a) Many adult sexual abusers residing in the
community are supervised under the jurisdiction of the courts, correctional
departments, probation or parole divisions or mental health agencies.
Approaches to reducing and managing risk in the community may involve imposing
various supervision conditions, expectations and requirements; monitoring and
tracking; linking clients to appropriate programs and services; facilitating
successful reentry to and stability in the community following release from
correctional or other facility custody; promoting continuity of care within and
across facility-based programs and services and community-based services;
educating and engaging the public and communities; using and encouraging other
system partners to use empirically informed assessment information to guide
interventions and strategies; and engaging positive community support networks,
which may include trained volunteers. Some strategies are explicitly designed
to reduce the recidivism risk of sexual abusers by assisting them with
developing and enhancing prosocial attitudes, skills and behaviors; increasing
healthy and appropriate interests; effectively managing risk factors;
developing positive and prosocial community supports; and enhancing other
protective factors. Other strategies are primarily designed to promote
accountability, deterrence and risk management.
b) Research indicates that focusing
supervision activities primarily or exclusively on risk management is not
effective in reducing recidivism, whereas using risk-reducing interventions,
such as treatment and other skill-building interventions, to complement risk
management-based supervision strategies leads to better outcomes. To support a
balance of risk reduction and risk management efforts, contemporary trends
involving sexual abusers in the community often emphasize multidisciplinary and
multi-agency collaborations. These collaborative efforts are part of
contemporary practices in the treatment and supervision of sexual abusers, as
supported by the extant literature. It may include communication and
partnerships among professionals, such as sexual abuser-specific treatment
providers and other treatment providers (e.g., substance abuse, mental health,
marital and family therapists), probation or parole officers, case managers,
child welfare professionals, victim advocates, law enforcement officials,
polygraph examiners and others.
c)
In many jurisdictions, collaboration occurs through multidisciplinary case
management teams, the composition of which may vary depending on the risk,
needs and circumstances of a given client. Key elements of effective
collaboration include a clear delineation of roles and responsibilities,
complementary policies and procedures, ethically sound communication and
information-sharing mechanisms, and a shared community safety goal. Through
effective partnerships, early intervention can be exercised to reduce the risk
posed by sexual abusers prior to behaviors that are not yet criminal in nature
and to facilitate the exchange of information to develop appropriate treatment
plans, inform risk management decisions, make recommendations regarding victim
contact, and increase the overall stability and success of clients in the
community.
d) In cases in which a
client will be released from a correctional, inpatient or other institutional
setting, the transition to the community is likely to be more successful when
collaboration exists among professionals with case management responsibilities
in the facility and in the community. Transition and reentry planning should be
initiated well in advance of the client's release in order to identify any
current and ongoing intervention needs, promote continuity of care, explore and
begin to address potential barriers to reentry in the community (e.g., housing
or employment challenges), clarify any post release conditions and
expectations, and facilitate access to community resources and services, which
may include community-based sexual abuser-specific treatment.
e) Research on correctional populations,
including sexual abusers, demonstrates that interventions are most effective
when guided by evidence-based principles of correctional intervention (i.e.,
risk, need and responsivity). Therefore, community-based risk reduction and
risk management strategies involving sexual abusers are ideally matched
accordingly and may change over time, based on current and empirically informed
assessment information. Although higher risk/higher need clients may require
supervision, monitoring and treatment of greater intensity and dosage, less
intensive supervision and other risk management and risk reduction strategies
may be more effective and sufficiently adequate for sexual abusers with lower
recidivism risk, fewer intervention needs and greater protective
factors.
f) Overarching Risk
Reduction and Risk Management Considerations
1) Treatment providers recognize that the
community management of sexual abusers generally involves a variety of
interventions, strategies and mechanisms.
2) Treatment providers appreciate that sex
offender-specific public policies and practices have varied goals (e.g.,
deterrence, retribution, risk management, risk reduction, prevention) and may
reflect different interests and priorities for stakeholders. Some may
complement sexual abuser-specific treatment, other risk-reducing interventions
and prevention strategies; others may not.
3) Treatment providers recognize that some
interventions and strategies used to promote risk management and risk reduction
with clients have more empirical support than others.
4) Treatment providers remain apprised of the
current research pertaining to the impact and effectiveness of various risk
management and risk reduction policies and strategies utilized with clients in
the community.
5) Treatment
providers are encouraged to work with researchers to assess the impact and
effectiveness of community-based risk management and risk reduction strategies
utilized with clients.
6) Treatment
providers play a role in educating stakeholders regarding the current empirical
support for various strategies and encourage the use of research-supported
principles and practices to promote effective risk reduction and risk
management with clients in the community.
7) Treatment providers appreciate that the
application of empirically informed assessments of risk and need can enhance
the potential effectiveness of risk management and risk reduction strategies
for sexual abusers in the community and support the use of those assessments
system-wide.
8) Treatment providers
strive to ensure that collaborative partners and other stakeholders have access
to current, empirically informed assessments to guide decision making regarding
risk management and risk reduction of sexual abusers in the
community.
g)
Multidisciplinary Collaboration
1) Treatment
providers recognize that effectively reducing and managing risk among sexual
abusers in the community often involves collaboration across multiple agencies,
entities and disciplines.
2)
Treatment providers appreciate that their respective roles and responsibilities
with clients are part of a broader system of community management.
3) Treatment providers strive to engage
stakeholders, such as the judiciary, treatment providers, probation and parole
officers, correctional staff, victim advocates, law enforcement agents,
employers, landlords and housing officials, civic organizations, mentors, the
faith community, and other community supports, in contributing to risk
reduction, risk management and prevention activities.
4) Treatment providers recognize that
collaborative partnerships are more effective at increasing community safety
when the various stakeholders are appropriately trained and knowledgeable about
working with sexual abusers. Therefore, treatment providers promote education
and training of the involved professionals and nonprofessionals (e.g., family
members, community supports).
5)
Treatment providers ensure that information-sharing and collaboration occur
within the parameters of confidentiality provisions, informed consent and other
ethical standards.
h)
Collaborating with Probation/Parole or Other Community Supervision
Professionals
1) Treatment providers working
with sexual abusers shall collaborate with probation and parole officers,
correctional and other facility staff, case managers, and post release
aftercare professions to support successful public safety and client
outcomes.
2) For clients who are
under court-mandated or other formal supervision in the community (e.g.,
probation, parole, aftercare/step-down from an inpatient treatment facility),
treatment providers strive to obtain supervision- and treatment-related
information from the appropriate authorities. This minimally includes copies
of:
A) presentence investigations, prerelease
evaluations, previous sexual abuser-specific evaluations, treatment summaries,
and conditions of probation/parole or post release placement in the community;
and
B) when possible, documents
regarding the investigation of the offenses.
3) Treatment providers working with sexual
abusers review with the probation officers/parole agents and other case
managers the specific conditions that are designed for risk reduction and
management purposes and discuss the rationale with the clients. These
conditions often include, but are not limited to, the following:
A) Abstaining from alcohol and/or illegal
drugs, when substance use is a risk factor;
B) Adhering to treatment expectations (e.g.,
participation, compliance with program rules and individual treatment
plans);
C) Practicing healthy
sexual attitudes and behaviors;
D)
When appropriate, disclosing offense history, risk factors and effective coping
strategies to professionals who are involved with the client and the client's
significant others;
E) Making plans
for work, social and leisure activities to enhance quality of life and reduce
possible exposure to cues or situations associated with the client's risk of
reoffending;
F) Complying with
other conditions of supervision, such as restricted internet access,
employment, volunteering, polygraph examinations and electronic/GPS monitoring;
and
G) Complying with restrictions
on contact with children or other vulnerable parties (e.g., adults with
developmental limitations), as deemed necessary for a given
individual.
4) Treatment
providers working with sexual abusers establish and clarify the appropriate
parameters (e.g., timing, type of content) and mechanisms (e.g., written,
verbal, face-to-face) for reciprocal information-sharing with the
probation/parole officer or other relevant case management professionals in
order to promote well-informed decision making. This minimally includes the
following:
A) Attendance in
treatment;
B) Overall participation
in treatment;
C) Specific changes
in dynamic and protective risk factors;
D) Progress toward specific goals in
treatment;
E) Engagement and
compliance with supervision;
F)
Referrals to and/or participation in additional programs and services;
and
G) Adjustments to level of
supervision or supervision strategies.
5) Treatment providers report, to the
appropriate professionals with the authority and responsibility for
supervision, in a timely manner, any violations of their clients' conditions of
supervision and significant adverse changes in dynamic risk factors.
i) Treatment providers shall
recognize the distinct but potentially complementary roles and responsibilities
of treatment providers and supervision officers, clarify these roles and
responsibilities to clients and other professionals, and actively strive to
maintain these professional boundaries.
1)
Treatment providers are aware of the ethical concerns related to dual
relationships and adhere to any licensing, discipline-specific, ethical or
other credentialing standards and guidelines regarding dual relationships and
conflict of interest.
2) While
supporting complementary risk reduction and risk management efforts with
clients, treatment providers strive to ensure that:
A) Sexual abuser-specific treatment providers
limit their role to that of a clinician and do not attempt to assume the roles
of supervision officers or law enforcement agents, or represent themselves as
such.
B) Probation/parole officers
do not represent themselves as specialized sexual abuser-specific treatment
providers unless they possess the requisite education, training, supervision,
licensure and continuing education;
C) Probation/parole officers who deliver
"general" cognitive and/or behavioral interventions to promote skill-building
and behavior change among clients are well-trained and appropriately supervised
to deliver those interventions with fidelity; and
D) Probation/parole officers do not assume
specialized clinical responsibilities within treatment programs for sexual
abusers with clients for whom they have supervision responsibility.
3) In order to promote a
collaborative treatment approach, treatment providers are encouraged, when
clinically appropriate, to allow probation/parole officers to observe clinical
treatment sessions in programs for sexual abusers. However, the following
guidelines should be taken into consideration:
A) Treatment providers recognize that these
observations can:
i) help educate officers
about individuals who sexually abuse and the nature and approach to treatment
for sexual abusers; and
ii) help
officers obtain information that may enhance their supervision of a given
client.
B) Treatment
providers recognize that these observations can impact client confidentiality,
inhibiting client participation and disclosure; disrupt continuity of the
treatment process; and blur clients' perceptions of officers' roles.
C) If allowing these observations, treatment
providers:
i) Ensure that officers identify
themselves by position and work responsibilities and clarify to session
participants their roles and responsibilities as supervision
officers;
ii) Review and clarify
the purpose and possible impact of having officers present;
iii) Obtain appropriate informed and
voluntary consent from clients; and
iv) Ensure that officers are aware of and
adhere to professional ethics, including, but not limited to, confidentiality
limits and boundaries.
j) Engaging Community Supports
1) Treatment providers shall recognize that
an appropriate support person can assist professionals and clients with risk
reduction, risk management and other successful outcomes for clients, victims
and communities.
2) Treatment
providers collaborate with clients and other professionals to identify and
engage community support persons in the supervision and treatment processes,
when appropriate and feasible.
3)
Treatment providers acknowledge that appropriate support persons are able and
willing to:
A) Appreciate that clients are
responsible for having engaged in sexually abusive behavior;
B) Recognize that recidivism risk can
increase and decrease over time;
C)
Maintain routine contact with the individual who has engaged in sexually
abusive behavior;
D) Understand,
recognize, intervene and report when risk factors are present;
E) Maintain, model and assist clients with
practicing prosocial attitudes and behaviors;
F) Support adherence to supervision,
treatment and other expectations pertaining to risk reduction and risk
management;
G) Participate in the
development and implementation of safety plans for victims and other vulnerable
persons as applicable; and
H)
Communicate routinely and effectively with the professionals responsible for
assessing, supervising and providing treatment to sexual abusers.
4) Treatment providers establish
and clarify appropriate parameters (e.g., timing, nature, limits, methods) of
reciprocal information-sharing with support persons.
5) Treatment providers take appropriate steps
to ensure that support persons are equipped with knowledge and skills regarding
risk factors for reoffending, strategies for effectively reducing and managing
clients' risk for recidivism, and the strengths and limitations of strategies
in place.
6) Treatment providers:
A) educate clients and identified support
persons regarding the roles, responsibilities, expectations and risks and
benefits associated with serving as part of a collaborative support network;
and
B) elicit informed consent
accordingly.
k) Collaborating with Child Protective/Child
Welfare Professionals
This Section pertains to clients whose sexually abusive
behaviors, interests, preferences, or arousal involve children and the
potential for these clients to have planned or unplanned contact with children
(e.g., children in their own families, the children of new romantic partners,
friends, coworkers, or neighbors). It is important to note that contact is not
limited to the client's close physical proximity with a child or adolescent,
but also includes one-to-one interactions such as telephone calls, emails,
written notes and communications through third parties.
1) Treatment providers shall prioritize the
rights, well-being and safety of children when making decisions about client
contact with minors.
2) Treatment
providers take reasonable steps to support a client's adherence to any no
contact orders or other restrictions that have been imposed by the courts or
other entities statutorily authorized to impose restrictions for that
client.
3) When contact with
children is at issue under the terms of any legal disposition (e.g., court
order, probation/parole order), treatment providers may provide written
assessment-driven recommendations regarding an individual client's acceptable
level of contact with children that range from no contact to supervised or
unsupervised contact.
4) Treatment
providers' recommendations regarding contact with minors should be minimally
informed by the following:
A) Empirically
informed assessments of recidivism risk and protective factors;
B) The client's history of deviant sexual
interests, fantasies and behaviors involving children;
C) The nature, extent and duration of the
offending behaviors of the client;
D) The client's engagement and progress in
sexual abuser treatment, particularly with respect to general and sexual
self-regulation, sexual preoccupations and extent of sexual deviance variables;
the abuser-victim relationship; and offense-related motivations, grooming
patterns, attitudes and offense-specific variables;
E) The presence of positive prosocial
supports for the client who can serve as chaperones;
F) The client's engagement and compliance
with supervision expectations and conditions;
G) The ability, skills and willingness of
nonoffending parents or guardians to provide an environment that is
appropriately conducive to maintaining the child's emotional and physical
safety;
H) The availability and
professional opinions of a qualified child advocate, mental health or child
welfare professional to whom the child and family are therapeutically engaged,
and the confidence that the child will be able to articulate interests and
concerns regarding the potential for contact with the client;
I) The child's reported interests for contact
or no contact, or if contact would not be in the best interests of the child;
and
J) The extent to which
community strategies are currently in place to provide adequate mechanisms and
resources to ensure adequate child safety plans for victims and other
minors.
5) Treatment
providers collaborate with the proper authorities or professionals to support
restrictions that prohibit clients from having contact with a child if the
child does not want contact or if contact would not be in the best interests of
the child or other vulnerable persons.
6) Treatment providers consider the impact
that the client's contact with siblings may have on the victim and approve
contact that minimizes distress to the victim.
7) Treatment providers work collaboratively
with child welfare/child protection agencies, victim advocates and others
(e.g., treatment providers, probation/parole officers) to develop safety plans
for victims and other vulnerable children.
8) Treatment providers obtain informed
consent from a child's nonoffending parent or legal guardian before approving a
client's contact with that child, while adhering to the parameters of any legal
or other restrictions.
9) Treatment
providers may support structured and/or supervised contact with children when
the following occur:
A) the client is making
acceptable progress in treatment and/or supervision;
B) he/she is effectively managing dynamic
risk;
C) appropriate safety
precautions are in place; and
D)
contact is assessed to be in the best interest of the child by the
appropriate/designated professionals working with those responsible for child
welfare decisions, taking into account the expressed interests of the
child.
10) Within the
bounds of confidentiality, treatment providers regularly exchange information
in a timely manner with child welfare workers involved in a client's case and
with child welfare workers involved in monitoring the safety of children with
whom the client is having or considering having contact, unless otherwise
specified by law. Information may include, but is not limited to, the
following:
A) Client's treatment
progress;
B) Significant changes in
dynamic risk factors; and
C)
Significant barriers and social services agreements in place with goals and
objectives that have to be met by all in order to promote contact or
reunification.
11)
Treatment providers familiarize themselves with restrictions related to
client-victim contact and abide by those restrictions in a therapeutic
manner.
12) Treatment providers
ensure that, as warranted for a given client, contact with children is
addressed as part of a comprehensive community risk management plan and should
be linked to the client's re-offense risk, progress in treatment, and/or
compliance with supervision, as applicable.
13) Treatment providers document all
decisions about a client's contact with children, including whether contact is
recommended, the type of contact that is recommended, the preparations made
with children and chaperones, and information obtained during the ongoing
monitoring process.
l)
Addressing Family Reunification and Visitation
1) Treatment providers shall collaborate with
child welfare workers to address family reunification efforts when clients have
abused children in their own families and wish to have contact with them, or
they seek to begin relationships with individuals who have children.
2) Treatment providers recognize that family
reunification, in many cases, is not an advisable goal because of the risk and
potential for harm that may be unmanageable (e.g., high risk, lack of
appropriate caregiver supervision, nature of the victimization, impact on
family and victim). However, family reunification may be one of the many ways
that victims and families attempt to resolve issues generated by the offender's
abuse and may be beneficial for other reasons in some circumstances.
3) Treatment providers are aware that
reunification is a gradual and well-supervised procedure in which a sexual
abuser is allowed to reintegrate into the familial network where the victims or
potential victims are present.
4)
Before providing recommendations regarding family reunification, treatment
providers collaborate with professionals from a range of disciplines who have
different agency missions and mandates, which may include child welfare
professionals, family therapists, victim services providers or advocates,
treatment providers, supervision officers, and other community
supports.
5) Treatment providers
ensure that any child contact decisions within the context of family
reunification efforts should be informed by a thorough assessment of the
client's risk, the child's safety plan, and consultation with other members of
the community risk management team, such as collaborative partners and
stakeholders.
6) Treatment
providers ensure that, as appropriate and indicated, contact with the client's
children, his/her current partner's children, or children of family members are
also discussed as part of the reunification process.
7) Treatment providers do not recommend the
involvement of the victims or potential victims in family reunification efforts
unless that involvement is likely to benefit the victims or potential victims
and unlikely to cause them inordinate levels of distress.
8) Treatment providers, if necessary,
recommend that the client be removed from the residence of the victims or
potential victims rather than removing the victims or potential
victims.
9) Treatment providers
consider the wishes of the victims or potential victims with regard to family
reunification, taking into account their ability to understand the
ramifications of their decisions.
10) Treatment providers ensure that a child
has access to a responsible adult chaperone trusted by that child before
recommending the client be allowed to have contact with that child.
11) Treatment providers may make
recommendations for a client to have contact with interfamilial victims and
other family members under 18 (or otherwise vulnerable persons) only when the
following are present:
A) A nonoffending
parent or another responsible adult who is adequately prepared to supervise the
contact;
B) The victim or minor is
judged to be ready for the contact by a professional who can monitor the
victim's or minor's safety; and
C)
The client has made acceptable progress in treatment.
12) Treatment providers ensure that
appropriate safety plans are developed and monitored during the family
reunification process. Safety plans should include explicit and nonnegotiable
rules and boundaries, as well as the method to address infractions.
m) Engaging Chaperones and
Community Supports
1) Treatment providers
shall exercise prudence and caution when involved with the selection and
education of responsible adult chaperones for contacts between clients and
children and other vulnerable parties who may be unable to give
consent.
2) Treatment providers
recommend as potential chaperones only adults who:
A) Accept and understand the client's history
of sexually abusive behavior;
B)
Appreciate that the client is solely responsible for decisions to act in a
sexually abusive manner (i.e., chaperones do not place responsibility on
victims or external circumstances);
C) Recognize the potential for risk and
intervention needs to change over time, either increasing or
diminishing;
D) Appreciate the need
for the client to have prosocial supports; and
E) Accept the role and responsibilities of
being an effective chaperone.
3) Treatment providers ensure that clients
educate potential chaperones candidly about the clients' sexually abusive
behaviors, antecedent and ongoing risk factors, and treatment and/or
supervision conditions.
4)
Treatment providers ensure that chaperones fully understand the safety plan for
the children and appropriate reporting procedures for violations of the safety
plan.
5) Treatment providers
monitor authorized contacts between the client and children through interviews
with the client, the chaperone and/or the child's therapist/support person, and
through other supervision options.
n) Continuity of Care
1) Treatment providers shall recognize that
continuity of care is necessary to support effective risk management and risk
reduction of sexual abusers in the community.
2) Treatment providers facilitate, in a
timely manner, the seamless access to and provision of follow-up services for
clients who transition from one program to another. This may include transition
from:
A) Institutional to community-based
treatment;
B) Community-based
treatment to treatment in a correctional, inpatient or other institutional
setting;
C) Programming within a
facility/institution or within the community, at a lateral level of transfer;
or
D) The current
jurisdiction/place of residence to a new jurisdiction of residence, due to
relocation or transfer of supervision.
3) Treatment providers seek information,
through appropriate release of information when necessary, regarding treatment
progress and take this into consideration when initiating treatment services
for a client who has been receiving services elsewhere or in another setting in
order to prevent duplication of efforts and promote timely, assessment-driven,
well-informed treatment planning.
4) Treatment providers, to the greatest
degree possible, include the client, institutional caseworker, institutional
treatment staff, community supervision staff, community treatment staff, family
members, and support persons in release planning meetings. When this is not
possible, electronic alternatives, such as teleconferencing or
videoconferencing, may be used.
5)
Treatment providers providing services to clients prepare written
treatment/discharge summaries for clients who change programs, transition from
an institution to the community, or transition from the community to an
institution (i.e., lesser level of care or increased level of care/security).
These summaries usually include the following elements:
A) Assessment of risk to sexually harm
others, including individualized risk factors and indicators of imminent
risk;
B) Assessment of dynamic risk
factors and protective factors/client strengths (e.g., prosocial support
systems);
C) Description of
offending pattern;
D) Description
of sexual and nonsexual criminal history;
E) Identification of relevant problems and
continuing interventions needs (including medication);
F) Level of participation in programming;
and
G) Recommendations for
community supervision, treatment and support services to guide post-release
case management decisions.
6) When appropriate and within ethical
parameters, bounds of confidentiality, and other information-sharing statutes
or professional regulations, treatment providers working in correctional
facilities or inpatient/other institutional settings provide community-based
providers, supervision officers/case managers, aftercare workers, and other
appropriate support persons with information that can be used to inform
appropriate post release or transitional treatment, supervision and management
in the community.