They Have No Idea How To Rehabilitate Sex Offenders

As Seen on Vocativ.Com convicted sex offenders may not work at all, according to a new study.

This is another case of "No Results". Of course, psychiatrists have long admitted that they do not cure anyone.

Prison programs that have been in place for decades to rehabilitate convicted sex offenders may not work at all, according to a new study.

“No evidence from academic or policy research has shown that the treatment programme significantly reduces sexual reoffending,” David K. Ho, a forensic psychologist at South Essex Partnership University in England, writes in BMJ. “Victims and the public deserve to know this.”

After reviewing hundreds of prior studies, Ho concluded that there is no evidence that prison rehabilitation programs reduce the risk of sex criminals striking again. If they do not work, Ho says, we are not only wasting state resources, but also putting society at risk by releasing unreformed sex offenders.

To date, the studies have simply followed criminals in therapy and tracked their outcomes. However, in order to draw real conclusions about whether psychotherapy works on sex offenders, we would need so-called randomized trials with a control group that receives “placebo” therapy.

Despite the obvious ethical issues of releasing sex criminals after fake psychotherapy sessions, scientists have been pushing for definitive trials for at least five years.

For more on the effort to rehabilitate sex criminals, check out the American Civil Liberties Union’s review of sex offender laws that do more harm than good.

The author seems to have missed the datum that subjective therapies, such as talking therapies, cannot be subject to double blinding.

As can be seen in this journal issue, modern science is still trying to figure out how to do double blind studies with regard to the various kinds of talking therapies.

Now you can do a double blind study regarding some aspects of the *training* of therapists. This study is fascinating regarding the attitude of the trainees vs the results of the therapy they deliver.

Essentially, if you train therapists to be in real communication with patients, they get better results. Who would have thought?

Six Months off Medications, and doing fine.

An Interesting look at one man's experience being off his medications for six months.

Seen at Furious Seasons and on the Daily KOS. Snippet:

What's stunning to me is that I remain virtually without symptoms, even of depression--and that's just not supposed to be happening here, especially since I am under massive amounts of stress, personally and professionally. Not according to the medical literature I've read. The course for bipolars who go off-meds is supposed to be highly predictable--they wind up in big trouble and either die or spend time in a psych unit or what have you. And of course they wind up back on meds after wreaking havoc on the Western world. They never get better or do just fine off-meds.

But, then, maybe the unbiased researchers who write the medical literature never talk to or examine people like me. OK, I know they don't.

So what is going on here? Was I a bad diagnosis back in 1989? Did meds somehow cure me while messing me up at the same time? Did therapy cure me? (Um, no since I haven't seen a therapist since the early 1990s.) Did I cure me? Or does bipolar disorder just burn out over time? I am leaning towards the latter two possibilities, but I'm not sure how to explain this except to say that's what seems to be going on.

One of the comments on his state is from a fairly well know psychiatrist who calls BS on BiPolar Disorder to begin with.

"Bipolar disorder isn't actually a disease.

"It's a collection of signs and symptoms lumped together in a diagnostic classification that has no basis or assumption of causation. There is no known neurochemical abnormality associated with "bipolar disorder", and patients with this diagnosis certainly have a plethora of different problems, all lumped together in one convenient/dumb diagnostic classification.

"[...] Your own experience isn't miraculous, it just verifies that much of contemporary psychiatric diagnosis is a bunch of malarkey.

The original author also had in interesting post some months back about a conversation with his shrink. It seems that by definition, nobody is ever cured of a psychiatric disease, because they don't know what is going on with their diseases, and therefore even if a person could be declared cured by any other reasonable standard, they can't say so.

Psychiatrist Fired after Death of Patient

A psychiatrist has been implicated and disciplined in the the death of a wounded veteran under going treatment at Fort Knox, Kentucky. The family is understandably upse and demanding investigations, etc. From the Courier journal in Louisville, Kentucky

A psychiatrist who treated Sgt. Gerald Cassidy, the wounded Iraq veteran from Indiana found dead in his Fort Knox barracks, has been "relieved of his duties," a spokesman for U.S. Sen. Evan Bayh said yesterday.

Bayh press secretary Jonathan Swain identified the psychiatrist as Dr. William Kearney.

The civilian doctor, contracted by the Army, is the fourth person to face job action in connection with the Sept. 21 death. Three soldiers in Cassidy's chain of command have already lost their posts.

Bayh, an Indiana Democrat, has linked the Westfield man's death to inadequate staffing and problems with care at the Fort Knox Warrior Transition Unit, which opened in June and is devoted to healing the wounds of war.

"The fact that (Kearney) has been relieved of his duties confirms the validity of the questions Sen. Bayh and the family have been asking," Swain said.

Although the Army is still investigating the death and its cause, preliminary reports show that the brain-injured National Guardsman may have been unconscious for days and dead for hours before someone checked on him.

Cassidy left a wife, a 5-year-old daughter and a 3-year-old son.

"This was a beautiful young man who did nothing wrong," said Cassidy's mother, Kay McMullen of Carmel, Ind.

She declined to comment specifically on the psychiatrist, but said: "The Army killed him with incompetent care."

Bayh is seeking clarification from the Army about whether Kearney's departure is temporary or permanent, and Kearney could not be reached for comment.

Constance Shaffery, public affairs officer at Fort Knox, confirmed that the psychiatrist is no longer working at Ireland Army Community Hospital but would not comment further, saying it is a personnel matter.

She also confirmed that representatives of Sens. Barbara Boxer of California and Joe Lieberman of Connecticut were on the base yesterday, although she said "it isn't primarily about Sgt. Cassidy."

"Staffers from the offices of Senators Lieberman and Boxer came to Fort Knox as one in a series of visits to Army installations to look at mental health care and Warrior Transition Units throughout the Army," Shaffery said. "Our elected officials often send staffers to visit Fort Knox and other Army posts to learn more (about) the Army and our missions."

Lieberman is a member of the Senate Armed Services Committee and Boxer has been working with other senators to examine mental health care for service members returning from Iraq and Afghanistan.

Natalie Ravitz, Boxer's communications director, said the visit is part of a series of planned visits to bases nationwide, "but Sgt. Cassidy's death did prompt our staff to move up their visit to Fort Knox.

"One of the issues Senators Boxer and Lieberman have been looking at closely is treatment for Traumatic Brain Injury and PTSD," Ravitz said.

Cassidy, 32, suffered brain injuries in a roadside blast in Iraq and was assigned to one of 35 transition units that were created after The Washington Post revealed substandard outpatient care at Walter Reed Army Medical Center.

Bayh said Cassidy received "substandard care" at Fort Knox and tried unsuccessfully for five months to get transferred to a specialized private facility in Indianapolis that could deal with his condition.

[...]

McMullen's voice broke with emotion as she said she hopes Bayh's efforts prevent other families from suffering like hers.

"I think things have gotten better" at Fort Knox, she said. "But I think they've got a long way to go."

Tantrums, casual sex and useless £12,000 therapy: what REALLY goes on inside rehab

Modern psychiatric and psychological drug rehab for the famous and the unknown is not only expensive, but worthless. As reporte4d in the Daily Mail.

[...]

I finally bottomed out in July 2005 when I had a panic attack. I'd been drinking for three days, virtually nonstop, having gone to a wild party at someone's house and slept on the floor for two nights.

My hands were shaking and I started hyperventilating and had to go to hospital where I was given Valium. It was an utterly terrifying experience and it signalled a turning point.

My body was clearly telling me it couldn't cope any more and I decided to tell my parents my secret - that I had a drink problem.

[...]

I had a high-flying career, good friends, and even a Prada handbag! I looked healthy and ate a reasonable diet. But I knew I needed help and I asked my father if he'd pay for me to go to rehab.

He generously agreed to do so at a huge cost of £12,000 for six weeks' treatment. I confessed all to my boss who was very kind, telling me to take a chunk of unpaid leave and simply concentrate on getting well. [...] My father was effectively paying £2,000 a week for me to sit around doing nothing.

[...]

In the evening we'd have "group workshops", which involved making notes about various aspects of our addictions and asking fellow patients to evaluate our work.

Most of the time we simply went through the motions quickly and then went back to playing Blackjack with Monopoly money and listening to our iPods.

The work assignments occasionally handed out were far too simple. For example, we were asked to write about our worst drinking experiences - but we'd already covered this in group therapy.

When we actually had lectures they were over simplistic, and patronising to anyone with half a brain.

We were asked to perform mimes showing each other how we could enjoy ourselves without resorting to drink and drugs on a given day. I mimed country-dancing.

[...]

After all this, and wasting 12,000 of her father's money, she eventually made some progress when she joined AA. Many more details at the original link.

Military Bars Soldiers with 'Personality Disorders' - Families Say the Disorders are the Result of the War.

From National Public Radio with radio show feed on the site

Thousands of military personnel have been dismissed for "personality disorders" since the war in Iraq began.

The military says the soldiers had pre-existing mental conditions that it is not responsible for treating. But soldiers, their families and veterans' groups counter that the mental condition is post-traumatic stress disorder caused by their experiences in Iraq and Afghanistan.

Daniel Zwerdling says if a soldier's medical unit diagnoses him with PTSD, the treatment could last months and make the military liable for the soldier's disability benefits. But if the soldier is diagnosed with a personality disorder — a condition that predates his military service — then the treatment would only last a couple weeks and the military would not be liable for the disability benefits.

Zwerdling says he found no evidence of a military psychiatrist diagnosing a soldier with a personality disorder in order to avoid the extended treatment and costs. However, he did hear that the personality disorder diagnosis has been used to discharge problem soldiers quickly.

William Wooldridge, who was an Army specialist in Iraq, says he was dismissed from the service for having a personality disorder.

During his second enlistment, Wooldridge says he underwent a stressful deployment to Iraq and had a breakdown. When he returned to the U.S., he was evaluated by an Army psychiatrist and received a discharge for having a personality disorder.

Wooldridge fought the diagnosis and eventually got it changed to PTSD.

Zwerdling says the military also needs to figure out how it will deal with the tens of thousands of soldiers and Maries who are returning home with serious mental health problems that interfere with their daily lives.

Currently, he says, the military has a terrible system for dealing with mental health problems and it is not doing much to make the system better.

Zwerdling and Wooldridge talk to Alex Chadwick about the issue.

The trouble with rehab, Malibu-style

The LA Times is carrying an expose on the scams run by a number of celebrity oriented rehab centers. The expose cites a number of horror stories involving the greed of these shady operations. Not a pretty picture, but too long to quote in full here. Here are a few snippets:

Hollywood rehab can produce unhappy endings, even when the patient isn't named Lindsay or Britney.

That's what Kelly Logan learned when he sought treatment for a methamphetamine addiction at Promises Malibu, detox destination to the stars.

Logan's brother, Garfield, says he paid $42,000 up front to admit the former professional surfer for a month at Promises' canyon-top Mediterranean-style home. Five days later, he says, Promises kicked Logan out for belligerent behavior but kept all the money.

"They're scam artists," said Garfield Logan, a plaintiff in one of four consumer-rights, breach-of-contract and unfair-business-practice lawsuits filed against Promises Malibu and its Westside branch in the last year. Promises has denied the allegations.

The suits and state licensing violations reveal a little-seen side to the high-end rehabilitation centers that have become a Malibu cottage industry and -- thanks to such patrons as Promises alums Lindsay Lohan and Britney Spears -- a tabloid feeding ground.

The legal problems also reflect how the Malibu properties -- the area has one of the densest concentrations of rehab retreats in the nation, experts say -- can differ from industry norms, as represented by the Betty Ford Center, Hazelden, Phoenix House and other leaders in addiction treatment.

All of the Malibu centers are for-profit enterprises in a field dominated by not-for-profits. With luxury as a principal appeal, many charge far more than the going rate for residential care. Court records indicate that Promises' fee is more than double the $23,000 cost for a month at Betty Ford.

[...]

Promises, Passages and other Malibu rehab firms have identified on their websites a number of psychiatrists and other physicians as staff members, even though the centers are not licensed to provide medical care.

Instead, they are limited to offering services such as detox monitoring that does not require medical treatment; group and individual counseling; and addiction education, state officials say. Over the last few years, Promises and several other centers that do business in Malibu have been cited by state regulators for providing medical services outside the scope of their licenses.

[...]

Many of the Malibu firms typically demand a month's payment in advance and refuse to refund any portion if the patient leaves treatment early or is expelled. No-refund policies at more traditional centers often apply to just part of the fee -- $5,000 in the case of Betty Ford, for example.

Civil War-Era Mental Asylum for Sale, But No One Wants It

Officials are baffled as to why a former state insane asylum has not sold in 15 years, despite

• being located in central WV,
  
• costing $300k per year to heat,
  
• filled with asbestos,
  
• possibly haunted and
  
• used as paintball park by off-duty cops

Never mind the deal killer: Once used by psychiatrists.

As seen in the Washington Post

For a few years after the patients moved to a new hospital, the state kept the heat on. But with 15 miles of pipe and 921 windows, that cost $300,000 a year. Eventually, the state cut back to groundskeeping and security, for a continuing annual cost of about $100,000.

"The biggest thing for me is that the property is not living up to its highest, best use," Hildreth said. "If we could open the doors and put it in the private sector, it could be something."

There have been attempts.

Local residents offered tours and made a little headway, fixing the clock tower, rebuilding the fountain in front of the main entry and cleaning up the mess from someone's paintball battle. But their pockets weren't deep enough, and the tours were halted in 2004 for safety reasons.

Two Tennessee developers hoped to create a hotel and convention center, but they couldn't raise $88 million for renovations.

Weston native Lowell Davis proposed a $300 million hotel and casino and persuaded Lewis County voters to pass a symbolic referendum allowing the casino, but the state rejected his plan.

If location counts, the hospital has appeal: It's two hours south of Pittsburgh and 4 1/2 hours west of Baltimore.

But some potential problems _ including piles of cancer-causing asbestos and other possible environmental hazards _ worry prospective bidders more than the ghosts that reportedly inhabit the dark and dusty hallways.

The buyer will bear those burdens with no financial help from the state. The state says it's not required to disclose the extent of possible contamination, other than to acknowledge hazardous materials "may exist in or on the property."

One developer, David Wamsley of Williamstown, toured the hospital with plans to raise $20 million for a project with commercial and residential elements. Three hours later, he figured he'd need 10 times that amount _ and 10 to 15 years to turn a profit.

Hildreth doubts environmental concerns will deter serious bidders.

What could be a problem is opposition by people like former mayor Jon Tucci, who argues that city officials should have a say on the future of a facility that once generated $90,000 a year in tax revenue.

"There has to be some kind of an anchor, an economic base to replace what this was," Tucci said. "This was the fulcrum of our community for 150 years."

Morgantown contractor Joe Jordan argues that such decisions should be left to the developer.

"If the city of Weston is going to legislate what you're gonna do with it, well hell, they may as well just buy it," he said

Dr. Feel Good

A poem found on the Advocate Web website. AdvocateWeb is a nonprofit organization providing information and resources to promote awareness and understanding of the issues involved in the exploitation of persons by trusted helping professionals. They are attempting to be a helpful resource for victim/survivors, their family and friends, the general public, and for victim advocates and professionals.

Dr. Feel Good
Toni

His guise was to heal,
But that was not the deal.
I put my well being into his hands,
and naively followed his commands.

I did not see he was there to seduce;
Feelings of shameful stupidity it would produce.
He caught me in a weakened state,
at his will would lie my fate.

Self respect is not all he would take.
I could not find it in my of him to forsake.
My awful secret I would conceal.
Who would believe me if I were to reveal?

Like a thief he took my dignity,
along with my trusting ability,
taking full advantage of my vulnerability.
He took it all the while
he kept a cunning smile.

What he took can not be replaced.
From my memory it can never be erased.
I could find no hiding place.
To his “charm” I fell victim.
My welfare did not matter to him.

His intentions I refused to believe.
The damage he could inflict I could not conceive.
By this ugly truth I am consumed.
And he? He remains immune.

But why me did he pick.
This man who supposed to heal the sick?
Was it the color of my hair?
Or was I just... THERE?

Drugs is what he would supply
in order to get me to comply.
Give in I would not do.
So I became a waste of time in his view,
but he was in too deep.
Of all of this he did not want me to make a peep.
Enough drugs and maybe she'll never wake from sleep.

Ethics is only part of what he lacks.
He provided a monkey for my back.
Like a child to a father, I trusted him.
That trust soon began to dim.

What he did is equivalent to child abuse,
it was the child in me he did use.
One day I may get bold
and of this story I will have told.

No one could get him to admit
to the moral crimes he did commit.
It is him and public opinion I fear.
I would be viewed as the guilty and my name left to clear.

He'd come out smelling like a rose all along
knowing it is he who is in the wrong.
I could testify,
and him try to defy.

But can he really be caught?
And unbiased justice truly be sought?
If so, could there be a happy ever after
come the end of this chapter?

A Record of Failure at Center for Sex Offenders

As reported in the Ledger Online of Florida. Another case where the rush for profits over-ran any possible humane impulse toward rehabilitation. And likely so continues ....

Inside a privately run treatment center here for pedophiles and rapists who have completed their prison sentences, where they are supposed to reflect on their crimes and learn to control their sexual urges, bikini posters were pinned to walls.

Two men took their shirts off, rubbed each other’s backs and held hands, while others disappeared together into dormitory rooms. Some of the sex offenders appeared to be drunk from homemade “buck” liquor secretly brewed and sold here.

And some of the center’s employees, who openly ignored the breaking of rules (“As long as they are happy, we let them go,” one explained), reported that a high turnover rate among staff members was mostly because of female employees leaving their jobs after having had sex with the offenders.

These and other observations were included in a memorandum composed in 2004 by six employees on loan here from Pennsylvania. They had been dispatched by the Liberty Behavioral Health Corporation, which ran the facility, the Florida Civil Commitment Center, and a facility in Pennsylvania.

Nineteen states have laws that allow them to confine or restrict sex criminals beyond prison in a trend that is expanding around the country, with legislators in New York last week announcing agreement on a new civil commitment law there.

The courts have upheld the constitutionality of such laws in part because they are meant to furnish treatment where possible. Most of the states run their own centers to hold and treat such predators, generally with meager results, but at a time when private solutions are popular for prisons, toll roads and other state functions, a few have teamed with private industry.

Yet as the story of the center here in Arcadia reveals, even a $19 million partnership between the state and a company that describes itself as “a national leader in the field of specialized sex offender treatment and management” failed to meet a central purpose: treating sex offenders so they would be well enough to return to society.

“It was like walking into a war zone,” Jared Lamantia, one of the visiting workers who signed the memorandum, recalled in an interview. “The residents in that place ran the whole facility.”

The memorandum is among thousands of pages of public and private documents about the Florida center reviewed by The New York Times, providing a rare window into the lives of civilly committed sexual predators and the people who guard and treat them. While programs like Florida’s are popular because they keep sex offenders locked away past their prison terms, they cost far more than prison — in the case of Florida, on average twice as much — with no measurable benefit beyond confinement.

For more than seven years, Liberty was in charge of almost every facet of the Florida center, where more than 500 men are held beyond their criminal sentences in a crowded former prison surrounded by cow pastures.

That ended last June in a cloud of claims and counterclaims, investigations and legislative hearings. By the end, after the state did not renew Liberty’s contract, the Florida Department of Children and Families was virtually at war with the company, with each side pinning blame on the other — the state accused of failing to properly finance the center, the company accused of failing to manage it.

“The place is a cesspool of despair and depression and drug abuse — of people being lost,” said Don Sweeney, a mental health counselor in St. Petersburg who treats some former residents of the center, reflecting on Liberty’s tenure there.

Many outside experts, even some of the center’s critics, said the state’s insufficient financing of the center made Florida as much to blame as Liberty for the many failings, many of which are common in other states. Florida spends less than $42,000 a year per resident, one of the lowest rates in the country.

“There was no money to support that facility and to do what had to be done,” Dr. Robert Bellino, a psychiatrist who worked at the center here, said of the company. “It’s a political football. They were always turning the screws on Liberty — ‘Cut this, cut that, don’t spend this, don’t spend that.’ ”

Ambitious Private Contractors

As legislators across the nation have answered public outrage about heinous sex crimes with civil commitment laws, a bevy of companies and well-paid specialists have cropped up like constellations around the expanding demand.

Liberty Behavioral Health and Liberty Healthcare Corporation, affiliates with common ownership, have emerged as the most ambitious private contractors in the commitment center arena. As recently as last year, the affiliates had accumulated contracts worth up to $26 million a year in California, Illinois, Pennsylvania and Florida, which was the biggest both in terms of compensation and responsibility.

Growing out of a company that provided emergency room employees to hospitals starting in the mid 1970s, Liberty Healthcare Corporation was founded in 1986 as a provider of mental health, developmental disability and primary care services. In its earliest days, it had no experience treating sex offenders and, its officials said, there was never a particular moment when company officials said to one another, “Let’s go into the sex offender business.”

Yet as Shan Jumper, Liberty’s clinical director in Illinois, tells it, after “analyzing market trends and seeing what areas they could jump into,” Liberty executives apparently recognized the potential.

By 1998, the company, which is privately held and based in Bala Cynwyd, Pa., won its first contract to provide services inside a civil commitment center, in Illinois. Rick Robinson, executive vice president and chief operating officer of Liberty Healthcare, described the move as a natural outgrowth of its work, which included creating an adolescent sex offender unit in an Arkansas hospital in 1995.

The states that have hired private companies reason that outside experts have more background in the complex realm of detaining and treating sex offenders than most public workers, and in several states where Liberty holds contracts, officials say they have been impressed with the company’s expertise.

But at the Florida center, even beyond a string of embarrassing failures — an escape, the death of an offender after a fight with another over a bag of chips, a sit-in that the state ultimately quashed with hundreds of law enforcement officers — the treatment record was poor.

In Liberty’s tenure, only one of the hundreds of men here progressed far enough in therapy to earn a recommendation from company clinicians that he be released. At various points, many residents were not attending the group therapy specifically addressing sex offending; in May 2005, 35 percent of the center’s 484 residents fell into that category.

In written responses to questions from The New York Times, as well as court depositions, legislative testimony, e-mail messages, letters and memorandums, Liberty defended its treatment record, blamed Florida as insufficiently financing its commitment program and, for years, failing to define exactly what it expected of Liberty.

Early Praise and Promise

Liberty’s early tenure in Florida won praise from independent evaluators who said the treatment program showed promise. Over the first four years the state asked for few changes, and on matters such as the treatment of mentally ill residents, had a “just do the best you can” attitude, as Susan Keenan Nayda, vice president of operations for behavioral health programs at Liberty, said in a court deposition.

But problems began to surface publicly in June 2000 in dramatic fashion when a resident escaped in a helicopter that an accomplice had landed inside the center’s perimeter. The helicopter crashed after departing with the escapee, who was caught 26 hours later in a canal with the pilot, 2 handguns and 28 rounds of ammunition. The pilot, a longtime friend, had visited the escapee 10 times in the five months before the escape.

The bizarre incident raised worrisome questions and the first hints of a conflict over the center’s combined goals of security and treatment. Too few Liberty staff members were in the yard when the escape occurred, a report by state officials found, and the center’s director had ordered razor wire removed from a security fence because, he said, the wire was damaging volleyballs from a nearby court the residents used.

The report also complained about the state’s role, questioning why corrections officers, who were in charge of security on the perimeter, were unarmed. Commitment centers across the country have wavered between following the legal mandate to run a therapeutic program, as laid out by the courts, and the politically acceptable alternative of a more prisonlike one.

In Florida, the conflict emerged again and again. The state’s emphasis swung, at various points, toward and away from a “correctional” approach, company officials suggested. At one point, Ms. Nayda told a Florida State Senate committee that even she was not entirely sure what the center was trying to be.

“There’s a little bit of confusion,” Ms. Nayda said. “What is this place? Is it a prison? Is it a mental health center? A residential treatment facility where people are clients? What is it? We ask that question sometimes too. We really don’t have a lot of guidance around what it is the state wants the facility to be, and we would encourage the state to look at that.”

By the end of 2000, the state moved its civil commitment center from Martin County on the state’s East Coast to its current home here in Arcadia, a 14-acre compound with eight dormitories and other buildings.

From there, the population rose swiftly, even as staff levels mostly stayed put. Liberty repeatedly sought more money from the state for the center’s operations, for special treatment of its large severely mentally ill population and for creation of a supervised release program.

Asked to respond to Liberty’s complaints about financing, Rod Hall, director of the mental health program office for the state Department of Children and Families, said, “The funding provided to operate the facility was the amount negotiated and agreed upon by Liberty prior to its signing of the contracts.”

Liberty’s monthly reports began suggesting that the company was feeling the crunch. The reports noted frequent troubling incidents: residents having sex, assaulting staff members and each another, hiding knives in their rooms.

Liberty also said it faced an unusual challenge in Florida, where hundreds of the center’s residents are not formally committed, but awaiting trials for commitment. These “detainees,” the company said, often reject treatment to focus on their legal battles.

Some critics, meanwhile, began questioning the treatment. Ted Shaw, a forensic psychologist who evaluates civilly committed sex offenders, complained that Liberty held men back in treatment as punishment for minor infractions.

Liberty officials deny the allegations, but Michael Canty, a child molester who was detained at the center but was never formally committed, concurred with Dr. Shaw, saying Liberty staff members would “harass, taunt — try to get you in trouble so you would get kicked out of treatment.”

Rising Tensions, and Violence

By the time the six workers from Liberty’s facility in Pennsylvania arrived here in 2004, tensions inside the center and with the state authorities were reaching a peak.

In April of that year, a mentally ill man jumped off the center’s roof and was injured after staff members rushed at him to get him down. In June, a resident stabbed another 12 times and the staff had residents mop up the blood, destroying evidence before outside law enforcement officials arrived, an internal report showed.

“It was basically a free-for-all prison, out of control,” said Josh Stiles, another of the visiting workers from Pennsylvania.

Liberty officials said they investigated and immediately took “appropriate actions” regarding all that their Pennsylvania employees reported. But they also said the atmosphere in the center at the time was “probably very conducive for allegations that were either unfounded or exaggerated,” and noted that a second group from the Pennsylvania facility, including its director, returned to Florida several weeks later and reported no similar problems.

Nonetheless, Lynda Sommers, a consultant hired by the state to monitor the facility over a number of years, also found it in disarray in the period after the second Pennsylvania group.

Ms. Sommers reported suspected sexual relationships between staff members and offenders, staff members who slept on the job, crumbling facilities, and vague policies on punishing troublemakers and treating the mentally ill.

Liberty’s own internal investigator, Kenneth Dudding, was also deeply critical of hiring decisions for low-level staff members, whose salaries started at a base rate of $12.89 an hour.

“You could have worked at Wal-Mart last week, they put you in front of a computer to read policy for a few hours, then they send you to a dorm and let you go,” said Mr. Dudding, who left after clashing with Liberty’s management.

As for female security workers, Mr. Dudding said they were easily manipulated by the sex offenders. “It’s like putting candy in front of a baby,” he said.

Mr. Dudding said he ultimately called a state whistle-blower’s hot line.

The inspector general of the Department of Children and Families investigated and issued stinging reports, saying that the facility’s safety director had tried to cover up wrongdoing by tampering with evidence, that an employee was suspected of selling marijuana, and that alcohol was being made and sold there.

Liberty officials said the safety director was fired for “failure to properly function in her role” before they received the inspector general’s critique, and they said they fired the worker suspected of drug sales — on whom no contraband was found — for an unrelated reason.

Then a group of residents, angry when the fire marshal demanded that they not have so many personal items, moved into a yard. For months, the staff could not persuade them to go back to their rooms, creating a scene one law enforcement officer called “Woodstock gone amok.”

Liberty said it first asked for help from the Department of Corrections and was turned down, only to ultimately get a response the company called “excessive.” In February 2005, several hundred corrections and law enforcement officers in riot gear arrived and restored order.

That spring, Liberty’s requests to the state grew more insistent. The company asked for $31.1 million for the next fiscal year; it received $18.7 million, the same as the year before.

By April, having described an “alarming” set of “chronic and serious” issues at the facility, the state was preparing to end its relationship with Liberty.

New Company Takes Over

In the end, the struggle between security and treatment may help explain Liberty’s doomed tenure at the Florida center.

“I had imagined that we would be trying to do research or publish or be innovative or at least use state-of-the-art equipment,” said Dean Cauley, a former therapist at the center. “When I arrived, the equipment wasn’t being used, tests were outdated and treatment was very much secondary to maintaining security.”

Liberty officials said that treating patients had always been their company’s reason for being. Most of the company leaders, including Dr. Herbert T. Caskey, the founder, were originally clinicians, not business people.

If states wanted simply to lock up, not treat, the worst sexual predators, Kenneth Carabello, Liberty’s director of regional operations for California and the western United States, said, “We’d let somebody else do this.”

Despite the center’s history, Don Ryce, the father of Jimmy Ryce, the 9-year-old boy whose 1995 rape and murder spurred the Florida Legislature to adopt a civil commitment law in his name three years later, said the law’s “overall intention” had been accomplished.

“There are a lot of people who are confined who otherwise I guarantee you would be out there reoffending,” Mr. Ryce said, though he added, “I’m not going to pretend there aren’t serious problems that need to be addressed.”

As Liberty departed, Florida picked another private company, the GEO Group Inc., to run the center here.

The GEO Group, once known as Wackenhut Corrections Corporation, has more than 23 years of experience running prisons. Of 63 centers GEO operates worldwide, 58 are correctional and detention facilities.

Last fall, under GEO’s watch, a new glimpse of turmoil began emerging. Early one morning, a resident said he was attacked by another in his bunk. His screaming, kicking and banging on his door went unanswered for almost 15 minutes before staff members responded, other residents said.

GEO officials said workers from the company and the Department of Corrections “responded promptly” to what GEO described as a “resident upon resident” fight, an assessment echoed in a DeSoto County sheriff’s report.

But some 100 residents signed a letter calling for an end to the practice of housing two residents in a single room. The center “is supposed to be a mental health facility, not a prison,” the residents wrote. “We are to be treated as patients, not state convicts.”

Ineffective Psychiatric Prison Rehab Programs

found this article on the probably ineffectiveness of psychiatirc rehab programs in prison

Prison probably hasn't changed the killer or child molester who just left a cell block and moved onto your block. There's a 40 to 50 percent chance the ex-convict down the street will cause trouble again, experts say. The ex-cons agree.

Of course, the argument is made that they need more shrinks and more money for shrinks in Minnesota.

But even as seen in this earlier story, even just changing the television shows available in prison will have a dramatic result.

But this wouldn't cost all that much. And conditions are the same or worse in many states around the USA

If they want to spend more money, they might want to look at this experimental program being tried in Mexico. here's an interesting statistic:

The 400 inmates who have been registered in the program were the base for the statistic for this study. The objective of the study was measure the rehabilitation success and the reduction of the recidivism was valid.

When the results were analyzed it was found that the recidivism rate in the inmates who did the drug-free withdrawal and any of the other courses is very low (10.24%).

Normally, according to the State data, recidivism due to robbery is 70%. From the 192, who were released, 124 had been arrested because of robbery. At the normal 70% rate of recidivism we would expect 87 persons from the 124 would have returned to prison. Instead only 10 have returned to prison.

With this rehabilitation treatment, the recidivism rate for robbery has reduced from 70% to 8.06%

But notably, this is not a psychiatric program. Which will surpise some people thoroughly.

Just Too Strange

As reported in this article from Birmingham, England, a middle-aged psychology student is dedicating her life to helping notorious child killers, sex offenders and murderers - by falling in LOVE with them. "Sally", 56, sees nothing wrong in the bizarre relationships. She claims instead that they could help the rehabilitation of the monsters behind bars.

“I was sexually abused by a serious sex offender as a child over a number of years,” she explained. “He was in a position of authority and I was assaulted within what I would call a loving environment.

“When he dumped me several years later, I thought if I couldn’t love him, I would love men like him. I began to write to some of Britain’s most violent sex offenders.”

Needless to say, the approach has been controversial.

And I would not say that the original decision was all that rational.