 You're watching FJTN, the Federal Judicial Television Network. We also want this training program to give you an opportunity to learn more about sex offenders. I attended the program today so I could take back information from myself as well as fellow officers about the investigating of people charged with sexually-based offenses at the federal level. It's also difficult for the victim to see it as a sexual crime. We at the Federal Corrections and Supervision Division feel that this is an important issue to be addressing and that we have made it a priority at the AO. I think this training will teach us to do better pre-sentences, number one, to start the process and secondly will help us supervise them by knowing what kind of conditions to impose and knowing more about the offender himself when he's released for supervision. The client is the community, or the community is the client. So I may be treating, we may be treating an offender an individual, but that individual may not be my primary client. We've always heard about this program at Butler, but now we've actually been here and have had an opportunity to see the staff, meet the staff, see the program so I think it's going to give us a lot of insight into what goes on back here and how we can continue that in the community. Welcome to the second installment of Special Needs Offenders FCI Buttoner Sex Offender Treatment Program. I'm Mark Maggio. Investigation and supervision of sex offenders pose many unique challenges to probation and pretrial services officers. This focused addition of the Special Needs Offenders series features Dr. Andres Hernandez and his staff discussing those challenges with nearly 100 pretrial services and probation officers. Dr. Hernandez is the director of the Sex Offender Treatment Program at the Bureau of Prisons Federal Correctional Institution in Butner, North Carolina. They met over two days in June of 2000 at FCI Buttoner. Sponsored in part by the Federal Judicial Center, the conference was entitled Effective Management of Sex Offenders in the Community. Now so much material was covered in those two days that we couldn't squeeze it all into one two-hour broadcast, so we divided the program into two parts. And this is part two. Today we concentrate on the sex offender-specific pre-sentence investigation, risk assessment, and sex offender management. Now as you may recall, part one featured general discussions of sex offenders and an overview of the treatment program at Buttoner. And we appreciate your evaluations and comments regarding part one of this program. And Dr. Hernandez put together a wealth of information and supplemental reading materials for the conference. And most of those materials and the complete unedited two-day conference slide presentation can be found on the DCN. Now one note about the slide handout. Our topic headings in the video match the topic title slides in the handout. And we provided the handout for the entire two-day conference rather than a short edited version. However, since this video program is an edited version of the two-day conference, the result can be a bit confusing for those who are trying to follow along. Now this problem was pointed out to us following part one, and we thank you for that, and we'll be sure to keep it in mind for future programs. Now other written materials referred to in this program can be found on the website for the Center for Sex Offender Management. Their web address is csom.org. But for now, let's join Dr. Karen Steinauer, staff psychologist in the Sex Offender Treatment Program at FCI Buttoner, as she talks about a sex offender-specific pre-sentence investigation. What I'd like to do is turn our focus to something that's very near and dear to all of our hearts. And that would be the pre-sentence investigation report. Our intention this morning is to share information with you about how you can make the pre-sentence investigation report more offense and offender specific. So start off with the certain general comments, general suggestions. Whenever possible, please describe victim characteristics. Even if on the images we talk a lot in our agency about the child pornographer, a fairly new type of offender relative to other types of offenders. And one of the things that we hear, as we mentioned yesterday so often, is that the child pornographer is not necessarily seen as a sex offender. Well, in fact, he is. And there are a lot of things that we need to know about him. So whenever possible, try to find out what you can about the images that the child pornographer is retrieving. And how they're collected. What methods of access to the victims. For example, did the person have a number of different jobs or volunteer opportunities in which that offender gained access to children? Did the person access pornography through the computer? Any prior access to victims? Any past experiences where one is working in a middle school, for example, or coaching a boys basketball team? Any prior information about opportunities they made available to themselves so that they could gain access to victims? That might not be an automatic part of an instant offense, but nonetheless very important to gathering full information about that offender. Methods for avoiding detection. Any aliases used? Did the person lead a nomadic lifestyle? What about rental of storage places? Private P.O. box. No pun intended. Threats to the child, verbatim if possible. And any travel abroad to protect against prosecution? Describe associations with other sex offenders. And that, when we're talking about that, we're really talking about the extent of the association and the type of the association. We have an individual we're working with right now who actually had befriended one of the inmates that we worked with previously who was just released. What we learned about that situation is that they had had an awful lot of contact over the Internet for a period of a couple of years, actually. And during the course of that time, they got to know each other pretty well and actually traveled to meet each other. The one person invited the other to come go to a park festival with his family. He happened to have a two-year-old child that he wanted to introduce the other offender to. So the extent of association with other sex offenders can be really important to us when we're trying to figure out what we need to do with that given individual in treatment. And one other general suggestion, sexual history, how did he learn about sex? At what point did he begin to have deviant fantasies? What was the content or the themes of the fantasies? At what point did he begin to masturbate to these fantasies? What was the intensity of the focus on the pornography, on the victims, on the chat rooms? What was the duration of abusive behavior within a given incident and over what period of time? Yes. How did you propose that we get this information on specifically the sexual history information in light of defensive attorneys maybe telling their clients that not to answer those kinds of questions? We recognize that there are significant obstacles to your getting this information. We also experience some of those obstacles as well. I mean obviously we're not looking at a situation in which someone is facing the sentence, but we are telling them up front that any information they give us is going to go to the probation officer, to the therapist, and to anyone else in the community who is in a need to know status. You're not going to be able to get all of this information in most cases, and we recognize that. What we're trying to emphasize today are the kinds of things that would be helpful to have if you could get them. What I've found has been somewhat helpful in my work with inmates in terms of trying to get information is to really zero in on what they're telling me about their desire to change. And by using that I'm saying well it doesn't sound like you've really given us all the information here and I really want to believe that you want to change, but if this doesn't match with this then I'm really concerned that maybe you're not being fully honest with me, that sort of thing, to encourage them to basically carry through in the way they've told you they will. Now in an investigation they're looking at time and we know that. They know that. Their defense attorney knows that. We're trying to work also at the other end with the defense attorneys. We get a lot of calls actually from them who have concerns about the individuals they're representing in court and they want to make sure that given that they really think this person does need to go to prison, they want to make sure that they're going to be okay in prison, that sort of thing. So we really do try to work at that end as well to educate the defense attorneys to be aware of what it is they're actually doing in defending these individuals that sometimes the time is actually a great help to the defendant. But I think it's a matter of art and skill and trying to get the individual to fess up to the notion that he wants to do the right thing. Sometimes looking, I think from an investigation and looking at sort of the guilt and looking at the fact that he's facing a family who's just been somewhat influenced by what he's done and the idea of coming clean. I don't know if you'd like to add to that, Andres? I want to underscore what Karen is saying. We recognize that a lot of this information you simply will not have access to. However, I've seen PSI reports in which the offenders do disclose and do talk to you and actually talk to you that is very detailed. I've seen pre-sentence reports that are extremely detailed and I can't tell you how helpful that is to us. It takes multiple, multiple interviews and a very good and trained clinician to obtain all that information. However, what we aim to do by giving you this information is simply to sensitize you to the various aspects of taking a sexual history so that you can, if you hear some of these things, that they will resonate and you may ask an additional question. Yes. A lot of times, but as the lady indicated, the attorney will not allow us to put the detailed information in there. What I'm saying is that we may make a reference as to the person who was seen at the treatment program in 1999 and will you guys use that as a flag for when you're questioning the offender as to what happened in 1999 at this program and hopefully you can withdraw the information from the offender that we couldn't get in the PSI exactly. Certainly we do use that kind of information. That's very helpful to us. Can you actually send for or retrieve the information or do you have to get it from the offender? No, we can actually send for that information. We have anything that we understand to be out there having to do with this person's history that we think would be relevant in a treatment program, we can ask for that information, whether it's with one of the federal agencies or with a private therapist, that sort of thing. And in fact, when we get intimates into the program, one of the things we do is let them know that we're going to be doing that and we get them to retrieve addresses and all that other type of legwork for us. They know up front that we're going to be doing this, that we're going to give information to them over. Moving along to personal history, if you can find out anything about the quality and nature of any significant relationships they've been involved in. And this should be verified with partners whenever possible. They can give a real slanted view of what actually occurred within that relationship, what the quality of that relationship was. What we found is that they're often invested in having us believe that they've had numerous, very successful relationships. And as we probe more, we find that a relationship might have lasted for two weeks, but it was really significant. So any information you can find out about the quality and nature of relationships and verifying that with partners whenever possible would be helpful. Occupational history. This is an interesting one because, excuse me, yeah. Question? How do we get that information to you? Because I had a situation where the attorney objected to me putting in that he still had contact with one of the victims and they were involved in a relationship. How would we get that information to you? Once again, we are in this presentation presenting to you an optimal level of assessment. Ideally, this is what ought to be communicated in a pre-sentence report. We're simply saying to you, this is what we recommend. This is ideal. If you can put it in that report, somehow convey that information to us, that is just ideal. But we recognize that you may be limited in providing us with that information and particularly in putting that information in the pre-sentence report. Did that answer your question? One more thing. Do you go back and contact the PEO? Have you guys ever thought about that? Do we go back and contact the PEO? The writer of the pre-sentence report? Yes. Sometimes I've done that. Not typically though. Do you feel that that is something that we should routinely do? I would think it would be helpful because a lot of times you have to get information that is taken out of the report because of objections. You know, we may know more to the story than what's presented in the report. We can certainly incorporate that into what we do and we'll give it serious consideration. Thank you. Thank you. Regarding occupational history, one of the reasons this is important is because it may highlight for us significant access to the preferred victim group. It could highlight certain methods of access to victims such as I was talking about yesterday, the meter reader, the heating and air repair person. More unstructured, less easily supervised occupations could call certain things into question. It certainly would help us to focus on that with that offender while he's in treatment to find out more about what he was actually doing with his time while he was on that job. The person that I talked about yesterday, the peeper, he spent an awful lot of time of his day going to different houses, gaining access to these houses, collecting information about women, all while he was believed to be working because his particular job was a very unstructured, unsupervised type of position. Also include any information regarding grievances that may have been brought against him or any firing or suspicious resignations. It may be that an employer suspected that this individual was engaged in some kind of inappropriate activity but didn't want to take the risk of actually firing that person for that reason or actually did fire that person for that reason, but we will not necessarily know to get at that unless we know that that person was fired or did resign very rapidly. Educational background, pretty self-explanatory. Military history. Include here any available travel itineraries. This is important because he may have frequented specific countries that are known among the sex-fender community as countries in which access to children is very easy. And it would be helpful for us to know where he was spending his time so that we could zero in on that when we're in treatment with that individual. What are those good things? We could list a few. There are probably many. Several that come out in our program pretty routinely are Thailand, Germany, Holland, the Philippines, Costa Rica, and several other Latin American countries. If the person was discharged from the military, what type of discharge was it? Were there any allegations made against him while he was in the military? Financial history. On the surface, it would seem like this would not be all that important, but if you could get information about any spending patterns, availability of funds, or any unexplained significant expenditures, we may be able to find out more information about what that person was spending his money on. It could be travel. It could be to purchase videos. It could be to pay for trips to other locations where he may have offended. So somehow getting at how that person spent his money and what the availability of funds was could be real helpful to us. Psychiatric history. Are there any psychological evaluations available? Was there previous treatment or hospitalizations? If so, when? What was the presenting problem when that person was evaluated or hospitalized? Any diagnosis that were made? What was the type and frequency of contact between mental health professionals? Any information you can give us about specific professional scene, we will use that information to follow up with that individual. So if we have a name and a general location, we do look that person up and try to get any evaluations. We also try to talk to that person directly about that treatment. That sometimes we'll require on our part that we get a release of information from the inmate, but usually shortly after they're in their program they know that that's actually something that we're going to be doing and they see that as a routine part of the treatment program. So we very rarely will have any problems with getting releases of information from them. I've already mentioned to include collateral and contact information and it goes without saying to verify information as much as possible. Now that we've covered some of the more general suggestions let's talk about some of the more specific information that would be helpful to have in our work with individuals. Let's start with the child pornographers. Starting off, we would ask that you try to get as much information as possible about the number and types of images. And here we're talking pretty much about the instant offense. Were there 25 images or were there 15,000? Were they kept in files on the hard drive or were they have a whole selection of disks? This is one of several ways we have to get at the extent of involvement on the part of the offender. How invested was that offender in focusing on those images? Andres had mentioned yesterday that for some of them this type of information will help us know whether they're actually having a relationship with images. Whether they're having a relationship with objects or things. It really helps us to zero in on what we need to do in a treatment process with them. The number and type and content of images also tell us about the arousal patterns of the offender. It is very different to have, say, a group of pictures of children nude, let's say in a nudist camp versus having an image of a three-year-old child being raped anally with a bottle. Those are very different type of images. Both may be conceived as child pornography, and yet they do tell us a great deal about the sexual arousal patterns of the offender. Some of the images the children are portrayed as having smiles and having, quote, unquote, a good time. Some of the images clearly depict children in great psychological distress crying, bleeding in restraints. That tells us a great deal about the offender, their sexual arousal pattern, so that there is no question for them to minimize and say, well, I was just looking at pictures. Many people do not appreciate what child pornography is. They often think it's, oh, those are new children. No, that's not it, and you know that very well. The image covers the content of the images. It's really important to know the details of what was actually in the images, as well as the method of organization that I had mentioned earlier about how much time they're spending filing, sorting through. There's a lot of focus on getting the entire series of pictures, so you might see three pictures that tell part of a story, and the offender is looking for the remaining three pictures that he knows are out there somewhere, so he'll spend a lot of time trying to essentially complete the set. That kind of information, like I said, is very helpful to us in doing our treatment planning with that individual. One more thing I forgot to mention about the extent of involvement. Did he spend three hours a week, or did the offender spend 50 to 60 hours a week looking at images or spending time on the chat lines talking about sexually explicit activity? This information will help us again to understand how invested he is in his sexually deviant behavior. We had an individual who actually had no contact crimes past the polygraph in regard to that as well, very highly educated, very well employed, pretty isolated, pretty uncomfortable in social situations, and he started out with just downloading a couple of pictures here and there, and gradually, within a year's period of time, had moved up to spending about 50 to 60 hours a week on the computer in addition to holding down a full-time job. Travel with intent or luring. For this offence group, try to gather information regarding again the degree of planning. Did the offender have a suitcase full of children's toys? Were there restraints? How about camera equipment? At what point did the offender begin to work out the details of his trip with the travel agent? How early did he begin working on this trip? That will tell you a lot about how much energy he put into having certain things happen when he actually got to his destination. How focused was he? We worked with an offender who had numerous chats with an intended victim over the Internet prior to traveling across state lines for the purpose of engaging in sexual activity with him, and prior to his departure, he informed the desired target that when he met him, he wanted to make sure he was wearing loose-fitting pants. This little piece of information was included in one of the pre-sentence investigation reports we received, and because of that little piece of information, we were able to confront very strongly this individual who said, no, he was really just trying to make a friend. He hadn't met this person, had talked to him online, found him to be a very friendly individual, and he was only going there to make a new friend. So the fact that he was asking this new friend to wear loose-fitting pants didn't make sense, and we were able to use that piece of information from the PSI to get him to fess up. In another situation, we noticed that one of our program participants was spending a lot of time studying Russian. Well, he said he enjoyed languages, he had always wanted to visit Russia, and that's all that was about. Additional probing helped us learn that he had intentions of going to Russia to adopt a child so that he could have that child for himself so that he could sexually abuse that child and essentially, as he put it, teach that child about sexuality. Well, this same individual had had a lot of contact with another individual, we're currently treating in our program, and what we came to find out in working with each of them was that they actually both planned to go to Russia as a way of escaping prosecution, and the prosecution would have been for basically the other individual sexually abusing his child, the two of them together getting more and more children to adopt and abuse and teach. And in the case of the other individual, he actually had planned to kill his wife, and they had talked about how they were going to do that so that he could have full access to his daughter. Interestingly enough, this same individual had two young sons, and he looked at these young sons as obstacles to his abusing his daughter. He couldn't figure out what he was going to do about his sons. So, given that he was willing to kill his wife, who knows what he might have been willing to do with his sons so that he could have access to his daughter. So, information about the amount of planning to spend time, years in advance, to learn a language so that you could go to that country to get children, it's a lot of planning that goes into that sort of thing. They're really focusing in. One of these individuals, the planning in and of itself is sexually arousing, and that's also very important for us to know. Spending sometimes months and years planning and fantasizing about how they're going to get there is sexually arousing in and of itself, and that's very important for us as treatment providers to know. Hey, the method of luring. Where did he get the child? The child who was pictured in the local newspaper. Did he send sexually explicit images or pornography to the child over a chat line as a way of desensitizing him or her to normalize some of the sexually abusive behaviors that he planned to do when he met this child. Those kinds of details are very helpful. Intent. This refers to what he actually planned to do. Did he plan to find a woman with female children who he could sexually abuse under the cover of stepfather or babysitter? This information tells us what he is capable of doing. So whether or not he actually followed through, what did he intend to do? Any paraphernalia used? A motel key, for example, cameras, restraints. We had an individual. This actually was another situation in which a PSI was extremely helpful to us. We had an individual who had met a young boy in like a 7-11 and befriended him and got him to bring another friend along. They went out late at night for a drive cruising. He had taken a weapon with him and he took them pretty far out and basically very suddenly said they needed to get in the back seat and take the clothes off. He got back there with them and basically said that they needed to perform oral sex on him. Well, one of the things that he was very resistant about in treatment was his use of coercion. What we learned from the PSI was that he had a weapon with him. So we asked him, where was that weapon? Well, it was between the two front car seats. How much in view of it was that weapon? How much did that weapon play a part in his coercing those children? Well, I didn't do anything with that weapon. The weapon was sitting there and he had already talked about the fact that he had gone shooting with them prior to going out to where he was. The other thing in the PSI that was helpful was that he had said to them, you'll either do this or else. You'll either do this or else and the fact that he had this weapon, and what does that tell you? There was a ton of coercion involved in that situation and that PSI information made a huge difference in what we were able to do with this individual. And finally, travel history. This information could reveal a predatory pattern. We already mentioned some of the countries that we hear a lot about. It's also important to know do they have pen pals in foreign countries or did the offender buy land overseas? We actually have an individual who I'm learning about Costa Rica because he wanted to buy land there and further probing of that situation revealed more intention there than he was admitting to. Yes? Professors are picked up on one particular case. When you have them in treatment, do you have them admitting to prior traveling that they're not going to rest it for? When we do a psychosexual history with them, we have a questionnaire that we ask them to fill out and one of the items on that questionnaire is their travel history. So we ask them to tell us where they've traveled and what they were doing there. What was the purpose of the travel? So we get a pretty extensive travel history from all the individuals in the program. And the whole purpose of it, again, is to look at the predatory pattern if there is one and have them explain what they were doing at that time. Do you have multiple incidents of them doing this? Yes, we do. In terms than not. Any questions about anything I've talked about so far this morning? Any comments you'd like to add? Yes? Just out of curiosity, do you guys also get the criminal complaint and the affidavit with your packet of information? The question is, do we get the criminal complaint, the affidavit with our packet of information? If it's a sex offense like child pornography type of thing, that also outlines a lot of this information. Yes, we do. But I would say it's more rare. We very seldom get that information. I've been with the program for a little over three years, and I've seen of the individuals I work with, I've seen that maybe three times. We see that information only when it has been provided to us by the government, by the prosecution. But in the normal course of the referral process, the primary document that we review is the PSI. Now, if you can make other documents available to us in that process, we certainly will be more than happy to look at that information. We see different types of PSIs. We see some that are very detailed, that are very offender-specific, and we see some that describe, for example, the offense conduct in rather cursory terms. Very short PSIs, and by contrast, very long and detailed PSIs. I don't know what... that is a function of, I'm not sure, but certainly the more detail we can provide the better interventions we can have. Again, information such as describing the offense conduct like the offender telling the victim where loose fitting clothing. That is key information for us to zero in and really go after what was his intention. Any other comments? I just wanted to add one thing. A question was asked earlier when Andres was presenting about contact with the probation officers. And one of the things that I wanted to mention about that in regard to the Sex Fender Treatment Program is that not only are we sending out discharge packets, but in every case we work with, we're contacting the probation officer prior to that person's release from prison. So we're actually calling up the supervising probation officer and asking for the name of the individual who's going to be working with that individual when he gets out. And then we call that person directly and provide information over the phone about what that person may expect to see in this individual when he meets him. And what some of the overriding concerns are that we have about this individual as he makes that transition to the streets. So there's an awful lot of contact regarding that offender with the probation officer prior to that offender's release from prison. And we feel really good about that. We feel we've learned an awful lot from probation officers in our contact with them starting to feel like a real team effort in managing these cases. So I just wanted to mention that before I turn the mic over to him because it's one of my favorite parts of my job, actually. So anyway, any other questions? Do you guys ever contact the investigating agents? Do we ever contact the investigating agents? A lot of times we don't get information during the TSI process because of any sort of free agreement or something. So a lot of times investigating the agents may be more cooperative after their sentence and may talk to you. I have not. I don't know if you have. We have not routinely done that. Sometimes when I've gone to court for a sentencing hearing and the FBI agent is there, I find that information just invaluable. But routinely we haven't done it. I'm glad you pointed out because it's something that we could incorporate into what we do. Okay. Thank you. We'll turn this over to Andres. Okay, folks. In this next segment, we're going to be talking about risk assessment. How many of you, just a show of hand, have been in court where you have seen mental health professionals, so-called experts, argue about the risk of a particular offender? Okay. Quite a number of you. This is a hot topic in the field of sex offender treatment. It's been hot because of the emergence of civil commitment. These are the so-called sexual predator laws that have been either resuscitated in many state jurisdictions or they have been developed. The Kansas-V. Hendricks Supreme Court opinion is certainly one opinion that ratified the legality of these civil commitment proceedings. And certainly, probably almost every state in the union now has some type of civil commitment for sex offender, for sex offenders. Risk assessment, systematic risk assessment, has been under the gun. The more traditional way of assessing risk is basically a professional saying, well, I think this person is a low-risk offender or I think this person is a high-risk offender. Well, the problem with that is not much reliability in those judgments. So, what is risk assessment? Can anyone give me a definition? Come on, we have some experts here. To read to which that person has the capacity to re-offend. Yes. It's a method for categorizing offenders along a continuum. We need to look at risk along a continuum. Now, what we also need to know that it's not a single continuum. It's a multifaceted construct or continuum. So, a person can be at risk the type and severity of behavior, say, at risk for committing sexual offense of a child, at risk for committing sexual assault of a child using a weapon or using extreme physical violence. Another facet of risk assessment is the likelihood that the behavior and this is the most common use, the likelihood that the behavior will occur. Now, oftentimes, we don't identify what behavior we mean. Is this person at risk for exposing himself again? If we know that sex offenders commit multiple paraphernalias in sexual offenses, child molestation, rape, exhibitionism, voyeurism, what not. We tend to only identify a global risk. But this is, in actuality, what we should be doing is identifying specific risk for specific behaviors. And we also need to anticipate and try to predict the time frame. Is this person at risk for committing this particular offense with this severity two months after release from prison, two years after release from prison, or 20 years after release from prison? And if so, what are the probabilities that that behavior will occur as predicted at two years, at two months, or at 20 years? This is very difficult to do. Very, very difficult. Now, some mental health professionals think, well, gosh, because it's so difficult, we shouldn't really do it. And psychologists and mental health providers should not be in the business of doing risk assessment or risk prediction. Well, I think that we are better prepared to engage in this behavior if done correctly than other persons, other professionals, because of our unique knowledge about the population, unique knowledge about risk prediction and risk assessment. So when you get a report that says this person is a low-risk offender, or he's a high-risk offender, what does that really mean? Generally, it means a global assessment of all of these categories, this multi-faceted construct. But I do want you to understand that not only is it a a multi-dimensional construct along a continuum, or several continuums, or continuum, I don't know how you say the plural of continuum. So what we really have is a snapshot in time. It's like taking a picture. Click. That's what we have. Risk changes. It changes all the time. It changes every day. If we were to graph how risk changes, it would change because of two different influences. The external dimension and the internal dimension. The internal dimension because the person may feel weaker to cope with sexual risk factors. It may be more vulnerable to act out. The internal dimension refers to the psychological state of mind of the individual. And the individual's prowness to act out, therefore, their risk. The external dimension again goes to those factors in the person's environment that make them more vulnerable to re-offend. Proximity to victim groups, substance abuse or alcohol and drugs. In other words, disinhibitors, alcohol and drugs or disinhibitors of a person's control. Sometimes they use anger as a form to disinhibit themselves. Does that make sense in terms of understanding what risk is? That it's not a static quality. It is really a very dynamic construct. It's changing all the time. It changes because the person is on supervision. It changes because the person goes off supervision. It changes because the person is just one month out of prison versus 10 years out of prison. It is constantly changing. Do you, any of you come from districts where risk assessments are used, systematically used to inform sentencing? Yes ma'am? Yes ma'am. Yes ma'am. If you're trying to develop a sex offender policy, this issue has come up with this whole risk assessment and we have these various instruments, whether or not we as officers, once a person has come out of the system, not necessarily coming from your program, but once they have been identified as a sex offender, even in history or the instant offense may have been, whether or not the officers are to administer one of these, to do one of the sex offender risk assessment evaluations and whether or not we should forward that to a professional. That's the controversy that we have within our district, who should do this and how often should it be done either when the person is on supervision or even at the sentencing phase. The officers just don't feel comfortable using one of these tools to say this person is from high risk, low risk risk or whatever. From my perspective, I think it's a question of policy and what policies are developed to do a systematic assessment, risk assessment of sex offenders. With the appropriate training and the policy to back you, you could administer one of these instruments. There is nothing about these instruments, there is some requires more training, but you could administer these instruments. It's a question of policy and whether or not you are going to be trusted and whether your judgment is going to be a reliable one. How should you do the risk assessment? Every time you have contact with the offender, the conditions that are in place, that individual at a particular risk have changed or may have changed. You need to constantly reassess that person's risk and match your supervision or whatever other interventions according to that risk. For us in prison it's very easy. For child molesters and child pornographers, the risk is extremely low. Why? Because there are no children and hopefully there is no child pornography. However, when they get out, their risk skyrockets, it changes. So when we make a risk prediction, it's about their functioning upon release from prison. Risk assessment is used to determine whether a sex offender may be a candidate for civil commitment. Now, do all of you know what civil commitment is? This is basically a way of detaining a criminal beyond his release, beyond his punishment or criminal sentence because of dangerousness to self, other property. These are proceedings that have been typically used for the severely mentally ill. People who have committed crimes and in good conscience we cannot release to the community because these people will harm themselves, harm others, destroy property and these people need to be in treatment. They suffer from a mental disorder or defect that certainly makes them unable to function in the community by themselves and need to be detained in psychiatric hospitals and other similar facilities for treatment purposes. Okay. How do we assess risk? And there are, I can identify, I've heard in professional conferences three ways of doing risk assessment. I think we've come up with four ways. The fourth is our way of doing risk assessment but I think it's a compromise between the others. The first is the unstructured clinical judgment. This is Dr. Eminence saying in my 25 years of experience I've seen 200 sex offenders and therefore this individual is a low risk offender or a high risk offender because I am an experienced clinician and I have tons of experience in the field and my clinical judgment ought to be trusted. Now that person's judgment may be very good or may not be very good. I've talked to many practitioners with 20, 30 years of experience whose professional judgment is certainly off. Oh, you've met them too. Okay, alright. So it's the validity of those judgments are unreliable. The factors that many clinicians used may or may not be related to recidivism. That is, re-offense rates. On the other extreme, if you could look at this as a dimensional construct on the other extreme of the continuum you have a purely statistical approach. This is the pure actuarial approach. I believe the last count was there were 24, 25 risk assessment instruments. Now there is some overlap in those instruments but each instrument is different. The MinSauce, the V-Rack, the SoRack, the Eraser, and I probably misspelled one of these, the Static 99, the New Jersey Risk Registrant, whatever. That's what that, and ETC, et cetera, because there are many. That's not a risk assessment instrument. There are many. What these instruments claim to do is they take a select group of factors. These are factors such as age of the offender, number of prior convictions, the gender of the victim, et cetera, that are associated or correlated positively with recidivism. And through a complex statistical procedure, they have developed a formula that classifies offenders at high risk if they have many of these factors at low risk if they don't have as many of these factors. And this is then validated with outcome data. Rearrest record new convictions and whatnot. The value of these risk assessment instruments largely depends on the quality of the experimental design, the outcome data, was the follow-up period two years, three years, or was it 20 years? I'd be more likely to use an instrument that had a 20-year follow-up period rather than an instrument that had only a two-year follow-up period because then I could only predict up to two years. However, this has been and nowadays it's now the preferred approach. Now the preferred approach has some limitations because you can only use these instruments only if the instruments were normed on the population that you are working with. Now in the federal system here we have a very unique problem. None of these instruments include child pornographers. None. So how can we then use an instrument that uses factors in a population that doesn't exist in the norming sample here, in the normative sample? But what do we do? Do we just toss them out and say this is a waste of time for us and we should only use them for contact offenders? Well, no. Because they have some value. Now because of some of these problems the proponents of these instruments have recommended that clinicians either adjust up or down the level of risk. So for example in the razor a quick and dirty five factor risk assessment instrument developed by a group of Canadians as well as the static 99. If you get, okay, high risk offender, but gosh based on a ton of clinical evidence you really feel that this guy is not a high risk offender because when you know a high risk offender he hits you in the face. He overwhelms you. But the instrument is saying he's a high risk offender. But the clinician says this individual has done all this therapeutic work to modify his risk gain self-control strategies. How can he still be a high risk offender? Well, then the developers of the instrument then said well you know what, we're going to give clinicians the option of adjusting up or down depending on their clinical judgment. Depending on what I'll define later as the dynamic risk factors. Because most of these, if not all of these clinical instruments only address static factors. These are factors that are related to the criminal's history. The sex offender's history. Things that don't change. You can't undo the crimes you've already committed. They're there and they will always be scored. So this is one compromise. Now they tell you that if you score high on one of these instruments, you shouldn't drop the person all the way to a low. They score high because there's a good reason. So there should be some moderate discretion to adjust up or down. The fourth approach and this is something that in our dialogue we've come up with and that is to use a risk assessment procedure that is guided by empirically supported risk factors. In which we use our structured clinical judgment. We anchor our judgment based on these set of factors. Not in a rigid, statistical formula or equation but rather using our clinical judgment. The burden here is we have to exercise good judgment and we cannot let our emotions guide our judgment. And that's why this is often a team approach. Not one single person is doing this because hey, I think he's a high risk offender. Ah, I'm going to say so. No. It ought to be supported by the empirical factors by the empirical literature that supports this. For example, in a recent report that we released we listed the factors that are most powerful and then the factors that are less powerful. And we talk about the notion of risk as a static one but also one that can be modified depending on the inmates or the sex offenders application of treatment, response to treatment, anticipation, anticipated cooperation with supervised release. So there is a we juggle all of these factors to come up with the most accurate and clinically meaningful risk category. Sir, you had a question. The difference between three and four is that in three you're using one of these instruments and then based on the overall score on that instrument then you adjust up or down based on clinical judgment. The fourth year we're basically using all the instruments because we're using the entire body of literature. Empirical knowledge. That's why it's empirically supported and we anchor our judgment based on what are the most powerful predictors. And that allows us for example to account for child pornographers. In many of these instruments unless you have a conviction or arrest for a sexual crime they're not counted. Now I'm not about to not count a child's pornographer's disclosure to me that he has 94 victims just because it's not on the record. I'm going to count him and I'm going to assess the level of risk based on those 94 sexual assaults. That's what number four enables me to do. These instruments limit my judgment limit what I can score. And that is one of the limitations. Again many proponents of the pure actuarial method they realize that hey there are a lot of loopholes here adjusted by clinical judgment but even when you have all of that you still have a lot of false negatives or false negative well people you're not accounting for like child pornographers. Yes ma'am. Should we be using any of these instruments or do anything on our own to inform the judge that this may not necessarily be the most accurate measure of this person's risk? Again that's a question of policy and it has to do with your particular district. The question is if we get in court an expert saying using the unstructured clinical judgment and basically saying he's a low risk offender because Billy told me that he doesn't have any fantasies about children and he has never really touched any child but yeah he did have 20,000 images of child pornography at home but he's really a low risk offender. Well I'm not sure I think that the government should be disputing that the government should be saying bringing their own experts and bringing that to court and saying well what do you have to say about this and the government should identify experts who really know what they're talking about. Now what should you do how should the judge look at that information and evaluate those conclusions? I mean the judge is asking us what do we think of this? I would say that's a bunch of baloney that's unstructured clinical judgment these are irresponsible conclusions now I feel with the authority to say that I've said that in court when I've been invited to sentencing hearings sometimes my opinions have not been very popular I feel that when there is irresponsibility in our profession I'm going to call that let me just take another five minutes and talk about some of these risk factors static I mean they don't change you can't undo the number of sex offenses you've had in the past and they stay most of these instruments are based on static factors such as number of prior offenses length of sexual offending history two years versus 20 years a 61 year old pedophile is probably a lot more difficult to treat than a 22 year old pedophile degree of force and coercion some of these instruments talk about whether a weapon or verbal threats were used the gender of victims individuals child molesters who target male children according to the empirical literature at a much higher risk than those child molesters who target female children now this is may seem like a contradiction to many individuals who work in the child sexual abuse field because they see a lot more female victims than they do than they see male children however we're talking about the offenders and those offenders who target male children abuse children molest children at a much higher rate than those child molesters who molest female children so that's what that indicator is all about psychopathy the traditional notion of psychopathy not antisocial personality disorder but psychopathy is certainly an indicator for not only sexual offense recidivism but also violent recidivism and general recidivism these people are career criminals they have absolutely no regard for human life they have absolutely no capacity and individuals who meet the traditional diagnosis of psychopathy based on the hair psychopathy checklist are poor candidates for treatment and are considered to be at high risk for re-offense not just sexual the age of the offender youth has a lot to do with it probably it's a function of hormones or I'm not sure why but young women are certainly viewed as higher risk some of these instruments put the age the cutoff at 25 there are more static factors now some of the dynamic factors and these are again factors that are probably more of an interest to the mental health practitioners because we can change these we can alter these deviant sexual interest and arousal yes offenders can reduce the degree to which they are sexually aroused or their response level and they can reduce their sexual interest in deviant stimuli through the use of covert sensitization through the use of other aversion therapies the opportunity to offend again this is another moderator if the person will go and be residing where he will have unsupervised in close proximity to children that is a risk factor and the opportunity to offend goes up so does the risk substance abuse use and abuse again as a disinhibitor not that substance abuse and not that alcoholism makes a sex offender I can't tell you how many sex offenders I've said oh I only offended because I was drunk or high no alcohol makes a sex offender the alcohol only acts as a disinhibitor response to treatment positive response to treatment positive response to supervision is certainly a moderator of risk psychosocial stability that refers to employment their ability to maintain stable employment their support they will have even financial support they will have upon release from prison this next section segment we'll talk about we'll present a model of sex offender management again this is I want to present the next segment with that caveat in mind this is a model of sex offender management in the community it is certainly not something that you are recommending that you doing your district because it may not be possible for a variety of reasons however if you feel that you can implement some of these elements in your districts and you can get the cooperation of others those who have the power to implement some of these changes by all means and certainly this is the intent of the session I'm going to be talking about sex offender management and I'm going to identify four key elements now this is not something that I came up with this is not something that I envisioned all on my own these are ideas that other people in the field have come up with I will certainly offer my commentary my interpretation of the model but this particular model has been stipulated has been written by the center for sex offender management this is an agency that primarily offers support to states and local jurisdictions parole, probation corrections etc we've had some contact with this particular agency but not extensive their focus is really state jurisdictions they are a federal agency through the office of justice programs and they have very good information they've had the funding to do a great deal of really good work the four elements that we're going to be discussing today are collaboration the victim centered approach sex offender specific treatment that I think we've already talked about to a great extent and we're also going to be talking about clear and consistent policies and again this refers to what you can implement in your district this is not something that we're going to be recommending policies that you implement given the resources that you have given the limitations given the policy restrictions you have what can you implement to affect good sex offender management in your district so let's talk about collaboration what do we mean by collaboration in this model this model recognizes that a single individual a single probation officer a single treatment provider alone can make very little difference it is the combined effort or efforts of individuals agencies systems and collaborative policies that actually produce the intended effect and that is effective management of sex offenders in the community it requires the establishment of an interagency community management team I'll talk more about what that means again be thinking about how you can implement this in your district given your vendors given your administrative support given your policy support we're going to be talking about delineation of roles for the members of the team and also the establishment of expectations and contingencies this is very very important because once you assemble the team once you delineate roles for members of the team now what now what are these people supposed to do and how are they supposed to enforce these conditions or what they set out to do what is the team comprised of or who comprises the team the probation officer the polygraph examiner the treatment provider and monitors now who are monitors can anyone give me an example of a monitor a significant other yes absolutely any example of another monitor employer yes and neighbor absolutely the police of course and others as appropriate now this others they may not have full participation as monitors but these people may be they may be victim advocates what is the role of a victim advocate in this management team anyone have any idea sometimes team members may lose sight of the goal and the goal is community takes precedence over that individual offender community safety and every action of this team ought to be done in the best interest of the community and community safety public safety the reason why I do what I do is not because I love sex offenders and I love to treat them I actually don't like it I don't like to treat sex offenders I do it because it's important I do it because I see myself as an important agent of public safety that's why I do what I do alright so what are the roles of the team members well I think you know what your role is of course supervision of the offender and coordination of the team you are the most important element of the team the treatment provider of course provides evaluation therapy risk assessment provides progress reports the polygraph examiner provides sexual history and maintenance examinations does anyone know the difference between a sexual history or a full disclosure and a maintenance examination some of you are nodding yes some of you are nodding no sir you don't want me to answer I'll answer I'll answer sexual history just gathering a lot of background details about the offense details about other things that may not be convictions and just other risk factors related to the person's behavioral characteristics and maintenance exams are based on monitoring their progress monitoring their compliance with supervision whether they are fully disclosing absolutely that's a better answer that I could have given but to paraphrase for the camera for the benefit of the camera full disclosure polygraph examination is to understand and get an accurate account of the offenders sexual offense history the number of offenses the type of offenses a full account the maintenance examination is to address the degree to which the offender is adhering to certain conditions they may be conditions of supervised release conditions of treatment and it is usually about a period of time since the last polygraph examination the polygraph examiner will typically say since the last examination have you done X, Y and Z have you been unsupervised with a minor child under the age of 18 yes or no that is a typical maintenance examination polygraph maintenance examination will typically occur anywhere from 4 to 6 months whereas a sexual history examination or full disclosure may only happen once the monitors they provide behavioral observations we are delineating roles for team members this is important that you do establish roles and that you get people to collaborate and agree to these roles and expectations so let's talk about the expectations regular ongoing multi-directional communication this means the team should be communicating on a regular basis there ought to be communication that is not just one way not just the treatment provider to the probation officer or not just the probation officer to the treatment provider there should be multi-directional communication ongoing regular formal and informal okay this is one of my pet peeves behaviorally anchored progress reports this is very important progress ought to be measured by not how the person is doing in therapy and how compliant they are in session or how pleasant they are in session or whether or not they have insight or not have insight progress ought to be measured by specific behaviors that have to do with reduction of risk many therapists will offer a progress report that simply says he's doing fine he's participating and complying with all the phases of treatment and that's the progress report he cooperates he gives good feedback to other people and he thinks about the feedback of the person he's popular in the group he's well respected by treatment staff that tells me nothing about that individual and how that individual is doing so there has to be behaviorally anchored goals that should reflect the treatment plan and the treatment plan ought to be a behaviorally anchored treatment plan now I did include a copy of a progress review that we use in the sex offender treatment program it targets multiple areas of progress in therapy this is one way in which treatment providers can anchor behaviors that are relevant to assessing somebody's progress a person's ability to have insight a person's participation in treatment and verbal comments may or may not tell me something about how they're really doing I'm more interested in whether or not they are practicing relapse prevention techniques or the skills the learning that they are making I am more interested in the presence of cognitive distortions I am more interested in the presence of acceptance of responsibility behaviors now those are behaviorally anchored progress reports we want full participation of each member we don't want to leave people out because I think that each team member has a lot to contribute collaborative problem solving coordinator possessing final authority coordinator who is the coordinator you as the final authority because you are really the representative of the court it is your responsibility the supervision of this individual is ultimately your responsibility a victim centered approach we should be doing things developing policies developing procedures and recommendations that are consistent with the interests of the community children the community is the client you've heard me talk about this yesterday and the overriding principle in sex offender management and policies in this four prong model is public safety the protection of the public the third element in this model is sex offender specific treatment now we've talked about what that means people ought not to dabble in sex offender treatment they really need to have established programs with the correct infrastructure to actually implement sex offender specific treatments as we've mentioned in the past it ought to be long term and comprehensive it should be individualized we shouldn't infuse that with individual therapy no it should be individualized so there shouldn't be a cookie cutter approach to every offender every offender has a different sexual arousal pattern every offender has a different sexual offence pattern and treatments should address those individual differences they should for the most part employ cognitive behavioral and recent survey done by the safer society and in the safer society they surveyed a bunch of treatment providers it was a national survey and they asked what type of therapies do you use in sex offender treatment now the type of responses that they got were very very diverse you don't want to even know what certain treatment providers are doing because there are very unorthodox techniques but for the most part they found that people were sticking to this approach now the cognitive behavioral approach has received a great deal of empirical support so this is not just a survey of popularity this works adjunct treatments sometimes can be very powerful medication treatment family therapy couples therapy substance abuse therapy can have a very profound treatment I've had sex offenders come into the program and say you know doc I just want your individual therapy you know that group therapy with the other guys I don't want to do that just give me the individual therapy a little bit of that victim empathy and a little bit of that cognitive restructuring no that's not the way it works we sex offender treatment providers we determine the terms of treatment are not negotiable we determine what they need if these people knew what they needed they wouldn't be in the position that they are clear and consistent policies very very important now what do we mean in what realms reduce plea bargaining in many jurisdictions we have reductions of charges from sexual offenses to non-sexual offenses plea bargaining from sexual assault to simple assault from sexual assault to battery having diversion programs deferred adjudication these are all programs probably with good intentions that in many ways foster or enable the offenders minimization very frequent occurrence for example in outpatient community programs where there is deferred adjudication I did work in an outpatient treatment program in the Houston area and the modal it appears that the modal sentence was 10 years of deferred adjudication probation deferred adjudication nobody did any time now that's not a conviction deferred adjudication so people come in I didn't do it prove it I haven't been convicted so our hands are tied we can't do anything about it and we don't have any leverage and as we've talked about before in order to effectively manage sex offenders we must also have external pressure and without sexual convictions there's very little pressure we can exert on these people waivers of confidentiality I responded via a letter in in a district I won't mention the district far away from North Carolina in which there were two mental health providers a psychologist and a psychiatrist firmly stating that the information that is disclosed to them during evaluation and treatment should not be released to the probation officer that information is confidential should not be released to the probation officer and release that information is a significant threat to the therapeutic relationship and the sanctity of that relationship between the doctor and the patient waivers of confidentiality in this field are essential we must be able to communicate freely with one another across disciplines across agencies if somehow we all impinge the effect of supervision of that offender we need to be communicating openly directly and with full consent and understanding from the offender that that is what's required develop meaningful search and seizure policies as I've talked to probation officers there is quite a difference across districts between what you can do in one district and what you cannot do in another district and it's important that if we are to supervise and manage sex offenders effectively in the community we must hold them accountable and we must be able to as I go into their cell as I please and as I deem necessary and search their cell top to bottom and I can go to them and say turn around I'm going to pat search you and policies do support my actions effective sex offender management programs ought to have the same power and give you the same discretion to do that frequent unannounced field visits I already talked about this established non-negotiable treatment contingencies and one way in which you can do this is by pre-selecting treatment providers as to avoid treatment shopping has anyone had an offender who said you know mister or miss so and so you know my therapist blah blah blah and complain can I go to this other person I I bet you've had that I encountered many of those individuals in my outpatient practice people who wanted to treatment shop when the heat was on when the spotlight was on them when they were in the hot chair all these you know interesting metaphors they wanted to jump ship and go to another treatment provider they should not be allowed to do that you should determine whether a treatment provider a service provider is actually delivering what you need if he's not that's a different question but it should not be at the discretion of the offender develop pre-revocation sanctions do some of you have pre-revocation sanctions one a few and developing clear and consistent revocation criteria now would you care to discuss some of your re-revocation sanctions yes sir if an offender missed more than two meetings we're removing them from the community placing them in a halfway house or if the failures of polygraphs may remove them from the community also so failure to attend treatment failure on the polygraph examination may you may increase your level of control over that offender yes sir I'm in the same district as Jeff we don't cease treatment we will move them to a different we may start over a different phase of treatment and so the offender doesn't win necessarily from the standpoint of being removed from a treatment program treatment continues it's more in a controlled setting to repeat what you said the offender is not removed from treatment they just perhaps go to an earlier phase of treatment but they're not removed from treatment