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Sex Offender Rehabilitation and Treatment Services

The Sexual Offender Rehabilitation and Treatment Services (SORTS) was established in 1999, under what is commonly referred to as the Sexually Violent Predator (SVP) Act, to offer sexual offender treatment to those who meet certain criteria, including a history of sexually violence offenses.* As of April 2008, over 140 residents resided at this maximum security facility, on seven wards. Among those, the most common DSM Axis I diagnoses are the paraphilias; many of our residents also carry Axis II diagnoses, predominantly Antisocial and/or Narcissistic, or Personality Disorder NOS with antisocial and/or narcissistic features.

SORTS offers a range of opportunities to interns. Should you choose this adjunct rotation, you will be working with individuals with severe personality disorders, and some psychopathic individuals-populations rarely accessible through outpatient and most inpatient settings. We believe working with these individuals, and our treatment team, will help you develop and hone new theoretical and skill sets that will serve you well, regardless of your future plans. SORTS also offers the opportunity to work with a truly diverse multidisciplinary team. Because we are a residential facility, you will probably have contact with someone from every facet of our organization at some point in your rotation; we believe every department at SORTS plays a valuable role in the treatment of our residents. In addition, SORTS provides additional education in sexual offender treatment and assessment-such as the psychology department's biweekly "Lunch and Learn" program, in which relevant materials are reviewed and discussed. Interns also have access to our growing library of multimedia materials in this area.

TREATMENT PROGRAM OVERVIEW Our mission is "to protect the citizens of the State of Missouri by securely detaining and effecting positive change through integrated state-of-the-art mental and physical health care in those with a history of sexual offenses. We are dedicated to enabling our residents to become productive members of the community and their families without further victimizing others." In a nutshell, our goal can be expressed as "No more victims."

To that end, our treatment program is built on a biopsychosocial model that incorporates into treatment multiple elements as contributors to sexual offending. Our psychotherapeutic model operates on the core elements of: 1) cognitive-behavioral principles, 2) personal responsibility for past and current behaviors, and 3) compassion and a genuine belief in the resident's capacity for change.

The treatment program consists of four Phases. Each Phase builds on the skills and principles gained in previous Phases, while introducing new challenges and expectations:

PRE-ENGAGEMENT/ENGAGEMENT: These residents are typically either new to SORTS treatment or have not yet demonstrated a relatively consistent commitment to change. Target topics for this Phase include learning to respond appropriately to rules and authority, admitting one is a sex offender in need of treatment, learning the basics of SORTS treatment, and making healthier leisure choices.

COGNITIVE RESTRUCTURING: Residents at this stage of treatment are considered to have met the expectations of the Pre-Engagement/Engagement Phase, including commitment to change. Target issues for this Phase include increasing awareness of the thoughts/feelings/behavior process and thinking patterns, disclosing offenses and developing personal offending cycles, and beginning to address the emotional states associated with their offending and other unhelpful behaviors.

EMOTIONAL INTEGRATION: This Phase of treatment focuses on addressing the elements that we believe lead to long-term change - making substantive changes in leisure activities and attitudes toward same, accepting and learning appropriate coping strategies for all emotional states, and dismantling unhelpful core beliefs. This Phase also expects residents to discuss past unhealthy relationships and begin to learn and practice developing appropriately intimate relationships with staff and peers.

COMMUNITY REINTEGRATION:This Phase is still "under construction," but as the name suggests, will focus on mastering the skills needed for a return to the community through gradually decreasing levels of supervision and restriction. Planned activities of this phase also include college courses, finding meaningful work and housing outside the facility, family therapy, development of relapse prevention plans, and developing support networks.

OPPORTUNITIES AND ACTIVITIES OF SORTS INTERNS A typical day at SORTS may involve:

Individual therapy session
Co-facilitate/facilitate Thinking Errors group
Lunch and Learn
Individual therapy session
Documentation/Assessment/Report Writing
Supervision

At the start of your rotation, you will work closely with the Training Coordinator to develop and refine an individualized schedule based on your experience, your needs, and your interests. Presently, those activities include:

ASSESSMENTS: Testing batteries typically include cognitive instruments (e.g., WAIS-III, WASI), objective psychological (e.g., MMPI-2, MCMI-III), and projective psychological (e.g., Rorschach, TAT). Interns administer, score, and interpret the appropriate tests, then prepare reports integrating findings and offering recommendations for future treatment.

PSYCHOEDUCATIONAL CLASSES: These short-term didactic classes follow a set curriculum focusing on specific topics. Classes vary by semester, but have included: Anger Management, Communication, Men's Issues, Understanding Mental Disorders, Group Therapy Basics, and Mindfulness. Interns will serve as primary facilitator during their second semester with us, and have the option of developing a psychoeducational class.

SUPERVISION: You will receive at least one hour of supervision each week, with the Training Coordinator or one of the other licensed psychologists on staff.