Psychosexual Evaluation

Psychosexual Evaluation
Supervised by: Michelle J. Yep-Martin, Psy.D., M.S., M.A. 500 West 27 Avenue, Suite D Anchorage, Alaska 99503 Phone: 907.677.7089 Fax: 907.677.7094
Date

MonthDayYear
Date
Client

First NameLast Name
Date of Birth

MonthDayYear
Date
Sex
Marital Status
Offender #.
Phone Number
Please enter a valid phone number.
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Probation Officer:

Criminal History

	Date	Charge	Conviciton	Disposition
1
2
3
4
5
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7
8
9
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Criminal History
Information in this section was derived from the pre-sentence report.
Mental Status Exam
Attitude
Other
Appearance
Mood
Affect
Orientation Impairment

PersonPlaceTimeSituationNone
Thoughts
Suicidality
Homicidality
Delusions
Insights
Judgment
Provisional DSM-5 Diagnosis

F32.9 Unspecified Depressive DisorderF42 Obsessive-Compulsive DisorderF43.25 Adjustment Disorder (with mixed disturbance of emotions and conduct)F65.9 Paraphilia, unspecifiedF43.10 Posttraumatic Stress Disorder (PTSD)F84.0 Autism Spectrum DisorderF90.0 ADHDZ72.811 Adult Antisocial BehaviorF10.20 Alcohol Use DisorderF63.81 Intermittent Explosive DisorderOther
Reason for referral
Index crime?

YesNo
Index crime
Information on this section was derived from the pre-sentence report filed ; and/or a treatment referral packet.
Count 1: Count 2: Summary:
Procedures and Instruments
Intake questionnaire

Clinical Interview

Mental Status Examination

STATIC-99R

STABLE-2007 

CPORT

CASIC
BIOPSYCHOSOCIAL HISTORY
Information on this section was derived from a clinical interview and the pre-sentence report filed ; and/or a treatment referral packet.
Biopsychosocial History
Include the following: Physical health Drug effect Family circumstances Relationships Mental health Coping skills Social skills Self-esteem Mr. [X] is a BLANK year old BLANK (Caucasion) male who was referred for sex offender intake assessment by his Federal Probation Officer to determine his appropriateness for community-based sex offender treatment. An Informed Consent was obtained for this evaluation, in addition to a Release of Information from his Probation Officer. EXAMPLE: When asked about his index offense, Mr. [X] stated he had been experiencing marital difficulties with his wife and a decrease in sexual intimacy. He reports feeling sexually frustrated at the time and that he began watching adult porography and began experiencing exhilaration adn a different type of arousal than he experienced with phsyical sexual intimacy. He reports seeking increasing diverse stimuli which led to viewing child pornography, having nostalgic memories of his early sexual experiences as well as fantasies of engaging in sexual activity with children. Mr. [X] acknowledged that he engaged in sexual coping and that he often drank to mild or moderate intoxication whil viewing pornography. Mr. [X] reported that over time he felt increased guilt and shame around what he was viewing which he stated I why he stopped and why he destroyed one of his laptops. When asked if he needed se offender specific treatment, Mr. [X] acknowledged that he thought he would benefit from it. Specifically he states he would like to develop healthy deterrants from being sexually driven and support to become more socially adept and confident. He would like to address issues related to fear of rejection and feel more confident in meeting positive people and acquaintances. During his interview for this assessment, Mr. [ X ] denied experiencing any history of physical, emotional or sexual abuse growing up or in his family of origin. Mr. [ X ] reported ….. Children, health problems, spouse, Mr. [X] reports he has limited social supports. He talks to Mr. [ X] states he has no maintained any friendships from prior to his offense. He reports his parents are supportive of him and want to see him, “better himself.”
Sexual History
First sexual experience. Summary of sexual relationships, longest relationship, sexual concerns EXAMPLE: Mr. [X] reported his first sexual experience occurred when he was BLANK years old with _________. He denies being sexually abused by and adult during his childhood. Mr. [X] reports that he was socially isolated in middle school and spent a lot of time alone. He reports his longest relationship was BLANK.
Mental Status Exam:
This is a process to estimate the psychological and behavioral functioning of an individual. It uses questions and observations of the client as he engages in self-description. The following domains were evaluated: general appearance, behavior, orientation, mood and affect, content and thought, gross cognitive function, suicidality or homicidality, attitude toward examiner, level of alertness, speech and language functioning, memory, perceptual disturbances, associations and judgment and insight.
Example to modify: The psychosexual evaluation was conducted via telehealth due to ongoing risks associated with the COVID-19 pandemic. ________ stated he was in a place where he could speak privately and confidentially. He had a normal affect, appropriate for the circumstances. He was alert and oriented times four (person, place, time, and situation). He fully engaged in the assessment interview. _________’s responses to the questions were coherent and easy to understand. He demonstrated an appropriate level of attention and concentration throughout the interview. He did not indicate significant memory impairments during the interview. His thought process was clear and logical, and he did not exhibit any psychotic symptoms or other disturbances of thought. He denied any auditory or visual hallucinations. ________’s insight and judgment are estimated to be ________. He denied any previous suicide attempts and denied any current suicidal ideations. He was cooperative throughout the intake and was open to answering quest
RISK ASSESSMENTS
There are no actuarial measures for offenders whose offenses are non-contact internet based only, such as downloading and possessing child pornography. Mr. [X] falls into this category. Given the lack of actuarial measures, leading psychologists in the field of sex offender evaluation/treatment Dr. R. Karl Hanson and Dr. Micahel Seto opine that an examiner can use commonly accepted dynamic risk factors for other sexual offenders to look at an examinee's risk if they are an internet-based offender. The tool selected to assess dynamic risk factors is STABLE-2007. 

 

The STABLE 2007 RISK ASSESSMENT


STABLE-2007 measures empirical risk factors routinely addressed as part of correctional rehabilitation (ie. criminogenic needs) for adult males convicted of a sexual offense. Risk for sexual offending is based upon multiple psychological factors, including a general propensity for rule-breaking/criminality and sexual–specific risk factors (Brouillette-Alarie Hanson, 2015). 

The Stable-2007 manual uses the following precautionary language for use with individuals convicted of child pornography-only offenses: a) the tool may be used as a clinical guide to identifying treatment needs and supervision targets, b) the tool should not be used to estimate recidivism rates or to assign nominal risk categories, and c) users should explicitly acknowledge that the tool is not validated for child pornography-only offense. 

A recent meta-analysis that included a sample with a high number of CSEM-exclusive male subjects found the STABLE-2007 to have good predictive accuracy for a new child pornography offense. These preliminary findings are promising to investigate further the generalizability of the Stable-2007 items to individuals convicted of Internet sex offenses. The Stable-2007 and the Sex Offender Treatment Intervention & Progress Scale (SOTIPS) are two of the commonly-adopted dynamic risk assessment tools for individuals convicted of Internet sexual offenses. (Azizian A. From Research to Practice: Designing a Treatment Program for Individuals Convicted of Child Sexual Exploitation Material. (2021) 5(2): Journal of Mental Health & Clinical Psychology)

STABLE- 2007 assesses 13 stable risk factors that have been shown to correlate with sexual recidivism, each scored using a three-point rating system, where 0 refers to “no problem,” 1 refers to “some concern/slight problem,” and 2 refers to “present/definite concerns.” for a total of 26 possible points. For individuals who did not offend against a child under 14 years old, emotional identification with children is not scored and there are only 12 items, the scale is subsequently scored out of 24 points for that group.
STATIC-99R?

YesNo
On the STATIC-99R which predicts sexual recidivism, this offender scored in the risk range. Offenders with this same score from the routine samples have been found to sexually recidivate at % to % after 5 years. The Revised STATIC-99 Coding Form is attached.
STABLE 2007?

YesNo
Mr. scored out of a possible [24/26] points on STABLE-2007 which places him in the density range of criminogenic needs.
Mr. STABLE – 2007 item scores are summarized in the table below.

STABLE-2007 total score out of 24/26
STABLE -2007 does not measure all targets relevant to risk and to correctional rehabilitation and Mr. may have other needs not included in this measure.

CPORT?

YesNo
CPORT RISK ASSESSMENT
For CSEM offending men with no official history of any other type of sexual offense, the only validated static risk measure to date is the Child Pornography Offender Risk Tool (CPORT). The Child Pornography Offender Risk Tool (CPORT) is a seven-item structured tool to assess the likelihood of future sexual offending over a 5-year fixed follow-up. CPORT was significantly predictive for child pornography offenders with no known contact offenses and is the only CSEM offender-specific risk assessment tool to have shown predictive validity for sexual recidivism. The accurate assessment of risk involves gaining an understanding of all available, relevant factors associated with outcome behavior. The historical, non-changeable aspects of the offender referred to as "static" risk factors (e.g., age at first offense, number of previous convictions), have been demonstrated to relate to recidivism potential. CPORT evaluates many different factors such as the age of the offender at the time of the incident; any prior criminal history; any prior failure on conditions such as probation, parole, or conditional release; any prior sexual offense history; an indication of pedophilic interests; and gender of the victim in child pornography content, An offender undergoing a “CPORT Evaluation” is given a “risk score” for reoffending. Numerous sources of information that are helpful in determining a risk score for CPORT may include criminal history, police notes, offender interviews, victim and family interviews, and warrant information. If more than one item is missing on CPORT, the tool will not be scored.
Mr. scored a out of 7. Appendix A, CPORT form attached.
CASIC?

YesNo
CASIC ITEMS
The companion measure to CPORT is the Correlates of Sexual Interest in Children Scale (CASIC). Recent research suggests that admission of sexual interest in children is a risk factor for any sexual recidivism. Behavioral correlates (coded yes/no) of admission of sexual interest in children in the risk tool for men convicted of child pornography offenses include: (a) never married (b) child pornography content including child sexual abuse videos (c) child pornography content included sex stories involving children (d) evidence of interest in child pornography spanned 2 or more years (e) volunteered in a role with high access to children and (f) engaged in online sexual communication with a minor or officer posing as a minor (10%). If more than one item is missing, CASIC will not be utilized. CASIC must have a score of 3 or more to score positive on item #5 of CPORT.
CASIC

Date Completed Information Sources

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	Date Completed	Information Sources
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	No (0)	Yes (1)	U/K (?)	Items	Notes
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-
-
-
-
-

Mr. CASIC score is out of 6.
If more than one item is missing, CASIC will not be utilized. CASIC must have a score of 3 or more to score positive on item #5 of CPORT.
Static Risk Factors of Concern
Example: Risk indicators include: admission of pedophilic interests, and more boy-focused content in both child pornography material, as well as nude/other child material. For a person with this score and no contact offense history, the observed five-year recidivism rate is BLANK % for any sexual offense and for any child pornography offense.
Responsivity Factors
EXAMPLE: Mr. X finds the therapeutic process helpful in facilitating self-awareness and making changes. His motivation to reflect, present, and provide and take feedback is high. He is sensitive to a therapist’s cultural awareness and his/her ability to address issues without assumptions and judgments.
Recommendations
Example Violation of any of the items below is grounds for termination from the community-based sex offender treatment program. Amenability to sexual offender-specific treatment is assessed within the first 60 to 90 days. If found amenable, the client will continue in treatment, if determined non-amenable, he/she will be referred back to his or her Parole/Probation Officer. All sexual offender treatment is under the Containment Model programming that includes polygraphy. It is recommended that [X] complete sexual offender-specific treatment to include individual therapy and once weekly group therapy. He might benefit from participating in individual psychotherapy to help him address impulse control issues and recognizing and respecting boundaries. It is recommended that [X] complete a substance abuse assessment. He might benefit from joining a 12-Step program to help better manage his substance abuse problems. This is a problem that he acknowledges has existed for many years. He might benefit from a psychiatric evaluation to determine if he needs to be taking psychotropic medication. He is expected to actively engage in weekly group sex offender treatment. He will be on time for sessions,actively participate and maintain transparent communication regarding risk and lapses with his treatment providers, probation officer, group, and safety net. [X] will not have unsupervised contact with minors. Supervised contact will be approved by his treatment providers and probation officer. [X] should maintain consistent, full-time employment. No employment with or frequenting places where children congregate (for example, H2Oasis, school grounds, fast food restaurants with play areas, public swimming pools, playgrounds, toy stores, etc.). PO and Provider approval is required for any exceptions. No use of pornography or pornographic materials. No frequenting establishments geared toward adult sexuality (i.e., lingerie stores, adult bookstores, adult video stores, etc.). Failure to follow all of his probation/parole conditions and treatment recommendations is reason for discharge from the community based sex offender treatment program. Respectfully submitted,
Supervisor’s Signature: Michelle J. Yep-Martin, Psy.D., M.S., M.A. Department of Corrections Approved Provider Supervisor, State of Alaska
Should be Empty:

	Dynamic Risk Factor	Score	Comments
Significant social influences
Capacity for relationship stability
Emotional identification with children
Hostility toward women
General social rejection
Lack of concern for others
Impulsivity
Poor problem-solving skills
Negative emotionality
Sex drive and preoccupation
Sex as coping
Deviant sexual preference
Cooperation with supervision

Psychosexual Evaluation

Mental Status Exam

Thoughts

Index crime

BIOPSYCHOSOCIAL HISTORY

Static Risk Factors of Concern