Promoting an Outcomes-Based Treatment Milieu for Juvenile Sexual Offenders: A Guided Approach to Assessment
Calley, Nancy G., Journal of Mental Health Counseling
This article is designed for mental health counselors working with juvenile sexual offenders and focuses on the use of an integrated array of standardized assessment instruments in the treatment of this population. A sequential guide is included to aid the counselor in the identification of salient treatment issues and to promote an effective and comprehensive service utilization process and an outcomes-based treatment environment. Specific assessment instruments designed to measure general risk factors, mental health disorders, substance abuse, and family functioning are discussed. A case illustration is provided to demonstrate the use of assessment instruments in the treatment process.
Despite an increasingly enhanced understanding of factors related to juvenile sex offending, this category of offenses continues to comprise a significant portion of juvenile delinquency. In fact, data indicate that 30 to 50% of child sexual abuse cases are perpetrated by juvenile offenders (Valliant & Bergeron, 1997). This alarming statistic illuminates the need for continued research dedicated to the various aspects of treatment related to juvenile sex offending (treatment that begins with effective assessment protocols). As the complex etiology of juvenile sex offending has continued to emerge, it is now necessary to utilize assessment procedures that take this complexity into account. In fact, according to Righthand and Welch (2001), "in view of the heterogeneous nature of juveniles who have sexually offended, comprehensive assessment of individuals are needed to facilitate treatment and intervention strategies" (p. 27). While there have been contributions to the literature regarding the use of assessment instruments in the treatment of juvenile sex offenders (Prentky, Harris, Frizzell, & Righthand, 2000; Witt, Boslye, Hiscox, 2002; Worling & Curwen, 2001), the focus has largely concentrated on the use of single assessment instruments intended to identify a broad range of risk factors (Prentky, Harris, Frizzell, & Righthand, 2000; Worling & Curwen, 2001), comprehensive lists of assessment instruments designed to assess multiple clinical issues (Grisso & Underwood, 2004; Righthand & Welch, 2001), and the assessment process itself (Grisso & Underwood, 2004; O'Reilly & Carr, 2006; Worling & Curwen, 2001). As a result, there is a need for the identification of a specific array of assessment instruments designed to assess primary clinical issues associated with this population for use in treatment planning. Such an array of assessment tools may guide the mental health counselor's treatment of juvenile sex offenders and may promote an outcomes-based treatment milieu by focusing treatment directly on specific issues and lending itself more directly to the evaluation of treatment outcomes.
ROLE OF THE MENTAL HEALTH COUNSELOR
The growing body of research suggests that between 65 to 70% of youth in the juvenile justice system meet the criteria for a mental health disorder, often coupled with a co-occurring substance use disorder (Skowyra & Cocozza, 2006; Wasserman, Ko, & McReynolds, 2004). In response, Skowyra (2006) has urged that "the development of a sound screening and assessment capacity is critical in order to effectively identify and ultimately respond to mental health treatment needs" (p. 6). The significant prominence of co-occurring mental health issues of youth in the juvenile justice system requires that mental health counselors be prepared to work with this population. As mental health counselors are trained to work specifically with mental health issues, they must be able to work across a broad range of treatment environments, particularly environments in which a large population exists with mental health needs. The juvenile justice system is one such treatment environment with a significant population with mental health needs. Mental health counselors working in the juvenile justice system may treat juvenile sex offenders in residential or community-based programs as well as in the youth's home following residential placement or as an alternative to residential placement. …