SRSTC: Treatment Programs

The risk principle requires concentrating more intense treatment on higher risk offenders. This principle is easy for SRSTC to follow since individuals deemed to be low risk would not be committed under Chapter 980 to SRSTC.

The need principle requires that treatment be focused on social and psychological factors that predisposed to offending. SRSTC identifies these factors through the treatment process using a research-based framework.

The responsivity principle requires using treatment methods to which offenders are generally responsive and tailoring treatment to the learning style of the individual. SRSTC seeks to tailor treatment to the learning style of the individual through the use of four treatment tracks and individualization within track based on detailed assessment. The methods used include cognitive behavioral therapy and motivational interviewing.

Phase 1 programming works with patients in meaningfully engaging in the treatment program. It focuses on assisting patients in building the attitudes, skills, and motivation that are necessary for effective treatment participation. Phase 1 helps patients learn to better regulate their impulses and emotions.

Phase 2 programming works with patients to develop a shared understanding of their specific treatment needs, including an understanding of the factors that contributed to their past offending. During this phase patients work on seeing in a more objective way how these factors have affected them in the past and how they continue to affect them now. Achieving this requires attending specifically to the thoughts, attitudes, emotions, behaviors, and sexual arousal linked to their sexual offending and learning to recognize when these thoughts, emotions, behaviors, or sexual arousal occur. As patients become aware of the impact of these factors therapists assist them in discovering and developing the determined motivation required to overcome these problems.

Phase 3 programming works with patients to assist them in effectively managing their personal risk factors and developing healthier ways of functioning in order to transition to the community. Within each of these defined phases patients advance if and when they demonstrate satisfactory progress in the earlier phases.

The Conventional Treatment Track is designed to treat patients without significant cognitive deficits and with no more than moderate levels of psychopathic traits. This does not mean that patients in the track are homogeneous. IQs can range from the lower end of the average range to those who have superior intelligence. Patients in this track range from individuals in which psychopathic traits are largely absent to those in which moderate levels of these traits are present. This requires that treatment services be significantly individualized within the track.

Although patients in this track tend to be less impaired than those in the other tracks this does not mean that the psychological risk factors underlying their offending are necessarily less marked. Treatment in this track is more similar to treatment that would be provided in high intensity Department of Corrections programs.

• Phase 1 focuses on self-management and learning how to participate in treatment.
• Phase 2 focuses on patients learning to understand themselves through life history review and analysis of past offenses.
• Phase 3 focuses on living in a healthier way and community preparedness.
   

The Corrective Thinking (CT) Treatment Track is designed specifically for offenders with marked psychopathic traits and normal levels of cognitive functioning. Individuals who display psychopathic traits are difficult to treat but are treatable. These individuals require a treatment approach that can initially address the personality disorder traits that interfere with the conventional treatment process and simultaneously monitor and address these traits during the conventional aspect of sex offender treatment.

• Phase 1 focuses on psychopathic features, personality disorder traits, and general criminality and helping the patient manage the behaviors associated with these characteristics.
• Phase 2 focuses on the patient learning to identify the individual psychological factors that contributed specifically to their past offending and demonstrating motivation to work on them.
• Phase 3 focuses on the patient working to manage their identified sexual offense risk factors and developing healthier functioning.

ACT is designed to address the individual treatment needs for a unique and specialized population. This population has treatment needs in some or all of the following areas:

• Offense-related thoughts, feelings, attitudes, beliefs, behavior, and sexual interests
• Cognitive deficits related to intellectual disabilities, learning disabilities, and/or traumatic brain injury
• Serious and persistent mental illness
• Significant trauma history and trauma symptoms

These needs create unique challenges that require responsive approaches to providing treatment. As each patient has individual needs, treatment is tailored to meet the needs and approaches that work best for each person. Examples include adjustments to pace, presenting information in multiple ways, emphasizing concrete and specific examples rather than abstract concepts, repetition, role-play exercises, mentoring, expanded use of individual treatment, and offering additional support.

• Phase 1 focuses on treatment engagement, where the goal is for patients to develop a therapeutic alliance with facilitators, learn the skills necessary to engage meaningfully in the treatment process, and demonstrate behavior stability.
• Phase 2 focuses on the identification of individual treatment needs, including those factors that have contributed to offending in the past and could again in the future, as well as those factors which protect the individual from risk. Emphasis is placed on recognizing and managing risk, learning healthy coping strategies, and demonstrating motivation to make use of those strategies.
• Phase 3 focuses on healthy lifestyle, where the goal is for patients to demonstrate and practice consistent risk recognition, effective management strategies, pro-social lifestyle and relationships, as well as preparing for reintegration into the community.