Tertiary Prevention of Child Sexual Abuse

Study Overview
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Brief Summary
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This is a feasibility study designed to inform the development of a multinational study of the effectiveness of a tertiary prevention program for child sexual abuse. This study targets adult men who have engaged in child sexual abuse, and will be implemented within the Minnesota Department of Corrections. Data will include measures of the implementation process, short-terms changes in criminogenic factors, and staff and participant factors that could influence outcomes.

Official Title
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Mobilizing Evidence Into Tertiary Prevention of Child Sexual Abuse: A Pilot Study

Conditions
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Child Sexual Abuse

Intervention / Treatment
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* Behavioral: group therapy
* Other: Treatment as usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male 18 or older Serving time in MnDOC facilities for Criminal Sexual Conduct in the first, second, or third degree, whose victims were less than 14 years old Individuals assigned moderate to high risk to reoffend as determined upon entrance to the Minnesota Correctional System by the DOC Risk Assessment/Community Notification Unit. Exclusion Criteria: Diagnosed with an active, uncontrolled major mental disorder (e.g. bi-polar, schizophrenia, schizoaffective disorder, major depression with psychotic features) Unable to read English at the 5th grade level Unable to speak English IQ of less than 85 as measured by standard intelligence tests Diagnosis of intellectual disability Engaged in violent behavior while incarcerated, as indicated by disciplinary actions and/or segregation within 60 days of intake

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: Random assignment clinical trial. Participants are randomly assigned to the intervention group or treatment as usual.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>32-week group therapy | Behavioral: group therapy<br>* 32 weeks of group therapy<br>|
| Active Comparator: Control group<br>Treatment as Usual | Other: Treatment as usual<br>* Control participants remain in their current placement and may be eligible for a number of services offered to inmates to facilitate rehabilitation and planning for release to the community, including sexual offender treatment. MnDOC's sexual offender treatment is a two to three year program, thus most of our control subjects will not have enough time remaining on their sentences to complete such treatment. However, a number of them may participate in MnDOC's current program.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Violence Risk Scale-Sexual Offense Version (VRS:SO) | Clinician rating scale. 24-items measuring likelihood of sexual offense recidivism using a 4 point scale. | 7 days post-intervention | 
| Coping Using Sex Inventory (CUSI) | Self-report scale. 16 items measuring consensual, non-consensual, and child-focused sexual coping strategies using a 5-point scale | 7 days post-intervention | 
| Compulsive Sexual Behavior Inventory-13 (CSBI-13) | Self-report scale. 13 item scale measuring the presence of compulsive sexual behaviors on a 5- point scale. | 7-days post-intervention | 
| Types of Jealousy Scale (3 subscales; reactive, preventive, and anxious jealousy) | Self-report scale. 15 items measuring the intensity of reactive jealousy, experience and use of preventive jealousy, and frequency of anxious jealousy on a 5-point scale. | 7 days post-intervention | 
| Faith in People Scale | Self-report scale. 5 item scale measuring attitudes toward human nature. Two forced- choice items and three agreement/disagreement items. | 7 days post-intervention | 
| Trust in People Scale (Survey Research Center) | Self-report scale. 3 item scale measuring perception of general trustworthiness of others. | 7 days post-intervention | 
| Aggression Questionnaire (AQ; Buss &amp) - Physical Aggression, Verbal Aggression, and Anger Subscales ONLY | Self-report scale. 21 items throughout the 3 subscales measuring how characteristic physical aggression, verbal aggression, and anger-related behaviors are for respondents on a 7 point scale. | 7 days post-intervention | 
| Revised UCLA Loneliness Scale (R-UCLA) | Self-report scale. 20 items measuring subjective feelings of loneliness and social isolation on a 4 point scale. | 7 days post-intervention | 
| Self-Critical Rumination Scale (SCRS) | Self-report scale. 10 items measuring self- criticism on a 4 point scale. | 7 days post-intervention | 
| External/Internal Shame Scale - Sense of Isolation/Exclusion Subscale ONLY (EISS) | Self-report scale. Measures perceived sense of exclusion and being isolated or misunderstood by people on a 5 point scale. | 7 days post-intervention | 
| Children and Sex Questionnaire Emotional Congruence Scale (CSQ:ECWC) | Self-report scale. 15 item scale measuring emotional congruence with children on a 5 point scale. | 7 days post-intervention | 
| The Openness to Men and Women Scales (OPM, OPWO) | Self-report scale. 18 items assessing openness to intimacy with women and men on a 4 point scale. | 7 days post-intervention | 
| Difficulties in Emotion Regulation Scale - Short Form (DERS-SF) | Self-report scale. 18 items measuring problems with emotion regulation including subscales for strategies, non-acceptance, impulse, goals, awareness, and clarity on a 5 point scale. | 7 days post-intervention | 
| Coping Strategy Indicator (CSI) | Self-report scale. 33 items measuring adaptive and maladaptive coping strategies (avoidance, problem-solving, social support seeking) on a 3 point scale. | 7 days post-intervention | 
| Aggression Inventory (AI)- Impulsive, Impatient, and Avoid subscales ONLY | Self-report scale. 22 item scale measuring perceptions and use of aggressive behaviors for men a women on a 5 point scale. | 7 days post-intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Group Climate Questionnaire - Short Form (GCQ-5) | Self-report scale. 12 items measuring group perceptions of the group therapeutic environment on a 7 point scale. | Every 14 days for first two months, than every four weeks for next four months | 
| Curative Climate Instrument (CCI) | Self-report scale. 14 items measuring specific change processes perceived as helpful to individual group members (catharsis, insight, and cohesiveness) on a 5 point scale. | Every 14 days for first two months, than every four weeks for next four months | 
| Treatment Motivation Questionnaire-Revised (TMQ-R) | Self-report scale. 23 items measuring internal and external reasons for participating in treatment, motivations relating to connecting and sharing with others, and clients' potential lack of confidence in treatment on a 7 point scale. | Every 14 days for first two months, than every four weeks for next four months | 
| Therapeutic Agency Inventory (TAI) | Self-report scale. 15 items measuring clients' experience of agency in making positive change and ability to take an active role in their therapy on a 5 point scale. | Every 14 days for first two months, than every four weeks for next four months | 
| Relationship Questionnaire (RQ) | Self-report scale. 4 items measuring adult attachment style on a 7 point scale. | Every 14 days for first two months, than every four weeks for next four months | 
| Working Alliance Inventory - Short Form (WAI- SR) | Self-report scale. 12 items measuring three domains of the therapeutic alliance: goals, tasks, and bond on a 5 point scale. | Every 14 days for first two months, than every four weeks for next four months |