Some have argued that acturarial methods such as the RRASOR, the MNSOSTR, and the Static-99, can outperform clinical judgments when utilized at a civil commitment hearing to make a prediction. Although actuarial data can be used to identify a group of persons to be considered for possible civil commitment, at present it cannot be used to accurately predict the likelihood of future acts of sexual violence with respect to any specific individual within such a group. For that reason, it might be best to restrict the use of acturial data to the initial screening process, rather than introducing it at the commitment hearing itself.

No abstract

The clerical sex abuse crisis that has unfolded over the past ten years has generated a considerable literature. Marie Keenan's study, based partly on research she undertook with nine clergy offenders, is published at a time when emotions continue to run high, especially in Ireland, and the effects of the crisis are still being felt. In her introduction Dr Keenan explains that her aim is to offer 'a model of performance that helps to conceptualize and understand, but never justify, the perplexing problem of child sexual abuse by Catholic Clergy.'Her book is divided into three sections. In the first section she surveys the problem, by summarizing data from different countries, making use of government reports and published studies. She shows quite clearly that the hierarchy knew this problem existed but consistently failed to learn from history.The title of the second chapter, 'Organized irresponsibility,' reveals her conclusion from the evidence she surveys. More than anything, this section is a plea for honesty and transparency, in place of the secrecy, hypocrisy and dishonesty which characterize the church's way of handling issues, particularly those that relate to sexuality and celibacy. She reviews the literature on clericalism, accountability in the church, sexual ethics and the seminary formation system, and concludes that the process of clerical socialization in this closed system has contributed to the problems related to clergy and sexuality, including clergy sexual abuse.Coming from a background in psychology, I found her second section, 'Theorizing Sexual Abuse,' particularly helpful. Keenan shows the limitations of focusing on the individual offender or single factor theories (pp. 93-94), and argues convincingly for the need to see clerical sexual abuse in the broader context of the church as an organization, with its own particular theology, clerical culture, and attitudes to sexuality and power. She notes that Pope Benedict appears to favour an explanation that blames the individual priest, and that he makes a connection with relativism (pp. 224-25). She

This article proposes that cognitive-behavioral interventions can be appropriate and pastorally effective means of intervention in an inpatient psychiatric facility in the context of managed care. Starting from the standpoint of self-regulation failure, it is suggested that the following factors are significant in effective therapy; rest, the safety of the closed ward, counselor empathy, the experience of self-efficacy through counseling sessions principally through utilization of cognitive-behavioral approaches, and the support of staff and patients. Case examples are described and Borderline Personality Disorder is explored as a special case. The article concludes with the suggestion that the most significant factors in returning patients to outpatient care are the rediscovery of meaning and the installation of hope.