Evaluation and Treatment Services for Adults

Evaluation Services     Treatment Groups     Special Focus Group      Adjunct Family Groups

Phallometric Testing and Arousal Reconditioning Services

Evaluation Services

Rationale

An evaluation is conducted to assess psychological, social, sexual, behavioral and relational functioning. An evaluation can address questions such as need for treatment, treatment amenability and venue, risk issues or need for adjunct services.

Comprehensive evaluation services are available for:

• Criminal Court - Pre-sentence or post-sentence; under the patterned offender statute; or court ordered sex offender evaluation statute.
• Family Court - Custody or visitation disputes where sexual misconduct has been alleged.
• Employer concerns - In cases of sexual harassment or sexual misconduct in the workplace.
• Self-referral

An evaluation can include the following components:

• Clinical interviews
• Review of all related reports, legal documents, criminal complaints and any collateral documents
• Psychological testing
• Objective measures of sexuality
• Polygraph exam (by contract provider)
• Psychiatric exam and chemical dependency evaluation are referred out when appropriate

A detailed report with recommendations that address issues and concerns, treatment amenability and venue, and/or the need for ancillary services is provided at the conclusion of the evaluation.

Rationale

Treatment for sexually abusive behavior is best conducted within a well defined structure where goals, expectations and accountability are specified in writing and adhered to in a predictable fashion.  The treatment format and process are designed to address the need for individual and public safety, behavioral control and management.  When behavior is stabilized, the focus shifts to understanding resolution of underlying psychosocial issues that contributed to the offense.  Treatment concludes with a focus on relationship skills and the development of a maintenance plan.

Admission Criteria

• Age 18 or older
• Has been convicted of Criminal Sexual Conduct I-V, Indecent Exposure, Indecent Conduct, Lewd Conduct, Invasion of Privacy, or
• Has committed a behavior that would constitute criminal sexual offense, or
• Has a fantasy, thought or urge to commit an offense
• Seeks treatment and is willing to participate in treatment
• Is not engaged in criminal sexual behavior

Exclusion Criteria

• Active or unmanaged mental illness
• Low intellectual functioning
• Active chemical dependency
• Significant denial or minimization

Treatment Format

Treatment is conducted in weekly two hour group therapy sessions and individual conjoint or family therapy twice per month.

The treatment program is highly structured.  All program expectations are described in writing prior to beginning treatment.  All clients are expected to actively participate in all sessions.  All sessions are goal oriented, with the expectation that progress is made towards completion of the treatment goals.  Current behaviors and life-styles are monitored as part of each session.  Spouse, family members and significant others are included at different points in the treatment process.

Rationale

For some clients who enter treatment, it may not be possible to begin a process of insight oriented therapy until the client is able to effectively manage his affective reactions and compulsive patterns.  The focus of the Behavior Management Group is to teach techniques which provide structure and boundaries.  In this group, clients establish a foundation of cognitive and behavioral skills which will assist them in managing their sexual behaviors and provide a container for affect and feelings.  Once a firm foundation has been established, clients are then able to begin treatment and address the issues underlying their sexual behaviors.

Admission Criteria

• Individuals with a history of compulsive sexual behaviors
• Individuals who are assessed to have a pattern of compulsive sexual behaviors

Exclusion

• IQ less than 85
• Active chemical dependency

Treatment Format

Group is highly structured.  The focus of the first six months is on relapse prevention and behavior management techniques.  The second six months involves teaching clients to incorporate issues associated with affect into their relapse prevention program.  Theses issues include victim empathy, grief and loss, sexuality, and family of origin issues.   Also, during the second six months, clients are expected to teach and demonstrate the basic concepts of relapse prevention and behavior management techniques to new group members.

Strict expectations are established regarding issues such as attendance, homework assignments, sponsor participation, or seeing a psychiatrist for a medication evaluation.

Rationale

Some clients need to have treatment presented more slowly and in a concrete format.  Reasons for placement in the E. Q. Group include lack of insight, poverty of thought, below average intellectual functioning, low reading and/or writing skills, and deficits or impairments in adaptive functioning including underemployment, lack of education, and poor interpersonal skills.

Admission Criteria

The individual must meet at least three criteria to be admitted to this group:

• An assessed IQ between 70 and 90, with exceptions dependent on client functioning.
• Difficulty processing abstract information
• Difficulty with concept Formation
• Difficulty with language, either written or verbal
• Quality of social interaction indicates a low IQ
• History of learning difficulty: i.e., assessed with learning disabilities, special classes, illiteracy, and/or poverty of social skills

Exclusion Criteria

• Assessed neurological deficits that preclude program participation
• Profound mental retardation

Treatment Format

Treatment is presented in a skill-based format, with clients expected to demonstrate behavioral changes over time.  Additional behavioral characteristics that may justify inclusion are passivity, dependency, low self-esteem, low frustration tolerance, aggressiveness, and poor impulse control.

Clients attend weekly group sessions focusing on social interaction.  Individual and family sessions meet twice per month with client's primary therapist.  One group session each month will focus on a specific treatment goal relevant to the majority of group members.

Rationale

MIRROR is an acronym for Maturity, Identity, Responsibility, moral Reasoning, Options, and Reflections.  This treatment group is offered to the population of young adult male offenders, aged 18-22, who have been convicted of having consensual sexual relations with an under age adolescent.

The goal of the MIRROR group is to reinforce the positive aspects of group members' behavior in order to improve their ability to negotiate life without re-offending.

These males, barely out of adolescence themselves, are generally immature, have a poor sense of personal in interpersonal boundaries, lack communication and relationship skills, lack empathy, and need basic sex education.  Intervention can prevent the inappropriate behavior from becoming a pattern.

Admission Criteria

• Males 18-22+ years old
• Conviction for Criminal Sexual Conduct with an adolescent 13-17 years old
• Relationship with victim suggests actual or perceived consent
• Admission of the sexual behavior
• No active chemical dependency

Exclusion Criteria

• Use of force or kidnapping
• Use of a weapon
• Active chemical abuse
• Prior sex offense conviction
• Sibling incest

Treatment Format

Clients attend a biweekly 2-hour therapy group which alternates with psychoeducational groups.  Completion of the curriculum portion and from the therapy portion of the program may occur independently of one another within a maximum of 18 months.  The client is discharged from the program if he is not able to complete it within 18 months.

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