The Center for the Treatment ofProblem Sexual BehaviorThe Connection, Inc.
CTPSB Program Goals
Community SafetyReducing future sexual violence and abuseClient SuccessTo remain offense freeTo improve their lives
AssessmentsPrison and CommunityCommunity-Based ServicesPolygraph ServicesPost Conviction Sex Offender Testing (PCSOT)Residential ServicesTheJanuary CenterDay ReportingProgram
Focus of today’s presentation is on community-basedtreatment services
Adults mandated to treatment by CSSD or DOC95% male, 5% female10% – Speak Spanish as primary languageApproximately 1100 clients in treatmentApproximately1800 unique clients receiving treatment annuallyAdditional 800 clients receiving polygraphservicesonlyAdditional 400 clients seen for assessment in prisons for DOC annually
Determines appropriateness and need for SO specific treatmentProvides risk assessment and recommendations for supervision and treatmentEstablishes initial treatment plan to treat identified issues related to risk of sexual re-offendingIdentifies comorbid issues that may need treatment – psychiatric, substance abuse, etc.Identifies responsivity issues that may interfere with treatment and client engagementIdentifies protective factors
Evidenced-Based Assessment Tools
StaticRiskAssessment (2002R,99R) (Hanson, 2002)Sex Offender Treatment Intervention Progress Scale –SOTIPS (McGrath et al. 2007, 2012)Dynamic Risk AssessmentRisk Assessment improves whenStaticandDynamicrisk factors are considered. (Hanson, 2009)
Evidenced-Based Assessment ToolsCont’d
SOTIPSProvides evidence based assessment of dynamic risk factors and measures progress over time.Replacesolder version OSOTNPS(McGrath, 2002)Dynamic Risk Assessment:Evaluates those factors that affect risk and are amenable to treatment.Provides a way to individualize treatment as not all clients have the same dynamic risk factors.Needs to be continuous, ongoing and shared with supervising officers.
Evidenced-Based Treatment ModelsRisk, Needs, Responsivity Model (RNR) (Andrews andBonta, 2010)Cognitive Behavior Therapy (Landenberger, 2005)– change thinking to change behavior and feelingsGood Lives Model (Yates, Prescott, Ward, 2010)Relapse PreventionSelf RegulationPositive approach to treatment
Treatment concepts and techniquesMotivational Interviewing(Marshall, 2011)–joiningrather than confrontingStages ofChange(Prochaska, 2005)– assists with choosing effective interventionsTrauma Informed(Levenson, Prescott, Willis, 2014)– awareness of impact of traumaIdentification of Protective Factors(DevriesRobbe, 2014)– identification of what client currently uses or can develop to effectively manage risk and be successfulThese models and concepts promote:Client accountabilityTreatment EngagementRecidivism reduction
Group Therapy – most clients attend weekly groups.Group therapy is effective for most clients(Ware, 2009)Benefits:Group cohesion is a primary factor in positive changeCan assist clients in improving interpersonal deficitsVicarious learning takes placeGroup process increases motivation to changeAssists clients with revealing secretive behavior and thoughtsClients identify similarities with other clients and help each other (holistic)
Treatment - Groups
Types of groups:Phase 1 – (34)Ongoing assessmentLearning CBT conceptsPhase 2 – (45)Accept responsibility for offense behaviorIdentify dynamic risk factorsImprove social supports and skillsManage identified dynamic risk factors
Specialized Treatment Groups
High Risk Groups (8) – for clients with deviant sexual preference.Cognitive Issue Groups (2) – for clients with cognitive issues that impact ability to complete treatment.Spanish speaking groups (9)Young adult groups (4)Women’s groups (3)Responsivity Groups (7) – additional group provided at no charge to provide one to one help with assignments, journaling, polygraph books, etc.
Other Treatment ServicesIndividual Treatment – for clients who do not fit into the group processHigh risk and disruptiveClients who speak different languagesClients with logistic or scheduling obstacles to the groupscheduleMedication Assessment and ProvisionAPRN’s are available state wide to assess client’s need for medication to manage offense related symptoms or disorders.Approved Supervisor ProcessAssist Officers and Victim Advocates with client’s supportive people who want to be involved in the supervision process.Family meetings: as needed to assist client’s family members.In collaboration with Victim Advocates.Family reunification.
Length of Treatment
Average length of treatment: (1/1/15 – 6/1/15)Positive Discharges: 26.9 monthsNegative Discharges: 14.1 monthsAdministrative Discharges: 16.7 months
Programmatic Improvements in Past 2 Years
Consultation with nationally recognized expertsRobin Wilson, David Prescott for treatmentCharlesSlupski, Ray Nelson, Walt Goodson forpolygraphAugmented staff training and retention practicesInitiatedregular meetings with CSSD and DOC to review problems and developsolutionsImprovements in polygraph procedures leading to more completions and fewer inconclusiveresultsIncreased number of Spanish speaking clinicians
Treatment Improvements inPast 2 Years
Revised assessment proceduresIncreasedfocus on trauma’s effect on treatmentresponseIdentifyingprotective factors when making dischargedecisionsDevelopingprocedures for clients with transgenderissuesSOTIPS– better assessment of risk and treatmentprogressAdded High Risk groups in more locations
David Zemke, LMFTThe Connection, Inc.The Center for the Treatment of Problem Sexual [email protected]