So you have been asked to admit a new client to your sex offending treatment program.? Only problem is s/he is in a pre-trial status, or even voluntarily seeking admission at the advice of an attorney or after a search warrant or some other legal action has been initiated.? With no conviction or pre-sentence report to justify admission, what are your options?
First, it is the standard of care to only admit into sex offender treatment those who have been proven or admit to such behaviors.? Completing an actuarial risk assessment is also considered accepted practice.? Neither of which can ethically be done without some third-party corroboration; namely the criminal justice system.? This is because the law requires mental health professionals to work in the best interest of the client.
When receiving funding from the criminal justice system an agency is also signing up to work in the best interests of the community.? To balance these will require the mental health professional to have a clear sense of the legal and ethical (not always the same thing!) responsibilities involved.
So, what is the answer?? There are two stages.
One approach that is used in our program is to never have the client work against his/her own best interests.? The client signs a confidentiality waiver releasing our staff to talk to individuals in the criminal justice system about what s/he says concerning any sexual offending behaviors s/he may have ever engaged in.? A discussion ensues about their rights and our responsibilities to them and to the referring agency.? If the client does not want to sign the release, we are unable to proceed with the treatment.? The client has rights and we can?t violate those rights in an attempt to shoehorn a client into the program at an outside organizations request.
Once the waiver is signed, it is explained to the client before any assessment that s/he has the right not to incriminate himself and should not reveal anything illegal to us without understanding it will be reported to the criminal justice system as they have just released the agency to do so.
2. Providing Services.
If the client has chosen to admit to sexual offending behavior voluntarily and prior to arrest and/or conviction, then s/he is admitted into the treatment program.? This is quite rare except when a plea bargain has been arranged and the client is certain it will be accepted.? This is often done much later in the pre-trail status of the client.? So initially, you will most likely have a client who is not admitting; and ethically can?t be compelled to do so.
CDTC has developed an education track within the program to allow for such situations.? Many of the?requirements of the treatment program are removed and the client is free to be apart of group working on a separate curriculum.? The education track exposes the client to many important concepts including criminal thinking errors, sexual offending cycle, relapse prevention skills, and the stages of change model among other things.
The client and referral source are given letters explaining the procedure and emphasizing that this service is in no way a substitute for treatment and does not mitigate in any way the client?s risk for re-offending in the community.? Unfortunately, most referral sources are referring clients to sex offending treatment programs to do exactly that; to mitigate their liability while the client continues to reside in the community.? However, it does allow the funder some recourse by referring the client to mental health professionals who will take what actions are ethical and legal concerning the client.
What do you think?? How would you handle this situation?