Village
Counseling
Center
Sexual Abuse Prevention
& Treatment Program (SAPT)
LEVEL I Workbook
JSO Outpatient Treatment Program
LEVEL 1
Evaluation & Orientation
CLIENT NAME: / DATE LEVEL RECEIVED:MANDATORY SKILL REQUIREMENTS
/ DateAssigned / Date
Completed
1. / Offense Cycle (Central Process)
2. / Cognitive Restructuring
ADDITIONAL SKILL REQUIREMENTS
1. /2. /
TREATMENT ASSIGNMENTS
Successfully complete the following:1. / All required intake assessments and questionnaires.
2. / Polygraph Exam (Denier’s Only).
3. / Personal & Treatment Goals.
4. / Present Verbal Offense Description in Group.
5. / Present Written Offense Description to Group & Family.
6. / Present Autobiography to Group.
7. / Present approved Offense Description to group.
8. / Thinking Errors Assignment.
9. / Present 4-Step of Offense to Group.
10. / Present 4-Step of Offense to Family
INDIVIDUAL TREATMENT ASSIGNMENTS
Successfully complete the following:
1.
2.
3.
RESPONSIBILITY & GOALS
I take responsibility for the following actions related to my offense:
1.2.
3.
4.
5.
6.
Personal & Treatment Goals I hope to accomplish while on Level I:
1. / Be able to think rationally and eliminate thoughts which can lead to deviant behaviors. (cognitive restructuring/thought changing module)2. / Be able to describe the abuse cycle related to my offense. (central process module)
3.
4.
5.
6.
7.
8.
OFFENSE DESCRIPTION
Please fill out an offense description for your offenses. If you have more than one offense/victims, ask your therapist which offense you should use as part of this assignment.
Date of Offense: ______
Place of Offense: ______
Time of Offense: ______
First Name & Age of Your Victim(s): ______
1. What were you doing before the offense? (Up to one day before)
2. What happened during the offense?
(What did you, your victim, and anyone else who was there do?)
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3. What were your thoughts before, during and after the offense?
Before:
During:
After:
4. What were your feelings before, during and after the offense?
Before:
During:
After:
5. What were your sensations before, during and after the offense?
Before:
During:
After:
6. What did your victim do or say?
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AUTOBIOGRAPHY
What do you hope to learn about yourself from your autobiography?
How do you feel about writing your autobiography? (Identify using feeling words)
What is one special thing about yourself that you would like the group to know about you before you begin?
1. Family
Date of Birth: Place of birth: ______
Family Members:
Name / Relationship / AgeMother
Father
Describe your family as a whole. For example, what kind of things you do together, how you get along with each other, how you feel about each other?
Describe each family member and how you feel about them:
Mother -
Father-
Were you ever separated from any of your family? If so, who did you live with and for how long?
Who? ______For how long: ______
Why: ______
How old were you?______
How did you feel about being separated?
Have any of your family members died? Who? When?______
How old were you? How did/do you feel about it?
Has anybody in your family committed any crimes?
Who?
How did these crimes affect you?
How do you feel about these family members?
Has anybody in your family committed a sex offense? Who?______
How did this offense affect you?
How did they affect your family?
How do you feel about that family member?
How were you disciplined?
Who disciplined you? Do you consider any of your discipline to be abusive? If so, Why?
2. School
First school and location: ______
Last School and Location: ______
How many schools have you attended? How do you feel about changing schools?
What types of things did your parents do to prepare you to begin school?
How much school did your parents complete? Mother Father______
How much school have your brothers and/or sisters completed? ______
How important is school in your family?
Very (I will graduate) Somewhat (I might graduate)
Not very (I probably won’t graduate) Not at all (I want to drop out)
How important is school to you?
Very (I will graduate) Somewhat (I might graduate)
Not very (I probably won’t graduate) Not at all (I want to drop out)
What are your favorite subjects?
What subjects do you like the least?
What are your personal goals for school?
Have you gotten in trouble at school and if so, When did you start getting in trouble at school?
What did you do?
What did the school do?
How often have you skipped classes?
How often have you skipped school?
What did you do when you skipped and what made you decide to skip?
Were you ever caught skipping? If yes, what happened?
Did you ever have to repeat a grade? If yes, what grade and how come?
How did this affect you?
3. Childhood
What do you remember most about your childhood?
What was your favorite game? Who was your best friend?
Did you have any pets? If yes, what kind and what are/were their names?
How did you feel about your pets?
Did you commit any cruel acts to animals or to younger or smaller children (physically harming them, making fun of them, teasing them, AND VICTIMIZING them? If so, what did you do and to whom?
did you ever set fires or do other destructive acts? If so, what did you do and why?
Do you or did you enjoy violent scenes in movies? If so, what kind of violence do you like and how does it make you feel?
Did you have any kinds of surgeries or major illnesses? If so, what did you have?
what is your worst memory from childhood?
What activities did your family do together? What is your favorite memory from childhood?
4. Peers
As a teenager, who was your best friend? Who is your best friend now?
Do your friends commit crimes?
Who are you more comfortable WITH?
People who commit crimes People who do not commit crimes
How come?
How do you choose your friends? What qualities do you look for in a friend?
Are your friends part of the reason why you are here? If yes, how did they contribute to you being here?
Are you in a gang? If yes, what gang?______
How did you decide (or decide not to) get involved with a gang?
What special feelings (if any) do you get from being in a gang?
Have you ever wanted to get out of your gang? Why or why not?
5. Delinquent history
How many times have you been arrested? How many times have you been to the detention center? How long were you in the detention center? _____
how many times have you broken the law and gotten away with it?
Do you or did you enjoy committing these crimes? How come?
Are you planning to continue to commit crimes if you think you can get away with them? Why or why not?
6. Sexual history
describe the first sexual experience you can remember.
Describe how and where you learned about sex when you were younger. Please include things such as magazines, movies, school, watching others, books, etc.
How old were you when you first learned about sex?
Describe any sexual experiences you have had with people who were older than you, including those which were consenting and those that were non-consenting.
Describe the sexual experience you are most embarrassed and ashamed about. (Include things such as wearing women’s clothes, masturbating, sex with animals, molesting young children, etc.)
Have you ever made obscene telephone calls? If so, what did you say or do? How did it make you feel?
Have you ever peeped at others? If so, how did it make you feel?
How did you stalk or groom your victim(s)? How long were you doing it?
Describe your sexual fantasies. How often do you have THEM? Can you link them to your offense?
How old were you when you started to sexually fantasize? How have your fantasies changes over time?
How many times per week do you masturbate? ______
Approximately how long do you masturbate each time?______
Besides your victims, who else do you know that has been sexually abused?
First name Relationship
list everybody that you have ever had sexual contact with (including your victim(s). Start with your first experience and go in order through your most recent enxpereince.
First Name / Male/Female / His/Her / Your age / Sexual ActHow can you tell if your partner consented? (What did they say or do that made you think that they were consenting to sexual contact?)
7. Committing offense
What was your offense?
When did it occur?______Where?______
Was it planned? By who?
Did you commit your offense alone?
Who was with you?
Who is/are your victim(s)? What are their names and ages?
How do you think your victim(s) feel about what you did? What do you think they would like to say to you if they saw you right now?
How do your parents think of you now that you have committed a sexual offense?
How do you feel about being in treatment?
Who is responsible for you being in treatment?
8. Drug/alcohol history
How old were you when you first tried alcohol? Drugs? ______
What drugs have you used?
What types of alcohol have you tried?
How often did you use drugs/alcohol?
What is your favorite drug (include alcohol)
How does it make you feel?
When was the last time you used drugs/alcohol?
Have you ever Blacked Out? If so, when?
Have you ever had withdrawals or craving symptoms? If so, what were they like?
what is the most you’ve ever used at one time?
How much do you use? How often do you use?
what is the worst experience you ever had with drugs/alcohol?
Have you ever tried to stop using drugs/alcohol? If so, when and what happened?
Since you began using drugs/alcohol, what is the longest amount of time you have gone without using?
Did drugs/alcohol play a part in any of the crimes you have committed? If so, which crimes and how were drugs/alcohol involved in your crime?
Do you think you have a drug/alcohol problem? Why or why not?
Do most of your friends use drugs/alcohol?
How do you feel around people who use drugs?
How do you feel around people who do not use drugs
9. The future
What are your chances of committing another crime?
Very likely Somewhat likely Not likely No chance
if you commit another crime, what are the chances that you would get caught?
Very likely Somewhat likely Not likely No chance
If you commit another crime and got caught, what are the chances that you would be re-committed to a residential treatment program?
Very likely Somewhat likely Not likely No chance
Do you have any role models? If so, who? If not, how come?
How would it feel to be like your role model? What things about them would you like to have BEEN the same about you?
Where do you see yourself in ten years? What will be the best thing about you? What will be the same about you?
10. You now
What are the best things about you now?
What things about you would you like to change?
Why do you need treatment?
What might your friends and family say about you years from now? Why do you think they would say this?
What are some other important things about you that have not been asked?
Thanks for sharing all of this personal information and for taking a risk to trust others.
THINKING ERRORS
Thinking Errors are unhealthy thinking patterns or irrational thoughts that we all sometimes used to avoid taking responsibility for something we have done. One of the problems with thinking errors is that by using them it becomes easier for us to avoid being completely honest. This makes it much harder to get the treatment we need to avoid re-offending in the future. Most of us use thinking errors at one time or another but some of us use them more often and in ways that can hurt others and ourselves.
Here’s a list of Common Thinking Errors:
Blaming: Putting it off on somebody else. Blaming usually builds up resentment and anger toward someone else.
For example: “It wasn’t my fault.” “She came on to me.” “The police framed me and made me say I did it.” “I wouldn’t have an anger problem if my parents didn’t piss me off all the time.”
Minimizing: Believing that it really wasn’t that bad. Sentences that often starts with the word “Just” or “Only.”
For example: “I just touched her breast.” “I only did it once.” “He probably won’t remember me touching him when he’s older.”
Denial: Believing that you didn’t do it all.
For example: “That wasn’t me.” “I didn’t do anything.” “I didn’t touch her.” “We were only wrestling.”
Justifying: Taking a little bit of responsibility, but giving a reason to make it sound like it was OK to do.
For example: “He yelled at me, that’s why I hit him.” “My girlfriend wouldn’t have sex with me. What was I supposed to do?” “My Step-mom pissed me off so I messed with her little girl.”
Excuses: A way of finding an explanation that makes the action totally acceptable.
For example: “I committed my offense because I was sexually abused.” “My victim asked me to do it.” “I molested her because I was curious about sex.”
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Entitlement: The belief that you have the right to do what you want. It disregards the rights of others and treats others property and bodies as if it’s the offender’s right to do with as they please.