Current Treatment Services
The clinical components of the SAFE Program include:
- Assessment and diagnostic procedures
- Treatment modalities: individual sessions, group sessions, family sessions
- Clinical consultation to the SSU staff
- Evaluations with the SAFE Program Psychiatrist
- Coordination or liaison with local agencies serving the family
Contracted Assessment and Intervention services
SAFE can also contract with an agency or program to conduct specialized assessment evaluations with treatment recommendations and/or individualized treatment services. Our program welcomes the opportunity to serve as a resource to our community and other service providers.
Assessment and Diagnostic Procedures
The child or adolescent with problematic sexual behaviors and his/her parent(s) participate in a comprehensive diagnostic assessment before treatment (Intake) and after treatment (Discharge). The assessment framework utilized by the SAFE program examines several domains (e.g. individual, family micro-system, community exo-system, cultural social macro-system). The intake and discharge assessments are conducted by a Clinician and a Research Associate (RA). The assessment assesses clinical symptoms consistent with the DSM-V diagnoses, including suicidal ideation and homicidal ideations, abuse history, delinquent behavior, parental discipline, peer relationships, problematic sexual behavior disclosure and sexual history, school progress, and motivation.
Treatment plans are informed by a comprehensive assessment, documenting the role of individual and family problems in the problematic sexual behaviors (i.e. ADHD, poor impulse control) and related to community adjustment; and are reviewed every three months with the family. The program addresses common themes associated with problematic sexual behaviors (e.g., behavior problems, family relations, peer relations, academic performance). Thus, all clinical assessment and program monitoring data are used to identify individualized treatment targets, document treatment progress and needs, and determine the response of each child and adolescent to these clinical services.
Individual Treatment Sessions/Services
Individual sessions are provided to the child or adolescent to address other treatment topics not covered in group, to expand on the group topics, and/or to review topics requested by the child or adolescent and his/her parents (e.g., preparing for mid-term court hearing). Some of the topics covered in individual sessions include, but are not limited to: thinking errors, life history/sexual history timeline, clarification/disclosure, relapse prevention plan, who to tell about the problematic sexual behaviors and how to deal with this incident, responsibility/apology. Other topics include victimization, school issues, peer issues, family problems/communication, mental health issues and other topics as identified throughout treatment. Medication trials are also available as needed from our forensic psychiatrist. Communication with parents is ongoing throughout treatment. In general, clinicians ask parents/caregivers/legal guardians to provide information about how the child or adolescent is doing both at home and at school and other treatment-relevant behaviors.
Group Treatment Sessions
The SAFE/SSU collaborative program includes a 1.5 hour weekly psycho-education group ranging from 7 to 9 months for all the youth deemed appropriate for this modality. This group addresses the child and adolescent problematic sexual behaviors and also works on building skills in order to successfully navigate the world. Groups are run by both SAFE clinicians and SSU probation officers who work as a team in order to provide comprehensive services and supervision.
A total of seven parent psycho-educational groups are held alongside the adolescent treatment group. All of these groups are facilitated by the SAFE treatment clinicians. This group is an opportunity for parents/caregivers to gain support from one another and to learn how to best support their children during treatment and after treatment. This group intervention is an effort to accelerate change and aid in their understanding of several topics such as: the problematic sexual behaviors, the treatment their children are receiving, the family’s role in treatment, how to deal with the disclosure, their child’s motivation of the problematic sexual behavior, thinking errors, empathy for the victim, how to improve supervision, how to support their children during and after treatment, and what happens during the clarification session between them and their child.
As needed during treatment, the SAFE clinician will schedule family sessions. Some of the topics discussed during these sessions include: the impact of the problematic sexual behaviors on the family, how the family can support the child/ adolescent after treatment ends, how to better communicate with each other, how the family can reduce their denial and minimization of the problematic sexual behaviors, how family members can support the client and his relapse prevention plan. Before treatment ends, a clarification of the problematic sexual behaviors’ session is scheduled between the client and his parents. Clients and parents are prepared for this clarification session during individual sessions.
Clinical Consultation to the SSU Staff
In order to coordinate between the justice and mental health systems, weekly collaborative treatment team meetings are held with the SSU probation officers to review program and case progress, and quarterly interdisciplinary program meetings are held to discuss case progress, obstacles, and plans. The SSU probation officers are directly involved in the assessment and treatment of children and adolescent with problematic sexual behaviors, as well as in developing case formulations and treatment recommendations. They participate in the delivery of treatment services by co-facilitating the group, meeting regularly with clinicians, jointly reviewing outcomes, and developing discharge plans, and completing discharge evaluation ratings.
Evaluations with the SAFE Psychiatrist
After the intake assessment, at any time during treatment, and after the discharge assessment the SAFE treatment clinicians can consult with the SAFE Medical Director regarding diagnosis, and medication concerns. While in the SAFE Program, the child or adolescent can be seen by the SAFE psychiatrist for medication evaluation, medication management, or for any other clinical concern.
Coordination/Liaison with Local Agencies Serving the Family
Treatment at the SAFE Program might be the primary treatment setting for the children and adolescents, but we understand that some of our clients may require other specialized treatment services. We assist the family with referrals to other treatment services in their communities. We coordinate treatment services during treatment and prior to discharging a case. We schedule treatment providers meetings in order to meet the other service providers and discuss the services our clients are receiving, treatment goals, and any obstacles the client or family might have that can prevent them from their full participation in treatment.