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Sexual Abuse Family Education and Treatment Program (SAFE-T) for court-involved youth convicted of a sex offense

Juvenile Justice
Benefit-cost methods last updated December 2019.  Literature review updated June 2019.
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Sexual Abuse Family Education and Treatment Program (SAFE-T) is a community-based treatment program that provides sexual abuse specific assessment, treatment, and support. This analysis is on SAFE-T for adolescents who have sexually offended. SAFE-T has multiple goals and aims to discourage sex offending, improve social skills, encourage appropriate anger expression, and improve trust. SAFE-T begins with a comprehensive assessment which informs an individually tailored treatment plan for the youth and their family. The treatment plan varies depending on participants’ needs but typically includes a combination of concurrent individual, family, and group-based therapies.

Participants in the included study received an average of 18 months of treatment, including an average of 10 months of group therapy and 11 months of family therapy (often concurrently). The included study did not report the race/ethnicity of participants; 6% of participants were female. Participants in the comparison group received usual treatment services for youth with sex offenses, which included some participation in group therapies and milieu treatment approaches.

Key Terms

Court-involved youth: Youth who are processed through the juvenile justice system but who are not ordered to a period of confinement in a residential or correctional facility. This includes populations of arrested youth, diverted youth, charged youth, adjudicated youth, and youth on probation or formal supervision.

Youth in state institutions: Youth who are confined in a residential or correctional facility when they participate in the program.

Youth post-release: Youth who are returning to the community following a period of confinement in a residential or correctional facility and who participate in the program after release to the community.

The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2018). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $7,663 Benefits minus costs ($10,328)
Participants $1,758 Benefit to cost ratio $0.59
Others $14,706 Chance the program will produce
Indirect ($9,221) benefits greater than the costs 25 %
Total benefits $14,905
Net program cost ($25,233)
Benefits minus cost ($10,328)
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Benefits from changes to:1 Benefits to:
Taxpayers Participants Others2 Indirect3 Total
Crime $6,983 $0 $13,659 $3,491 $24,133
Labor market earnings associated with high school graduation $873 $2,050 $1,134 $0 $4,057
Costs of higher education ($193) ($292) ($88) ($96) ($669)
Adjustment for deadweight cost of program $0 $0 $0 ($12,616) ($12,616)
Totals $7,663 $1,758 $14,706 ($9,221) $14,905
Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $19,264 2016 Present value of net program costs (in 2018 dollars) ($25,233)
Comparison costs $4,240 2015 Cost range (+ or -) 50 %
The per-participant cost of Sexual Abuse Family Education and Treatment Program (SAFE-T) represents the average annual cost over the 18-month program. We estimate the cost of SAFE-T by applying the average length of treatment for participants in the included study to the average monthly cost of a similar program: Multisystemic Therapy – Problem Sexual Behavior (MST-PSB). We use the average monthly cost of MST in Washington, estimated using cost information provided by C. Redman (personal communication, Washington State Juvenile Rehabilitation, April 16, 2019), which relies on estimates from Barnoski, R. (2009). Providing evidence-based programs with fidelity in Washington State juvenile courts: Cost analysis (Doc. No. 09-12-1201). Olympia: Washington State Institute for Public Policy. We use MST-PSB’s monthly cost because it also relies on a combination of group, family, and individual therapy and adjusts treatment strategies to fit the needs of participants, much like SAFE-T. The comparison group received typical sex offense treatment services. We calculate costs for the comparison group using an estimate of the cost of sex offense treatment for youth on parole in Washington, provided by J. Pelander (personal communication, Washington State Juvenile Rehabilitation, July 8, 2016).
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.

^WSIPP’s benefit-cost model does not monetize this outcome.

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Treatment age No. of effect sizes Treatment N Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis Unadjusted effect size (random effects model)
First time ES is estimated Second time ES is estimated
ES SE Age ES SE Age ES p-value
Crime 15 1 85 -0.493 0.226 16 -0.493 0.226 24 -0.493 0.029
Sex offense^ 15 1 85 -0.069 0.335 16 n/a n/a n/a -0.069 0.838

Citations Used in the Meta-Analysis

Worling, J.R., & Curwen, T. (2000). Adolescent sexual offender recidivism: Success of specialized treatment and implications for risk prediction. Child Abuse & Neglect, 24 (7), 965-982.