Description of Adult Sexual Offender Treatment Services

Counseling and Consultation Services provides a comprehensive treatment program to sexual offenders. The following is a description of each of the treatment components provided by Counseling and Consultation Services:
 

• Sex Offender Individual Counseling –Individual Sessions are usually provided to the sex offender by a male clinician.  The sessions are used as an adjunct to the offender’s group sessions and will address issues such as sexual reconditioning, pattern, and relapse prevention plan.  These sessions are scheduled on an as needed basis. 

• Sex Offender Group Counseling – The offender will participate in a Sex Offender Process Group once per week the entire time they are in treatment.  The group will consist of 8-10 sex offenders and will be co-facilitated by a male/female clinician. The groups meet for 90 minutes. The Process Groups will concentrate on processing the issues/dynamics associated with their sexual offending.

• Psycho Education Group - In addition to the Process Group, the offender will participate in a Psycho-Educational Group once per week that consists of seven modules (communication/stress management/assertiveness, anger management, human sexuality/sex education, cognitive restructuring, victim empathy, sexual reconditioning, and relapse prevention).  The Psycho-Educational Group is conducted in an educational format and is facilitated by one (1) clinician. Each offender will attend this group once per week when they first enter treatment.  It will take approximately one (1) year to complete all seven (7) modules. 

• Sex Offender Family Counseling – Family counseling will be provided every other week.  The session will involve the offender, his/her spouse, and/or other appropriate family members.  This session will address the family dynamics associated with sexual offending and rehabilitation, as well as reunification issues. 

• Plethysmograph Assessment – Plethysmograph Assessments will be completed every six (6) months to objectively monitor sexual arousal patterns, reconditioning efforts, and treatment gains. These assessments are 150 minutes in length and are conducted by a clinician of the same sex as the sexual offender.

• Polygraph Examination – The offender will undergo regular maintenance Polygraph Examinations to validate their honestly, as well as monitor their adherence to program guidelines while in the community.  These examinations are conducted every six (6) months and the services are contracted to be performed by a Licensed Polygrapher specializing in sex offender polygraphy.

Call (423) 257-8600 for more information about this program.

Adult Sexual Offender Risk Assessment

Counseling & Consultation Services provides a comprehensive Risk Assessment to Sexual offenders. The following is a description of each of the evaluation components provided by Counseling & Consultation Services:

 Our evaluation consists of multiple interviews, review of collateral material, objective testing designed to address risk (community safety) and amenability to treatment. These assessments can be completed and a report including specific recommendations sent within 60 days.  In emergencies, we have been able to complete an assessment in 7 days. The following is a description of each component of our assessment:
 

• Intake – Involves collecting general information about the offender’s social, medical, psychiatric, and criminal history. In addition, information is obtained about the person’s family history, marital relationship, alcohol and drug use, developmental history, community environment, and sexual history.

• Specialized Testing – Inventories developed from hundreds of evaluations completed on Sex Offenders are utilized to obtain information pertaining to sexual thoughts, feelings, and behaviors endorsed by the offender. The inventories are self-report paper and pencil inventories that help identify cognitive, affective, and behavior dynamics associated with sexual acting out.

• Penile Plethysmograph Assessments  – Penile Plethysmograph Assessments are conducted to identify sexual arousal patterns which may contribute to deviant sexual offending.  Sexual arousal involves increased blood flow into the penis that is measured by a strain gauge. Differences in arousal between stimuli depicting consensual sexual activity and deviant sexual activity allow clinicians to better address risk through the identification of deviant sexual arousal patterns.

• Clinical Interview – An intensive interview that focuses on the individual’s sexual offensive history. This interview addresses specific dynamics associated with an offender’s risk to re-offend, as well as whether the offender is amenable to treatment intervention.

• Family/Spouse Session - An interview with the offender’s family or spouse to assist in identifying environmental factors associated with an individual’s risk to re-offend, as well as factors which will affect treatment. This involves assessing access to victims, structure, supervision, and social support.

• Polygraph Examination – A Polygraph Examination is completed to validate the veracity of the information the offender disclosed concerning his/her sexual acting out history. The Polygraph is contracted to a Licensed Polygrapher who specializes in conducting Sex Offender Polygraph Examinations.

Call (423) 257-8600 for more information about this service.

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Risk Assessment for Minors

Who may be referred for a Risk Assessment:

• Adolescent Perpetrators (ages 12-17). Juveniles who have been identified by the Courts or Social Services to be in need of intervention for sexual offending or sexual acting out behaviors.
• Sexually Aggressive Youth (ages 8-11). Children who are sexually aggressive, have possible Court involvement, and are in need of intervention because of sexual acting out behaviors.
• Sexualized Children (under the age of 8). Children, who are sexually reactive, possibly involved in sexualized behaviors with other children, or may be identified as victims of sexual abuse. These children may or may not have come to the attention of the Court or Social Services Agencies.

1. Evaluate whether sexual behaviors are age appropriate or require intervention.
2. Evaluate child and community risk.
3. Evaluate amenability to treatment.
4. Provide safety recommendations to family and community agencies.
5. Provide recommendations for treatment options.
 

The Risk Assessment may include three or more of the following components:

1. Family Session

The Family Session is conducted first with the family of identified client and/or caregivers, without the identified client present. This session is utilized to evaluate the strengths of the family, levels of functioning in the family's communication, cohesiveness, flexibility, sexuality, family structure, intergenerational abuse, family stress, age appropriate involvement, emotional needs and power in the family. During this session Limits of Confidentiality and the assessment process is discussed.

2. Individual Intake Interview

This session is conducted with the child or youth. The Limits of Confidentiality Form is       discussed. Information is gathered about medical, personality, sexual development, family, and educational history of the patient from his or her perspective.

3. Clinical Interview

This interview is conducted to identify the child/juveniles sexualized behaviors, sexual  victimization, and the dynamics of sexual reactive/offensive behaviors which will be the focus of community safety and treatment efforts.

4. Polygraph Examination

"Lie detector test" will focus on the honesty of the patient about the sexual offense history.       Performed by a private licensed polygrapher and exceeds standards for scientific procedures as set forth by the Supreme Court of the United States. Use of the Polygraph during the assessment is typically required for those clients who are referred for sexually offensive and sexually aggressive behaviors. Some discretion is used based on the age and level of sexual development of the identified client.

5. Penile Plethysmograph Assessment

Penile Plethysmograph Assessments are conducted to identify sexual arousal patterns which may contribute to deviant sexual offending.  Sexual arousal involves increased blood flow into the penis that is measured by a strain gauge. Differences in arousal between stimuli depicting consensual sexual activity and deviant sexual activity allow clinicians to better address risk through the identification of deviant sexual arousal patterns.

Deviant sexual arousal patterns are one of the highest predictors of risk to recidivate.  This test helps identify sexual arousal to a wide range of sexually deviant stimuli and is only utilized with adolescent sex offenders when requested by the Courts or the family. No one under 14 years old will be given a Plethysmograph Assessment.

6. Recommendation Session

This is available for the family and referral source with the identified victim to discuss risks, safety plans, and treatment options once the assessment is completed.

Call (423) 257-8600 for more information about this service.

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Out Patient Treatment Services

Goals for Treatment:

1. Ensure community safety from further sexual assault.

2. Address the treatment needs of the family to reduce risk of recidivism.

3. Address treatment needs of the family to improve family functioning and promote healing.

4. Address the treatment needs of the identified client to reduce risk of sexual acting out behaviors.

5. Address treatment needs of the individual to improve individual functioning and promote healing.

Adolescent Offenders (ages 12-17):

Peer Therapy Group: The adolescent will participate in a Peer Therapy Group with other adolescent sexual offenders. The group consists of up to ten adolescents and meets once a week for the duration of therapeutic process. Group sessions meet for 90 minutes and are facilitated by our Family Therapist. The Process Groups will concentrate on processing issues/dynamics associated with their sexual offending.

Family Therapy: The adolescent with his/her parents/primary caregivers will participate in family therapy sessions one to two times per month. Family sessions meet from 45 to 60 minutes and are facilitated by our Family Therapist. Family sessions concentrate on addressing issues/dynamics associated with successful community intervention of sexual offending problem.

Parent Education Group: Parents of adolescents will participate in a Psycho-Educational group for 10 - 13 weeks. This group meets from 60-90 minutes in duration. Parents will receive information on topics such as victim empathy, communication and sexuality. This group is facilitated by a member of our Treatment Team.

Individual Counseling: The adolescent sex offender may be asked to participate in individual counseling session- one to two times per month. These sessions are adjunctive to the adolescent's group therapy sessions and will address issues related to the sexual acting out behaviors.

Family Group: Parents and their adolescent meet every other month in the family group. This group meets 60-90 minutes in duration. Parents and adolescents receive information about treatment progress. We also use this group as a forum to introduce information that meets families needs: communication, discipline, love, etc.

Physiological Measurement of Sexual Arousal: This assessment is designed to evaluate the presence or absence of deviant sexual arousal. Deviant sexual arousal is one of the best indicators of risk to re-offend. It will not be completed on an adolescent who is under 14 years old. The Treatment Team will determine whether or not to utilize this on an as needed basis for adolescents 14 - 16 years old. The measurement will be required every six months during treatment for anyone 17 years old and older.

Polygraph Examination: The polygraph examination will focus on the honesty of the client about the sexual offense history and the current activities of the client during treatment. A polygraph examination will be completed every six months.

Adolescent Offenders (treatment typically lasts 12-18 months)

Peer Therapy Group (meets weekly, open and ongoing)
Family Therapy Sessions (1 -2 sessions per month)
Parent Education Group (weekly for 10 - 13 weeks, time-limited, closed)
Individual Sessions (1 -2 sessions per month)
Physiological Measurement of Sexual Arousal (frequency based on age/necessity)
Polygraph Examinations-Maintenance (every six months)
Staffing and coordination with involved systems

Peer Therapy Group: The youth will participate in a Peer Therapy Group with other adolescent sexual offenders. The group consists of up to ten youth and meets once a week for the duration of therapeutic process. Group sessions meet for 60 minutes and are facilitated by our Family Therapist. The Process Groups will concentrate on processing issues/dynamics associated with their sexual offending acting out.

Family Therapy: The child with their parents/pnimary caregivers will participate in therapy sessions one to two times per month. Family sessions meet from 45 to 60 minutes and are facilitated by our Family Therapist. Family sessions concentrate on addressing issues/dynamics associated with successful community intervention of sexual offending problem acting out.

Parent Education Group: Parents of children will participate in a Psycho-Educational group for 10- 13 weeks. This group meets from 60-90 minutes in duration. Parents will receive information on topics such as victim empathy, communication and sexuality. This group is facilitated by a member of our Treatment Team.

Individual Counseling: The youthful offender may be asked to participate in individual counseling sessions one to two times per month. These sessions are adjunctive to the child group therapy sessions and will address issues related to the sexual acting out behaviors. These sessions are 30-60 minutes in duration.

Family Group: Parents and their child clients meet every other month in the family group. This group meets 60-90 minutes in duration. Parents and child clients receive information about treatment progress. We also utilize this group as a forum to introduce information that meets family's needs: communication discipline, love, etc.

Polygraph Examination: The polygraph examination will focus on the honesty of the client about the sexual offense history and the current activities of the client during treatment. A polygraph examination will be completed on an as needed basis determined by the Treatment Team.

Sexually Aggressive Youth (treatment typically lasts 6-12 month)

Peer Therapy Group weekly (10- 13 weeks, time limited, closed)
Parent Education weekly (10- 12 weeks, time limited, closed)
Family Therapy Sessions (1 -2 sessions per month)
Individual Sessions (1 -2 sessions per month)
Staffing and coordination with involved systems
Polygraph Examinations-Maintenance (PRN)

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Sexualized Children-Victims of Sexual Abuse (under age of 8)

Peer Therapy Group: Sexualized children and victims of sexual abuse will participate in a peer therapy group facilitated by our Family Therapist. This group meets 10 - 13 weeks and is 60 minutes in duration. This group will address issues related to victimization, such as secrecy, impact, and personal safety. This group is designed with consideration of the age, gender and development of the child.

Parent Education Group: Parents of child clients will participate in a Psycho-Educational group for 10 - 13 weeks. This group meets from 60-90 minutes in duration. Parents will receive information on topics such as victim empathy, communication and sexuality. This group is facilitated by a member of our Treatment Team.

Family Therapy: The child client with their parents/primary caregivers will participate in family therapy sessions one to two times per month. Family sessions meet from 45-60 minutes and are facilitated by our Family Therapist. Family sessions concentrate on addressing issues/dynamics associated with successful community intervention of sexual victimization problems.

Individual Counseling: The child client sex offender may be asked to participate in individual counseling sessions one to two times per month. These sessions are adjunctive to the adolescent's group therapy sessions and will address issues related to the sexual abuse.

Sibling Group: Siblings of child victims who have not been identified as a victim of sexual abuse may participate in a sibling group. This group meets 10 - 13 weeks, and is 60 minutes in duration. Group goals are to offer emotional support and friendship to siblings as their family progresses through treatment.

Mother's Support Group: Mothers of children and/or adolescents in our treatment program may attend a support group. This group meets every other month and is about 120 - 160 minutes in duration. Group goals are to offer emotional support and friendship to women as their children and families progress through treatment.

Polygraph Examination: The Polygraph Examination will be used as determined by the Treatment Team on a case by case basis.

Sexualized Children (treatment lasts 6 - 12 months)

Peer Therapy Group (weekly, time-limited for 10 - 13 weeks, closed)
Parent Education (weekly, time limited 10 - 13 weeks, closed)
Family Therapy Sessions (1 -2 sessions per month)
Individual Sessions (1 -2 sessions per month)
Sibling Group (weekly, time limited 10 - 13 weeks, closed)
Mother's Support Group (every other month, ongoing open)
Polygraph Examination (PRN)

Note: Peer Therapy Group, Sibling Group and Parent Education are typically conducted conjointly. Treatment plan may vary based on the needs of the family and the individual.

Call (423) 257-6054 for more information about these programs.

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Intensive After School Program For Adolescent Sex Offender
(Intensive Out Patient)

Description of Services

The Intensive After School Program is designed to interrupt the cycle of sexual offending/sexual acting out in an environment that provides intensive therapeutic intervention with the identified client and his or her family/caregivers/support system, while the individual is residing in the community or is transitioning to community. Services will be provided to adolescents from the ages of 12-17 who are not actively psychotic, homicidal or suicidal and have a full scale IQ 70 or above, as referred by the Agency in need of intervention for sexual offending or sexual acting out behaviors. Individuals that do not meet these criteria will be considered on a case-by-case basis. Each individual and/or their families/caregivers/surrogate families will participate in 3-4 hours of treatment services per day (Monday - Thursday). The treatment services shall include, but not be limited to the following:

Sex Offender Peer Therapy/Process Group (60-90 min., meets daily, open and ongoing)

The focus of this group will be addressing the dynamics of the sexual offending behaviors with the identified client in a peer group setting.

Psycho-Education Peer Group (30-45 min., meets 2 times weekly, open, on-going)

The focus of this group is to educate the identified client on topics, such as human sexuality, anger management, cognitive distortions, communication, stress management, sexual reconditioning, and victim empathy.

Community Issues Peer Process Group (30-45 min., meets daily, open, and on-going)

The focus of this group is to address issues directly related to community behavior, accountability, self-responsibility, safety plans, dating, etc. This group will apply skills learned in "real life".

Individual Therapy Sessions (30-60 min., as prescribed)

The focus of these sessions will assist the identified client with his or her individual issues, such as sexual victimization, emotional losses, self-awareness, and abandonment/attachment issues.

Unstructured Work Time (30-45 min. per day)

Offer individual support with homework tasks related to treatment tasks, such as journaling.

Family Therapy Sessions, conducted with or without adolescent offender with biological family and/or caregivers/surrogate families (45-60 min., weekly)

The goal of these sessions is to address the levels of denial within the family and/or surrogate family system, which interferes with safety, support, accountability, and structure in the home environment. These sessions also would include addressing risk, decision-making, visitation in the context of the child's living environment, etc.

Polygraph Examinations (PRN)

The Polygraph Examination will focus on the honesty of the client about his/her sexual offense history and the current activities of the client during treatment. A Polygraph Examination will be a minimum of every six months.

Plethysmograph Assessments (PRN)

This assessment is designed to evaluate the presence of absence of deviant sexual arousal. Deviant sexual arousal is one of the best indicators of risk to re-offend. It will not be completed on an adolescent who is under 14 years old. The Treatment Team will determine whether or not to utilize this on an as needed basis for adolescents 14-16 years old. The measurement will be required every six months during treatment for anyone 17 years old and older.

Length of Treatment Services

Each referral will initially be approved for a one (1) month period. The Contractor shall be responsible for submitting the request for continuation of subsequent monthly services. Each case will be reviewed to evaluate continuation of services and approved on a month-to-month basis if continuation of services is justifiable. The maximum length of stay in this program is six (6) months. Extensions beyond the six (6) month period may be granted by the Executive Director based upon need.

Call (423) 257-6054 for more information about this program.

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