Below is an extract of the section titled "REHABILITATION " in SOCIETY’S RESPONSE TO THE VIOLENT OFFENDER - Australian Institute of Criminology - First published in 1989, subsequently updated that re-enforces that treatment of violet criminals is an exceedingly complex issue which ideally has to be tailored according to the plethora of factors that influenced the particular crime.

REHABILITATION

The ideal of rehabilitation holds that through exposure to the benign influence of correctional and welfare programs, violent offenders may learn alternative behaviours, become law-abiding members of the community, and conduct their interpersonal relations in a non-violent manner. History has shown this to be easier said than done. A majority of opinion in contemporary Australia regards rehabilitation as fruitless.

Systematic reviews of overseas research on rehabilitation paint a similarly pessimistic picture. There is little in the overseas literature which has been demonstrably effective.

But this may be less an indictment of rehabilitation as a strategy than of inadequacies in the implementation of programs. Rehabilitative programs may simply be lacking in sufficient quality, duration and intensity to produce an observable effect. (Sechrest et al. 1979; Martin et al. 1981). Cynics would argue that rehabilitation has never been seriously attempted.

Because of the complexity of violence and its various manifestations, not all violent offenders are alike. Consequently, there can be no single rehabilitation program for violent offenders.  Those persons who are sentenced to prison in Australia following conviction for crimes of violence are not a cross-section of the Australian public (Walker & Biles 1987).  Upwards of ninety per cent are male. Nearly half are in their twenties. Not at all do they resemble the well-scrubbed, respectable, middle class school-boy. The majority were out of the workforce at the time of the incident for which they were convicted. Perhaps as many as one-third are unable to read and write. Many are lacking in basic social skills. Some are intellectually handicapped, others suffer in varying degrees from neurological impairment or brain damage. Hayes (19 estimates that at least one prisoner in eight in New South Wales suffers from some intellectual disability.

CASE THREE Two mentally retarded brothers in their mid- twenties were charged with the murder and sexual assault of a 7 year old boy. One of them, the instigator of the crime, made full admissions and finally pleaded guilty, giving evidence for the prosecution at the trial of his older brother. During a visit to the older brothers flat the younger went out to obtain some wine, returned and immediately left again to pick up a young boy whom he had seen in the street. The boy voluntarily went to the flat but probably became frightened and attempted to leave. Following this, the first brother subjected him to a sustained assault involving strangulation, attempted drowning and the infliction of head injuries. The second brother did not interfere or raise the alarm. During the attack the boy was sexually assaulted by the first brother and towards the end, when unconscious or possibly dead, by the second. The body was placed on a neighbouring property by the instigator of the crime while the older brother kept watch in the street. The flat was cleaned up and knowledge of the boy denied during a police door knock following the discovery of the body. When interviewed the next day; the younger brother made full admissions about his own and his brothers involvement. These two young men came from an unsettled family background and had been in an institution for the intellectually handicapped until their mid or late teens. The younger had spent time in a treatment program aimed at improving his general functioning. There was a history of a minor sexual offence against a young boy whom he had met up with in similar circumstances six years previously. Both brothers survived in the community in a marginal way; one in a boarding house, one in a flat, and received support from their mother. Neither was involved in any treatment, rehabilitation or work program, both were illiterate and their time unstructured apart from regular visits home. They received life sentences for the murder with lengthy non-parole periods of 28 and 24 years being set. Their time in prison will involve protection from other prisoners and placement in special units. No special treatment programs are available for them. Each knew the wrongness of his actions, but neither had anything like a normal appreciation of the seriousness of what happened and its implications.

In addition, there are those prisoners who are schizophrenic, or who manifest more extreme delusional symptoms. Amongst those who are more 'normal' may be found a range of personality disorders including general hostility, coldness, and the inability to feel remorse or to empathise with others. It should be noted that very few services are devoted to the identification of people who may require treatment.

Whilst none of these circumstances should be regarded as excusing or justifying violence, some are more or less intractable. The likelihood of restoring all violent persons to a peaceful constructive role in the community is thus remote.

Many aspects of the prison environment are regarded as impediments to rehabilitation.

The basic prison setting is not conducive to the acquisition of social skills and to the learning of adaptive behaviour appropriate to resuming life as a responsible member of the general community. The experience of incarceration can be extremely stressful and humiliating, not the most ideal setting for developing self-esteem. In the custodial setting, violent offenders are exposed to few appropriate role models. Indeed, for well over a century, prisons have been referred to as 'schools of crime'.

With few exceptions, Australian correctional agencies do not provide specific programs for inmates convicted of crimes of violence. Nor do community welfare agencies. Many of the more general programs do address the needs of violent offenders, however.

Whether these programs are sufficient in quality and scope to meet the needs of all violent prisoners is a key question. To the extent that they are not, this probably reflects less on the competence and innovativeness of prison administrators than it does upon the political climate and the severe cost constraints under which they labour. Annual reports of Australian corrections departments are as likely to boast of reductions in the costs of meals for prisoners and of a decline in the number of escape incidents as they are to herald new programs for prisoner rehabilitation. Australian prisons have been criticised for insufficient vocational, educational, life skills training, and for inadequate drug and alcohol rehabilitation programs (Australian Law Reform Commission 1988, p. 26).

Counselling and Therapy for Violent Offenders

All Australian corrections departments employ professional psychologists/case workers who are available for assessment and counselling of prisoners. The selection of the most effective treatment for a violent person requires sophisticated clinical judgment. The sources of an individual's violent conduct must be identified; then a course of treatment appropriate to the individual and his or her circumstances must be selected.

Most programs of rehabilitation require the willing participation of the offender. The individual must first recognise that a problem exists, and then accept responsibility for the problem, and accept responsibility for changing their behaviour. The idea of enforced rehabilitation is regarded by many penologists as futile; indeed, to others, the idea of forced rehabilitation is obnoxious. Not least important is the fact that many violent offenders will respond to coercive treatment with defiance and rage.

The essential basis of rehabilitation for violent offenders is to encourage the individual to identity and to recognise warning signs - once the individual is able to identity the stress and the anxiety which herald an impending loss of control, he is then able to learn appropriate alternative responses.

One of the most common approaches to aggression management is referred to as 'social skills training' (Henderson 1984; 1989). This entails identification of the target behaviour (aggression); recognition of the situations and circumstances under which it is likely to occur; the learning of alternative responses under such circumstances; the practice or rehearsal of these alternative behaviours, and the generalisation of these responses in future real- life situations. This learning process is reinforced by corrective feedback and rewards. Having met with considerable success in the treatment of psychiatric patients, social skills training is being applied more frequently to offender populations.

Whilst some individuals are more responsive to treatment in a one-on-one setting, others benefit more from group therapy. A group setting permits an individual to identity with others and to recognise that his problems are not necessarily unique. Group settings, moreover, are more efficient.

Violence often occurs to compensate for a poor self- image. Rehabilitation programs thus seek to restore the self-esteem of the violent offender. In addition, the lack of empathy which appears to characterise many violent people may be addressed by encouraging them to relate to the experiences and feelings of others.

It should be immediately apparent that the restoration of an offender's self-esteem may be difficult to achieve in a setting often referred to as 'a dumping ground for society's wreckage', and indeed designed as a place of discomfort and deprivation. But such are the inherent contradictions of Australian penal policy.

Perhaps one of the most effective agents of rehabilitation for violent offenders is simply the passage of time. Whilst aggressiveness tends to be a fairly stable personality trait, the natural aging process does have a moderating effect on violent behaviour. Not all violent adolescents become violent adults; not all violent individuals in their twenties remain violent in their fifties. When this attrition does occur it often results from simple maturation. In general, aggression and other anti-social personality traits tend to dissipate during the fourth decade.

Prison Industries

All Australian corrections departments provide some vocational opportunities for prisoners. Only a few years ago, following a national survey of prison education and work programs (Braithwaite 1980), Australian prison industries were described as 'among the most inefficient and unbeneficial for inmates in the world, and….getting worse'. (Braithwaite 1984, p. 56). Given the overriding concerns of prison administrators - security and cost control - this may not come as a surprise.

Workshops exist in most institutions, and some prisoners in rural areas are engaged in primary production. Among typical prison industries are the production of automobile number plates, and various products for internal prison consumption, such as clothing, farm produce, and baked goods.

Victoria is the only Australian state to have created a special Prison Industries Commission, directly responsible to the state's Minister for Corrections for the management of prison industries and farms, and for the vocational training of prisoners.

The Commission is also engaged in the development of new industries and in the marketing of products.

The difficulties inherent in providing meaningful work for prisoners are compounded by the fact that most prisoners are poorly educated, lacking in vocational skills, and come to prison with a history of unemployment which may reflect choice as well as circumstance.

Since Braithwaite's critical comments in the early 1980s, significant increases in the prison populations of most Australian jurisdictions have heightened the difficulty of providing appropriate vocational training and meaningful work for all prisoners.

The capital costs of manufacturing equipment are not trivial. Space constraints in overcrowded, antiquated facilities, many well over a century old, further limit the kinds of production processes which may be housed there. Minimal remuneration for prison labour may not provide sufficient work incentives. The operational rhythm of prison systems, which can entail frequent interruptions of daily routine and indeed, frequent transfer of prisoners between institutions, militates against productivity and ultimately the profitability of prison industrial enterprise. The suggestion that award wages be paid, at least in those activities which are productive, offends the values of many who would subordinate rehabilitation to retribution.

Well over a decade ago, Australia's foremost penologist advocated that private businesses establish branches within correctional institutions (Hawkins 1976, p. 125).

The possibility of vocational training, meaningful employment, and eventually a post-release career with the employer remains an elusive ideal, however.

Special Programs - Sex Offenders

In some jurisdictions, one still sees vestiges of the old sexual psychopath laws, under which offenders deemed to have uncontrollable sexual instincts may be detained at the Governor's pleasure (See, for example, South Australia, Criminal Law (Sentencing) Act 1988, s. 23 (3) which has the same effect as the recently repealed Criminal Law Consolidation Act, s.77a).

A more recent model for the rehabilitation of sex offenders has been presented by a joint working party of the South Australian Health Commission and Department for Community Welfare (South Australia 1988).

Under the proposed South Australian model, the first step in the rehabilitation of a sex offender, as is the case with violent offenders in general, is an initial assessment of the individual. This will identify those psychological and physiological properties which may impede or facilitate successful completion of a treatment program.

The offender then must acknowledge responsibility for his crime, and begin to acquire an understanding of the stimuli, thoughts, feelings and circumstances which tended to precede his aggressive acts. Having developed the ability to recognise the antecedents of aggressive behaviour, the offender must then learn to intervene as these antecedents emerge, and to gain control over the process.

At this point, the offender and therapist begin to construct an alternative behavioural repertoire. The development of a positive self concept is the foundation for this process.

The offender then learns the replacement of anti-social thoughts and behaviours with pro-social ones, and acquires new sexual and social skills which will permit satisfying, positive, and non-aggressive relationships with others.

Reintegration into society may well be a gradual process. At this stage, and for a considerable period thereafter, the offender can benefit from a post treatment support group and access to therapeutic treatment when needed.

In June of 1987 the Western Australian Department of Corrective Services established a pilot program for the treatment of imprisoned sex offenders (French 1988). Operating as a therapeutic community within Fremantle Prison, the program accommodates twelve prisoners at a time. The average number of participants between June 1987 and October 1988 was ten per month. Participants include persons convicted of sexual offences against children as well as sexual assault against adults.

The program includes both individual and group counselling, and includes sessions on sex education, social skills, relaxation skills and anger management, negotiation and conflict resolution, victim empathy, and dealing with depression and low self-esteem. It provides for recreational opportunities as well. A review of the program was conducted in 1988, and a full evaluation, including an assessment of the effectiveness of the program, is planned after two years of operation (Indermaur 1988). It is envisaged that the program will be extended to enable graduates to have access to periodic guidance and therapeutic services from general correctional facilities throughout the state, as well as during the period prior to their release from custody, and the period following their discharge from prison.

Special Care Unit

Until well into the 1970s, unco-operative, 'difficult', or otherwise intractable offenders in New South Wales received systematic beatings by prison officers at the notorious Grafton Gaol (New South Wales 1978). At the time, correctional authorities were less inclined than their counterparts today to recognise the principle that if prisoners are treated like animals, they will behave accordingly. Today, arguably more appropriate means are employed to deal with those prisoners who experience difficulty in adjusting to the experience of incarceration. Established in 1981, the Special Care Unit exists within a maximum security setting at Long Bay Correctional Centre, Sydney. The Unit is described as a therapeutic community, and at least two-thirds of prisoners participating in the program have had previous convictions for violent offences. Inmates agree to identify and to work on five self- nominated personal issues; aggression management, impulse control, conflict resolution and nonviolent negotiation are among those most often emphasised. The basic counselling strategies employed by staff are the encouragement of cognitive self-control and stress/relaxation management. In addition, a variety of educational and recreational activities are available including creative writing, pottery and sport. These serve the purpose of training the individual to develop patience and of enhancing self- esteem.

Participation in the Unit program, which lasts four months, is voluntary and selective.

Prisoners are received into the program from prisons throughout New South Wales.

Since 1981, over 605 male prisoners have been admitted to the program, and at least 50 percent have completed it successfully. During the eight years of the program's operation, there have been only three incidents involving violence against staff, none of which entailed serious injury (Hely & Propper 1989). The program is also envisaged as a vehicle for training prison officers in counselling and leadership techniques. Between 1981 and 1988 approximately 240 officers were rotated through the Unit.

Although participation in the NSW special care program does appear to have a beneficial effect on prisoner adjustment to the custodial setting, the question remains whether participation in such programs provides any measureable long-term benefits to those prisoners who are eventually discharged from custody. No such evaluation has been published. Indeed, there is a dearth of rigorous, objective evaluation of correctional programs in Australia generally.

Intellectual Disability, Mental Illness, and the Violent Offender

Much as one might be tempted to regard violence as a clear-cut matter of good and evil, life is not always that simple. Some of the most heinous and repulsive acts may be perpetrated by individuals who, by virtue of their mental incapacity, may be less than entirely blameworthy. Nor is mental incapacity an 'either-or' situation. It is perhaps more useful to conceive of a continuum, between, at one extreme, the person fully in possession of his faculties and at the other, the mentally ill person who may be unaware of the wrongness of his actions. In between are a range of people with varying degrees of disability, arising from brain damage, congenital handicap, or mental illness. The vast majority of individuals on this continuum, regardless of their disability, can still be found criminally responsible for acts of violence which they may commit.

Needless to say, offenders suffering from one or more handicaps or disorders have certain vulnerabilities and special needs. A recent review of these issues in New South Wales (Hayes 1988) has called attention to the importance of identifying intellectual disabilities and implementing special educational, welfare, and vocational programs for intellectually disabled offenders. These not only serve the interests of intellectually disabled offenders, facilitating their adjustment to prison and ultimately, to life back in the community, but can help to reduce problems of prison management in the long run.

In other cases, there are those persons who may have been of normal mental condition at the time of committing an offence, but who may become mentally ill whilst in prison.

The stressful experience of incarceration, it should be noted, may also have adverse effects on a prisoner's physical health. For example, upon occasion it can induce prisoners to maim themselves and to take their own lives (Walker 1987).

Of the small number of offenders who can be identified as very dangerous, at least in certain situations, there are some who may be detained indefinitely because of unfitness to stand trial or because of a finding of not guilty by reason of mental illness or insanity.

Most (but not all) accused persons who are found unfit to stand trial suffer from a psychiatric disorder or mental retardation. A few will never be fit to stand trial. Their indefinite detention at the Governor's pleasure or its equivalent raises particular problems. These were addressed by an inquiry in New South Wales, and by special provisions made in that state's Mental Health Act of 1983. (University of Sydney 1986).

Detention at the Governor's pleasure of those found not guilty by reason of insanity also raises issues regarding the institution or institutions at which they may be detained, and the procedures and criteria to be used when they are considered for release. Practices vary from state to state.

One might envisage a hospital inside a prison or a secure ward inside a 'civilian' mental hospital. Commentators have suggested that prisons should be reserved only for those persons who have been adjudged guilty of having committed a crime. Persons who have been adjudged not guilty by reason of insanity, they argue, should be confined in a non-penal setting (Potas 1982, p. 58).

CASE FOUR A middle-aged man who was the successful manager of a branch of a national organisation returned home one evening from a social occasion and shot and killed his wife and two children. He turned the rifle on himself inflicting a serious head wound with brain injury. After emergency treatment and some weeks in a general hospital he was transferred to a psychiatric hospital where he remained for three years. There was complete amnesia for the shootings and for his mental state in the weeks leading up to them. His gait had been affected by the brain injury and neurological recovery took the best part of several years. When he was considered well enough to stand trial, assessment revealed a man still without memory for the events and his mental state at the time, whose intelligence was in the superior range and apparently unaffected by his brain injury; and who was conspicuously lacking in insight and social judgment. At trial, evidence was given by friends and associates strongly supporting the diagnosis of severe depression for some time before the shootings. This along with psychiatric evidence led to his being found not guilty on the grounds of mental illness. He was unconcerned about his transfer from hospital to prison. (In the jurisdiction concerned, patients who are found not guilty by reason of mental illness at the time of the offence may serve their detention in prison rather than a psychiatric hospital). His financial position was satisfactory but his proposed plans for life after release were inappropriate, especially for presentation to a Parole Board. After a few years he was released to f a nursing home where he would have adequate supervision. There had been no return of the severe depression which led to the murders and the attempted suicide.

Medical and Psychiatric Treatment. With some violent offenders, medical and psychiatric assessments may be important in understanding and attempting to treat their violent conduct. The results of medical and psychiatric assessment pre-trial and presentence may influence the course of legal proceedings, the defences raised, and the final disposition of the offender. Subsequent treatment, if available and effective, and psychiatric opinion may, in some jurisdictions and for some offenders, affect the decision to release on parole or licence and the conditions imposed for supervision.

Psychiatric assessments of dangerousness may be problematic but are often sought, quite often on offenders without psychiatric disorder.

It is important to note that not all violence, even if extreme or bizarre, has a psychiatric or medical basis. Although assessment is often appropriate - if only to exclude medical or psychiatric diagnosis - explanations of violent behaviour usually lie elsewhere and interventions, not to mention judicial responses, will be non-medical. Even when a disorder is present, social, situational and personality factors may not only be important but predominant in any explanation of what has occurred.

Mental illness is a relatively weak predictor, statistically speaking, of future violence when compared to a history of violent acts; no matter what the cause of violence may appear to be, a careful history of violent conduct is essential. However, mental illness may be a crucial factor in individual cases and particular psychiatric diagnostic groups present higher than usual risks for violence (Mullen 1984).

CASE FIVE A man in his early twenties who had migrated to Australia from Europe with his parents was charged with their murders. He had no other relatives in Australia and at his trial psychiatric evidence was supported by observations made by work mates. He gave a history of slowly developing paranoid beliefs involving his parents. At first they were thought to be talking about him and laughing at him behind his back. Slowly he began to fear for his safety and took precautions so they could not enter his bedroom at night. Later he began bringing food home to avoid eating what his mother had cooked. His fears increased and he moved out of the house although continuing to visit. On one visit he ate a stew prepared by his mother, only to develop vomiting and diarrhea. He decided he had to kill his parents, waited until the next pay day and then on a Saturday morning bought an expensive rifle. Not wishing to use an unlicensed firearm he obtained a shooters' licence from the local police station and informed the gun shop of its number. That afternoon he visited his parents and shot them both as soon as the door was opened. He then rang the police, giving his name and address, saying he had shot his parents, the door of the flat was open, the firearm was on the coffee table and that he had to go and feed the budgerigars. On arrival the police found everything as he had stated and noted his complete unconcern. Psychiatric assessment found him to be suffering from a schizophrenic illness of more than a year's duration. The trial for the murders resulted in a jury returning verdicts of not guilty on the grounds of mental illness. He was detained indefinitely in a psychiatric hospital at the Governors pleasure. Despite treatment he remained virtually without insight into his illness or his actions for several years. His suicide in hospital appeared to coincide with the development of some appreciation of what he had done.

Medical or psychiatric intervention with violent offender is usually by the offering of treatment or, if the person is facing sentence, by offering recommendations about treatment a sentence. The basis of the intervention must be an assessment least adequate to the legal, medical and psychiatric issues present by the individual offender.

While this may not be too difficult an offender who can attract, or obtain, the necessary resources pre-trial or pre-sentence, real problems arise in providing assessment services for the offender population as a whole.

Assessment procedures will depend upon the stage which proceedings have reached, what is already known of the violent person and the setting and resources available for the assessment. The referrals from courts, correctional authorities and parole boards are often dealt with by small, under-resourced services or professionals with little experience of the criminal justice system Assessment may lead to a treatment dead-end: recommendations cannot be implemented if treatment programs are unavailable the community or in prison. This is particularly so in the case of offender with complex problems but no clear cut diagnosis of a disorder amenable to a specific line of medical, psychiatric correctional management, including admission to a particular institutional program. These problems were addressed Dame Roma Mitchell (1985) when she examined services to such persons in South Australia. As a result of her recommendations the Management Assessment Panel was established and now assesses individuals and negotiates management programs, often with multiple agencies.

Problems of assessment and treatment are compounded by the often poor flow of relevant information within the criminal justice system

The Australian states and territories each have their own criminal laws, correctional services and health systems. There is no one way by which medical and psychiatric services are delivered to our criminal justice systems and to offenders within the community, and it is not the intention of this monograph to attempt to review the differing systems in the states and territories. It is difficult to decide whether differences in service delivery have arisen at times more because of the influence of particular events, such as escapes, and personalities rather than the rational adoption of sped models.

Certain medical and psychiatric conditions may be important violence and require mention here in broad groupings, rather the in detail. Treatment approaches, which are often obvious on diagnosis is made, are dealt with similarly. Reviews of the subject (Roth 1987; Tardiff 1988) and practical approaches to the problem (Reid 1988) are readily available.

In assessing violent patients a 'decision tree' has been suggested (Reid 1988). It is also useful for violent offenders generally, although the incidence of medical and psychiatric disorder will be lower. Assessment takes place sequentially from first to the third category.

The first category is that of organic, or physical, conditions leading to dysfunction of the central nervous system. Included here are substance abuse (such as of alcohol, sedatives and amphetamines), the effects of prescribed medication, intracranial pathology (including head injury, tumour or vascular disorders), seizure or seizure- like syndromes ('epilepsy') and systemic disorders (medical conditions including infections, diabetes and endocrine disorders).

A second category includes psychiatric disorders such ( schizophrenia, schizophreniform and paranoid disorders. Mood, or affective disorders, require special consideration, as severe depression can be associated with violence or suicide.

The third and final category includes personality and developmental disorders, and reactions to stress and to emotional trauma. These are frequently important in both first offenders and recidivists.

Reviews of the psychiatric health of prison populations (Gunn 1978) show that while the incidence of psychosis, schizophrenia or severe depression is about the same or a little more than in the general community, alcohol and drug abuse is much higher. Many prisoners believe they need some form of help. Varying diagnostic criteria make estimates of personality disorder in prisoners difficult to assess.

Mentally ill persons seem not to make an undue contribution to violent crime but some subgroups present an increased risk of such conduct, conduct which when it occurs largely within institutions or families, may not always be reported to the police, and if it is, may not lead to further action by the criminal justice system. A small number of patients exhibit repeated, even frequent, episodes of sometimes serious violence, testing the resources and therapeutic imaginations of those caring for them. They are, it is stressed a minority amongst psychiatric patients. Their careers may include periods in prison and their sentencing may pose great difficulties. A few persons who commit homicide or serious violent offences may be found not guilty on the grounds of mental illness and ordered to be detained indeterminately in a prison or psychiatric hospital, depending on the jurisdiction (Wallace, 1986).

Psychiatric disorders which may have an association with violence are many but it is not an essential diagnostic feature of most. It is, for example, with some personality and conduct disorders. With schizophrenia, some other psychoses, and mental retardation, violence is an associated feature. It is an infrequent feature of mood disorders and some other conditions.

The treatment of medical and psychiatric disorders in violent offenders is, in the first instance, treatment of the disorder itself with special efforts to control violence if it is continuing or threatens to recur. Some disorders may not be amenable to treatment, for example dementia or a longstanding paranoid psychosis, so symptomatic and behavioural control may be a prime aim with due respect for the comfort, rights and liberty of the person.

Important treatment approaches include, often in combination, pharmacological, behavioural and psychotherapeutic techniques and, in psychiatric hospitals, the occasional use seclusion and restraint. Psychopharmacological treatment commonly involves, in the mentally ill, use of antipsychotic drugs (the major tranquillisers), antidepressants and lithium. The latter drug has been used with some success for violent patients and offenders who do not have a diagnosis of mood disorder, a disorder for which it is primarily prescribed. Long-term use of the major tranquillisers is not advocated for the control of violent offenders who do not have an appropriate psychiatric diagnosis.

The use of drugs in the treatment of sexual offenders is controversial and relatively uncommon in Australian institutions. Antiandrogen drugs have been used.

Indeterminate detention of certain sexual offenders is available in South Australia despite recommendations for its abolition. It is rarely combined with psychiatric or medical treatment due to the nature of the f offenders detained.

It is fair to say that medical and psychiatric approaches to the assessment and treatment of violent offenders are hindered by imprisonment because of the prison environment and reduced access to services and professional staff, including psychologists. Mentally ill offenders may be transferred to psychiatric hospitals or special units, where treatment can be offered, for at least part of their imprisonment. When those who commit serious violent offences are sentenced, other considerations may outweigh those of rehabilitation and treatment. Where it is possible to provide treatment for a violent offender; in prison or in the community, it should be given in an appropriate setting with proper legal and procedural protections, especially for those who have chronic disorders or disabilities or who are subject to indeterminate detention. Appropriate attention must be given to personal and social problems, to supervision conditions and to compliance with long-term drug therapy.

The unintended consequences of imprisonment

While there may be good reasons to imprison violent offenders, rehabilitation is not one of them. Despite the occasional (and patently erroneous) reference to the 'motel- like accommodation' of prisons, the prison environment can be highly threatening. The self-doubt and low self-esteem which often give rise to violence tend to be reinforced. Prisons have been described as analogous to jungles, where power and exploitation are dominant values.

Almost invariably, prison has serious adverse consequences for the offender. The deprivation of liberty can be an extremely stressful experience. Many prisoners, whose propensity to maladaptive behaviour may have landed them in trouble in the first place, experience great difficulty in adjusting to a prolonged period of custodial confinement.

The stresses induced by confinement may have adverse effects on a prisoner's physical and mental health. These stresses may be compounded by separation from family and friends. Indeed, it can be argued that the subculture of most Australian prisons emphasises aggression as a coping strategy. Assault, rape, self- mutilation and suicide all occur within prisons. Threat, intimidation and force are common currency. The popular injunction 'if you can't do the time, don't do the crime' obscures the fact that the prison setting may be a futile environment in which to seek to instil such values as warmth, trust and empathy, precisely those qualities which are appropriate to life as a respectable member of the community.

Non-custodial options

In certain cases, usually involving relatively minor violent offences or significant mitigating circumstances, it may be deemed appropriate by the sentencing authority to impose a sanction other than a term of imprisonment.

Considerable attention has been accorded non-custodial options in recent years, in part because they appear to offer greater (or at least no less) rehabilitative potential than imprisonment, at a fraction of the cost per offender.

Non-custodial sentences can include one or more of a variety of options, including probation, a monetary fine, a good behaviour bond, community service orders, restitution, or a suspended sentence of imprisonment. Probation may entail a number of conditions, including the requirement that the offender undergo medical or psychiatric treatment, or that he participate in a drug or alcohol rehabilitation program. A monetary fine, which entails the payment of a specified sum to general revenue, is an uncommon sentence for violent offenders, given the relative severity of the offence and the fact that many violent offenders are drawn from relatively disadvantaged backgrounds.

CASE SIX After pleading guilty to an armed robbery; a man in his thirties remained on bail while a probation pre-sentence report was prepared. The probation officer referred him for psychiatric assessment, although there was no history of psychiatric disorder: However; his wife was receiving outpatient treatment and there were long- standing financial and family problems. When asked about himself, the man stated that he was a pauper; always would be and would not know how to spend one thousand dollars if he had it. He had been working but had taken much time off to care for his children and accompany his wife to the psychiatric outpatient department of a large hospital where she was receiving long-term and frequent treatment. Little money was available and while his wife and three young children ate what more nutritious food might be in the house, he ate mashed potatoes flavoured with meat extract. The armed robbery occurred one day when he had sufficient money to spend 60 cents on a green and orange water pistol for his 6 year old son whose birthday it had been three weeks before. While returning home on a borrowed motorcycle he noticed a bank. He thought of money and returned shortly after, having altered the motorcycles number plate with adhesive tape. With the water pistol in his pocket and its paper bag in his hand he asked the female teller for money. After she had placed some in the bag he told her that was sufficient and left, accidentally dropping the bag in the street. He returned later to retrieve it. Of the $180 taken he banked $100 and spent $80 on baby food. The sentence was a bond with probation supervision.

A good behaviour bond requires the offender to comply with certain conditions, not the least of which is obedience to the law. Good behaviour bonds may be accompanied by a financial surety, the breach of which can entail the forfeiture of a specified sum.

CASE SEVEN Following a brief argument in a place of entertainment this heavily intoxicated man in his early twenties picked up a sharp cooking utensil and attacked a relative stranger: He was restrained after injuring his victim and the police called. He was unable to explain the reason for the attack and remembered it poorly. For some days he had been drinking in excess of a bottle of whisky a day. His past history revealed he had been a hyperactive child, had experienced difficulties towards the end of his schooling, but had received no special attention or treatment. Five years in professional sport were successful but this ended after severe injuries in a motor vehicle accident which occurred while he was drunk. After this his drinking became seriously out of control, he had self-destructive urges and became impulsively violent as well as oversensitive and lacking in self- esteem. A series of sexual involvements caused conflicts and more drinking. Symptoms of alcohol dependence were apparent. He had not worked since his motor vehicle accident. He had become abstinent after the assault but remained distressed about the conduct of his life. After pleading guilty he was given a suspended sentence, probation supervision and referred for psychiatric treatment aimed at his rehabilitation.

Community service orders require offenders to devote a specified number of hours to constructive activity in the community. It may enable them to acquire work skills which they might not otherwise develop. This form of generalised restitution is now available in all Australian jurisdictions (Australian Law Reform Commission 1987). Used primarily for minor offenders, it is generally regarded as unsuitable for perpetrators of serious violent crime. In cases where they are used as a sentencing option, community service orders appear to be no less effective a rehabilitative response than imprisonment.

Restitution entails the payment by an offender to a victim, in cash or in kind, to compensate for injuries or loss inflicted in the course of a crime. The concept is hardly a new one; its roots are dearly visible in the dispute settlement practices of pre- industrial societies. The principle of restitution has been incorporated in the sentencing law of most Australian jurisdictions. Of course, the common law has long provided victims with a course of action in cases of injuries arising from intent, as well as from negligence: a victim can sue the offender for damages.

Laudable as these remedies may seem, they are largely peripheral. Most violent offenders, by choice or by circumstance, were either out of the workforce or employed in relatively menial occupations at the time of the incident leading to their conviction.

Their ability to pay restitution or damages for the losses which they may have inflicted is thus limited. Most state criminal injuries compensation schemes provide for recovery from the convicted offender of monies up to the amount awarded to the victim under the scheme. (For a more detailed discussion of criminal injuries compensation, see Grabosky (1989)).

A suspended sentence of imprisonment may be imposed in some jurisdictions, subject to revocation in the event of subsequent offending or breach of specified conditions. In such circumstances, the offender would serve the term of imprisonment originally specified by the sentencing authority.

One recent innovation in Australian corrections is home detention. Home detention requires offenders to remain at home during those hours when they are not at work or engaged in approved study, religious activity, or rehabilitation programs. It is used as a sentencing option in its own right in the Northern Territory, and as the basis for early release from prison in South Australia and Queensland. It appears likely that a number of jurisdictions will complement this alternative with electronic surveillance and monitoring technology. Some commentators have cautioned that excessive reliance on electronic monitoring, at the expense of personal contact, can have adverse implications for rehabilitation. Fox (1987), for example, has suggested that such measures may be more appropriate as alternatives to custodial remand than to a fixed term of imprisonment.

Non-custodial sanctions may also be employed at the end of a period of imprisonment.

Indeed, the option commonly referred to as parole entails release from custody prior to the expiration of a prison sentence.

These non-custodial options are usually accompanied by binding conditions, which may be tailored to suit the rehabilitative needs of the offender. They may, for example, include the requirement that the offender abstain from alcohol or drugs, that he refrain from contact with the victim or with other specified persons, that he pay restitution to the victim, or that he participate in a specified counselling or treatment program.

Conditions usually require regular reporting to probation and parole officers

In recent years, state and territory corrections authorities have expanded probation and parole services to accommodate a growing number of non-custodial clients. For example, the New South Wales Department of Corrective Services has established a number of Attendance Centres which provide programs for probationers, parolees, and those offenders sentenced to community service.

These programs do not focus on violence per se, but rather on general skills, as many of the clients lack the ability to read and write, and are unable to perform the simple arithmetic necessary to budget their income. Among the programs offered are basic literacy, job seeking and interviewing techniques, money management, and general communications skills.

The economics and relative flexibility of non-custodial options make them attractive, at least in those cases where the offender in question poses no danger to the public, or where the offence may not be so heinous as to militate in favour of a more punitive response. Non-custodial options are often less injurious to the offender; and thus potentially more conducive to rehabilitation.

Domestic Violence Offenders

In recent years specialised programs for perpetrators of domestic violence have been developed under various auspices in Australia. In some cases, these programs have been established within the community, and are available to violent men on a voluntary basis. In others they have been established as an adjunct to the probation and parole services of state or territory corrections departments.

Participation in these programs may be voluntary for probationers and parolees in general, or may be made an explicit condition of probation or parole. As with other rehabilitation strategies, the basic principle of these programs is to enable participants to recognise stress and anger, to develop skills for control of anger and to assist in self-image building. Despite the proliferation of these programs in recent years, none has been subject to systematic evaluation. It thus remains to be seen which, if any, of these programs actually work, and which operate most effectively and most efficiently.

That Australian correctional rehabilitation programs in particular; and public policy initiatives in general, have escaped rigorous evaluation is unfortunate. It may be explained in part by the fact that administrators and policy- makers tend to invest their reputations in programs per se, and can ill afford the risk of a demonstrably unfavourable outcome.

With regard to correctional rehabilitation strategies, this concern is compounded by the knowledge that the vast majority of overseas rehabilitation programs which have been subject to evaluation have been shown to be unsuccessful. The apparent failure of rehabilitation may arise from inadequate design and funding of programs, from the immutability of many anti-social personality traits, and from the persistence of social conditions which help spawn criminal behaviour. If anything does work to rehabilitate violent offenders in Australia, the current lack of investment in planning and evaluation will militate against its early discovery. 

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