1. The Center for the Treatment of Problem Sexual Behavior The Connection, Inc. Program Description January 7, 2016 1

2. CTPSB Program Goals Community Safety  Reducing future sexual violence and abuse Client Success  To remain offense free  To improve their lives 2

3. 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 3

4. 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 4

5. 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 factors 5

6. 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) 6

7. 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

8. 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 treatment 8

9. 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

10. 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) 10

11. 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 11

12. 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. 12

13. Treatment Other 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. 13

14. 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 14

15. 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 clinicians 15

16. 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 16

17. Contact Information David Zemke, LMFT The Connection, Inc. The Center for the Treatment of Problem Sexual Behavior dzemke@theconnectioninc.org 860-918-8233 17