Full Clinical Evaluation

A full clinical evaluation is a comprehensive psychiatric evaluation that will assess for the presence of neuropsychiatric disorders, major mental illnesses, personality disorders, and behavioral disorders which contribute to the presentation of problematic sexual behavior. The evaluation may include the following:

  • Review of collateral records (e.g. police report, witness statements, and treatment records)
  • Consultation with collateral contacts (e.g. probation, family members, treatment providers)
  • Psychiatric interview
  • Psychological testing
  • Physiologic testing
  • Medical testing
  • A final report with diagnostic impressions and recommendations
  • A case conference with the individuals involved in the patient’s treatment. The goal of the conference is to review the recommendations and develop an effective treatment and supervision plan.

Risk Assessment and Treatment Needs Evaluation

Risk assessment for future problematic sexual behavior and/or sexual recidivism includes assessment of static (historical) and dynamic (current and changing) risk factors. Static factors are used to determine those risk factors, which are stagnant while dynamic factors, determine the amount of risk, treatment needs, and current ability to manage risk. Risk assessments facilitate decisions about treatment needs, dispositional planning, and community supervision.

Interim Evaluation

An interim evaluation is used to evaluate treatment progress and risk management needs. This assessment often includes a clinical review, treatment plan update, updated risk assessment, and consultation with collateral contacts.

Forensic Evaluation

Clinicians at the Institute for Sexual Wellness are skilled in the forensic evaluation of individuals charged with sex offenses. The following types of evaluations are available at the Institute:

  • Not Guilty By Reason of Insanity
  • Aid in Sentencing
  • Civil Commitment of Sexually Dangerous Persons
  • Violence risk assessment
  • Sex offender classification appeal
  • Medication evaluation for chemical castration

Training

Case Consultation and Staff Training

ISW values collaboration with other individuals involved in each patient’s care. Treatment effectiveness can increase by working together on cases. Therefore, ISW provides case consultation to residential treatment staff, law enforcement, and others working with the patient. Case consultation includes clinical conceptualizations, discussion of recommendations, education on risk and protective factors, and working with others to develop and execute realistic, effective supervision and treatment plans.

Professional Workshops

The experts at ISW offer a wide range of professional development workshops. The following list provides examples of ISW workshops and seminars (please contact ISW if you would like a more comprehensive list):

View All Professional Workshops

Professional Training

Paraphilic interests are fairly common in men and include a wide variety of behaviors typically seen in clinical populations seeking evaluation and treatment for paraphilias.[1] Those who most frequently seek psychiatric treatment for sex offenses are those accused of or involved in child molestation, voyeurism, exhibitionism, fetishism, frottage, and public masturbation.

Many psychiatrists are unfamiliar with the fundamentals of the assessment and treatment of sex offenders. The advent of laws for the civil commitment of sex offenders has resulted in the need for psychiatrists trained in paraphilias. As a result of sex offender legislature, the treatment and release decisions regarding sex offenders has become a focus of attention for psychiatry. Forensic psychiatrists or psychologists must render an opinion as to whether the sex offender has a diagnosed mental disorder and, as such, represents a risk to public safety if released from custody into the community. In order to render opinions regarding sex offenders, forensic psychiatrists should be educated about the evidence based approach to the treatment and evaluation of this offender population.

The Institute for Sexual Wellness offers professional training clerkships for clinicians interested in learning more about the treatment and evaluation of sex offenders. Individuals interested in participating in the clerkship should submit a letter of interest to Dr. Sorrentino.

Training Curriculum

The training consists of a two-week curriculum which includes the following:

WEEK ONE:

Tutorial in Risk Assessment Instruments: Trainees will be educated about the various risk assessment instruments used in sex offender evaluations. More specifically, trainees will be educated about the research methodology and principles involved in the penile plethysmograph, ABEL screening test, and actuarials.

Conducting the Sex Offender Risk Assessment: Trainees will observe a sex offender evaluation. The trainee will be educated about the specific questions asked in a sex offender evaluation.

Report Writing: Trainees will be asked to prepare a sex offender report for the court. The report will not be submitted to the court, but will be used as a training exercise. Dr. Sorrentino will supervise the report.

WEEK TWO:

Testifying in Court: Trainees will observe courtroom testimony in sex offender cases.

Clinical Treatment of Sex Offenders: Trainees will sit in on sex offender groups. In addition, trainees may observe individual therapy sessions including behavioral treatments such as aversive conditioning.

Trainees will participate in the weekly hormonal/antiandrogen clinic. This is a clinic devoted to the treatment of sex offenders with testosterone lowering agents.

[1] Crepault C, Coulture M: Men’s erotic fantasies. Arch Sex Behav. 1980, 9:565-580.

Forensic Consultation

ISW is frequently asked to offer attorney consultation in addition to being retained as experts for those involved in the legal system. Attorney consultation is available to assist with a multitude of issues, including the following topics:  dangerousness, insanity defenses, mitigation reports, competency to stand trial, recommendations for administering objective testing and psychological assessment, appropriateness for chemical castration and to evaluate treatment progress.