A Clinical Team consists of mental health professionals including psychiatrists, social workers, recreational therapists and aides, nurses, security aides, psychologists and counselors. The Clinical Team is responsible for designing the treatment program; providing formal treatments in the form of groups, classes, and psychotherapy; and individual treatment planning. Representatives from all areas meet regularly as a Treatment Team. This Treatment Team works together to design, provide and monitor a committed resident's plan of treatment. While custodial workers and dietary workers are not directly on the treatment team, they are still considered part of the overall ward milieu and as such may be consulted and have input into the overall treatments offered to residents as may be impacted by environment and supportive services issues.
Detainee residents are individuals who have not been committed as sexually violent predators. The law says that those awaiting a trial must be held in a secure environment which could include a county jail. Detainees are sent here by a judge, are awaiting trial and have a right to expect courteous behavior and consideration from staff. Security concerns require that this facility have rules, regulations and policies which are not commonly found in other mental health facilities. There are also some limitations on SORTS because it is a maximum security facility. Yet, because this is a mental health facility, SORTS does not function as a jail. Detainee residents are expected to become responsible members of the community here, and the rules and regulations aim at supporting that goal. Many detainee residents have difficulties understanding this goal, and feel frustrated initially. Basic medical care and mental wellness activities are offered to all detainees. Persons needing acute mental health services will also be provided service.
Once committed to the program for treatment, members of the treatment team meet individually with a resident in order to assess the areas in which the resident needs treatment. When the assessment has been completed, the team drafts an Individual Treatment Plan (ITP) and meets with the resident to get his or her reaction to it and make whatever changes are necessary. The ITP indicates the groups, classes and sessions that the resident needs to attend along with specific objectives for all these activities. The ITP is not a one-time document; instead, as the resident changes and situations change, the plan will be updated.
Treatment consists of group therapy, classes and activities along with individual therapy sessions. Group is the preferred mode of treatment as in groups people realize there are others with similar problems and confrontation and feedback can be offered more effectively. A lot of educational material can be offered in a group setting.
Basic Minimal Goals of Treatment
This facility utilizes a cognitive-behavioral treatment model guided by a relapse-prevention approach. The program is designed to help the resident meet the following goals:
- Accept full responsibility for sexual offending and its consequences.
- Gain control over deviant sexual urges and behavior.
- Recognize thinking errors and correct thinking errors.
- Identify and learn to cope with negative emotional states that put one at risk for re-offending.
- Address norm-violating behaviors in the past in order to clarify values and behaviors with goal of pro-social behavior.
- Identify offense cycle, identify daily behaviors related to a persistent and pervasive lifestyle that maintain the offense cycle and high-risk behaviors in concrete terms and acquire coping skills/intervention to prevent relapse.
- Demonstrate empathy for victims and present detailed scenario from victim/other's point of view.
- Resolve issues from childhood and understand their effect on functioning.
- Develop plan for functional use of leisure time.
- Be able to interact in a non-exploitive, socially appropriate way and have ability to establish emotionally healthy relationships.
- Understand and manage conditions such as substance abuse, stress and psychiatric illness.
- Develop functional support system and sound relapse prevention plan.
The length of treatment depends on the resident. Many residents mistakenly focus on release by the courts from their first day of treatment. This delays their progress in making the changes necessary for them to become fully-functioning members of society. The critical aspect of treatment involves internalization, integration and application of both classroom material and individual feedback. Treatment for sexual offending involves far more than simple classroom participation. Just as some people can learn to drive with only a few lessons, safe, defensive driving requires a much longer time. All residents must complete the core program. Additional individualized work will be required in order to demonstrate internalization, integration and application of both classroom material and individual feedback.