Sexual Offender Treatment - Individual & Group

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 can not cope.

II. Assessment
The program provides sexual offender specific assessment and evaluation for each identified youth by either Albert Cowen M.Ed/LSW, Ed Haskins MA/LSW or James Crafton BA/LSW, all certified juvenile sexual offender counselors through the University of Louisville. Since a determination of risk 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 personal issues of each youth. Included as part of the assessment process is the administration of the Million Adolescent Clinical Inventory. For those youth with drug and alcohol issues, a Chemical Dependency assessment is also provided. This involves a self-reported history of drug and alcohol use and relevant family information, collateral information from other sources, and administration of the Substance Abuse Subtle Screening Inventory to assist in determining if the youth has a Substance Abuse or Substance Dependency Disorder and whether drug and alcohol treatment is additionally needed.

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

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 above all other concerns, youth are visually supervised when not locked in their individual rooms. This includes all interactions with other youth as well as parents or community resource providers. Policies and procedures are in place to reduce any risk of abuse whether verbal, emotional, physical or sexual.

V. Treatment
Every youth in the program is generally provided individual counseling once a week and family counseling once a month. Those youth identified as needing sexual offender specific counseling are usually also placed in a twice weekly sexual offender specific therapy group co-led by Albert Cowen M.Ed/LSW, Ed Haskins MA/LSW and James Crafton BA/LSW. 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 co-led as well by Albert Cowen, Ed Haskins and James Crafton.

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 verified by their counselor. Parents also receive a supplemental Pathways Guide for Parents 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. Male youth are provided The Courage to Heal Workbook (For Women and Men Survivors of Child Sexual Abuse) to assist them through the individual counseling process. Female youth may also or otherwise be provided with In Their Own Words (A Sexual Abuse Workbook for Teenage Girls) for the same purpose. Also, workbooks from the Hazelden Foundation are additionally utilized to assist with drug and alcohol treatment. These workbooks focus on quitting identified substances such as alcohol or marijuana or on basic “step work” referencing twelve-step support group principles. Other Hazelden workbooks are utilized to help youth work on identified emotional issues such as depression and anxiety.

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 ten months to one year although some youth may require more time. A series of three benchmarks reflect progress through treatment and are expected to be systematically achieved by the youth. It is also expected that they will discuss and demonstrate development of new skills first during individual counseling, then during group counseling, and lastly during family counseling. A first Progress Review takes place when the youth reaches the third stage of the daily program and occurs with the case-load counselors and the Program Manager. Along with reviewing the youth’s progress in sexual offender treatment, much of the focus at this time is also on the youth’s behavior and adjustment to the daily program.

A second Progress Review occurs once the youth has completed Chapter Six of the Pathways workbook. By this point, it is expected that the youth has demonstrated an understanding of both grooming behaviors (those behaviors directed specifically toward setting up a victim) and maintenance behaviors (any behaviors that keep a person thinking or acting in self-centered and self-indulgent ways). This Progress Review tends to be more oriented to the youth’s sexual offender treatment and involves the youth discussing a list of his/her own maintenance behaviors. Along with the case-load counselors, this review includes either the Program Manager or the Director. The purpose of the second review is to assess the youth’s level of development and to help focus the youth on issues that may need addressing before a Relapse Prevention Plan is constructed. Following the review, the youth are expected to work on demonstrating an understanding of cycles of behavior, both the offense cycle (which involves setting up a victim) and the maintenance cycle (which involves day-to-day behaviors which could lead to getting on an offense cycle). By this point, the youth are expected to be able to recognize when they see themselves on a maintenance cycle and to be able to identify ways to exit to this cycle.

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 to a Petition Review Committee which involves the counselors and the Superintendent. At this time, the youth are petitioning to have a court hearing 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 Superintendent, the committee must agree that the youth has made the necessary changes that have been identified in the Relapse Prevention Plan. That it is being put into action as a part of the youth’s daily behavior. The judge will be provided with a copy of the Relapse Prevention Plan along with a “Client Safety and Supervision Plan” (the form is taken from the Pathways Guide for Parents) which lists rules and restrictions 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. 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 counseling and includes both the youth and the victim. 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 counseling for himself/herself. If so, the victim’s counselor is contacted about the proposed process. Ideally, clarification would then occur as a conjoint counseling effort with the other counselor. 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 again in the home. Typically, most if not all of their interactions together would occur under some level of adult supervision. Once the Transition Release process is authorized by the judge, then the youth can also be transported to any necessary medical or counseling appointments by parents or guardians. Until this time, any transportation to appointments is performed by staff. If the youth has not yet reached the third stage of the four stage daily program, then any need to be transported outside of the center is done in a secured manner requiring use of hand cuffs to a restraint belt plus leg shackles. Once youth successfully complete the Transition Release process, they are scheduled for a permanent release hearing to review the overall progress of treatment, aftercare planning, and any possible registration requirements.

VI. Aftercare
Some weeks before discharge, a Wrap Around meeting is held to review aftercare planning. For this meeting to occur, the counselor, a parent or guardian, and the Probation Officer must be in attendance; otherwise the meeting will be rescheduled. Also, invited but not required, would be other program staff, school officials, social service workers, and other community resource providers. At this meeting, an aftercare plan is developed and should contain the following:

Identified family and/or positive adult support
Arrangement of a risk-free community living situation
A required, specific level of supervision
Identified family and/or positive adult support
Continued sexual offender specific counseling on an outpatient basis

In the end, aftercare planning should require the agreement of all parties and should support the goal of relapse prevention. Outpatient counseling should start before the youth is permanently released. If due to unforeseen circumstances, it is not possible for the youth to see their new counselor before they are permanently released, an appointment should at least have been be scheduled. It should be possible to inform the judge about the status of outpatient treatment by the time of the Permanent Release Hearing. 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 the tools needed to be successful once permanently released from the program.