As a supervisor, I assume that therapists have command of basic psychotherapy skills.  I also recognize that treatment of special populations requires special skills that are often not developed within the parameters of standard Masters and Doctoral programs (although an education on that level is essential for learning and mastering essential treatment templates).  These special skills are represented by the following standards, all of which I believe should be included in basic training and orientation for new and established staff.  Staff under supervision are expected to develop and/or maintain these standards within the parameters of their job descriptions and responsibilities.

Requiring hundreds of hours of therapy as is more the case in other countries and in the highest levels of training

THE STANDARDS

1.     GROUP THERAPY;  GROUP PROCESS;  INDIVIDUAL, AND FAMILY THERAPY SKILLS:  This means attending to the underlying group process, not simply conducting individual therapy or confrontation in a group context.  It also means the ability to meet a client's needs in many dimensions as well as the ability to recognize those needs.  This includes ongoing and regular supervision to help determine whether client schemas are properly deciphered and treatment methods are hitting the mark.  Mindell’s Process Work is especially useful:  Sitting in the Fire.

2.     WORKING KNOWLEDGE OF DSM V:  EMPHASIS ON PERSONALITY DISORDERS, MOOD DISORDERS, SEXUAL DISORDERS AND SUBSTANCE ABUSE:  Personality disorder traits are extremely common in our clients and knowledge and ability as to how to manage those traits in therapy is essential.  Being able to recognize the need for medications, CD treatment and other special needs is crucial for treatment to be successful.  Schemas……..

3.     UTILIZATION OF PSYCHOLOGICAL AND DIAGNOSTIC ASSESSMENT:  Therapists, whether or not they have expertise in administering and interpreting assessment materials, must be able to translate the diagnostic and assessment data into clinical strategies, treatment goals and language useful to the therapist-client interaction and make use of these resources regularly.  Therapists should be famiiar with MCMI-IV subtypes and their role in formulating treatment strategies.

4.     WORKING KNOWLEDGE OF DECEPTION AND THE CRIMINAL MIND:  Knowing the limitations of the problem-solving and support-oriented therapeutic modes in sex offender treatment.  Includes an awareness of relevant features of forensic psychology.  The ability to work in an adversarial relationship and to be able to identify features of the criminal mind that are impacting the work.

5.     KNOWLEDGE OF STANDARD SEX OFFENDER TREATMENT ELEMENTS: Relapse prevention and self-regulation models; offense chains, cycles and process models; Good Lives; dynamic risk needs; responsivity; schema therapy; typologies; strength-based approaches; theories of cognitive distortions and the origins of sexual deviancy; Cognitive-Behavioral Approaches, Addiction Model, Risk Assessment and Management, The Sex Offender Literature, The Role of Corrections, The Relevant Laws and Statutes, Treatment Dynamics of Physical and Sexual Abuse.  This includes the ability to defend one's individual, as well as one’s agency's, approach to Sex Offender Treatment in venues outside of treatment, such as court appearances and public discussions.

6.     WORKING KNOWLEDGE OF AGENCY THEORY, GOALS, POLICIES AND PROCEDURES: Must be familiar with the staff training manuals and client workbook and study materials - whatever is currently in use in your agency.

7.     WORKING KNOWLEDGE OF RESPONSIVITY TECHNIQUES, INCLUDING  USE OF IMAGINATION, METAPHOR, HUMOR, FILM AND LITERATURE & OTHER TEACHING TOOLS, and, INCLUDING HERMES’ WEB:  The ability to engage clients through drama and humor and collective images is often crucial to treatment success, albeit humor that is not at the expense of clients or other staff. Must have ability to follow-through on issues, perspectives and language raised in the responsivity/orientation training/modules clients undergo.

8.     WORKING KNOWLEDGE OF PSYCHOPATHY: including the Hare Psychopathy Index/PCL-R, and the ways in which psychopathy or sociopathy can interfere with effective treatment.  The HARE should not just be used for cut-off scores, but using the quadrants to determine in which areas treatment should begin. 

9.     WORKING KNOWLEDGE OF ADJUNCTIVE THERAPIES:  POLYGRAPH, PHALLOMETRIC/ABEL, EMDR & MEDICATIONS:  Although not able to administer or evaluate need, must understand principles of operation and clinical procedure and how to utilize data that results from any of these interventions and be able to explain and defend their use to clients and outside parties.

10.  PSYCHOLOGICAL PRINCIPLES:  WORKING KNOWLEDGE OF APPROACHES THAT PROVE USEFUL IN OUR TREATMENT CONTEXT:  Object Relations, Developmental Psychology, Psychodynamic/Psychoanalytic Approaches, Systems Approach, Cognitive-Behavioral, Early Attachment Issues and others. 

11.  WORKING KNOWLEDGE OF TRANSFERENCE, COUNTER-TRANSFERENCE ISSUES: This includes a working knowledge of the clinician’s own edges and requires that you know what your own raw materials are and how and where new information plugs in and integrates.  This includes the willingness and ability to bring these issues into supervision and seek outside assistance for any issues that exceed the scope of supervision.

12.  WORKING KNOWLEDGE OF SEXUALITY ISSUES:  ANATOMY, PHYSIOLOGY, PSYCHOLOGY, INCLUDING TOUCH, BODYWORK, PORNOGRAPHY AND FANTASY.  A high comfort level in all these areas is essential, including awareness of the personal impact of each of these issues.

13.  WORKING KNOWLEDGE OF CULTURAL  DIMENSIONS OF TREATMENT:  Ethnic and Racial Issues (African-American, Native American);  Social, Legal and Political Dimensions;  The Internet;  the Media; The Role of Poverty.

14.  WORKING KNOWLEDGE OF THE SPIRITUAL DIMENSIONS OF TREATMENT:  Comprehensive treatment acknowledges the importance of addressing the spiritual dimension of treatment.  Each primary therapist needs to find their own way to address these issues, especially when religious or spiritual issues conflict with treatment objectives.  Discernment is also critical in terms of knowing when spiritual or religion may be utilized as a defense or shield against accountability and treatment.

15.  WORKING KNOWLEDGE OF CRIMINAL JUSTICE SYSTEM AND REFERRAL SOURCES:  Restorative Justice and Community Dimensions; Community Notification;  DOC/DHS/agency and Probation Department Procedures;  Sentencing Structures and Definitions;  Courtroom Etiquette.

16.  CONSISTENT DEMONSTRATION OF TREATMENT PLANNING AND EXECUTION SKILLS:  The ability to blend all dimensions of a client's reality with all the information we have collected and create a workable plan and case formulation that will move along effectively in a timely fashion.  Must be reflected in ongoing charting and record-keeping so that the plan and its effects are evident to an objective reader.

17.  CONSISTENT DEMONSTRATION OF TREATMENT EVALUATION SKILLS:  Ability to conduct intake, pre-sentence and special evaluations to determine clients' treatment needs.  Must demonstrate capacity to discriminate levels of need, discriminate between treatment options and create treatment recommendations that accord with the level of risk and difficulty that a particular client represents.

18.  BASIC REPORT WRITING SKILLS:  Requires elocution, good spelling, organization of ideas, good sentence structure and ability to discern what facts and opinions are necessary to create a good report.  Ability to adjust to different audiences is also essential.  All reports written should be suitable for challenging in court.

19.  MAINTAIN PROFESSIONAL SPECIALTY, INCLUDING MEMBERSHIP IN PROFESSIONAL ASSOCIATIONS SUCH AS ATSA,  SOCCPN & MnATSA:  track web pages, list serves, position papers, current literature, etc.  Attend conferences and special trainings.

1. MAINTAIN AN UNDERSTANDING ON DE-INSTITUTIONALIZATION AND TRANSITIONAL ISSUES: understand how these issues will play out in creating an effective maintenance plans, a “living document” that will carry clients successfully out into the community.

1. WHILE MAINTAINING ALL OF THE ABOVE, BE A TEAM PLAYER AND ADD TO THE CLINICAL STRENGTH AND EFFECTIVENESS OF YOUR TEAM, RECOGNIZING BOTH YOUR STRENGTHS AND LIABILITIES AND PLANNING AND EXECUTING YOUR WORK ACCORDINGLY:  whether in outpatient treatment, or even more so in residential/correctional treatment, being a team player is essential.  Intra-team conflicts are inevitable, but need to be identified and addressed quickly and resolved.  Clients are astute in sensing weak spots and targeting them and any clinical team will be in a group process parallel to that of the client or treatment community – a process which needs constant monitoring and maintenance.

YOUR PARTICULAR JOB DESCRIPTION AND AGENCY DUTIES WILL PLACE DIFFERENT DEGREES OF EMPHASIS ON EACH OF THE ABOVE STANDARDS.  IT IS MY BELIEF THAT TOP-LINE THERAPEUTIC INTERVENTIONS NEED TO DRAW ON ALL THE ABOVE SKILLS AND KNOWLEDGE IN ORDER TO BE EFFECTIVE WITH THE DIFFICULT CLIENTELE WE FACE, AS WELL AS CONTEND WITH OUR UNUSUAL POSITION IN THE EYE OF THE PUBLIC.