Seth Wescott, LMLP & Megan Bradshaw, LMSW March 21, 2019 A New Direction Forward: Collaborative Efforts for Youth with Sexual Behavior Problems Seth Wescott, LMLP & Megan Bradshaw, LMSW March 21, 2019

Objectives Participants will gain an understanding of the need for collaboration between corrections and treatment in order to provide the most effective services for youth with sexual behavior problems Participants will receive knowledge on the latest risk assessment instruments that help guide treatment decisions Participants will learn how Kansas’ reliance on assessment-driven supervision has resulted in better outcomes for youth with sexual behavior problems

Mission and Vision Mission Statement Vision Statement The mission of the Kansas Department of Corrections – Juvenile Services (KDOC-JS) is to promote standards of excellence in juvenile justice by supporting data driven policies and proven approaches delivered in the least restrictive environment possible and equipping families, communities, and partners across the state to best meet the needs of kids Vision Statement To lead the nation in juvenile justice by strengthening families, empowering youth, and making communities safer

Cheyenne Rawlins Decatur Norton Phillips Smith Jewell Republic Washington Marshall Nemaha Brown 17 12 22 Doniphan Cloud Atchison Sherman Thomas Sheridan Graham Rooks Osborne MC Mitchell Clay Riley Jackson Pottawatomie Leavenworth 2 15 21 Jefferson 1 Ottawa Wyandotte Lincoln Shawnee 29 Wallace Logan Gove Trego Ellis Russell 28 Geary Wabaunsee 3 7 10 23 Saline Dickinson Ellsworth Morris Osage Douglas Johnson 8 Greeley Wichita Scott Franklin Lane Ness Rush Barton Lyon Miami 20 McPherson 4 Marion 24 Rice Chase 5 9 Coffey Pawnee Anderson Linn Hamilton Kearny Finney Hodgeman Stafford 6 Reno Harvey 25 27 Butler Greenwood Gray Edwards Woodson Allen Bourbon Ford 31 Sedgwick 13 Pratt Kingman Stanton Grant Haskell 16 Kiowa 18 Wilson Neosho Crawford 30 Elk Meade Clark Barber Sumner Cowley Morton Stevens Seward Comanche Harper Montgomery Labette 19 Chautauqua Cherokee 26 14 11 1

Commitment to Reform In 2015, a bi-partisan commitment from leaders in the executive, legislative, and judicial branches of state government charged the Kansas Juvenile Justice Workgroup with developing policy recommendations intended to advance three goals: Promote public safety while holding juvenile offenders accountable Control taxpayer costs Improve outcomes for youth, families, and communities across Kansas The workgroup involved a comprehensive, data-driven assessment of Kansas’ juvenile justice system

2015 Workgroup Recommendations Prevent deeper juvenile justice system involvement Provide swift, appropriate responses to youth behavior Target the use of pre-adjudication detention for higher-level youth Protect public safety by focusing system resources Focus residential beds on youth who pose the greatest public safety risk Hold youth accountable through stronger community supervision Sustain effective practices through oversight and reinvestment Reinvest in evidence-based community alternatives to reduce reoffending and improve outcomes Ensure juvenile justice professionals receive effective training Incentivize better system performance through oversight and data collection

Legislative Results: Senate Bills 367 (2016) and 42 (2017) Provided a policy change and a framework to implement across time many of the Juvenile Justice Workgroup recommendations After the passing of SB367, there were common questions among both stakeholders advocating for reform and for continuation of current practices, including: Would specific policy chances achieve the intended result How can the void in access to community-based services be addressed In today’s presentation, we will talk specifically about the work done in partnership with Clinical Associates

Out-of-Home Placements JCF commitments have dropped 31%, from 237 in FY15 to 164 in FY18 The number of misdemeanants placed at the facility down 90%, from 34 to 4 over the same period. Overall out-of-home placements have decreased by 63%, from 878 in FY15 to 321 in FY18.

Revenue for Community Based Services K.S.A. 75-52,164 specifies that the Secretary determine “cost savings as a result of cost avoidance resulting from decreased reliance on incarceration in the juvenile correctional facility (JCF) and placements in youth residential centers.”

Reinvestment in Community Based Services KDOC-JS has obligated approximately $7.5 million in FY18 to sustain and expand community based services Services target youth who score as moderate, high, or very high risk on the YLS/CMI $2.5 million for statewide contracts for Functional Family Therapy (FFT®), Sex Offender Assessment and Treatment Services, Moral Reconation Therapy (MRT®), and regional pilot projects for Youth Advocate Program (YAP®) and Aggression Replacement Training (ART®) $4.0 million for a new reinvestment grant program $1.0 million for new regional collaboration grant program

Strengthening Community Supervision In 2017, KDOC-JS released revised standards for the delivery of community supervision to align with revised and new policies of SB367/42 Program/service delivery emphasis while reducing use of standard contacts in probation services Graduated Responses and Incentives Supervision duration align with case length limits Case planning Earned Discharge Credit

Needs Identified Supervision and Safety Comprehensive Community Based Treatment Continuity of Care Training and Education for Stakeholders Family Engagement Collaboration with Supervision Agency Staff Specialized Staff

State Initiated Contract for Community Based Sex Offender Evaluations and Treatment In Fall 2015, a Request for Proposal (RFP) was sent out seeking community partners Two primary goals of the RFP To establish an assessment process/resource for all youth adjudicated of a sex offense for the judge’s use pre-disposition; and To provide sex offender treatment to youth adjudicated of a sex offense in the community (including post-release from incarceration)

Education and Outreach Community Outreach Engagement Strategies

Program Design and Components Duration of 6, 9, and 12 months determined by risk level Allows youth to complete treatment prior to the expiration of probation Tele-video treatment allows for youth in rural areas without hours of transportation to and from treatment Booster sessions for youth exiting the juvenile correctional facility

Goals of Current Contract Provide treatment services to approximately 120-140 juveniles who have committed sexual offenses identified to participate in community treatment. Assessments of individuals, cognitive-behavioral interventions counseling, group counseling, individual counseling, family counseling, family/parental support groups, booster sessions, and program consultation services. It is anticipated that there will be the need for approximately 120 assessments statewide on an annual basis.

A Different Approach to Serving Youth with Sexual Behavior Problems Community-based sex offender assessment and treatment became available statewide for the first time as a result of the reforms, beginning in July 2016 81 evaluations were completed in FY18, 58 of which recommended community-based treatment instead of incarceration In FY18, 41 new youth were allowed to enter community-based treatment after disposition, and 90 youth in total received treatment Of 55 discharges in FY18, 82% (N=45) were successful with no court revocation or termination of treatment

Treatment Philosophy Risk Management & Good Lives Approach Goals Individualized Empathic and collaborative

Psychosexual Evaluations of Adolescents Conducted prior to placement in treatment Goal is to gather information and provide recommendations for treatment Includes psychosocial assessment The more info we have the better (affidavit, police reports, victim statements, prior evaluations/treatment records, etc.)

Treatment Targets 5 Core Components Protective Factors Sexual Education Sexual Self-Regulation Typology-Specific Technology and Sexual Behavior Fostering a Healthy Identity Protective Factors

Sexual Education Issues of consent Anatomy and physiology Healthy sexual development Appropriate outlets for sexual feelings

Sexual Self-Regulation Healthy boundaries Importance of communication regarding boundary violations Support system members (peers and family) History of trauma/past sexual abuse/learned schemas regarding sexual behavior Impulse-control Managing sexual arousal Emotion regulation

Typology Specific Lifestyle Delinquent Youth Conduct Disordered otherwise criminals Adolescent Onset, Non-Paraphilic Youth Experimental Compensation for deficits in social skills Primarily directed at pre-pubescent females Early Adolescent Onset, Paraphilic Youth Emerging deviant sexual interests (Hunter, 2006)

Technology & Sexual Behavior Cell Phones Sexting: 20% of teens have sent nude or semi-nude photos (22% of teen girls and 18% of teen boys) Cyberbullying: Easy way to spread rumors or get revenge Social Media The Good (Facebook, Instagram, Twitter) The Bad (After School, Askfm, MeetMe, Snapchat) The Ugly (Yubo, Monkey, Kik, Omegle)

Pornography “Any form of media whose sole purpose is sexual stimulation” 1980s-1990s: age at first exposure = 16.5 Now: 9 or 10 Almost all kids are exposed to pornography by the time they enter puberty Only 25% will tell an adult at first exposure 30% of the internet is pornography (400,000 websites) Larger than Amazon, Netflix, Twitter combined How do kids first see pornography these days?

Fostering a Healthy Identity (Good Life) Formulating a healthy support system Family Peers Therapy (when appropriate) Creating a successful living plan Goals for success on supervision Long-term goals Moving toward an independent lifestyle Reintegration/Integration Maintaining healthy and safe behaviors within the home Identifying/relying on support persons to help during the process Continued monitoring/follow-up throughout reintegration

Protective Factors Positive family functioning (e.g. adequate supervision, consistent and fair discipline) Positive peer social group and availability of supportive adult Commitment to school Pro-social attitudes Emotional maturity Self-regulation Problem-solving skills

What Treatment Looks Like Risk and need driven Identify responsivity issues at the outset and work through them—or ignore them for the time being Goal is to reduce risk, increase accountability, improve functioning, establish healthy behavior patterns Treatment is discontinued once goals are accomplished No specific timeline Weekly, bi-weekly, monthly sessions Individual if needed Family sessions are part of the contract

What it Doesn’t Look Like “Here’s your Pathways workbook, fill it out and we’ll go through it.”

Referral Data Total Referrals for Evaluation: 227 Ages 13-22 Average Age = 17 97% Male Pre vs. Post Sentencing: 44% Pre-Sentence 56% Post-Sentence

Cheyenne Rawlins Decatur Norton Phillips Smith Jewell Republic Washington Marshall Nemaha Brown 1 3 5 Doniphan Cloud Atchison Sherman Thomas Sheridan Graham Rooks Osborne MC Mitchell Clay Riley Jackson Pottawatomie Leavenworth 2 6 5 Jefferson 9 Ottawa Wyandotte Lincoln Shawnee 18 Wallace Logan Gove Trego Ellis Russell 1 Geary Wabaunsee 29 21 5 8 Saline Dickinson Ellsworth Morris Osage Douglas Johnson 4 Wichita Scott Franklin Greeley Lane Miami Ness Rush Barton Lyon 6 McPherson 7 Marion 4 Rice Chase 2 7 Coffey Pawnee Anderson Linn Hamilton Kearny Finney Hodgeman Stafford 2 Reno Harvey 1 Butler Greenwood Gray Edwards 4 Woodson Allen Bourbon State Description – capital is Topeka, most populous city is Wichita, most populous county is Johnson 15th largest state by area 34th most populous with a population of 2,911,641 (2.9 million) Talk about the rural nature of KS – population concentrated in Sedgwick (Wichita), Johnson and Wyandotte Counties (Kansas City metro area), and Shawnee County Tie this in to where we are receiving referrals Judicial Districts Not Served: 13{5th, 8th, 13th, 14th, 16th, 17th, 19th, 25th, 26th, 27th, 28th, 30th, 31st} Ford Sedgwick 6 Pratt Kingman Stanton Grant Haskell Kiowa 54 Wilson Neosho Crawford 2 Elk Meade Clark Barber Sumner Cowley Morton Stevens Seward Comanche Harper Montgomery Labette 1 Chautauqua Cherokee 3 1 10 1

Outcomes (Psychosexual Evaluations) FY17 FY18 106 Total youth evaluated (70 recommended for treatment) Referrals from 23/31 Judicial Districts in Kansas JSORRAT (71 were able to be scored) Low = 39 Moderate Low = 14 Moderate = 13 Moderate High = 4 High = 1 81 Total youth evaluated (58 were recommended for treatment) Referrals from 18/31 Judicial Districts in Kansas JSORRAT (47 were able to be scored) Low: 31 Moderate-Low: 7 Moderate: 8 Moderate-High: 1 High: 0

Treatment Participation FY17 FY18 39 Participated in Treatment In-person: 32 Tele-video: 7 Group: 23/39 Individual: 16/39 90 Participated in Treatment Individual outnumbered Group Majority in-person Most clients remained in home

Outcomes (Treatment) 17 Discharged 55 Discharged FY17 FY18 17 Discharged Low Risk: 10 Absconded: 1 Terminated: 4 Revoked: 1 Deceased: 1 55 Discharged Low Risk: 39 Terminated: 7 Revoked: 3 Sentence Expiration: 3 Transfer to other jurisdiction: 3 Avg. length of treatment = 5.29 months

External Peer Review (April 2018) David Prescott, LCSW, LICSW Observations (group session, individual session, evaluation) Staff Interviews Recommendations that focus on: Trauma Informed Care (Incorporating ACE data) Motivational Interviewing skills and techniques Understanding and building on protective factors

Avoiding Pitfalls Treatment providers often misinterpret responsivity issues as risk factors Empathy Denial Motivation Treatment providers often focus on responsivity issues instead of risk issues Offenders who present with responsivity issues are NOT necessarily high risk

Ineffective Strategies Assume that Relapse will happen Foster an identity of a “sexual offender” “different” or “deviant” Limit pro-social supports Rely on “workbook” treatment Equate task completion with treatment success Stress understanding “empathy”

Effective Management Strategies Collaborative Involves Family, Supervision Officers, Pro-social support, Mental Health, other community resources Foster a “normal” identity Increase Pro-social Activities It’s not what you want to avoid, it’s what you want to accomplish

What’s Next? PROFESOR Data Community Outreach Legislative Updates Parent Engagement

megan.bradshaw@ks.gov (785) 296-0897 wescott@clinical-assoc.com (913) 449-3106