• 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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Robin J. Wilson
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Association for the Treatment of Sexual Abusers
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Phone: 503.643.1023
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Vol. XXI, No. 4
Fall 2009
The Interactive Self Management Plan:
Picking Up Where Programs Leave Off


A written self-management plan (SMP) has become a formal component of many established sexual offender programs, whether occurring in custody or in the community. These plans are typically intended to provide program participants with a document that summarizes core concepts in a manner personalized to each offender. The plan can be described as a kind of “living document” that hopefully will be repeatedly referred to over time, contemplated, and changed by the offender based on insight and/or life experience and practical circumstances.

It seems reasonable to surmise that, in many ways, the SMP represents a primary vehicle for offenders to continue to relate back to their experience in a sexual offender program. This could well occur more often than the more laborious and less personalized activity of re-reading documents, such as program handouts.

Some programs may primarily task the individual offender with completing a written SMP. Such a plan may be composed of compiled pieces of written homework addressing various program concepts. Alternatively, each offender may be provided a list of questions, in a type of “fill in the blank” exercise. Other programs may more directly assist the formation of SMPs by having a therapist and/or the treatment group discuss each preliminary written response with the offender before a final written version is produced.

Problems that sometimes occur with these approaches is that consumers of SMPs, such as probation/parole officers, find an offender’s written responses hard to read, or even illegible. Responses might be relatively self-referenced and, thus, difficult to understand outside of having attended the treatment program with the offender. Professional consumers of SMPs may find themselves having to piece together management strategies and feedback using the offender’s written SMP and the formal program discharge summary. If such a professional challenges an offender with feedback in a discharge summary, this may carry less weight, as the former was not in the program, may not be a therapist, and so on.

One approach that may add to the utility of the SMP involves an active interview format resulting in the creation of the Interactive Self-Management Plan or ISMP. This protocol provides an opportunity for the treating professional to gauge, in a more realistic fashion, the extent to which an offender has learned, retained, and is able to access core program components in a practical, meaningful manner. In my work over the past six years while providing sexual offender treatment to hundreds of offenders, I have found this to be a particularly useful approach. A standard set of questions is utilized, addressing core program concepts, such as different types of risk factors, cognitive distortions, managing sexual arousal and fantasy, and so on. Also included are various questions about lifestyle, such as social support, leisure activities, residence, occupation, short and long-term goals, and so on.

All questions are first asked within a positive frame, such as, “What type of work or employment is most healthy for you?” Following the offender’s response, the question can be reframed as, “Are there any types of employment that would not be healthy for you, or that you need to avoid?” It is very important that the interview questions lead off by modeling an emphasis on a positive/approach note and, then, where relevant, be followed by a more challenging/ avoidance perspective.

Offender responses are recorded in near-verbatim manner by the facilitator, permitting probing for additional information, or clarification of any response given. For our purposes, I employ a simple setup with a laptop computer. Copies of the standard interview questions are saved on the laptop. Each offender is interviewed by the facilitator and the verbal responses are concurrently typed into the laptop. The goal is to capture enough of the response that the offender will recognize it as his own when he later reviews the ISMP (instead of necessarily having a verbatim response). Thus, specific terms or more idiosyncratic use of language are ideally captured in an offender’s verbal response.

Latencies to respond can also be noted. These are particularly important if an offender is to apply core concepts in real-world, real-time situations. Paying attention to such response times is a time-honored practice going back to pioneers in the field such as G. Alan Marlatt. Consider the practical utility of observing how quickly and easily an offender is able to recall concepts and apply them in real time, versus writing down a response on a take-home assignment. Of course, if the offender goes off on a tangent, or his response to a given question seems disorganized, such observations can also be quickly typed in to be used by the facilitator and then removed when producing the final version of the document.

It may be necessary to find ways around a facilitator directly typing responses into a laptop, if typing skills are particularly poor (though in our day of computer usage this is likely becoming less of a concern). Depending on the nature of any given program it may be possible to audiotape the interview, with appropriate consent, and later transpose key features of each response to the final document. It may also be necessary to have both group facilitators present during the closing interview with the best typist recording responses. Regardless, the most practical and flexible approach involves the facilitator(s) asking the questions and typing in the responses during the actual interview.

One additional and critical aspect of the ISMP procedure occurs during preparation of the final document. This involves the program facilitator adding comments immediately following each offender response in any content area where this is deemed important. These additions are carefully phrased as suggestions to avoid defensive reactions. It also is useful to reference certain responses made by the offender on written assignments, where appropriate.

These facilitator comments often sound like, “You stated that you were uncertain what kind of cognitive distortions were happening for you when you were offending. In a written assignment you selected victim stance thinking...,” or “Remember that in group other members asked you if you might have been doing victim stance thinking around the time of your offending.” With this type of feedback, I am able to draw together all the major components of the program to reactivate the multimodal experience of the offender in the program itself. This should assist additional learning and retention of core concepts, as well as highlight moments of insight during the program experience.

Both offenders and, especially, community supervisors have lauded the fact that these comments provide ongoing feedback to offenders long after a formal treatment program has ended. Supervisors quickly and easily have a summary of key issues to address in any program area. Offenders cannot frame the work of the supervisor as unrelated to that of the program therapist, as the latter’s comments are on the ISMP in black and white. The facilitator comments create the interactive framework of the ISMP, and can almost come across as a conversation or dialogue on paper. Wherever possible, the facilitator can reference comments made by other participants in group, offering feedback to the specific offender on an issue. This is intended to extend the experience of program and group participation well past the end of the program itself.

Considering the interactive nature of the ISMP, I have found that the process of actually putting feedback on paper is greatly enhanced by using any of the currently popular voice recognition software programs. With such a program, I am able to add my comment sections to an ISMP with relatively little effort, and almost no typing.

Feedback from treating professionals who have adopted this interactive approach (including those who have never used voice recognition software before) has also tended to be very positive. Naturally, there is a learning curve and the procedure certainly takes more time and effort than simply having offenders write responses to questions and hand them in. However, the final product seems to be of particular value to both offenders and supervising professionals, post-program. The ISMP format also allows treating professionals to more openly display their skills and knowledge in providing feedback to the offender.

Considering the importance of continuity of care and of ensuring that offenders continue to refer back to program material after program completion, I would argue that the ISMP holds tremendous potential as a treatment tool for sexual offenders. ATSA members may want to consider whether the protocol, or some version of it, might augment their practice with this population.

The following is a sample of the initial pages of an ISMP. In this example, the client was bright and verbal.
 

INTERACTIVE Self-Managment Plan

NAME:                  Mr. John Doe
DOB:                    Month, day, Year
DATE:                   September 1, 2009
FACILITATOR:        Dr. Jordan Hanley, Ward St. Clere, Inc.

NOTE: The following information was provided by Mr. Doe in group sessions, a limited number of individual sessions, in written assignments, and a closing interview. His response to each question is listed first, followed in some areas by additions provided by the facilitator. These begin with “F—” for easy identification. Additions were intended to provide feedback and enhance the utility and thoroughness of the Self Management Plan. They were also intended to provide useful material for discussion during the Maintenance phase of the sexual offender treatment program, where applicable.

People who commit sexual offences typically go through several stages before and during an offence. Awareness of these stages, the factors that put you at risk, and an individually prepared plan to deal with risk and lapses, supports your desire to avoid offending in the future. This self-management plan is yours to complete, use, review regularly, and update as needed.

Even if you do not believe you would be at risk of offending again, consider the factors that would be important if you were. This is not just a piece of homework; this is an important piece of protection for you and others.

Think about the sexual offence or offences that you have committed and all of the important general and specific information that you have gained from this program. Now, answer the following questions:

      1.    Risk Factors and Coping Strategies:

What feelings or moods could put you at risk of sexual offending again?

Depression would be the main one. And, then, next would be feeling stressed out.

a) How have you best been able to manage these feelings or moods?

Now, I know with depression that I need to be with somebody, not to be by myself. I need to talk to my closest people and friends and be able to share my feelings with people in general. This allows me to relax. It is like having contact with reality, as depression is something I create in my head by thinking too much about things.

For managing stress or anxiety, I do pretty much the same thing. But, in order to avoid being stressed, I have plans put together in advance—like not working too much or doing a lot of overtime. I work my job now and I am done. I don’t take things home with me to think about from work. I also exercise three times a week now, and that helps me with stress.

F—So you are talking about being connected and active with people as a way to help with feeling down, as well as making changes in your lifestyle to manage stress. These are very good ideas, as it is often easier to manage what lets depression and anxiety build up, rather than trying to manage these after they are already very strong.

b)    What sexual thoughts or fantasies could put you at risk of sexual offending? What skills do you now have to challenge and change these?

The fantasy that mainly got me in trouble was about feeling younger than I actually am and, so, I have to watch out for that one. Like, not fantasizing about being a teenager in my mid-teens, and to watch out for that way of thinking. Again, I think this has to do with my middle-age crisis kind of thing. I remind myself I am not like I was before, not only sexually—I am not as strong as I was before physically or as quick.

I have realized you start losing things, including my kids growing up and going away from home. I need to remember this is something happening to me that I can’t stop. There are feelings that I will naturally have about these things happening. I can face it like an adult and realize it is regular part of my life. Now, I am seeing advances in accepting my feelings and the situation I find myself in. Like my kids are growing up and me getting old. There are advantages to getting older. It’s not all bad stuff.

F—So you are talking about being aware of the feelings that you have about something, not just looking at an issue as a problem to solve or think about. Then, there is the importance of sharing how you feel with other people and getting support and understanding from them. You are recognizing you are changing and, in some ways, becoming more wise but also more vulnerable – and accepting that this is occurring to you as a natural part of life.

c)    What triggers or situations (for example, getting in an argument or your friends ask you to go for a drink) could put you at risk of sexual offending? How would you go about dealing with these situations/triggers to ensure that you make positive choices?

A trigger for me is like when one of my kids does something and I suddenly realize they will soon be old enough to leave home. Now, my wife and I are making plans of what to do when that happens, so we know what we are going to do. My oldest son will soon be finished school completely and my other son is in Grade 11. So, there are practical things we can do to help make this easier. Like changing the car for a smaller car, as we don’t need a big car for a bigger family. It’s different now to be making plans together, and I feel good about it.

F—This sounds like a very good idea – identifying an issue, then what the connected feelings are, then sharing those with your wife, and then making some practical decisions on how to handle things as you both get older. Actually carrying out these decisions is very critical as you can then experience that life is continuing and you can be happy and satisfied as things change. For example, actually getting a smaller car, or starting to look at downsizing your residence. Making a change allows you to experience the result instead of worrying about what the change will be like.

Additional triggers you identified in the program included experiencing sudden and strong feelings of stress, being denied sexual activity and release when feeling strong sexual urges or arousal, and anything happening that triggers fantasies of being a teenager. Other triggers could be seeing a young teenage girl or girls and having an urge to go talk to them, suddenly losing an important source of social support, suddenly losing employment, or suddenly experiencing any strong and uncomfortable feelings.

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