David S. Prescott, LICSW

The Estimate of Risk of Adolescent Sexual Offense Recidivism

Overview

The ERASOR, developed by Jim Worling and Tracy Curwen in 2001, is an empirically-guided, single-scale instrument designed to estimate the short-term risk of a sexual reoffense among youth ages 12 to 18. The ERASOR looks at risk factors that are that  fall under 5 headings, including sexual interests, attitudes, and behaviors; historical sexual assaults; psychosocial functioning; family/environmental functioning; and treatment.

The ERASOR is in widespread use throughout Canada and the United States and by a growing number of clinicians in other countries.
 

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Assessing Risk with the "ERASOR"

by Steven Bengis, David S. Prescott, & Joan Tabachnick

Review originally published in NEARI News, October 2011

Question

How accurate is the use of clinical judgment, total ERASOR score, and the number of risk factors present in predicting risk of sexual recidivism in adolescents?

The Research

191 male adolescents between the ages of 12 and 19 were assessed by graduate-level practicing clinicians using the ERASOR. All of the youth in the study had been convicted of and/or acknowledged criminal sexual behavior and were receiving treatment in one of five agencies in southern Ontario, Canada. Unlike previous recidivism studies that relied on historical record review for their results, this study used prospective methodology and followed its participants for a period ranging from one month to nearly eight years collecting recidivism data from three sources to increase accuracy. While acknowledging the study's limitations, the authors indicated the following study outcomes:

• When using either total ERASOR scores and/or the number of risk factors present, the ERASOR predicted sexual recidivism in both long and short term follow-up;
• With a shorter period of 1.4 years, clinical judgment based on the ERASOR results was also predictive; and
• The research indicated that five dynamic risk factors were signficantly related to sexual recidivism including: obsessive sexual interests/preoccupation with sexual thoughts; antisocial interpersonal orientation; lack of intimate peer relationships/social isolation; interpersonal aggression; and problematic parent-child relationships/parental rejection.

Implications for Professionals

In an age of declining resources and profound social consequences to those who sexually abuse, it is more important than ever to focus our most intensive supervision and treatment interventions on those who are at highest risk to reoffend.  Empirically based risk assessment tools (like the ERASOR, the J-SOAP-II, the J-SORRAT-II, and the MIDSA), offer us the opportunity to more accurately assess the adolescents in our care.  However, as we have written previously, it is vital that professionals do not confuse risk assessment with comprehensive assessments that guide assessment and treatment. Unlike much of the earlier research, this study examined the total score of the ERASOR, the number of risk factors present and clinical judgments of risk, an important comparison. The conclusion is that clinicians do better making short-term judgments. Thus, clinicians need to be very careful to limit predictive statements based on clinical judgment to shorter time frames, and reassess youth routinely. This study adds to our growing confidence that, used properly (e.g., not as a stand-alone instrument), the ERASOR and other tools can be used to guide risk assessment. Important to note is that the study points out that none of these scales currently examine the impact of protective factors on recidivism. It is critical that clinicians keep abreast of the current research and apply that information to creating more comprehensive risk assessments, treatment plans, goal setting, and safety plans for each individual adolescent.

Implications for the Field

As the field of sexual re-offense risk assessment develops, researchers are beginning to coalesce around a set of dynamic risk factors that appear to have the strongest predictive validity (aggression, substance abuse, antisocial behaviors, social isolation, and lack of parental involvement). But even in this small sample ERASOR study, there are some adolescents in the low to moderate risk category who go on to offend sexually. Teasing out the factors that may lead to that outcome and weighting those factors accordingly may be important. Of even greater importance (and this is noted by the study authors) is the development of strong protective factors. All the study participants were enrolled in "abuse-specific" treatment programs. How do these programs impact on outcomes, with what specific interventions, relationships, and modalities and how do these modalities need to be modified for different adolescents to ensure a better outcome? The field has evolved significantly from its earliest years when, in the absence of solid research, a clinician's subjective opinion about risk was the only option. Today, our work with adolescents is guided by an increasing amount of risk research. Even with this research, the authors offer an important caution:   ...although there is often an expectation that risk assessments should be able to pinpoint the exact probability of a reoffense, the accuracy of current risk assessment tools for both sexual and non-sexual recidivism--for both adults and adolescents--is such that precise probabilistic estmates that are generalizable across various populations are not yet possible ... it might also be prudent, therefore, for professionals in the field to continue to educate consumers of risk assessments about the scientific limitations of these tools. We could not agree more.

Citation

Worling, J.R. Bookalam, D., & Litteljohn, A. (2011). Prospective Validity of the Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR). Sexual Abuse: A Journal of Research and Treatment. Advance Online Publication, 1-21. doi: 10.1177/1079063211407080.