Forensic Psychology

by Graham M Davies

  20.2.6 Potential Effective Interventions for Adolescent Females with Antisocial Behaviour

  One important implication that can be drawn from the studies reviewed in this chapter is that antisocial behaviour in females can emerge at different ages and follow different patterns. Therefore, like in males, prevention efforts should start early in females, especially for the ones at risk for engaging in an early onset of antisocial behaviour. Antisocial behaviour in females can also emerge in adolescence, which suggests that interventions during this developmental period also need to be considered. Intervention programs designed for at-risk youth or youth with behavioural problems that have showed positive effects on females’ antisocial behaviour should be of particular interest for researchers and clinicians (e.g. Chamberlain, 2003; Conduct Problems Prevention Research Group, 2002). Because a subset of females with antisocial behaviour is at risk for adjustment problems in adulthood (e.g. girls with an early onset of antisocial behaviour), the transition between adolescence and adulthood might be an important period to intervene.

  Association with deviant peers, emotional problems, substance use problems or difficulties related to finding a job or to complete a diploma are among the factors that may compromise a successful transition to adulthood (Rutter, 1996; Thornberry, 2005). Interventions aimed at promoting educational attainment or job-related skills, social skills, social supports, mental health as well as relationships with prosocial peers may help females with antisocial behaviour to have a more successful transition to adulthood (Heller, Price, & Hogg, 1990). Given that females with antisocial behaviour are at an increased risk to associate with a deviant partner (Moffitt et al., 2001), to become pregnant at an early age (Bardone et al., 1996; Fontaine et al., 2008), and to have poor parenting skills that would increase the likelihood of an intergenerational transmission of antisocial behaviour (Zoccolillo et al., 2005), interventions that aim to prevent females’ antisocial behaviour and related adjustment problems should be a social priority. Although the social costs of females’ antisocial behaviour, compared to males, may seem less substantial a priori, they may become increasingly manifest as these females grow up, enter intimate relationships, and become mothers themselves (Pepler & Sedighdeilami, 1998).

  Early intervention programs, such as the Nurse-family Partnership, a program of prenatal and early childhood home visitation by nurses targeting first-time mothers who present certain vulnerabilities (e.g. young age and from households of low socioeconomic status), can be particularly cost-effective. Assessment of the Nurse-family Partnership showed that this program can reduce the use of welfare, child abuse and neglect, and criminal behaviour on the part of low-income, unmarried mothers for up to 15 years after the birth of the first child, as well as reported serious antisocial behaviour and use of substances on the part of adolescents born into high-risk families (Olds et al., 1997, 1998).

  It should be noted that program assessments do not always depict such positive effects. Modest or even iatrogenic effects have been found, particularly in group settings where contagion is likely to occur because deviant youths are placed together (Dodge, Dishion, & Lansford, 2006; Lipsey, 1992). Further, certain programs appear to be more promising than others. For instance, the Oregon Multidimensional Treatment Foster Care (MTFC), a program developed as an alternative to group and residential care for youth with delinquency and severe emotional problems, is proving worthwhile (Chamberlain, 2003). This program aims to create supports and opportunities for youth in a way to make them have a successful community living experience and to help their family members or other aftercare placement resources to use effective strategies allowing youth to maintain the gains made during the MTFC program after they return home. The program includes multiple intervention strategies, such as family and individual therapy, skill training and academic supports, and is adapted to be more responsive to the clinical needs of girls. For instance, in addition to the original components of, among others, close supervision, clear structure and limits, and reinforcement of prosocial behaviour, the interventions designed for adolescent females with antisocial behaviour particularly focus on mental health issues, history of trauma and abuse, educational history, substance use, sexual history, and relational aggression. There is evidence suggesting that the MTFC can reduce delinquent behaviour in girls referred from the juvenile justice (Leve, Chamberlain, & Reid, 2005).

  One important question that remains to be answered is whether or not gender-specific programs are needed for adolescents with antisocial behaviour. Research suggests that it may not be necessary to design and implement distinct programs for males and for females (Lanctôt, 2010). For instance, cognitive-behavioural programs targeting different social skills (e.g. problem solving skills, anger management) appear to be relevant to males as well as to females. Promising programs and practices for female youths, however, integrate components that may be specifically relevant for females with antisocial behaviour, including comorbid mental health problems and issues with intimate and interpersonal relationships. In addition, one important aspect that would need to be particularly addressed in programs targeted at young females is their early victimization histories as victimization, notably sexual abuse, has been shown to be an important risk factor associated with antisocial behaviour in females (Lanctôt, 2010). Despite promising approaches, however, further experimental and longitudinal studies are needed to test the effects of interventions for females with antisocial behaviour.

  CASE STUDY 20.1 KATE

  In kindergarten, Kate was manifesting aggressive behaviour, hyperactive symptoms and emotion regulation problems. She grew up in an adverse family environment, characterized by harsh parenting, psychological abuse and poverty. The youth services had to intervene a few times given the adverse family situation and Kate’s conduct problems. In adolescence, she was using drugs and alcohol and had depressive and anxiety symptoms. Kate was also involved in delinquent behaviour, namely shoplifting and vandalism. She was arrested for drug dealing and was involved in a couple of fights, during which she once seriously injured another girl. She was hanging out with delinquent peers who acted aggressively toward each other (they notably used relational aggression). At age 17, she became pregnant and gave birth to a baby boy. Her parents did not want to help her, and nor did the father of her child. Although she was able to complete a high school diploma, she has relied on the welfare system since her baby was born. Now at the age of 19, she is still using drugs and is involved in shoplifting. She has a boyfriend, who also uses drugs. They both want to quit using drugs and are seeking professional help. Kate is also seeking a job. She has provided good care to her son since he was born. However, now aged 2 years old, her son is showing higher levels of aggressive behaviour compared to other toddlers.

  20.3 ADULT FEMALE OFFENDERS

  20.3.1 Prevalence and Recidivism

  One of the most consistent findings over the years is that women commit far fewer criminal offenses than men. Statistics from Australia, Canada, the United Kingdom and the United States show that women account for about 20% of all charges or arrests and about 5% of the incarcerated population (Blanchette & Brown, 2006). When only violent offenses are considered, the data indicates a greater gender disparity. Although the data fluctuates according to studies and to type of violent crime (e.g. simple versus aggravated assault), female offenders appear to be responsible for about 10% of violent crimes (Warner, 2012). Over the last two decades, in comparison with earlier base rates, rates of violence by women have increased tremendously (Benda, 2005; van Wormer, 2010). For example, in Canada, the rate of women charged for a violent crime almost quadrupled between 1981 and 2001, then levelled off by 2005 to a rate of approximately 150 women charged for a violent offense per 100,000 women in the population. In contrast, the rate of men charged with violent offenses peaked in 1993 at 930 males per 100,000 males in the population, and decreased to reach 788 men per 100,000 by 2005 (Public Safety Canada, 2006).

  It is unclear whethe
r this situation has occurred because women commit more violent offenses or because changes to the criminal justice system have led to increased arrests and charges for violent offenses among women. There are some suggestions in the literature that changes in arrest decisions by the police (for example, changes in criminal justice system policy dictating that anyone who has engaged in domestic violence must be charged and the recognition that women engage in sexually assaultive behaviours) does play a role in the increase in official rates of violence by women (van Wormer, 2010; Warner, 2012). Interestingly, however, there does not appear to be a corresponding increase in official arrest rates for sexual offenses among women. For example, in Canada, between 1994 and 2003, the yearly rate of women accused of sexual assault has consistently been between 1% and 2% despite victimization evidence that shows women are responsible for at least 10% of all sexual offenses (Cortoni, Babchishin, & Rat, 2016).

  Besides committing fewer crimes than men, women offenders recidivate at much lower rates than men (Blanchette & Brown, 2006). Bonta, Rugge, and Dauvergne (2003) found that in a two-year period following release from custody, men had a 44% reoffending rate whereas the rate for women was 30%. These authors report that Canadian and UK rates are somewhat equivalent, citing UK recidivism rates of 50% and 45% for men and women respectively. Research also shows that differences in reoffending rates are greater when subtypes of recidivism are examined. Bonta et al. (2003) found rates of violent recidivism of 7% for women versus 14% for men. Finally, research shows that rates of sexual recidivism among women who have committed sexual offenses are even lower. In a meta-analysis of the recidivism rates among female sexual offenders, Cortoni, Hanson, and Coache (2010) found a sexual recidivism rate of 1.5%. In contrast, the sexual recidivism rate for male sexual offenders is 13.5% (Hanson & Morton-Bourgon, 2005).

  Although these findings all indicate that women reoffend less than men, there is some evidence that not all women are at lower risk than their male counterparts. In their study examining the predictive utility of the Level of Supervision Inventory (LS-CMI, Andrews, Bonta, & Wormith, 2004), an instrument developed to assess risk of recidivism, Andrews et al. (2012) found that for the exact same predictors, women had actual lower rates of new criminal offenses than men – but only among women assessed as moderate or low risk of recidivism. Female offenders who scored high on the LS-CMI for risk of recidivism had the same criminogenic characteristics and the same recidivism rates as the men who also scored high on the scale. This latter finding suggests that when female offenders continue engaging in criminal activities, they increasingly resemble their male counterparts.

  20.3.2 Pathways to Offending and Related Criminogenic Factors

  Female offenders are a diverse group of individuals with differing motivational and offending patterns. They also vary in the factors that led them to engage in criminality: some women exhibit a combination of gender-neutral and gender-specific criminogenic factors whereas others exhibit only gender-specific ones (Brennan, Breitenbach, Dieterich, Salisbury, & Van Voorhis, 2012; Daly, 1994; Salisbury & Van Voorhis, 2009; Simpson, Yahner, & Dugan, 2008). Daly (1994) conducted a groundbreaking analysis of the pathways followed by women into their criminal behaviour. Up to that time, feminist theorists had posited that women became criminalized as a result of their need to escape abusive situations in their home environment and becoming ensnared in problematic lifestyles that led to their offending behaviour. In her analysis, however, Daly found evidence for five explanatory pathways to offending behaviour. Subsequent research by Brennan et al. (2012), Salisbury and Van Voorhis (2009), and Simpson, et al. (2008) has largely supported these gendered pathways albeit with some sample specific-differences. This research provides support for the feminist position that female criminality is best explained by distinct etiological pathways that include drugs, defensive violence against partners, and childhood physical and/or sexual victimisation. Summarized here are the main pathways and their accompanying criminogenic characteristics as established by Brennan et al. (2012):

  The “normal functioning” drug/property pathway: Offenders in this pathway demonstrate few childhood problems and have no evidence of abuse or psychological issues. They appear to be those adolescent-limited offenders who got “snared” into ongoing criminality during their adult years due to drug use and parental stresses. These women tend to demonstrate lower risk of criminal recidivism and present with few criminogenic factors.

  The battered women/victimization pathway: This pathway involves women with severe child and adult histories of physical and sexual victimization, chronic drug problems, unsafe housing, and chaotic lives. Criminal activity and substance use are common in the women’s families. Not surprisingly, social support from their families tends to be poor and parenting is stressful. Their conjugal relationships are characterized by conflict and violence. Women in this pathway tend to demonstrate above average mental health issues, anger and hostility problems, and problems with aggression.

  PHOTO 20.1 Adolescent-limited offenders get involved in criminality due to drug use and parental stresses.

  Source: © wavebreakmedia/Shutterstock

  The poor marginalized antisocial pathway: This pathway is characterized by women who are poor and socially marginalized, have educational or vocational deficits and poor employment skills. They show little evidence of sexual or physical victimization or mental health problems. These women originate from or reside in high crime neighbourhoods, have antisocial significant others, and are mainly involved in drug or property offenses. Their main criminogenic needs relate to their links to an antisocial subculture, antisocial peers, higher family crime, residence in higher crime areas, and frequent drug trafficking.

  The antisocial aggressive pathway: This pathway is akin to the harmed and harming women first established by Daly (1994). Women in this pathway are characterized by lifelong histories of sexual and physical victimization, high rates of placement in foster care during childhood, antisocial significant others, hostile antisocial personality, mental health issues, and homelessness. These severely abused women develop at an early age hostile antisocial personalities combined with mental health or depression issues, marginalization, and homelessness. Not surprisingly, they have few educational and vocational skills. They lead chaotic lives with little to no employment, homelessness, and poverty. This pathway involves women with serious mental health problems, psychosis, self-harm and suicide attempts who are aggressive, violent, and noncompliant.

  As can be seen in these descriptions, the manifestations of gender-neutral or gender-specific issues tend to differ according to the specific pathway that led the criminal behaviour. For example, trauma issues, dysfunctional relationships and mental health problems appear particularly relevant for women found in the “battered women” and the “antisocial aggressive women” pathways. In contrast, lifestyle instability, drug abuse problems, low educational achievement and the presence of antisocial attitudes and peers are the criminogenic factors typically found among women in the “poor marginalized antisocial”. Of course, it is important that these pathways are prototypes. Some overlap in characteristics among various women can be expected.

  20.3.3 Interventions for Adult Female Offenders

  Therapeutic interventions for female offenders, just like with all offenders, aim to reduce the likelihood of future offending by addressing the issues that have led the woman into the criminal behaviour. As mentioned earlier in this chapter, there has been a long tradition of applying male-based knowledge to understand criminal offending by women. This tradition has also included adapting for female offenders therapeutic interventions developed and validated for male offenders by simply changing “he” for “she” in the material. Such approaches have been criticized for failing to take into consideration risk and receptivity factors that are specific to women (e.g. Covington & Bloom, 2006). These criticisms have led to the development of gender-informed interventions that attend to differences in gender responsiveness
to treatment while ensuring that the relevant criminogenic factors are addressed (van Wormer, 2010). Interventions may range from single-issue treatment programs (e.g. substance abuse treatment) to more complex interventions that simultaneously address a number of criminogenic needs problems (e.g. trauma-informed violence prevention program). There are universal gender-informed principles that should be incorporated in women offenders’ treatment programs, regardless of whether the treatment is intended to address general criminal behaviour, substance abuse problems, violent behaviour, domestic violence or sexual offending. Specifically, treatment programs for women offenders must be based on an empirical model of offending among women, address the factors that have led to the offending behaviour and put the woman at risk of reoffending, be delivered at an intensity that ensures sufficient opportunities for change, and attend to gender-responsiveness issues.

  PHOTO 20.2 Therapeutic interventions addressing the issues that have led to criminal behaviour.

  Source: © Monkey Business Images/Shutterstock

  20.3.4 What is Treatment Responsivity?

  In the same way as correctional interventions should be associated with an appropriate theoretical and empirical framework about the causes of criminal behaviour, the choice of treatment modalities delivered to offenders should be based on empirical evidence. The types of treatment that have been empirically demonstrated to be effective with all offenders, male or female, are cognitive and behaviourally-based structured interventions (Andrews & Bonta, 2010; Dowden & Andrews, 1999). This type of treatment entails the combined use of various therapeutic techniques that include demonstrating and reinforcing vivid alternatives to pro-offending styles of thinking, feeling, and acting; reinforcement of anticriminal and prosocial behaviour; graduated practice of new skills in treatment; identification and removal of obstacles toward increased levels of anti- offending behaviour; and cognitive restructuring. During treatment, the woman should learn to recognize the connections between her cognitions, emotions, and behaviour.