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Sex Offender Treatment Board Establishes Practice Standards for Evaluation and Treatment of Sex Offenders
Sex offender therapist  
The Sex Offender Treatment Board (SOTB), one of 10 volunteer citizen boards and councils overseen by the Oregon Health Licensing Agency (OHLA), has established practice standards for the evaluation, treatment and management of juvenile, adult male and developmentally disabled sex offenders.
The SOTB, in collaboration with OHLA, established the first-ever practice standards for the profession in Oregon after initiating administrative rulemaking in March 2009.  The Oregon Legislature established the SOTB in 2007 to provide oversight for the practice of sex offender treatment.
The new standards are specified in Oregon Administrative Rules (OAR) 331-840-0070, Code of Professional Conduct, which can be found at http://www.oregon.gov/OHLA/SOTB/SOTB_Laws_and_Rules.shtml.
OHLA and the SOTB adopted the adult standards from the 2004 Association for the Treatment of Sexual Abusers (ATSA), Practice Standards and Guidelines.  A copy may be purchased by contacting ATSA at http://www.atsa.com​ or may be viewed at OHLA in Salem upon request.
The new administrative rules are effective March 15, 2010.

Focusing on the Unique Attributes of Sex Offender Treatment
"We have established these standards because traditional psychotherapy is not sufficient for sex offense-specific treatment," says SOTB Chair Dr. William Davis.  "These standards acknowledge the unique evaluation and treatment methods for adults, juveniles and those with developmental disabilities."
The new standards require that all certified and associate sex offender therapists adhere to the same practice standards and guidelines when evaluating, treating, and managing sex offenders.
Sex offender treatment is a standard condition of probation and post-prison supervision or parole for offenders who have committed a sexual crime.  Certification is currently voluntary in Oregon but uncertified sex offender therapists may not use the title Certified Clinical or Associate Sex Offender Therapist.
"I appreciate the thorough work of the subject-matter experts on the board and professionals in the field who reviewed and commented on the treatment standards," says OHLA Director Randall Everitt.  "These standards help to ensure sex offenders receive the most effective and standardized treatment while protecting the public from offenders who return and remain in the community."

Guiding Principles Provide Context of Sex Offender Treatment
Both the adult and juvenile standards include "Guiding Principles" that provide context to sex offender treatment, including:
  • "Most individuals who sexually offend will benefit from treatment oriented to reduce the risk of recidivism by using the treatment interventions shown to offer the greatest promise...."

  • "Inadequate, inappropriate, or unethical treatment is harmful to the client, damages the credibility of all treatment providers, and presents an unnecessary risk to the community."

  • "Management of the factors that contribute to sexually abusive behavior is a life-long task for many adults who sexually offend."

  • "Safe and effective intervention and management approaches for juvenile sex offenders and youth with sexually abusive behaviors:

    • Are victim centered with the primary emphasis on the safety and well-being of past and potential victims, the protection of the community and the rights of victims and their families.

    • Recognize that juveniles who sexually abuse are different from adults who commit sex offenses.  Responses to these youth must take into account these differences as well as their specific developmental needs.

    • Require collaboration of all community agencies, law enforcement, juvenile courts, mental health, child welfare, schools, and an integrated system that recognizes the importance of diverse perspectives, shared resources and mutual commitment to work together."

Standards Specialized by Age Group, Developmental Abilities
While there are common aspects of sex offender treatment standards for all client groups, such as clarification that the role of the evaluator is not to establish innocence or guilt but to determine treatment and management needs, each of the standards addresses specific issues of each client group:
Adult Standards
The adult standards include sections describing the various aspects of sex offender treatment, including:
  • Professional conduct toward clients and other professionals

  • Evaluation to determine the client's risk to reoffend and to develop an individualized treatment plan

  • Intervention strategies to assist the client to effectively manage thoughts, feelings, attitudes, and behaviors

  • Community-based risk management
Juvenile Standards
The juvenile standards describe the specific assessment and treatment methods for this age group, which focuses on conducting more frequent evaluations of the juvenile offender in recognition of the "...risk levels, needs, and circumstances of these youth and their change over time."
Evaluation and treatment of juveniles focuses more on the role of parents/guardians and levels of supervision, asking such questions as, "Are the juvenile's parents/guardians minimizing or denying the seriousness of the alleged offense?"
Under Oregon law, evaluators must obtain consent of the parent/guardian and the informed assent of the juvenile for the evaluation, unless the juvenile is 14 years of age or older.
Developmentally Disabled Standards
As with the juvenile standards, standards for evaluating and treating clients who are developmentally disabled require the evaluator and treatment provider to have sufficient training and experience for these specific populations beyond that for evaluating and treating adult clients.
Evaluations of developmentally disabled clients examine "...the interaction of the offender's intellectual or other developmental disabilities, mental health, social/systemic functioning, family and environmental functioning, and offending behaviors because of the importance of the information to planning subsequent sentencing, supervision, treatment, placement and housing, day programming and behavioral monitoring."

Concerns Raised over Use of Penile Plethysmography
OHLA and the SOTB received and considered two written comments prior to conducting a public administrative rules hearing on January 8, 2010, from the Juvenile Rights Project and a private individual.
Among other issues, both comments raised concerns over the use of penile plethysmography on juveniles and the developmentally disabled.
Penile plethysmography measures changes in penile circumference or volume in response to sexual and non-sexual stimuli, and, according to ATSA, "...provides objective information about male sexual arousal and is therefore useful for identifying deviant sexual interests during an evaluation, increasing client disclosure, and measuring changes in sexual arousal patterns over the course of treatment."
Hearings Officer Bert Krages stated in his report that "The comments indicate that there is at least some degree of controversy regarding the use of penile plethysmography on juveniles and developmentally-delayed persons. 
"Absent a more comprehensive submission of comments expressing a diversity of views in the field, the hearings officer is in no position to make a recommendation in favor or against the use of penile plethysmography...."
SOTB juvenile treatment standards state that penile plethysmography should be used only when a juvenile is post-pubescent, at least 14 years of age, and exhibits risk factors such as type and number of victims.
According to the standards, "Information and results obtained through penile plethysmography examination, shall be considered, but must not become the sole basis for decisions regarding transition, progress and completion of treatment."
"Our first responsibility as professionals is, 'Do no harm,' " says Dr. Davis. "With any type of methodology, we want to ensure that there are no abuses and that utmost discretion is used."
"OHLA and the SOTB will uphold these standards and requirements for professional conduct and client relationships," says Everitt.  "Anyone found in violation will be subject to disciplinary action."

For More Information on OHLA, SOTB, Treatment Standards
The Oregon Health Licensing Agency (OHLA) is a state consumer protection agency overseeing licensing and regulation of multiple health and related professions.
For more information on OHLA, the Sex Offender Treatment Board (SOTB), sex offender treatment standards, and other OHLA-regulated professions, visit www.oregon.gov/OHLA.