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What? In My Neighborhood?

What? In My Neighborhood?. Assessing Sexual Offenders Inmates for R esidential C ommunity - B ased A ddiction T reatment RC-BAT Peter R. Cohen MD, Medical Director, ADAA April 29, 2010. Why Do We Have to Consider Violent Sexual Offenders for RC-BAT?. It’s the Law!!!

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What? In My Neighborhood?

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  1. What? In My Neighborhood? Assessing Sexual Offenders Inmates for ResidentialCommunity-Based AddictionTreatment RC-BAT Peter R. Cohen MD, Medical Director, ADAA April 29, 2010

  2. Why Do We Have to Consider Violent Sexual Offenders for RC-BAT? It’s the Law!!! • The right to petition for reconsideration of sentence, except for childhood sexual offenders • Requesting an 8-505 order for a substance abuse evaluation

  3. What are We Assessing? • The Risk for Repeating Sexual Offenses? NO • What is my clinical opinion of the ability of the offender to benefit from community-based treatment? • Is the offender amenability for treatment in a community-based facility? YES

  4. What Is Convincing? The Walk, Not the Talk The 4 C’s of Inmate's Behavior A Pattern of… • Cooperation • Compliance Following Institutional Rules • Commitment To Treatment • Confluence of Reports What the Police Reported vs. What the Convict Describes

  5. Why Does the Inmate Need to Show a Pattern of Following the 4 C’s? • Community-based therapeutic residential settings are not prisons • The 4 C’s are an essential ingredients for effective therapeutic community treatment • ASAM Level III.3 residential treatment is not designed to treat persons with severebehavior disturbances or psychiatric problems.

  6. Why Are You Making Me Do So Much Work? • The nature of RC-BAT & Safety Other residents, their children, being housed in the same program and are located in near a neighborhood • Research and professional consensus says… There is a need for combined treatment for sexually offending behavior and addiction

  7. Why Are You Making Me Do So Much Work? • But…alcohol and drug use is never a stand-alone explanation for sexually offending behaviors • And…there is no Maryland RC-BAT program that also provides expert, specialized sexual offender treatment

  8. Why Are You Making Me Do So Much Work? • And…Treatment for addiction is not a substitute for sexual offender treatment • And…Sexual offender treatment outcomes are disappointing • Significantly more treatment and outcomes research is needed • Current research: the overall reduced rate for reoffense =10 - 17 %

  9. Why Are You Making Me Do So Much Work? • Finally… TREATMENT FOR ADDICTION IS NOT MEANT TO BE A SPECIALIZED FORM OF INCARCERATION IN THE COMMUNITY Persons must demonstrate a pattern of following the 4 C’s to predict that they will behave appropriately in the program and not inappropriately in the community

  10. What Do You Need to Do?Slow Down the Action STEP 1: REVIEW • The police report of the inmate's sexual offense, related to the sentence or because probation or parole has now been violated • Past discharge summaries of substance abuse and other behavioral treatment episodes : successful or unsuccessful • The history of any incarceration-based infractions

  11. What Do You Need to Do? STEP 2: DISCUSS with the inmate this history to ascertain the following: • The inmate's motivation to control such behaviors • The level of self-observation and self-concern • The actual history of attempting to make amends or change such past behaviors 

  12. What Do You Need to Do? • STEP 2: ASK 5 Basic Open-Ended Questions • What have you learned since your convictions related to ______ (specific offense)? • (With regards to sexual offenses) What action have you taken to change your behaviors around females or males? • What is your opinion (or what do you think) about what happened during your crime? • (With regards to incarceration-based infractions): What is your opinion (or what do you think) about your getting this infraction (or these infractions)? • Have you ever had treatment or needed to receive treatment for… (your sexually offending behaviors or your violent behavior)?

  13. What Do You Need to Do? • STEP 2: DISCUSS and ASK • Have you ever had treatment or needed to receive treatment for… (your sexually offending behaviors or your violent behavior)? If yes, then… • Did you show up for treatment? • Did you complete treatment? • What did you learn?  • If you didn't complete treatment or show up, why not?

  14. What Do You Need to Do? STEP 3: FILE this information in the legal notes section of the TAP summary After gathering this additional information and before submitting the 8-505 report to the court …

  15. What Do You Need to Do? STEP 5: “STAFF THE CASE” and SUBMIT • “Staff the case” with his or her supervisor • Submit a draft of the evaluation and cover letter to the ADAA for review. 

  16. What Do You Need to Do? STEP 6: FINALIZE the case with the ADAA within 24 hours STEP 7: SEND YOUR RECOMMENDATION

  17. What Do You Need to Do? STEP 7: SEND YOUR RECOMMENDATION • Community-based treatment is or is not recommended • If appropriate for addiction treatment, but not for RC-BAT: state just that, but do not recommend any specific treatment or facility or location

  18. What Do You Need to Do? STEP 7: SEND YOUR RECOMMENDATION • Please note: A judge cannot write an 8-507 order for incarceration-based treatment. It is up to the discretion of the incarcerated setting.

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