| Introduction | ix |
| 1. | Relevant Components of Sex Offender Civil Commitment Laws: The Evaluation "Referral Questions" | 1 |
| The Relevant Statutes | 2 |
| Different Types of Assessments | 3 |
| Who Is Allowed to Do These Evaluations | 7 |
| The Overall Criteria for Commitment | 8 |
| The Issue of Lesser Restrictive Alternatives | 23 |
| Summary Comments | 24 |
| 2. | Procedures for Conducting the Assessment | 27 |
| National Standards | 27 |
| Standard Procedures for Gathering Information | 31 |
| Ethical Considerations | 49 |
| Summary Comments | 49 |
| 3. | Diagnostic Issues Within Sex Offender Civil Commitment Assessments: Defining Relevant Paraphilias | 51 |
| Defending the Labels We Use | 51 |
| Why Diagnose at All? | 54 |
| DSM-IV Definitional Problems for Paraphilia | 56 |
| Paraphilia, Not Otherwise Specified, Nonconsent | 63 |
| Other Relevant Types of Paraphilia NOS | 80 |
| Thresholds for Diagnosing a Paraphilia | 81 |
| The Descriptive Language We Use | 85 |
| Summary Comments | 86 |
| 4. | Diagnostic Issues Within Sex Offender Civil Commitment Assessments: Diagnostic Issues Beyond the Paraphilias | 87 |
| Nonparaphiliac Diagnoses Common in Sex Offender Civil Commitment Assessments | 87 |
| Differentiations Among Commonly Diagnosed Disorders | 93 |
| Drawing the Predisposition Nexus | 99 |
| Summary Comments | 102 |
| 5. | Using Risk Assessment Instrumentation | 103 |
| The Overall Risk Assessment Methodological Choice | 104 |
| Comparing the Accuracy of Differing Methodologies | 106 |
| Selecting What Instruments to Use | 115 |
| Interpreting Actuarial Instrument Results | 139 |
| Summary Comments | 143 |
| 6. | Recidivism Base Rates | 145 |
| What Do We Know About the Sexual Recidivism Base Rate? | 146 |
| Why Base Rates Matter | 151 |
| For Which Sex Offenders Do Base Rates Matter? | 154 |
| Summary Comments | 160 |
| 7. | Clinical Adjustments | 161 |
| Defining Proper Adjustments | 162 |
| The Theoretical Basis for Clinical Adjustments | 163 |
| Adjustments Based on Risk Factors | 164 |
| Adjustments Based on Protective Factors | 171 |
| Assessing Beyond the Actuarial Scheme | 173 |
| Evaluator Bias | 176 |
| Summary Comments | 177 |
| 8. | The Evaluation Report and Court Testimony | 179 |
| The Evaluation Report | 180 |
| Testifying About Evaluation Findings | 184 |
| Summary Comments | 188 |
| 9. | Ethical Issues | 189 |
| Procedural Concerns | 189 |
| Communication Concerns | 195 |
| A Final Comment | 199 |
| Appendix A | Relapse Prevention Interview | 201 |
| Basic Principles of Scoring | 201 |
| Relapse Prevention Interview Score Sheet | 209 |
| Appendix B | Templates for Segments of Precommitment Forms and Reports | 211 |
| Informed Consent Form | 211 |
| Diagnostic Segment | 212 |
| Actuarial Instrument Time and Legal Status Limitations Template | 214 |
| Appendix C | Sample Precommitment Evaluation Report | 217 |
| State Statute # Evaluation | 217 |
| Appendix D | Templates for Segments of Reexamination (Postcommitment) Evaluation Report | 225 |
| Treatment Benefit Template | 225 |
| Template for Risk Management Segment | 227 |
| References | 229 |
| Index | 237 |
| About the Author | 243 |
