The Center for the Treatment ofProblem Sexual Behavior

The Connection, Inc.

Program DescriptionJanuary 7, 2016

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CTPSB Program Goals

• Community Safety Reducing future sexual violence and

abuse

• Client Success To remain offense free To improve their lives

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Services

• Assessments Prison and Community

• Community-Based Services

• Polygraph Services Post Conviction Sex Offender Testing (PCSOT)

• Residential Services The January Center

• Day Reporting Program

Focus of today’s presentation is on community-based treatment services

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Clients • Adults mandated to treatment by CSSD or DOC

• 95% male, 5% female

• 10% – Speak Spanish as primary language

• Approximately 1100 clients in treatment

• Approximately 1800 unique clients receiving treatment annually

• Additional 800 clients receiving polygraph services only

• Additional 400 clients seen for assessment in prisons for DOC annually

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Assessment• Determines appropriateness and need for SO

specific treatment

• Provides risk assessment and recommendations for supervision and treatment

• Establishes initial treatment plan to treat identified issues related to risk of sexual re-offending

• Identifies comorbid issues that may need treatment – psychiatric, substance abuse, etc.

• Identifies responsivity issues that may interfere with treatment and client engagement

• Identifies protective factors5

Evidenced-Based Assessment Tools

• Static Risk Assessment (2002R, 99R) (Hanson, 2002)

• Sex Offender Treatment Intervention Progress Scale – SOTIPS (McGrath et al. 2007, 2012)

Dynamic Risk Assessment

• Risk Assessment improves when Static and Dynamic risk factors are considered. (Hanson, 2009)

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Evidenced-Based Assessment Tools Cont’d

• SOTIPS

Provides evidence based assessment of dynamic risk factors and measures progress over time.

Replaces older 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. 7

Treatment

• Evidenced-Based Treatment Models

Risk, Needs, Responsivity Model (RNR) (Andrews and Bonta, 2010)

Cognitive Behavior Therapy (Landenberger, 2005)– change thinking to change behavior and feelings

Good Lives Model (Yates, Prescott, Ward, 2010)

Relapse Prevention

Self Regulation

Positive approach to treatment8

Treatment• Treatment concepts and techniques

Motivational Interviewing (Marshall, 2011)– joining rather than confronting

Stages of Change (Prochaska, 2005) – assists with choosing effective interventions

Trauma Informed (Levenson, Prescott, Willis, 2014) – awareness of impact of trauma

Identification of Protective Factors (Devries Robbe, 2014) – identification of what client currently uses or can develop to effectively manage risk and be successful

• These models and concepts promote: Client accountability Treatment Engagement Recidivism reduction 9

Treatment• 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 change Can assist clients in improving interpersonal deficits Vicarious learning takes place Group process increases motivation to change Assists clients with revealing secretive behavior and

thoughts Clients identify similarities with other clients and

help each other (holistic)

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Treatment - Groups

• Types of groups: Phase 1 – (34)

Ongoing assessment Learning CBT concepts

Phase 2 – (45) Accept responsibility for offense behavior Identify dynamic risk factors Improve social supports and skills Manage identified dynamic risk factors

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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.

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TreatmentOther Treatment Services• Individual Treatment – for clients who do not fit into the group

process High risk and disruptive Clients who speak different languages Clients with logistic or scheduling obstacles to the group

schedule• Medication Assessment and Provision

APRN’s are available state wide to assess client’s need for medication to manage offense related symptoms or disorders.

• Approved Supervisor Process Assist 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.

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Length of Treatment

• Average length of treatment: (1/1/15 – 6/1/15)

Positive Discharges: 26.9 months

Negative Discharges: 14.1 months

Administrative Discharges: 16.7 months

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Programmatic Improvements in Past 2 Years

• Consultation with nationally recognized experts Robin Wilson, David Prescott for treatment

Charles Slupski, Ray Nelson, Walt Goodson for polygraph

• Augmented staff training and retention practices

• Initiated regular meetings with CSSD and DOC to review problems and develop solutions

• Improvements in polygraph procedures leading to more completions and fewer inconclusive results

• Increased number of Spanish speaking clinicians15

Treatment Improvements in Past 2 Years

• Revised assessment procedures• Increased focus on trauma’s effect on treatment

response• Identifying protective factors when making

discharge decisions• Developing procedures for clients with

transgender issues• SOTIPS – better assessment of risk and

treatment progress• Added High Risk groups in more locations

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Contact Information

David Zemke, LMFT

The Connection, Inc.The Center for the Treatment of Problem Sexual Behavior

dzemke@theconnectioninc.org

860-918-8233

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