Sexual Offender Treatment

I. Program Description

Male and female youth accepted at MVJRC who have been adjudicated with felony sexual offenses will be provided with sexual offender specific treatment. The guiding principle of this model is that community safety and victim justice is the foremost and overriding concern of treatment. In other words, the main goal is for there to be “no more victims”. Upon completion of treatment, each youth will have demonstrated the skills necessary to lower any risk to re-offend. Each youth will be able to:

Identify difficult situations/triggers
Identify early warning signals
Avoid high risk situations
Cope with high risk situations that can not be avoided
Escape high risk situations in which the youth feel that they cannot cope.

II. Assessment

The program provides sexual offender specific assessment and evaluation for each identified youth. Since the determination of risk for placement has already been made by virtue of placing the youth into the residential setting of MVJRC, assessment is geared toward developing appropriate strategies for approaching the issues of each youth. Included as part of the assessment process is the administration of the Million Adolescent Clinical Inventory (as described in the Mental Health Treatment section). For those youth with drug and alcohol issues, a Chemical Dependency assessment is also provided (as described in the AOD treatment section).

At MVJRC, we utilize The Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II) and The PROFESOR (Protective + Risk Observations for Eliminating Sexual Offense Recidivism) to identify the needs of our youth who have been adjudicated for a sexual offense. A JSOAP-II is completed as a pre-test and every 6 months, to be compared to a post-test at the time of discharge to help show the youth's progress in treatment of those factors that are subject to change. The PROFESOR is utilized at MVJRC to help identify and summarize protective and risk factors for individuals, aged 12-25 years old, who have offended sexually. Both assessments are used to assist with treatment planning while at MVJRC and to assist with treatment planning when returning to the community. Both assessments may also be administered throughout the course of treatment while at MVJRC, as clinically indicated.

III. Treatment Planning

Although treatment plans are developed to be as individual and comprehensive as possible, most youth receiving sexual offender specific treatment will operate out of the same basic treatment goals as they all share the objective of working to lower their risk to re-offend. These particular treatment goals are:

Recognize patterns of destructive behavior, sexual or otherwise
Recognize how these patterns affect everyday life
Practice new behaviors that change the patterns
Develop and utilize a Relapse Prevention Plan

The objectives of these goals on the treatment plan are tailored by the youth and the mental health therapist to fit with each of the treatment goals and for the youth to work on their particular behaviors. These objectives also provide guidelines for how youth may meet each treatment goal through the treatment process.

IV. Program Milieu

In the daily program, it is recognized that acceptance of personal responsibility and other aspects of character development are central to the treatment of each youth. This perspective particularly reinforces principles that underlie sexual offender specific treatment. Because concerns about safety and security are emphasized, youth are visually supervised whenever they are with other youth. Policies and procedures are in place to reduce any risk of abuse whether verbal, emotional, physical or sexual. The Daily Character Development Program (as described in the Mental Health Treatment section) utilizes a Cognitive Behavior Therapy approach that reinforces the sexual offender specific treatment being provided. Youth also practice through role playing how to deal with social skills in real life situations.

V. Treatment

The treatment delivered is largely based on Pathways (A Guided Workbook for Youth Beginning Treatment) by Timothy J. Kahn. As the youth work individually through the workbook, their comprehension and understanding of the material is reviewed and reinforced by their mental health therapist. Parents also receive a supplemental Healthy Families guide to assist in their understanding of the youth’s treatment and to encourage their active support of the difficult work the youth must do to complete their placement. These workbooks along with other materials provide a comprehensive, step-by-step approach that explains the dynamics of sexual offender treatment. Another treatment tool that is utilized involves use of personal Journaling. The journal is considered part of the confidential relationship of the youth with their counselor and is reviewed privately with the counselor. This process emphasizes helping the youth to recognize patterns of destructive behavior and to understand how their thinking affects their behavior. Those youth who were themselves victims of sexual abuse are also provided treatment to help them deal with their own experience of being a victim (as described in the Mental Health section). Also, Hazelden workbooks are utilized to help youth work on identified emotional issues such as depression and anxiety (also as described in the Mental Health section).

Those youth identified as needing sexual offender specific counseling are typically placed in a weekly sexual offender specific therapy group led by one or more of the mental health therapists. If the youth is also receiving drug and alcohol treatment, they will likely also participate in a twice weekly drug and alcohol therapy group also led by one or more of the mental health therapists.

In order to successfully complete the program, all youth participating in sexual offender specific treatment must follow a standard course of treatment that ensures that the youth has adequately demonstrated an understanding of treatment principles and how to avoid being drawn into a sexual offender abuse cycle. Average length of stay to meet all of the requirements is between 6-8 months, although some youth may require less time whereas others may require more time. It is expected that they will discuss and demonstrate development of new skills first during individual mental health therapy, then during group therapy, and lastly during family therapy. A Progress Review takes place when the youth reaches the third stage of the daily program and occurs with the Program Manager and the youth's mental health therapist. Along with reviewing the youth's sexual offenses and progress in sexual offender treatment, much of the focus at this time is on the youth's behavior and adjustment to the daily program.

The next step is to develop a Relapse Prevention Plan in which both high risk behaviors and warning signs are identified and an action plan is put into place to reduce the likelihood of re-offending. The youth present the plan in a Petition Review Committee with the Program Director and the therapist. At this time, the youth are petitioning to have a court hearing or a judges' review to ask their judge to sanction starting the two-month Transition release process. Transition Releases occur every other weekend typically starting with an 8-hour release, then successively for 2-days, 3-days, and 5-days. Before a court hearing is requested by the Program Director, he must agree that the youth has made the necessary changes that have been identified on the Relapse Prevention Plan. The judge will be provided with a copy of the Relapse Prevention Plan developed by the youth along with a Client Safety and Supervision (developed with the youth, his/her parents, and therapist) which lists rules and restriction the youth must adhere to both in the home and in the community. This may involve actions such as putting in place door alarms and other preventative measures, particularly if a victim lives in the home. If the judge finds these plans are credible and agrees that the youth is at a low risk to re-offend, the Transition Release process may begin. Once youth successfully completes the Transition Release process, they are scheduled for a permanent release hearing or judges' review to appraise the overall progress of treatment, aftercare planning, and any possible registration requirements.

If there is a family member in the home who was a victim of sexual abuse by the youth, a clarification process must have occurred beforehand. This process is put into action through family therapy and includes both the youth and the victim along with the victim's therapist, if there is one. Several preconditions must be addressed before this process can occur. The possibility of a clarification process should first be discussed with the youth's probation officer to insure that the court is made aware of what actions may be planned, particularly if a "no contact" order is in place and would need to be lifted before anything further would be allowed to happen. It is also necessary to determine if the victim is receiving therapy for himself/herself. If so, the victim's therapist is contacted about a proposed process. Ideally, clarification would then occur as a conjoint therapy session with the other therapist. Clarification offers an opportunity for the youth to apologize to the victim and let the victim know that the responsibility for the offenses rested solely with the youth. This is also an opportunity for the youth to share what he/she learned in treatment that makes it safe for the youth and victim to be together in the home. Typically, most if not all of their interactions together would occur under direct adult supervision.

VI. Transition and Aftercare

Before discharge, a wraparound meeting is held to review transition and aftercare planning, which has been previously described in the Mental Health section. In addition to elements already addressed in the Mental Health section, there is for continued sexual offender specific therapy to occur on an outpatient basis. Ideally, outpatient therapy should start before the youth is permanently released. If it is not possible for youth to see a new therapist before they are permanently released, it is recommended that an appointment be scheduled by the time of permanent release. In the end, transition and aftercare planning should require the agreement of all parties and should support the goal of relapse prevention. An overall expectation of aftercare planning is that when taken into account with the Relapse Prevention Plan and the Client Safety and Supervision Plan, the youth has been provided with the tools needed to be successful once permanently released from the program.