the policy nor treatment has implemented before. The contracts might help to create a final stage in the treatment program; though this was neither the intent nor the accepted purpose of the vouchers. The contracts also allow for release which has been extremely rare prior to the introduction of the release waivers (Krause, 2003).

What Research Has Been Documented About Program Effectiveness
Wood, et.al (2000), notes in their articles that is treatment in general; community treatment was more effective than institutional treatment methods. Polizzi, et.al. (1999) states that research shows that cognitive-behavioral treatment are among the most effective in preventing future offenses (also stated in Wood, et.al, 2000). It also states that some studies showed that offenders who participated in cognitive-behavioral therapy had lower rates of sexual recidivism. The article also suggests that the prison population of sex offenders may in fact not be a true representative of the sex offending population. Polizzi, et.al. (1999)also stated in their summary of reviewed studies that non-prison based programs that use the cognitive-behavioral approach showed to be more effective means of treatment to reduce recidivism. Wood, et.al. (2000) stated that child molesters who receive treatment reported lower rates of recidivism in other violent offenses than a control group that participated. OPPAGA (2004) states in a report of Florida’s evaluation of the program that experts believe a conversion phasing the offender back into the community is vital for success (but still the program has yet to cerate such a phase). It has also been documented (TCSOT, 2003) that there is higher success rates for patients treated in out patient treatment programs.

Conclusion
Supporters of the current civil commitment policy in Florida apply the mind set that one must determine what is more important to us ass a society, the rights of the offender or the rights our children should have. The protection of a sexual offender versus the protection of innocence is not a very persuasive argument. They might also point to the fact that as a nation we have given away more and more of our personal rights in the name of public safety and the fear of what we can not control, so what it is that we add one more freedom that a convicted felon may be stripped of. In opposition to this policy one must recognize that there is no sure way to determine which offender will re-offend that this judgment is left to human error; so how then do we justify locking them up for an indeterminate sentence for an offense they have not committed and perhaps may never commit. If they are to be confined for a time there should be an end to the program a completion stage for the offender to aim for. Lastly, if they are to be confined as a potential danger, as with any mentally ill person we have a duty as a civilized society to help them by providing the most effective treatment available in a facility designed to facilitate treatment. Just as our government has a duty to protect the public it has the duty to assist those who are in need without discriminating (Rollman, 1998), not to just warehouse these individuals and permanently restrict all their freedoms because they have committed a wrong in the past. If we continue on this path we will be restricting every class individuals that we do not care for and removing more of our individual rights.

References:
American Prosecutors Research Institute, APRI (2003). Involuntary civil Commitment of Sexually Violent Predators. Retreived 2/3/2004. www.ndaa-apri.org.
Becker, Judith V., Stinson, Jill, Tromp, Shannon, and Messer, Gene (2003). Characteristics of Individuals Petitioned for Civil Commitment. International Journal of Offender Therapy and Comparative Criminology, 47:2,185-195.
Florida Department of Children and Family Services (2001). Florida Civil Commitment Center: Treatment Program Structure. Liberty Behavioral Health Corp.
Florida Department of Law Enforcement (2003). Department of Law Enforcement: Sexual Predators. Retreived 2/32004. www.oppaga.state.fl.us/profiles/1079/right.asp?programnum=1079
Florida Legislature, OPPAGA, (2004). Effectiveness and Monitoring of the Martin Treatment Center for Sexually Violent Predators, report no. 00-12, September 2000, revised 1/31/04.
Florida Legislature, OPPAGA, (2000). The Sexually Violent Predator’s Program Assessment Process Continues to Evolve, report no. 99-36, February 2000.
Gangi, Robert (2003). Florida Civil Commitment Center: the Jimmy Ryce Law. Given to me by Dr. Quinn on 2/3/2004. http://mtwt.net/fci/jimmyrycelaw.html
Hanson, Karl R. (2002). Recidivism and Age: follow up data from 4,673 sexual offenders. Journal of Interpersonal Violence, 17:10, 1046-1062.
Hanson, Karl R., Scott, Heather, and Steffy, Richard A. (1995). A comparison of Child Molesters and Non-sexual Criminals: Risk Predictors and Long Term Recidivism. Journal of Research In Crime and Delinquency, 32:325-337.
Hanson, Karl R. & Bussiere, Monique T. (1996). Predicting Relapse: A Meta Analysis of Sexual Offender Recidivisms Studies. Journal of Consulting and Clinical Psychology, 66, 348-362.
Krause, Thomas W. (2003). Pacts Give Sex Offenders; Prosecutors an option. The Tampa Tribune. National pg. 1 A. December 22, 2003.
LaPeter, Lanora (2003). Pell Grants Aid Confined Sex Offenders. St Petersburg Times. Nation/World pg. 1 October 21, 2003.
Logan, Wayne (1999). Criminal Law: Liberty Interests in the Preventative State: Procedural Due Process and Sex Offender Community Notification Laws. Journal of Criminal Law and Criminology, 89:4, 1167-1231.
Martin, Greg (2003). “Lawyers Create Loophole:” lack of options for ‘sex predators’ cited. The Sun Herald: December, 2003.
National Center for Prosecution of Child Abuse (2003). Involuntary Civil Commitment of Sexually Violent Predators. Retrieved 2/26/2004. www.ndaa.org/apri/programs/ncpca/ncpca_home.html
Phillips, Colby S. (2003). Research Overview: Sex Offender Treatment Approaches and Programs. New Mexico Sentencing Commission, 2003. Retrieved 3/2/2004. www.nmsc.state.nm.us.
Polizzi, Danielle M., MacKenzi, Doris L., Hickman, Laura J. (1999). What Works in Adult Sex Offender Treatment? A Review of Prison and Non-prison Based Treatment Programs. International Journal of Offender Therapy and Comparative Criminology, 43:3, 357-375.
Rollman, Eli M. (1998). “Mental Illness:” A Sexually Violent Predator Is Punished Twice For One Crime. (Supreme Court review) (Case Note). Journal of Criminal Law and Criminology: 88:3, 985-1014.
Sample, Lisa L. and Bray, Timothy M. (2003). Are Sex Offenders Dangerous? Criminology and Public Policy, 3:1, 59.
Suhr, Jim (2003). Missouri’s Only Female Deemed A Sexually Violent Predator Ordered Freed. The Associated Press. March 2004. State and Regional.
Texas Council of Sex Offender Treatment (2003). The Management of Sex Offenders: Texas Civil Commitment of the Sexually Violent Predator. Retrieved 2/12/2004. http://info.sos.state.tx.us
Wakefield, Hollida and Underwager, Ralph (1998). Assesssing Violent Recidivism in Sexual Offenders. IPT Journal Vol. 10, 1998 Retreived 2/3/2004. www.ipt-forensics.com/journal/volume10/j10_6.htm
Wood, Raymond M., Grossman, Linda S., and Fitchner, Christopher G. (2002). Psychological Assessmanet Treatment and Outcome of Sex Offenders. Behavioral Science and the Law, 18, 23-41.

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