Within-treatment changes in dynamic risk factors for sexual recidivism

Dynamic risk factors for sexual recidivism are, by definition, changeable attributes whose modification should influence reoffending likelihood. This article reviews the literature surrounding within-treatment changes in dynamic risk factors, examining three interrelated tenets: that identified dynamic factors predict recidivism; that they are amenable to change through treatment; and that such changes are associated with altered recidivism likelihood. Extant evidence supports a significant modest association between dynamic risk factor change and reduced sexual recidivism. Crucially, research has demonstrated that post-treatment risk scores and within-treatment change scores each provide incremental predictive information, and that neither alone is sufficient for valid post-treatment risk estimation. Structured approaches to measuring treatment change, particularly assessor-rated tools such as the VRS-SO, show the strongest empirical support for clinical use. Additional considerations are discussed, including the causal status of dynamic risk factors, the emerging role of protective factors, and responsivity-informed approaches to maximising treatment-related change.PRACTICE IMPACT STATEMENT There is now substantial evidence that changes on dynamic risk factors influence changes in recidivism likelihood. In practice, failing to account for treatment change, or conversely relying solely on assessments of change, will impact the accuracy of post-treatment risk assessments – both risk and change are incrementally relevant. In clinical settings, assessment approach makes a difference, with the best support currently for structured assessor-rated tools that balance consideration of both risk and change.