 Welcome back. Dr. Hernandez presented the overview of sex offenders in the federal system on day one of the two-day seminar. On the following day, he discussed the specifics of Butler's sex offender treatment program. Today at this first part, I want to talk about the sex offender treatment program. And when I refer to the sex offender treatment program, I am now referring to the residential component of the sex offender treatment program. The SOTP is intended in the future to be a national program that includes several different components. And I'm going to talk about those components this afternoon. This is part of a larger proposal that we are working on. Today we're going to be talking about background of the SOTP overview, admission criteria, the referral procedures, and the discharge process. All right, background and philosophy. This program was actually started as a pilot program in 1989 where a few people who the Bureau of Prisons participated in a work group looking at the need for sex offender treatment in the Bureau of Prisons. At that time, the work group recommended the development of a 24-bed residential sex offender treatment program here in Butler. And it was originally conceived as a 24-bed program. In 1990, this program was formalized and turned into a component of our psychology services. The program lost its director in 1995, I believe. And there was a period of without, there was an interim director, but I came on board in January of 1997. Since that time, I have made along with the new staff considerable changes to the program. And what you will hear today, what you have been hearing thus far reflect the changes that have been implemented to the program. The program largely remains a cognitive behavioral program within a relapse prevention framework. Our philosophy is this program, being voluntary, is designed to help those who want to help themselves. Now, a lot of people say, yes, I want help, I need to change. They say that at a time that they're actually vulnerable, they're scared. They're afraid that if they don't comply with a judicial recommendation, somehow they're going to be locked up forever. Even though there is plenty of information that tells them that is not the case. A lot of inmates then who come into the program say, yes, I do want to participate, but when we actually put the heat on them and put them to task and demand that they change, many of them do not meet those expectations. And few withdraw from the program, many have to be expelled because of ongoing rigid resistance or just a blatant violation of program rules or BOP rules. This is a program that is task-based. It is not time-based. This is a question that I get all the time. How long is the program and how long does an inmate need to complete the program? Well, given the premise that treatment is a lifelong endeavor, I don't see a clear beginning or a clear end to treatment. Many individuals have started the change process way before they entered treatment. It may have been when they were put in handcuffs. At that moment they may have already started the change process. It may have been at sentencing. It may have been when they were put in a bus and transferred to this institution. Or they still may not enter the change process even after they are into the program or in the program for several months. The end, we don't have a clear end because this is not like a class where you have session number one and then session 16 and then you have your final exam and then it's over. I've had inmates who have participated in other sex-fender treatment programs who have stated to me upon entering the programs at DOC, I've been in treatment before. All I need is some of that victim empathy and some of that cognitive restructuring. I've had, I did have a long talk with that inmate to explain to him that that's not the way it works. These are not like college credits that you transfer from one institution to the other. It is task-based. Inmates are supposed to, program participants, sex offenders are supposed to achieve and maintain certain therapeutic gains. Yesterday Karen talked about acceptance of responsibility, talked about effective modulation or self-regulation of negative affect. She talked about effective application of relapse prevention skills. These are all the tasks that are required of sex offenders. That is how we judge their progress and that is how we judge their program completion. I have met no inmate who has left our program either because he has been expelled or has actually, his sentence has expired and then we have to put them out the door. No inmate that I know of has completed all phases of treatment. It is an ongoing process. I have an expectation that every inmate, every program participant will continue in some form of sex offender treatment or aftercare upon release from prison. So in, from my perspective, that doesn't, treatment doesn't end when they are out the door. Now they may have achieved a great deal in their progress. That is yet to be determined if they're going to maintain those gains. But again, it is task-based, not time-based. We've mentioned this before. Cure is not the goal. We don't intend to cure anybody. We certainly try to modify some of their sexual offense, sexual arousal patterns. We try to modify their criminal lifestyle and we spend a lot of energy and time doing that. But we recognize that these are very, very difficult patterns to break. And for some people, I have concluded that is almost impossible to break. And all we can do is help them, help themselves through two dimensions. The external dimension that is applying conditions externally that reduce the possibility that that individual will re-offend. And also the internal dimension, which is giving that person tools internally, psychological tools that he can use to then reduce his level of risk. So the goal is here, self-control. It is not cure. Treatment is long-term. I think I mentioned this before. Insexual demience is a lifelong problem. It is not something that's going to go away. A lot of program participants have unrealistic expectations. If not magical thinking about, hey, I'm going to complete the program. They get into this high because they have not been encountering any high-risk situations. Certainly in prison, they don't have any children to molest and very few stimuli or triggers. So they get into this high. They have an illusion of self-control, many of them, and go out and think, yes, I'm going to make it. I'm going to leave that life behind, and it's not going to bother me anymore. I'll just get an adult-appropriate relationship and my life will be fine and dandy. Well, that's not the way it usually works. They'll be confronted with multiple, multiple sexual risk factors. They're going to be confronted at every step of the way. If you have an inmate, a supervising who tells you, no, I've been fine. I haven't been bothered by triggers, sexual risk factors. They are really fooling themselves and being blind to those factors. This also has some implications for policy decisions. I was talking to an officer this morning about the gross inadequacy of three to five years of supervised release. And certainly that's not your fault. It's everybody's fault for thinking that that is adequate. It is by far not adequate at all. When we look at recidivism data, sex offenders actually do quite well. Three to five years post-release, recidivism rates are low. But as you get closer to 10 years and as you get closer to 15 years post-release, those recidivism rates skyrocket. They literally go up like that. So to me, that suggests that we need to modify our policies. Sexual deviance doesn't stop three to five years after release. Now there are some jurisdictions that are being very proactive and have recognized this problem and have also recognized the inadequacy of other interventions like civil commitment and how expensive that is and have looked at alternatives like lifetime supervision and probation. All right, let me give you a little overview of the program. Every inmate who comes into the program has been pre-screened. I have looked at the PSI. I have looked at collateral information. They have met the admission criteria. But they still go through an assessment period. This assessment period is to do an offender-specific evaluation and to determine whether or not they're going to be suitable for the program. In about two to three months, we will know if this person is a psychopath who will disrupt the program and needs to be immediately removed from the program. In two to three months, we will know if this individual will really come to terms with his sexual behavior problem and really work on what he needs to work. In two to three months, we have a very good understanding of the offender. We have multiple sources of information, multiple interviews, behavioral observations. We know if that individual will be responsible. We search their cells. We find out whether or not they continue an irresponsible behavior, whether they collect pornography, whether they collect sexually explicit materials, whether they write letters to children. We have a good opportunity to look at their entire behavior. The assessment phase is typically 60 days long, and that may vary plus or minus, more like plus, 30 days. At that point in time, we will know if that person will make a good treatment candidate. Now for the most part, nine out of ten times, that person will be put in the treatment phase of the program. It is seldom that an individual doesn't make it and has to be removed from the program after the assessment phase. The treatment phase, and I have a program description in your handout packet that describes the program. The treatment phase is comprised of group psychotherapy. Currently, we are offering, we place inmates in groups of about eight or nine with a co-therapy team. That particular group meets three times a week. In addition to that, the inmates receive approximately one hour per week or one hour every two weeks. There may be times that may be reduced to 30 minutes, and we try to gauge the individual's needs for additional treatment or less treatment. In addition to the group and individual psychotherapy, we also offer the inmate opportunities to obtain some skills and information through psychoeducational programming. Psychoeducational programming may be, the topics may include relapse prevention, may include community building, therapeutic community. It may include anger management. We are currently doing a comprehensive program on stress management. Again, how are these components related? Well, if we just offer them a stress management program outside of the context of a therapeutic process, and this question was raised yesterday, it's rather meaningless. What we try to do is make that stress management program very meaningful and tie it to their individual needs. Karen yesterday mentioned that many of the precursors to offending behavior have to do with ineffective modulation of negative affect to include boredom, depression, and anger. So if these people, when either they're bored, depressed, or angry, they tend to act out in inappropriate sexual ways more than not, more than other times, then we need to give them alternatives or give them tools to manage their boredom, their anger, and their depression in more effective ways. That's how we tie psychoeducational programming to their group psychotherapy to their individual psychotherapy. I have seen too many programs that simply put them through the machine of programs, the curriculum without making meaningful individualized connections to their sexual behavior problem. Therapeutic community. I mentioned this yesterday. All inmates who participate in the program reside in one unit. At this point, it's not the complete unit. In the future, we will have a complete unit, but they reside in two wings. Now, general population inmates are not allowed in those wings. So it gives the inmates some relative privacy to be in common areas, continue in dialogue, in therapeutic dialogue without fear of being overheard by general population inmates. This type of dialogue, this type of activity and investment in the therapeutic community is strongly, strongly urged by treatment staff. Inmates who participate in the program have to adhere to a higher standard of conduct. They have to, number one, although this changed not too long ago, well, up until a few months ago, inmates could obtain pornographic publications, commercially available pornography. That all changed. However, whatever pornography they have, they can still keep. They cannot receive any new publications. Now, ever since I've been with the program, I have had a very rigid stance on the use, possession of pornography by SOTP inmates. And it's not just pornography. It is anything, whether it's pictorial or in the form of written literature, that depicts sexual exploitation of children, women, adults, dogs, animals, whatever it is. Anything that encourages sexual violence, it is prohibited. That's why we don't just look for when we search a sale. We just don't look for obvious pornographic magazines. We search through letters. We search through everything. These people are quite good at creating their own sexually explicit materials, and they will do so with the Sunday newspaper, with the ads depicting children in swimwear, with the Sears catalog, with catalogs that are sent into the institution and are not of pornographic nature. They will cut them up and create pornography, sexually explicit materials that they will use to further their sexual deviance, their sexual arousal patterns. And that is something that SOTP inmates are held accountable to. I've had inmates who are gifted artists, and instead of using their art and their artistic skills to do something productive, they actually draw pornography, adults having sex with children, or I should say adults sexually abusing children. Very unacceptable, and that's when you really discover whether an inmate is really committed to the process of treatment. I talked about three values, and certainly I could talk more about values. My stance is these people have a problem not only with their sexual behavior, but they have a problem with their lifestyle. Their lifestyle is one of criminality. Their lifestyle is one of deception, one of dishonesty, manipulation, use and abuse of people, and they need to change that. They need to change that from the ground up. The metaphor that I use is if you have a house that needs to be remodeled, you can't just remodel the house without looking at the foundation. And if the foundation is cracked, and what I tell them yours is cracked, you just need to look at the cracks, you need to tear down that entire foundation and start from the ground up. And that means you need to anchor your life to values. And these are the pillars on which their house, whatever therapeutic work they do, on which it rests. These values, again, are responsibility in all aspects of their lives. So they can't just be responsible with us. They can't just be respectful with us. They need to be responsible, respectful, tolerant, honest with everyone. The correctional officer, their teacher, their food service foreman, everyone. And failure to do so is when we come in and reflect that back to them and say, well, this is what you're not doing. You say you want to change, you say you want to be responsible, you say that you are an honest person, and let me show you how you're not. So what decision are you going to make? That's what that means. And there is a great deal of pressure, peer pressure, to live up to these expectations and live up to the changes that they say they're going to make. The final phase of treatment, and this may begin when they first come in. We may need to, we start looking at some of these issues when they first come in. That may have to do with their release plans. Particularly if it involves an inappropriate release residence, where there may be substance abuse, there may be children at risk, or what we term enablers, people who will not be adequate monitors of behavior. In the final phase of treatment, what we do is we do risk assessment. And we'll talk about how risk assessment is done. This is a prediction of future behavior. It is a way to categorize or place along a continuum of risk an offender, and this is done for your benefit. I think that you need to know if you're getting a high risk offender, a very high risk offender, like the one we released recently, or if you have a low risk offender, a person who by every indication is likely not to reoffend given certain parameters if he's kept away from these sources of stimulation. But you also need to know if you have a high risk offender and with our suggestions on how that person ought to be supervised and how you ought to interpret their behavior. That's very critical. So we do the risk assessment and then communication with the appeal. What we do is prepare a discharge report. In this discharge report we're going to summarize the course of treatment. We're also going to provide you with a formal risk assessment and then we're going to recommend, in addition to the standard conditions of supervised release, special conditions or risk contingent release recommendations. Now we're not going to go overboard. We're going to try to meet with the recommendations the risk that the offender presents to the community or to the community that he is releasing to. We may have some problems here and we need to work on how to make this communication more effective. If the individual, if the offender is getting released from prison at the same time that he's being discharged from the SOTP, we, the staff of the SOTP, will take it upon ourselves to call the probation officer and forward that report. We have tried to work with our case manager, the case manager that works with us to place that packet in the central file, which is the most official chart or charting system in our agency. We placed two notes. We placed the discharge packet in what we call the FOI section, the Freedom of Information Act section. Those are the exempt documents that inmates do not see. And then we place another cover memorandum on section 5. Section 5 of the central file prompts the case manager, whoever the case manager is, to send information to the probation officer upon the inmates release from custody. So that memorandum compels the case manager to look in the FOI section and really take that packet and release it to you. That's where we may have a problem, because I cannot control what other case managers do. I have an influence on what case managers at these institutions do. But let's say an inmate who gets discharged and has another, say two years to go, goes over to the low security institution or goes to FCI Huasica in Minnesota, I have no way of controlling what that case manager does. Hopefully in the future we can develop some policies and some safeguards that compel case managers to send the information out to you. In the meantime, it will take some proactive action on your part to find out if the inmate participated in the sex offender treatment program and where to get that information. Now we will be more than happy to forward that information to you directly. But once the inmate leaves the program we have like too many inmates to keep track of. But if you give us a call, we also have duplicate records of those discharge packets and we'll be more than happy to release that to you as soon as you need them. Okay? So I'm recognizing that we do have a problem with dissemination of information but I also want to let you know that the information is available to you through us and also by prompting the case manager because that information ought to be in the central file. Any questions about that? Yes ma'am. What about sharing the information with treatment providers? By all means. This is a report that is intended to be used by the probation officer. It is intended to be used by the treatment provider who will see them in after care and in some cases it may be appropriate for certain other individuals to look at that report such as a family member say a spouse. It may be very important for that person to be either fully briefed or have that person read that report. Now all of these offenders have signed anyone who comes into the program they have signed waivers of confidentiality where we can release this information to you, to treatment providers as deemed necessary and to others as deemed necessary either by us or by you. So it's not necessary for us to execute release of information again? No. Yes ma'am. Is a copy of that release included in the packet or with the discharge reports or with the data or canopy? I can make that available to you. It is described in the discharge report in the form of a narrative. It says the inmate signed a consent of information agreeing to blah, blah, blah. Now we can also provide you with a signed copy of that in many discharge packets we have actually included a copy of the consent form. Yes ma'am. I get a lot of calls from the field telling me that institutions are not releasing information without a consent and I talked to Vicky Radine about this in Washington and she indicated that we're a need to know group so we don't need a consent and I thought it would be helpful for people to know that that when you get that response from the VOP to let them know that we are a need to know group and we don't need a release and that's in your policy. Correct. Okay. Let me talk about admission criteria. I talked to many of you, many other probation officers about what are the criteria for admission? Number one, he's a sex offender. Now he may be a sex offender because he says he's a sex offender and admits to having a sexual behavior problem a significant sexual behavior problem or he has been convicted of a sexual crime and yes child pornographers are sex offenders and I get that question a lot. I don't think there's any doubt in your minds but still there is some doubt in other people's minds whether child pornographers are true sex offenders and do they qualify for the sex offender treatment program and yes they do. The inmate volunteers for treatment and this is a very important consideration because I've had inmates who show up here at this institution recommended by the court they meet all the admission criteria and they say to me, well doc if this is a voluntary program I don't really want to do it I want to go back to Oklahoma or I want to go back to wherever he came from I never volunteered for the program I thought the judge ordered me into the program so we have to then not admit that inmate and we'll see if we can send him back. He's between 18 and 36 months from his projected release date that's what PRD means so that includes good conduct time but there is a considerable waiting list for the program and although an inmate with an 18 month sentence would be eligible for the program I don't have a bet for that person right now that person would have to wait a good 12 months a whole year on the waiting list before I can admit that individual so really to be placed on the waiting list and have a good chance of getting into the program at this point in time with only 36 months that individual needs to be closer to the 36 month marker probably no less than 33 months now can the individual be referred to the program with a longer sentence more than 36 months yes if he has a 50 month sentence a 78 month sentence yes they can refer the inmate I'll place that inmate on the waiting list he can be designated to an institution commensurate with his security level hopefully closer to his home and then at the time that he's getting closer to 36 months I will look at space availability and then prompt that institution that case manager to then submit a redesignation request for the sex offender treatment program and that's how we can get the inmate into the program yes ma'am approximately how long does a person stay in the program once you do get them into the membership program our intention is to treat that individual until his data release so they would stay in the program until they are released from custody the reason for that is because that is how we maximize our limited resources we aim to treat those individuals who will inevitably be released to the community because those are the individuals who will need it the most I am not going to treat a person who has a 15 year sentence before a person who has a 24 month sentence let's say you have someone into 24 month sentence and they're on the waiting list for 12 or even 18 months would you still put them in the residential program for the last 6 months even though there's a small amount of time left the answer to that at this point in time is no I would say to that referral person look by the time they get through the waiting list I am not going to be able to place that individual in the program he will not even have close to 18 months left now if the person after doing all the math will have say 16 months or 15 months left in custody yes I will admit that person into the program this is one of the problems that we're currently facing but we're also currently in the process of trying to remedy I think I mentioned before that we do expect that the sex offender treatment program will be expanded significantly come August probably to be implemented sometime in October or a few months thereafter tripling the bed capacity that will solve the problem of individuals who have 18 month or 21 month sentence and cannot get into the program even though they meet all the eligibility criteria there was another question yes ma'am for pre-sentence writers we are I guess advising the court the recommendations about the custody period to put in there may be referred for SOTP treatment at the appropriate time or something to flag that case so it won't fall into the plan my recommendation is for the court to be very specific about the language used in the judgment and commitment order specific referral to the sex offender treatment program at FCI Buttoner review for admission criteria it might even say something about and inform the court whether the judicial recommendation was followed so whatever level of specificity you want to determine the clearer of a response that you will get what I don't recommend is that the judicial recommendation read as recommended to for treatment it should say recommended for the sex offender treatment program at FCI Buttoner yes ma'am will that help place that person ahead of someone who possibly has already been there on the waiting list but did not have that specific order no it will hopefully ensure that I get the referral that's what it ensures and I will review the referral all admissions to the sex offender treatment program go through me so if I don't review the referral it never happened if I don't have any paperwork on that inmate it was never referred the only way in which the case managers are compelled to make that referral if they see on the judgment and commitment order this is what the judge wants at that point they will look up the policy and the policy says the director of the SOTP must review all referrals and then they will forward the information to me I will review it and respond respond back to them in formal communications alright has no pending charges or detainers now if our aim is to treat individuals who will be released to the community because that is what the effect of treatment is is close to aid that individual in the community so if that individual has a detainer to go do another 10 or 15 years in the state of Maryland it doesn't really make a whole lot of sense to treat that person when I have another individual who will hit the streets way before that other person will so pending charges that may interfere with release to the community or actual detainers lodged by other jurisdictions to the program it is not an automatic detainers may be in the form of concurrent charges or a sentence detainers may not be significant if they have to go do another 6 months in state custody well that's not significant especially if they are not going to be able to obtain sex offender treatment in that state jurisdiction or correctional system the person is not psychotic and that is floridly psychotic or psychologically unstable if that's the case that person needs to be psychologically stabilized before they come into the program he is literate and not mentally retarded we take people who are even of in the low average intelligence and some in the borderline range of intelligence but if they are mentally retarded we are really not equipped we have not made the modifications to these people and the individual is not a sadist and or a florid psychopath this is a career criminal a person who is cold, calculating, callous has no absolutely no empathy for others or a sadist sadists are not good for these type of treatment programs they actually enjoy quite a bit the retelling of their stories sadists need to be managed in a different way for this particular treatment program that would be a contraindication or the person is not a chronic treatment failure I've seen it too many times where the person has already been failed out of two treatment programs or has reoffended while in treatment and my response to the referral is well what's different now he has a proven history taking advantage of these opportunities these privileges and more treatment is not likely to do any any better okay the referral process I've talked about direct commitment the court makes a recommendation CCM office makes the referral to me then I approve the admission either immediate or to the waiting list then the inmate is designated by the regional director if it's a redesignation from other BOP institutions it follows a similar process the unit team or psychologist makes a referral I review that referral I either accept it for immediate admission or to the placement on the waiting list and then the regional director redesignates that inmate alright I think I've talked about this discharge there are two ways of discharging inmates one is upon release from custody and this is the traditional he completed treatment although they never complete treatment the SOTP mails a copy of the discharge packet to the probation officer or early discharge to program expulsion again that should be the case manager mails a copy of the discharge report any questions yes ma'am how frequently rather frequently there are many who come in many who don't make it in any case I don't consider the expulsion failures either for ourselves or for you the consumers of our services because in any case whether the person makes it to the end or is expelled prematurely you will still get a copy of a discharge report that is intended to help you supervise that inmate that supervisee in more effective ways so to me I'm still providing a service to all of you couple of questions yes ma'am what are some of the examples of what are the reasons why they're being expelled chronic resistance to therapeutic intervention or that is failure to change and this is chronic so this is not just one day I'm having a bad day and they blink the wrong way and I kick them out of the program this is repeated observations of behavior that has been highlighted for the inmate over and over again he has been offered multiple suggestions there have been multiple interventions switching treatment staff and treatment approaches and given their chronic failure to adhere to the treatment plan that's when they're discharged they always know it's coming other examples failure to adhere to certain policies if they assault anybody they're out of the program they know not to assault anybody possession of pornography that's a very good one any type of violation that significantly disrupts the program or the security of inmates by disclosing let's say confidential or personal information to GP inmates these are all grounds for immediate expulsion there is a rather cumbersome review process we don't just say we're going to kick that person out several, several times before we actually do it yes ma'am and then I'll get you sir is once expelled expelled does that mean that they can't maybe six months later or a few later if they haven't a changing part or motivated the question is once expelled can they return to the program and the answer to that is no and they know that and every inmate who comes into the program knows that because if I made one exception then that would lend itself to having people be kicked out and then readmitted they know that this is a unique opportunity that we are investing a great deal of ourselves into their treatment and if they waste their chances this is not their first chance this is not their second chance it's probably their 50th chance and that's what they fail to understand many of these individuals believe in the perpetual second chance they always think they should deserve a second chance they just fail to understand that they're probably in their 50th or 80th second chance so we try to clarify that for them sir if you have a court order and the judge recommends a person have sex offender treatment at Butler all this can be sabotaged by the inmate just saying I don't want to be involved absolutely the question is even with a strong judicial recommendation for treatment the inmate can sabotage the entire recommendation by saying showing up to the treatment program and saying look I don't want any treatment I don't have a sexual behavior problem I'm not a sex offender I don't want your treatment yes that can happen I'm trying to advocate for sentences to be fashioned after the conduct not the possibility of future treatment because let's say a person will get a reduction in sentence because he intends to participate in treatment there is no guarantee that that person will actually comply with that recommendation one more question and I think we need to take a break and I'll entertain more questions certainly during the break yes ma'am have you done any follow up on re-arrest rates if people have completed the program? the question is have we done any follow up of re-arrest rates on individuals that we have released the office of research in our agency did a brief study of inmates who were released from I don't know what this is from the from 1990 up to 1997 when I came in to study the data collection stopped now they looked at a control group and they looked at a experimental group a group of individuals who received SOTP services they found no significant differences in arrests the overall recidivism rates for both groups was very low experimental design problems with that particular study so I wouldn't place too much emphasis on those findings one of the problems by design is the length of follow up they were followed anywhere from 18 to 36 months and as I've said before most sex offenders tend not to re-offend during that period they tend to re-offend years good afternoon everyone I'm Karen Steinauer and I have been working with the Bureau of Prison since 1995 I've been with the sex offender treatment program since 1997 what I'd like to talk to you about this afternoon are the acceptable standards for assessment and treatment of sex offenders as you probably know from many of your interactions with providers in the field there's a whole variety of educational and professional experiences among those providers it's quite diverse what we have found is that a multidisciplinary approach to treatment and to management of sex offenders is the approach that works best the reason for that is that no one player plays the most significant role everyone's working together you have all these different vantage points from which to observe the behavior and the approach of the sex offender and working together seems to really help each other out in managing that sex offender in the community the purpose of this presentation is to assist you in becoming better consumers of mental health professional contracts in the field what do I mean by that exactly many of you will get sex offenders in the community for whom treatment will be required and when you get that person they're going to be looking for someone who can assist that individual through treatment program out in the community there aren't a lot of programs available of the ones that are available there are some that are actually fairly questionable what I'm going to go over today are some of the standards that are expected of good providers in the community and there are only guidelines by the way because universities and other kinds of training programs are short supply university certification programs that is basically you'll have a number of individuals who will not meet the criteria that I'm going to go over and I would not encourage you to be overly wary if you feel you have someone who has done an excellent job with treatment of sex offenders in the past even if they do not meet the criteria I'm going to mention I would still encourage you to look at that person in a very broad kind of way because some of the training experiences and professional experiences are in small supply at the same time I do want to suggest to you what the optimal type of experience professional experience and educational background would be for providers of sex offender treatment how many of you are familiar with ATSA okay good many for those of you who are not familiar ATSA stands for the association treatment of sexual abusers the organization's home base is in Beaverton, Oregon and they're dedicated basically to developing disseminating information about research, evaluation and treatment of sex offenders they get that information out to their membership and all members of ATSA are committed to abiding by certain standards of ethical practices or codes as we call them and I'm going to talk a little bit about them right now just for your information though ATSA does have a website that website is www.atsaatsa.com they have a lot of good information some of which you have in your packets for this conference and they're constantly updating it there are a lot of discussions that take place online regarding recent research in the field certain program practices there are a lot of people who go on to the chat lines in order to get information about how they might approach a given problem for sex offender and I would really encourage you to become familiar with that website okay what are the standards outlined by ATSA for providers of sex offender treatment education must have an advanced degree what does that degree need to be in basically you look mostly at psychology, sociology human sexuality social work criminology counseling and psychiatry they are the primary fields of study in which someone will have an advanced degree the bare minimum would be a bachelor's degree with a demonstrated level of experience under a licensed professional okay so you want basically an advanced degree preferably or a minimum of a bachelor's degree with a lot of experience under a licensed professional what about that experience basically looking for about 2,000 hours of face-to-face contact with sex offenders that's a lot of time if you think about it it's approximately one full year of contact that's 40 hours a week for 50 weeks of the year two weeks of vacation that's a lot of time with sex offenders that's really what it takes to get a real good sense of what the population is about in a very detailed and broad context kind of way it does not necessarily mean however as I mentioned before that everyone who will be considered a good provider of services in the community will have that much contact that is the optimal amount of contact and finally we're looking for individuals who stay current in the field reading the current literature keeping themselves up to date on research and practices and are willing to invest that amount of time to make sure they're aware of the nuances of working with this particular population it is a very unique population again I want to mention these are only guidelines use your gut instinct as well as grounded in the context of the information that you have from your own experience as well as from anything you might learn during this conference the most important thing I would like you to remember though is that sex offender treatment as a unique area of practice is something that you really can't dabble in if you have someone who does well a little bit of that and then oh yes I see five sex offenders a week for sex offender treatment for individual therapy there's not an infrastructure present for that treatment I would really take a second look at that provider as one that you might not want to have as a contract employee with the work you do with sex offenders any questions about that yes treatment providers moving into anger management is that seen as a similar process or is that dabbling then in that situation I would say that certainly anger plays a big part in many of the behavioral patterns of sex offenders as a population it does not play a part in all sex offenders in the population for sure but for many it is a very important component in that process of behavior is that relevant certainly someone who is doing sex offender treatment work may be very skilled in working with anger management and in that it does apply to the population to some extent that's reasonable but again the most important thing we're looking for is someone who is well grounded in the field knowledge wise in terms of research and is providing a certain structure that you can see as a full program not just individual therapy I mean we want to look for someone I'm going to go into some of this in a minute someone who also will provide group therapy has contact with the courts has contact probation officers and has really laid the groundwork for a very comprehensive intensive program as opposed to just a little bit of that kind of work I don't know if you want to add sometimes we have for example evaluations that we review from neuropsychologists whose primary practice is neuropsychology and they will test and evaluate a sex offender and they have probably I've been in court with them and they ask the typical questions so doctor so and so how many sex offenders have you evaluated well and they say well six well that's what we mean that's dabbling in sex offender treatment, sex offender evaluation and we caution you against those providers we don't mean to imply that a sex offender treatment provider ought to not treat other groups certainly I feel qualified to treat depressed individuals I have worked with families with children but I make it my practice to specialize in a field because it's hard enough to keep up with a field with one field let alone several fields so I feel more competent if I stay within a general area practice domestic violence is certainly not in congruent with a person who also specializes in sex offender treatment I see a great deal of overlap it's just a word of caution that's what we want to highlight ok what are some of the more important principles underlying the standards of assessment and treatment first and foremost the reason we even exist community safety takes precedence over any other considerations when I first started doing this kind of work and someone out in the community would ask me what do you do out in that prison I would say well I'm actually involved in sex offender treatment what? sex offender treatment why would you waste your time on them how can you do that kind of work I'm sure many of you have gotten similar responses from individuals as you've talked with them in the community well basically we're looking at community safety we're looking at protecting children if we can work with one offender who has made a difference in his life to the extent that he no longer will hurt a child you may actually especially given the statistics that we were talking about earlier have saved perhaps a hundred children from that abuse from that person community safety takes precedence over any conflicting considerations what else do I mean by that basically an individual just to give you an example family reunification someone is in the treatment program is going back to the community has done really well in the treatment program started out kind of shaky start a lot of DUIs a lot of alcohol problems really wasn't fully committed in the beginning to doing the work he was needing to do got put on probation once well in the program and eventually turned things around worked really hard earned that opportunity to be back out in that community again did a really really good job I actually was feeling pretty good about the possibility of his returning to his family his victims were not actually in his immediate family they were in distant family members homes, nieces and nephews but you know at the same time even though I felt like he might be ready to manage that the reality is that we want to make sure that he's ready before any family reunification takes place so for him even though for him to go back to his family I had to think of his children is he really ready? what were some of the things that got him sidetracked initially in the program well there were things like you know the lifestyle he had led before of not really paying attention to deadlines responsibilities things that he needed to do on a day-to-day basis he would miss an appointment here and there for example or he'd sleep late because well he didn't have an alarm clock he needed to know that there are certain things he needed to be able to manage well in order for him to earn that right to ultimately go back with his family and we wanted to give him the best shot at making it back to his family well the best shot means when he gets out there and he's working with one of you that he is getting his feet solidly on the ground in other ways he's going to be able to come for his family which means a job which means get up early in the morning get to work and do that consistently he needs to show that he's not going to go back to drinking he needs to show that he can manage some time with his children while supervised and not get angry with them over the least little thing so in that case not only is the safety of the community taking precedence but we're really seeing that as a benefit to the offender as well I guess I was saying this I've heard it before is 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 in fact it may be the community at large it may be his family it may be the children or potential victims that he in the future may have contact with so another way of saying it is the client is the community or the community is the client one of the other important principles underlying the standards of assessment and treatment is that there is no known cure we do not contend that individuals leaving our program are cured someone had asked this question earlier if that's the case then why are we putting all this money into treatment all this time and energy and it's because we basically know that some offenders will change to the extent that they can manage their sexual deviance they may still have a fantasy that comes to mind from time to time but they've developed tools on how to not reinforce that fantasy and move further along that continuum of escalation and additional perpetration okay yes with Dr. Hernandez the issue about the community being the client when you all do the pre-release or release and you do have an individual who is a sex offender going back to the family do you do any kind of work with the family project that person going back to their family we have some contact with some family members we do not work with all family members all families for that matter in regard to where an individual is in his treatment and what will need to happen in the home we do work with that offender during the course of his treatment in his being honest and forthright with his family members about what he has done and what that means and how that will affect his returning to the community certain things that will need to be in place the inmate will put together a very thorough relapse prevention plan that he will write and it will highlight all kinds of details about his offense patterns and his arousal patterns and will identify certain high risk situations that he will need to avoid at all costs when he's out there that sort of thing in regard to US probation we actually have a lot of contact with US probation I was telling someone earlier today I'm not just saying that because all of you are here there are a lot of really good questions that come from you as we're looking at releasing someone to the community we've had excellent feedback on what might be available in that particular community and we've been able to work with USPOs to identify certain needs that a given offender would really need to have some that they could do with that would be preferable to have them but certainly those that we find essential for that person making a good transition into the community we've even had the opportunity in some cases to help with the modification of conditions of supervised release by asking the probation officer to send us that what is it a 52 or something I can't remember the number of that form but getting the because we have trust that's built up in that therapeutic relationship we can work with that offender who says he really wants to change and has really worked hard on changing to get him to see that you know it doesn't stop when you go out the door you really need to continue that into the community so how can you best do that agree to certain modifications of the conditions of supervised release so we'll get them to sign it while they're in there and we'll send that to the probation officer actually before they get there and so certain things are already in place before they set foot out our door okay thank you very much for your attention today we thank Dr. Hernandez and all the folks at FCI Butler for making this seminar so worthwhile a great deal of thanks also goes to all of our participants their questions and comments throughout the seminar truly enriched the learning experience for everyone we have an update as to the status of the sex offender treatment program in the training Dr. Hernandez mentioned the proposal to expand a unit of 36 beds to 112 as of November 2000 the sex offender treatment program nearly doubled in size expanding to 66 beds in December they will be in the process of expanding and moving the unit to 112 bed area please remember to fill out your evaluations and rosters and fax them back to us we really need your feedback to help us design future programs and remember to check your FJTN bulletin for part two of this special needs offender series the sex offender treatment program at FCI Butler I'm Mark Maggio, thank you for watching