Issues Associated with Certification or Non-Certification of Treatment Providers Who Work with Sexual Offenders in California Gerry D. Blasingame, MA Licensed Marriage & Family Therapist

Definitions certification noun 1. the act of certifying or bestowing a franchise on [ant: disenfranchisement] isenfranchisement 2. confirmation that some fact or statement is true through the use of documentary evidence [syn: documentation] documentation 3. a document attesting to the truth of certain stated facts [syn: certificate] certificate 4. validating the authenticity of something or someone [syn: authentication] WordNet® 3.0, © 2006 by Princeton University.authentication

Definitions authentication noun 1. a mark on an article of trade to indicate its origin and authenticity 2. validating the authenticity of something or someone WordNet® 3.0, © 2006 by Princeton University.

Definitions board certification n. The process by which a person is tested and approved to practice in a specialty field, especially medicine, after successfully completing the requirements of a board of specialists in that field. For a physician, board certification is required in order to have the privilege of practicing in a hospital. Dictionary.com

Definitions Approval 2. The act of approving; an assenting to the propriety of a thing with some degree of pleasure or satisfaction; approval; sanction; commendation. dictionary.com

Current Status in CA Currently licensure is the only qualification requirements for those who aspire to treat or evaluate sexual offenders in California – State licensing boards establish minimum academic and experience requirements to obtain a license as a psychiatrist, psychologist, social worker, or marriage & family therapist. These requirements do not directly address sub- specialties such as work with sexual offenders.

Current Status in CA – The CASOM Task Force (2007) and the CA SOMB Report to the Legislature (2008) documented the lack of regulatory guidance for therapists who work with sexual offenders – Few counties have provider criteria (San Diego, Orange, San Francisco; all CSOM models) – CDCR has wording in contracts but only effects some providers serving parolee sex offenders – DMH provides internal training to staff at the State Hospitals and SVP evaluator panel members

Current Status in CA Of the 58 counties, treatment and supervision methods are inconsistent from county to county; not only are therapies inconsistent, so are adjudication and supervision strategies Public safety interests of CA citizens (evidenced by the heightened sentencing laws, laws to regulate where offenders may live, and laws associated with sex offender supervision) indicate a desire to improve how sex offenders are managed within the State

Current Status in CA Licensed therapists in CA are allowed to work within their “scope of practice” which is based on their training, education, and experience. Scope of practice is self-monitored and maintained by continuing education requirements. There is no prescribed “scope of practice” for sex offender treatment providers in California. Therefore, sex offender treatment, it’s practioners, and it’s content, are unpredictable

Current Status in CA Professional organizations within which therapists who treat sex offenders affiliate do not certify or credential their members (specifically CCOSO and ATSA do not) Many professionals in CA do not belong to either of these organizations while treating sex offenders; these are in unknown numbers

Current Status in CA CA has no Standards or Guidelines that are supported by regulation or legislation for training requirements causing professionals to collaboratively manage sexual offenders. – Therapists – Probation officers and parole agents – Evaluators – Judges, prosecutors, defense attorneys – Polygraph examiners

Status in Other States Several States have varying titles for those therapists who work with sexual offenders – Certified Providers – Approved Providers – Registered Providers

Status in Other States Colorado has long been a model for other States to follow, dating to 1992 (see The Colorado SOMB has established – Standards, Guidelines, Treatment and Behavioral Monitoring of Adult Sex Offenders, and – Lifetime Supervision Criteria, and – Standards for Community Entities that Provide Supervision and Treatment for Adult Sex Offenders who have Developmental Disabilities

Colorado SOMB’s Guiding Principles Sex offending is a behavioral disorder which cannot be cured. Sex offenders are dangerous. Community safety is paramount. Assessment and evaluation of sex offenders is an ongoing process. Progress in treatment and level of risk are not constant over time. Assignment to community supervision is a privilege, and sex offenders must be completely accountable for their behaviors.

Colorado SOMB’s Guiding Principles Sex offenders must waive confidentiality for evaluation, treatment, supervision, and case management purposes. Victims have rights to safety and self-determination. When a child is sexually abused within the family, the child’s individual need for safety, protection, developmental growth and psychological well-being outweighs any parental or family interests.

Colorado SOMB’s Guiding Principles A continuum of sex offender management and treatment options should be available in each community in the state. Standards and guidelines for assessment, evaluation, treatment, and behavioral monitoring of sex offenders will be most effective if the entirety of the criminal justice and social services systems, not just sex offender treatment providers, apply the same principles and work together.

Colorado SOMB’s Guiding Principles The management of sex offenders requires a coordinated team response. Sex offender assessment, evaluation, treatment, and behavioral monitoring should be non-discriminatory and humane, and bound by the rules of ethics and law. Successful treatment and management of sex offenders is enhanced by the positive cooperation of family, friends, employers, and members of the community who have influence in sex offenders’ lives.

Reasons to Approve Providers Increased specialization and advanced training is thought to improve outcomes, e.g. increase community safety through more competently trained treatment providers and supervision processes Creates regulatory mechanisms for accountability and consistency among providers throughout the State Creates minimum standards of training, education and experience for treatment providers, e.g. prescribes a scope of practice & content for CEU

Reasons to Approve Providers “Approval” regulation can clarify issues related to confidentiality and the mandatory nature of communication between treatment providers and appropriate parties, including probation officers and parole agents The AWA foreshadows the need for “certified” providers/programs (although it is unknown if CA will adopt the AWA) Increases reason for public confidence when offenders are said to have completed treatment

Reasons to Not “Approve” Providers Psychotherapists are licensed to practice independently and are to self-regulate their scope of practice. The scope of practice requirement within licensure laws is sufficient in that disciplinary action can be initiated if a consumer believes SO treatment is beyond a provider's competence. Licensed therapists are already required to complete CEU

Reasons to Not “Approve” Providers Good psychotherapist skills are required regardless of the type of client being treated. Evidence that factors associated with general psychotherapy, such as the characteristic of the therapist-client relationship, are more important to treatment success than any specific method.

Reasons to Not “Approve” Providers Therapists opposed to the Containment Models’ transparency and waiver of confidentiality may oppose such mandates within regulated practice. There is no empirical support for any specific intervention model to the exclusion of all other approaches. Not all sex offender treatment providers want to provide cognitive behavioral or relapse prevention oriented treatment; providers want autonomy to select their own treatment strategies.

Reasons to Not “Approve” Providers – No clear indication that SO treatment requires a level of specialized knowledge consistent with a medical discipline or sub-discipline. It seems more like a problem area like cardiovascular disease, depression, etc. Certification or approval of sex offender treatment providers cannot be equated to the rigorous requirements of physician’s board certification. Not all therapists treating sex offenders will agree with minimum standards of practice.

Suggested Qualifications if Moving Towards “Approved SO TX Providers” Licensure within the State of California Hours of experience requirements, e.g hours of face to face assessment, evaluation, and treatment with adult sex offenders within the recent five years Documented hours of CEU focused on sex offender treatment and management areas, e.g. 100 hours of sex offender specific trainings and workshops within five years

Suggested Qualifications if Moving Towards Approved SO TX Providers Training to be obtained in prescribed areas beyond general psychotherapies, e.g. a broad list of training topics and issues from which to select and manage one’s own training needs within that larger scope Adoption of a Code of Ethics such as that of ATSA Academic and clinical experience references upon request Sex and violent crime free history

Suggested Qualifications if Moving Towards Approved SO TX Providers Demonstrate evidence of knowledge of evidence based practices in written treatment plans for each offender-client Application/registry with the designated “approving” entity, e.g. the CA SOMB, and continuing provision of documentation demonstrating ongoing training

Suggested Qualifications if Moving Towards Approved SO TX Providers Alternate levels of approval should be available for clinical associates or interns, albeit less stringent Similar approval criteria should be established for those providing pre-sentencing evaluations and assessments during the course of adjudication and treatment Similar training requirements should be applied to other collaborating entities

Question before the CA SOMB Should or shall the Board invest further energies in the developing “approval” protocols to submit for consideration and/or recommendation for future reports to the legislature?