1. (a) The sexual offender treatment recommendations identified by the department shall be:

   1. (1) Community- based treatment;
   2. (2) Prison-based Intensive Sexual Offender Services (ISOTS); or
   3. (3) No treatment.
2. (b) Community based treatment shall include group therapy, both process oriented and psycho-educational, journaling, workbook completion, homework assignments, and other projects. Participants shall live in the prison community and shall meaningfully participate in community and community meetings.
3. (c) ISOTS shall include group therapy, both process oriented and psycho-educational, journaling, workbook completion, homework assignments, and other projects. The participants shall live together in a therapeutic community.
4. (d) The participant shall meet with their primary therapist upon entry into the treatment service to review treatment expectation, sign a treatment contract and confidentiality waiver, and review treatment rules.
5. (e) An ITP shall be established with the participant.

6. (f) ITPs shall include at a minimum:

   1. (1) The participant’s identifying information;
   2. (2) Treatment needs;
   3. (3) Goals and objectives; and
   4. (4) Identification of any necessary ancillary services to meet the specialized needs of each participant.
7. (g) Prior to admission into SOTS, the resident shall begin attending recommended behavioral health groups as part of his or her treatment plan.

8. (h) The resident shall be referred for participation in groups such as:

   1. (1) Cognitive behavior therapy;
   2. (2) Coping skills;
   3. (3) Dealing with trauma;
   4. (4) Socialization;
   5. (5) Victim empathy;
   6. (6) Anger management; or
   7. (7) Drug and alcohol treatment.
9. (i) All residents who enter the SOTS shall be administered the Prison Rape Elimination Act (PREA) potential for sexual assault or sexual victimizing screening instrument and housed accordingly.
10. (j) SOTS therapeutic services shall be offered in accordance with an ITP. If the resident is identified with any intellectual disabilities or requires medically restricted housing, a modified ITP shall be established.
11. (k) A resident with multiple treatment needs shall have a collaborative treatment plan established inclusive of areas such as substance use, behavioral health, and psychiatric needs.
12. (l) SOTS staff shall be responsible for determining completion of goals and providing feedback to the resident on how to better achieve goals.

13. (m) Sexual offender treatment shall be documented in the electronic health record using the progress note, group note, treatment plan, and discharge summary, including such documents as:

    1. (1) The assessment;
    2. (2) Polygraph or other validated technologies; and
    3. (3) Disclosure or administrative tools.
14. (n) Treatment plans shall be updated at least every 6 months or when goals are attained or require modifications based on the resident’s needs. Treatment plans shall also be updated when entering into the next phase of treatment.
15. (o) SOTS shall utilize a holistic approach to treating sexual offenders that includes a combination of cognitive behavioral therapy, psycho-educational components, and the treatment of co-morbid conditions. Emphasis is placed on addressing trauma and its impact on emotional, social, psychological and sexual adjustment.
16. (p) Residents in SOTS shall participate in clinical therapeutic groups and psycho-educational treatment aimed at the specific treatment needs addressed in their ITPs. In addition, residents shall participate in other behavioral health treatment, substance abuse treatment, as designated in their ITPs. Residents shall also complete a number of different homework assignments, journaling assignments, and projects during treatment.
17. (q) In their core clinical therapeutic groups residents shall address key components of his or her offenses and work on issues of accountability, responsibility, identifying and challenging distorted thinking, identifying and coping with feelings and inappropriate or maladaptive coping skills, developing a positive self-concept, increasing effective emotional management and establishing and maintaining trusting, supportive and equitable intimate relationships. Residents shall identify the patterns of behavior that lead to their offending.
18. (r) Caseloads shall be entered in the electronic client record for ongoing informational sharing and awareness for re-entry planning. The electronic client record shall also be used to document movement in SOTS for purposes of case management. Clinicians shall update this information, for instance when someone has transitioned out of SOTs whether it be due to being removed or because he or she has been issued a discharge summary.
19. (s) Quarterly progress reviews shall be conducted with the participant and documented on his or her treatment plan.
20. (t) The primary therapist shall complete clinical progress notes for each participant on the therapist’s caseload. Post treatment encounters shall be documented in the electronic health record.
21. (u) All discharges from sexual offender treatment services shall be documented by the primary clinician within 5 days of program completion.
22. (v) Community-based treatment shall be the recommendation for a resident upon release to parole or other community-based supervision.
23. (w) If an assessing clinician is recommending a resident for community–based treatment following the assessment, the resident shall be referred for additional screening as necessary to complete the assessment and recommendations. Once the assessing clinician determines that a community treatment referral is warranted, this outcome shall be reviewed by the administrator of SOTS and the deputy director of forensic services for thoroughness and concurrence.
24. (x) If the recommendation is approved, a treatment plan shall be developed for participation in behavioral health groups to address any treatment needs of the resident while waiting for release into community-based treatment services.
25. (y) The resident shall also participate in continuing treatment until released. If at any time during continuing treatment a clinician identifies a behavioral status change, acquires additional information with regard to the resident’s engaging in risky sexual behaviors, or is provided additional collateral information which is a cause for concern, a new assessment will be completed using gender validated tools as appropriate.
26. (z) All residents, who post an assessment by a department clinician and which receives a recommendation of community-based treatment shall with a SOTS clinician’s assistance establish an appropriate individualized treatment plan. If the resident fails a polygraph or shows deception, he or she shall be placed in ISOT to receive more intense treatment.

Source. (See Revision Note at chapter heading for Cor 500) #12793, eff 5-25-19