• Editor's Note
 • President's Message
 • In Memoriam: Gail Burns-Smith
 • Deconstructing Deviance: They’re all deviant except for you and me, and I’m not so sure about you
 • iVigilante? Public Disclosure and New Technology
 • Everywhere It Matters:
Working at the State Level to Influence Public Policy
 • The Established (but still evolving) Internship at the Shiloh Program
 • Vicarious Trauma: What are the protective measures?
 • The Interactive Self Management Plan:
Picking Up Where Programs Leave Off
 • Book Review: Assessment and Treatment of Sex Offenders: A Handbook
 • Book Review: The Other Side of Desire
 • Post-Doctoral Research Fellowship
 • Board of Directors Election Results
 • New ATSA Members
 • Paid Advertisement: The GEO Group
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Vol. XXI, No. 4
Fall 2009
The Established (but still evolving) Internship at the Shiloh Program

 

  Kay E. Jackson, Ph.D.

I started the Shiloh Program in 2008, as an outpatient treatment program addressing the psychological needs of sexual offenders residing in the community of New York City. I work with largely indigent, high-risk offenders with histories of significant violence. I had been working with the population in another treatment program for 12 years, but became so distressed about the tenor of the treatment program that I resigned in protest and disgust. I knew many of the members of the criminal justice community, and I asked them whether I would receive support for this new venture. I was very grateful to receive great encouragement and support. I began Shiloh in January 2008 with five men who had been members of a pornography treatment group for the preceding two years. As of June 2009, we had seen 165 people in the program, so the growth of the program has been substantial, and Shiloh now works with every agency attached to community-based supervision across the criminal justice system.

Though I had plenty of “work,” I still had little money (see above description of client population). I accept Medicaid funding for clients for six months while they become stabilized and seek employment. The program is going to apply for clinic status soon, but the work grew in advance of the funding options. I continue to have a bifurcated client population. Some of my clients are professionals, who have fiscal means. The other clients tend to be indigent, with little support, lots of restrictions, and poor opportunities. Clearly, the growth in the program necessitated some important changes. I had to decide how to cope effectively with the program growth while continuing to provide quality services to clients with massive, and largely unresolved, psychological problems.

For 17 years, I had provided supervision for doctoral students in psychology. Once the program had begun to demonstrate that it was established and growing, I decided to take on some graduate students as interns. I wanted to make sure that I could provide them with a meaningful experiential opportunity, and I wanted to be clear about what I needed back from them in exchange. I initiated contact with the John Jay College of City University of New York, because of their excellent reputation in the criminal justice field. I quickly learned that there were many students seeking the chance to learn about these offenders, and so I held an open house for potential students to explain what I could offer, and what I expected. This clear and very realistic communication formed the basis for the mutual decisions to take on four advanced Master’s candidates from two schools. Once the “word” got out that I would like to work with interns, I was fortunate to have a parole officer refer a graduate student from Iona College’s Master’s in Mental health Counseling and Forensic Psychology.

We met as a small group, myself and the four prospective interns, to discuss our mutual expectations. I clarified the importance of community safety through the provision of psychotherapeutic treatment as the program’s primary mission, my theoretical commitment to the implementation of a “good lives” approach to the provision of services, and my highly conservative position regarding direct client contact—For the first three months of their internship, interns did not speak directly with any clients. They observed groups and individual sessions, as well as intake sessions, but they bore no direct responsibility for the clinical treatment of any clients. They participated in the formation of progress reports based on their observations, and they read like crazy!

Because of the strength of my connections in the community, I was able to structure for the students certain specific opportunities that I believed would be interesting and relevant. As well, there were certain specific problems that the students could help me resolve. For many years, I observed an increase in the caseloads of the probation and parole officers responsible for the supervision of our clients. Parallel to this gradual, insidious process, the quality and thoroughness of the documentation provided by some of the parole officers diminished, and the frequency of their visits to the office decreased. I explored the possibility of employing the interns to provide the liaison work of gathering the documentation, and providing a presence in the Division of Parole for scheduling intake appointments and meeting new clients. I was able to gain the support of the Division of Parole across New York City in this venture, which has proven quite effective. Students have worked in pairs to travel to each Division of Parole site, and once again, I have been delighted that this has worked out so well. The feedback from Parole has been significant, and quite welcoming.

With help from friends and colleagues, I have been able to secure opportunities for the students to have some additional experiences during their internships: attending a week long NYPD sex crimes course, attending an in-service training for all staff in the Bronx Division of Parole, visiting the mental health unit of a maximum security prison, attending the New York State Association for the Treatment of Sexual Abusers conference, participating in case conferences, and participating in in-service trainings regarding cultural diversity, legal reentry services for offenders, and the creation of a sexual health program for South Asian adolescent females. Over the duration of their internship, we have had a continuous background conversation about the relationships between mental health services and offender treatment within the criminal justice system. I know that their presence in the program has been invaluable in reinvigorating my commitment to the work and, in turn, I believe I have been able to provide them with opportunities to explore and experience the work of providing services to this population.

In the paragraphs that follow each of my interns chronicles their experiences in training with me at the Shiloh Program. Each of them offers their perspective on how they have been affected by their introduction to forensic mental health services with sexual offenders.

It is a rare opportunity, to say the least, to be a part of shaping something as influential as the Shiloh Program. As four graduate students, we all started our externships at the Shiloh Program in January (with Jessica Morak joining as an undergraduate intern in May) and have been able to create some of the cornerstone features of the now established, yet still evolving, Shiloh Program. One important feature of the Shiloh Program is keeping accurate and updated attendance lists. These attendance reports are relayed to various agencies in the criminal justice system to inform on a client’s progress and attendance to the program. As interns, we created a separate system for attendance in order to keep this task more closely monitored. Another new addition to the Shiloh Program has been the introduction of a behavioral contract, initially designed by us. Each client is given a copy of the behavioral contract, which outlines specific guidelines for expected behavior while present in the office.

Other intern-related achievements have included: the provision of individual assistance to a small number of clients who lack both funds and insurance, making them otherwise ineligible for services and continued treatment; the introduction of a more intensive intake process that includes a discussion of the client’s initial history through the BioPsychoSocial; a new release of information form was created so that it could specifically pertain to the client’s current needs; and the development of a more cohesive system for filing physical papers, such as group and individual session notes, criminal history reports, and client-related documents. The filing system is now more accessible, but still completely confidential; research for sexual offenders has been expedited with increased access to exclusive journals concerning violence, sexual violence, and sexual offending which, in turn, has let us strengthen the caliber of our legal arguments; and monthly progress reports detailing attendance are created and delivered to the Division of Parole and the client’s respective Parole Officer.

We are Dr. Kay Jackson’s interns at the Shiloh Program for Outpatient Sexual offenders; these are our stories:


Tyree Price:
NYPD Sex Crimes and Child Abuse Investigation Course

One of the many perks of interning at the Shiloh Program is access to various training programs. On May 18, 2009 to May 22, 2009, a co-intern and I had the opportunity to participate in the NYPD Detective Special Victims Division Sex Crimes and Child Abuse Investigation Course. I was immediately blown away as I walked into the auditorium filled with detectives, firefighters, ACS workers, and individuals from other agencies involved with child protection. The training course consisted of medical, legal, and forensic experts presenting information on the latest crime-solving and prosecution-building techniques. Everyone in attendance received a binder full of information, including psychological profiles of different types of sexual offenders, as well as an overview of the New York State’s Sexual Offender Registration Act. This information is very important to us at the Shiloh Program.

Although the information on sexual offenders was important and very informative, to me, the most interesting part of the training course was the information and pictures about child abuse and sex crimes. The pictures that each speaker used as visual aides were shocking. I couldn’t believe that a parent or guardian, who is supposed to be responsible for the child’s safety and well-being, could hurt that child in any way. I saw pictures of children who were burned, beaten, bruised, and sexually abused. As I write, the images are popping into my head. I will never forget those images. For the first time, I was able to see sex crimes and child abuse from the victims’ point of view. While interning at the Shiloh Program I was only able to hear the perpetrators’ side of the crime. This training course opened up my eyes and made me more aware of the victims’ pain and suffering. Now more than ever, I can appreciate Dr. Jackson’s efforts to treat sexual offenders so there will be no more victims. Thanks to this training course and Dr. Jackson, I realize I want to do whatever I can to help keep sexual offenders from reoffending and to help the victims who survived their abuse. Overall, the training course was a great experience and one I would do again, given the opportunity. Oh, and I almost forgot…Everyone in attendance received a certificate on the last day, how cool is that?


Jennifer Pellegrino: Parole Interface

A major function of our role as interns at the Shiloh Program is interfacing with parole. Almost our entire client population is mandated to our treatment program. The majority of our clients are referred by parole officers. Therefore, our relationship with the division of parole and the different parole officers is an integral part of our treatment program. Information regarding concerns, attendance, participation, and progress in treatment is exchanged on a daily basis.

In an ideal situation, we would receive background information from the parole officer about the client. Such information may include details of the instant/current offense, statements from the victim, criminal history, and/or psychiatric history. Unfortunately, we do not live in an ideal world. The fact of the matter is that many parole officers have a tremendous caseload. Personally, I’ve heard of caseloads as large as 65 sexual offender parolees, all of whom are to be intensively managed, monitored, and supervised. Therefore, it is more understandable that parole officers do not have extra time in their day to send requested client background information.

However, the lack of information about a client greatly impacts treatment and its effectiveness. This mode of operation leaves the treatment provider to base approaches, strategies, and plans solely on information provided by the client. Therefore, the treatment provider may never know more than what the client intends for him/her to know. After working with this particular population, the amount of dishonesty, manipulation, and denial that many offenders have in regard to their offenses is evident. For this reason, and in order to provide the most effective treatment possible, it is essential that there is verification of the information provided by the client.

In order to work in conjunction with the division of parole and provide ethical and effective treatment to our clients, a role of the interns is to visit the divisions of parole on either a weekly or bi-weekly basis. During these visits, face-to-face contact may be made with a client, in order to ask questions in the presence of the parole officer to ensure honest responses from the client. At other times, contact is made with the parole officer in order to have questions answered and concerns discussed.

Our approach to this issue has been well received by the divisions of parole and other treatment providers. The parole officers have expressed that this system works well and that they would like to keep these procedures in place. This process is time efficient for the parole officers, because they do not have to leave their office, fax paperwork, or make any extra phone calls. From our perspective, the Shiloh Program also finds this system much more effective and advantageous in the assessment, evaluation, and treatment of our clientele for both clinical and research purposes. Due to the multidisciplinary approach that is applied to the intensive management and supervision of paroled sexual offenders, it is essential to work together and maintain communication for the sake of the client, past or future victims, and the safety of the community.


Morgan McMorran:
Development of the Biopsychosocial

The development of the Biopsychosocial (BPS) has been an extremely interesting aspect of my experience here at the Shiloh Program. We were interested in creating an instrument that can tap unique and relevant parts of our clients’ lives, as well as serve as a measure of self-report versus forensic ‘fact’. We began with a forced-choice series of questions, but soon evolved into free response as we realized that our clients’ experiences were much more varied than we had initially considered. The form then turned into an almost purely clinical piece with great amounts of information. However, we soon realized, with the input of Dr. Johnson and the Statistics Department at Baruch College, that the relative amounts of information we were gathering, though exceedingly interesting, would need to be generalized at some point in order to be useful on a research level. So, we converted the Biopsychosocial back into a forced-choice research instrument, using our newly-gained knowledge of ‘typical’ client responses from our experience administering it on a clinical level. It will need more tweaking but, hopefully, we are narrowing in on something that is representative and informative to and about our client population.

In terms of the clients and the actual administration of the BPS, we were initially apprehensive about the client’s possible negative reactions when greeted with a now 21-plus page document of pages to be filled out but, in general, the response has been very positive. The clients appear to sincerely enjoy talking about their lives, their stories, and having an hour or so devoted to the expression of themselves and their inner workings. I am learning not to be surprised when I am thanked after the completion of the BPS, not because it is over (ha), but for the interest, thoroughness, empathy, and care that we have invested in the client and in the administration of the instrument, and that’s a cool feeling.


Samuel Bruce: Direct Client Contact

The first time I observed a sexual offender therapy group, there was an interesting reaction from the clients. During introductions, in which clients also listed their offenses, one client refused to specifically name his. He said that he was not trying “to be funny,” but he did not wish to tell me what had led to his being in the program. Not long after introductions, my supervisor stepped out of the room for a minute or two, leaving me alone with the group. One of the clients then turned to me and said, “So, Mr. Bruce…” in a manner that was quite cordial but still clearly intended to test the new guy. This created a dilemma for me because I had been warned not to reveal personal information, but at the same time I could not appear to be rude or, more importantly, afraid. I managed to stall until Dr. Jackson returned and succeeded on the former goal, although I am still uncertain about the latter. After that, however, the group proceeded in a normal fashion and clients, with the single aforementioned exception, discussed their lives in front of me with no apparent reservations. In fact, I have since found that my observation provokes little or no reticence from the clients. At worst, I am sometimes asked about my own life and am, again, forced to diplomatically duck the question. One client, however, took a different approach. This was during a meeting of the mentally ill sexual offender (MISO) group, which had been recently started. One week, I ran the group on my own for a period while my supervisor dealt with a client in need of individual attention. During the conversation, one of the clients in the group, a man with a history of brandishing firearms during the commission of sexual offenses, told me that he had neither friends nor family in New York to provide him with an incentive to stay out of prison. During the next group session, when my supervisor was present, he talked about his current relationship with his family.

As much as we might prefer otherwise, my being the only male staff member at Shiloh has probably had an effect on my relationship with the clients. Being conditioned by prison life to struggle for hierarchical position may cause some clients to initially resent having a man—in particular, one who is younger than most of them—in a position of apparent authority in group sessions. Some clients attempt to assert dominance by either withholding information or implying that they are dangerous men. This phenomenon seems to quickly diminish, however, once they become accustomed to my presence and perceive that my aim is to be a treatment provider, not an officer.

For my part, I do not know how well I might have handled the experience of “jumping in the deep end” with direct client contact without the support I have had from my supervisor and colleagues. In a larger program, I might have been required to work just to develop a team relationship with a smaller group in order to have people with whom I might exchange ideas and advice. In this small program, I had this resource from the beginning. In spite of the typically frantic pace of the office, I am always able to review what happened immediately after sessions. Dr. Jackson has been extraordinarily available to all of us, much more so than even  a well-intentioned supervisor in a large program with double or triple the number of interns to manage. I believe that my learning curve in interacting with clients has been much faster here than it would have been in a larger program.


Jessica Morak: The Undergraduate Experience

Ever since I can remember, I knew that my fate lay in the field of clinical psychology. I never wanted to determine the guilt or innocence of an offender; I just wanted to talk to them. There is no opportunity that offers a more extensive hands-on experience for an undergraduate psychology concentrator than an internship with the Shiloh Program. An outpatient treatment program for sexual offenders is a unique arena to embrace and participate in actual clinical psychiatric services. As most psychologists and psychiatrists will agree, there are some aspects of clinical psychology, as well as psychological research, that cannot be learned in a classroom. I have been extremely fortunate to be able to observe and absorb these invaluable lessons.

This internship was the first time that I had ever been able to experience one-on-one interaction in a clinical setting. Moreover, dealing exclusively with a population of convicted sexual offenders was a challenging, yet intriguing, proposition. My first week was, unsurprisingly, intimidating as I had never before sat in on a therapy session. After my first day as an intern, I sat in on one of the other interns administering an evaluation to a patient. During this initial evaluation, I listened to a client describe the instant offense that had landed him in sexual offender treatment. I listened to the patient describe actions and events that I thought only occurred in sordid television and movies. I didn’t know how I would ever be able to administer this type of an interview without showing my inexperience, shock and, sometimes, disgust on my face. The amazing thing, however, about working in an office with such welcoming and helpful colleagues is that I was not expected to master these techniques from the start. I had time to learn them and everyone in Dr. Jackson’s office was more than happy to assist me in this task. After only one month of starting my internship at the Shiloh Program, I was able to administer the evaluation, by myself, with ease. Because I have not had as much experience with this type of population as the other interns (or Dr. Jackson), I remain occasionally unsure about how to handle novel situations. These scenarios include: How to read a police file and seek out the information needed, eliciting truthful answers from an uncooperative patient, and asking the right types of questions that will yield insightful answers. These are all techniques that I am eager to learn and know I will be exposed to through my eye-opening and, sometimes, mind-boggling internship at the Shiloh Program.

Dr. Kay E. Jackson: Concluding Remarks           

Practitioners might eliminate the possibility of taking on intern(s) because of the scale of their operations. However, my positive experience clearly suggests that aspiring mental health counselors can really benefit from being exposed to the work, regardless of the size of the program. In many respects, smaller programs offer more direct and intimate training experiences than a large operation might. By building on relationships I have developed over years of practice, these graduate students have had a training experience that is unique and entirely appropriate to the task of laying a solid foundation for their professional careers, wherever those paths may take them. It has been inspiring and reinvigorating to have participated in their training, and I am grateful for their ingenuity, curiosity, and help. Were I in the position to hire them, I would do so immediately!

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