Transcript The Challenges of Family Reunification with the Juvenile

“The Challenges of Family
Reunification with the Juvenile
Sex Offender: An Ecosystemic
Approach”
This presentation will review Ecosystemic Play Therapy Theory as it
applies to the process of family reunification with juvenile sex offenders.
I will review some related statistics and will present family reunification
under the broad umbrella of sexual abuse prevention and breaking intergenerational patterns of sexual abuse. Finally, I will provide information
on how to capitalize on a family’s strengths, work cooperatively with other
treatment providers, the courts, DYFS and probation in presenting an
outline of the process of family reunification and returning the juvenile
offender to the home and safely maintaining him/her afterward. The
presentation will include case materials and examples throughout.
Robb Hinds, MA
October 28,2011
Family reunification
•Don’t do it!
• or
•Don’t do it alone!
Why do reunification, then?
• The only statistics I’m going to show you…
– Amongst Juvenile Sexual Offenders 31% of
those twelve and under offended against
family members and 73% of those happened
at home.
– Amongst Juvenile Sexual Offenders 24% of
those twelve and older offended against
family members and 68% of those happened
at home.
–
OJJDP (2009)
That means……
• That about thirty percent of our Juvenile
Offenders committed their offense against
a family member……
• And that about thirty percent will need
some form of family reunification….
Because…
To be SURE……
•It will happen,
eventually, whether
you think it’s the right
thing to do or not!
The Jump Start Program…
What I do, What I’ve done
• Individual, group and family therapy
• Currently, two groups per week with
twenty clients
• Small groups (dyad, triad and sometimes
more) per week
• Probation meeting with each group
• Family therapy PRN
• It’s all about the MILIEU!
My Theoretical Foundation…
World Community
Metasystems
Dominant/National/Political Culture (Sex Offender Hysteria)
Regional Culture
Other Systems
Medical
System
School/
Daycare
Mental Health
System
Church
Social
Services
Legal
System
Employment
Probation/
Megan’s Law
Peers
Familial Systems
Nuclear Family
Extended Family
Ethnocultural
Context of
Child & family
Interactional Level
Child
Parent
(Ethnicity, Culture,
Religion, SES, etc.)
Dyadic Relationships
Representational
Level
Internal Working
Model of Self
Internal Working
Model of
Relationship
Sexual Offender
Monster
Historical Time
Internal Working
Model of Family
of Origin
Internal Working
Model of Self
Internal Working
Model of
Relationship
O'Connor & Ammen, 1997, as modified by Hinds 2011
The Ecosystemic Model and Theory
• Is “a hybrid model that derives from an integration of
•
•
•
biological science concepts, multiple models of child
psychotherapy, and developmental theory.”
"It is a systems theory that addresses intrapsychic,
interactional, developmental and historical processes.”
It differs from most systems theories in that it includes the
idea of the actively developing individual over time and
because the primary "unit” of focus “is the individual”.
It differs from ecological models (Knoff, 1986,
Bronfenbrenner, 1977) in that it begins with the individual as
a system that entails, at a minimum, the interaction between
the mind and the body, and that allows for various other
elements as needed or desired to describe intrapsyhcic
functioning.
The Ecosystemic Model and Theory
• Recognizes that the individual is "embedded within multiple interrelated
systems" and that "these systems must be taken into consideration.”
• The concept of nested systems, however, is not sufficiently complex to
reflect the nature of any individual's real ecosystem.....The very nature of
an ecosystemic model is such that it is readily inclusive of additional
points of view and evolves as time passes
• It begins with the individual and focuses on the functioning of the
individual and, in particular, on "optimizing the functioning of that child in
the context of his or her ecosystem.”
• The ecosystem is potentially either a source to support or to interfere with
the optimal development of the child (O'Connor & Ammen, 1997). In all
likelihood, both support and interference are likely to be normal and even
necessary parts of optimal development in some degree (Kohut, 1978),
only affecting development severely when in extreme degrees, such that
support is severely limited, or interference is excessive, or both.
The Ecosystemic Model and Theory
• Moves from the individual level to the level of interactions
•
•
•
•
that occur in dyads.
It incorporates interactions within various other systems,
including the parental/spousal unit(s), siblings and family.
And beyond the immediate family lie the extended families
and their respective histories.
And various additional systems, as well, including race,
ethnicity, culture and religion, on an abstract level, and
medical, educational, vocational, judicial, social service,
police and mental health systems on a more concrete level
(which of course applies to our clients).
Beyond these systems are regional culture,
dominant/political/national culture, world culture and finally
historical time; referred to as Metasystems. (S.O. Hysteria)
The Ecosystemic Model and Theory
• Metasystems influence individuals indirectly through their
influence on the representational understandings of the
culture's expectations, beliefs, and values. But this also
directly affects the child when these representational
understandings determine the behaviors of people in systems
in which the child is involved. The meta-systemic level refers
to both the current socio-cultural context and the recognition
that this context evolves over time and is affected by its
history. (The current state of affairs re: S.O.’s applies here).
• O'Connor (1994) emphasizes the importance of the passage
of time in the model. For the individual this means that
developmental change over the course of the life span must
be considered, as well.
The Ecosystemic Model and Theory
• They refer to Maturana's ideas about systems theory. that
•
•
living organisms are autonomous and autopoietic (selfcreating or self-defining), and that "what makes a living
organism living is it's way of being in the world is always
organized around maintaining its own being (p5)".
The individual is said to operate from a subject-dependent
perspective That we create internal meanings, and thereby
our definition of reality, as we experience and interact with
the world.
This subject dependent state means that "we understand the
regularity of the world as a result of our history of
interactions and current interactions without any point of
reference independent of ourselves (O'Connor & Ammen,
1997, p5)." (which we often see as egocentric).
The Ecosystemic Model and Theory
• As human beings we are drawn to engage in interactions with
•
others and to use language to develop meaning systems
about our experiences.
Maturana introduced the term structural coupling, which is
the process whereby the organism interacts with the
environment over time. This results in a coordination of
behaviors that take on meaning between the involved
organisms. From this develop interpersonal or social
systems and "an intrapsychic symbolic system in which the
individual becomes an observer of his or her experiences
(including behavior, affect and thoughts) and as an observer
develops internal models of self, others, relationships and the
world. The development of our intrapsychic systems cannot
emerge independent of interactions with others in our
interpersonal systems. (Our guys are lacking
here…they don’t observe their experience, they just
exist in it.)
The Ecosystemic Model and Theory
• These intrapsychic meanings affect our
behavior, which affects our interactions, which
affect our intrapsychic meanings, etc. in an
ongoing feedback loop and, in time, become
"internal representational systems" derived
from the history of our interactions with
others. (Our guys have trauma as part of
their representational systems.)
Historical information is embedded on three
levels according to Maturana's theory
• On the biological level, this entails the maturational and
constitutional abilities of the child (And we are beginning to know
how trauma effects brain development (Singer, 2010)).
• On the intrapsychic system level, it occurs in the internal
representational systems (And now they have an internal
representation as a sex offender, at least, or as a Monster, at worst).
• On a broader level, it occurs in social systems and culture, whereby
norms are established and passed on inter-generationally. (And now
we have “sex offender hysteria” where they grew up in families that
have sexual abuse in their histories, but now they are considered
monsters.)
Philosophic Underpinnings of Ecosystemic Theory
• Based on a phenomenologic philosophical
perspective that is consistent with the subjectdependent perspective previously described.
• From the phenomenological perspective, reality is
the result of an interaction of both the observer and
the observed. In contrast to the natural science
perspective, it assumes that objective reality is not
determined by an absolute external phenomenon,
nor is it arbitrarily determined by the observer's
internal processes. Rather, reality is the result of an
interaction of both the observer and the observed
(Giorgi, 1983, from O'Connor and Ammen, 1997,
p3)."
Key Elements of Ecosystemic Theory
• Concepts of personality and pathology, as well as the goal of
•
•
therapy.
Development in all social, emotional, and behavioral areas is
cognitively driven; that is to say, children cannot progress in
other areas beyond the limits imposed by their cognitive
development.
Once the environment inhibits progress in one or more areas,
the course of the child's subsequent development is altered,
sometimes irrevocably (p. 69)." Thus, the individual's
interactions with significant others in his or her environment
is seen as crucial to the individual's concurrent and
subsequent development and to our conceptualization's of
personality functioning and psychopathology (O'Connor,
1994).
Concepts of Personality
• O’Connor describes personality theories as
having several common elements
• They pose some force that motivates
behavior
• They incorporate "developmental changes in
functioning over the life span”
• They explain pathological functioning in a
manner consistent with the first two elements
The Ecosystemic Concept of Personality
• Ecosystemic theory (O'Connor, 1994) postulates that human behavior is,
at least to some degree, biologically driven, with the intent of individual
and species survival. "At its most basic level, this drive motivates humans
to seek rewards and to maximize personal gratification in a relatively
egocentric way. Secondarily, this drive motivates humans to avoid
punishment as a potential risk to survival.”
• “If the human infant's development and socialization proceed optimally,
the drive is modified to the point that the individual will seek to maximize
his or her own gratification while minimally interfering with other
individuals seeking to do the same. The drive is then channeled into
more social behavior, and the child becomes less egocentrically focused
(p. 68-69)."
• Ecosystemic theory includes a secondary drive that is social or affiliative
in nature motivating the individual to interact socially and to participate in
and form social groups (O'Connor, 1994).
The Concept of Pathology
• Psychopathology in this theory is diagnosed when individual's
•
•
are unable to get their needs met in a manner they find
satisfactory, or when getting their needs met substantially
interferes with the ability of others getting their needs met.
Thus, pathological behavior is viewed as the individual's "best
attempt at coping with his or her internal or external
circumstance....The phenomenology of the behavior is that it
has more positive than negative associations, or it would not
continue” (O'Connor, 1994).
Psychopathology in this theory is diagnosed when individual's
are unable to get their needs met in a manner they find
satisfactory, or when getting their needs met substantially
interferes with the ability of others getting their needs met.
The Concept of Pathology
• Allows for the explanation of dysfunction as resulting from
•
•
internal and/or external mechanisms (O'Connor, 1994) as the
source of an individual's inability to get her or his "needs met
may be individual, interactional, or systemic in origin.”
(O'Connor, 1997,p241).
The theory recognizes that some pathological conditions,
including genetic, biologic, neurologic, cognitive or other
constitutionally based disorders, have the individual as their
point of origin.
The theory also recognizes that some disorders have their
point of origin in one of the systems in which the individual is
embedded. In these cases pathology results when a healthy
individual is involved in a pathological system or from the
interaction between seemingly non-pathological individuals,
in a relatively benign environment (O'Connor, 1994).
The Concept of Pathology
• An individual who is unable to get his or her
needs met adequately as a product of distress
or conflict turns to socially unacceptable
means to get those needs met
The Concept of Pathology
• Thus, an individual who is unable to get his or her
needs met adequately as a product of distress or
conflict caused by any myriad of factors, who turns
to an inappropriate object to get their needs met,
whether sexual, emotional or otherwise, becomes a
juvenile sexual offender.
• Bottom line… they’re trying to get their needs
met, but doing it in the wrong way.
World Community
Metasystems
Dominant/National/Political Culture (Sex Offender Hysteria)
Regional Culture
Other Systems
Medical
System
School/
Daycare
Mental Health
System
Church
Social
Services
Legal
System
Employment
Probation/
Megan’s Law
Peers
Familial Systems
Nuclear Family
Extended Family
Ethnocultural
Context of
Child & family
Interactional Level
Child
Parent
(Ethnicity, Culture,
Religion, SES, etc.)
Dyadic Relationships
Representational
Level
Internal Working
Model of Self
Internal Working
Model of
Relationship
Sexual Offender
Monster
Historical Time
Internal Working
Model of Family
of Origin
Internal Working
Model of Self
Internal Working
Model of
Relationship
O'Connor & Ammen, 1997, as modified by Hinds 2011
MY BIG PICTURE…….
• Treatment of the Juvenile Sexual Offender and
Family Reunification
– Are about preventing sexual abuse….
– And about disrupting inter-generational patterns of
sexual abuse…..
– So that not only do our clients not commit further
offenses….
– But, that they also prevent their own offspring from
becoming offenders or from becoming victims.
Break for experiential exercise…
• What are the needs and goals of the
offenders?
• What are the needs and goals of the
victims?
• What are the needs and goals of the
family?
Needs of the offender….
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•
•
•
They want to be back home with their family.
They want to not offend anymore.
They want to resume having a ‘normal’ life.
They want to have their needs met without interfering
with the needs of others…and they want to learn how to
do that.
• They want to have a ‘normal’ sex life.
• They want to get over their guilt (if they have it) and
they don’t want to accept that they are to blame and are
responsible for the harm they’ve done.
Needs of the victims…..
•
•
•
•
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•
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They want their family to be whole again.
They want to be safe.
They want to feel they can trust others.
They want to be able to enjoy normal sexual development and
romantic/sexual relations.
They don’t want to feel stigmatized.
They want to feel good about themselves and to have positive selfesteem.
They want to stop feeling like it’s their fault.
They want to feel they have control and are empowered to control
their own lives.
They want to not be angry anymore.
They want to sleep at night.
They want to stop having flashbacks.
They want to stop being depressed and anxious.
Needs of the Parental Units….
• They want their family to be whole again.
• They want to love and support both of their children
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•
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•
(which is an almost impossible task to manage).
They want their abusing child to get help so he/she
doesn’t do it again.
They want their victim child to be okay.
They want to get over their own guilt for having allowed
such a horrible thing to happen under their watch.
They want it all to just ‘go away.’
Clearly the needs of these three
interdependent units are contradictory
• Thus, I say… Don’t do it!
• Except that, once the JSO is off of probation, all
•
•
these forces will come together and reunification
will happen anyway.
Thus, to safeguard the victims, we need to push
to do reunification….
We have a moral and ethical obligation to
undertake this work.
So How do you do reunification?
• Again, first, YOU CAN’T DO IT ALONE!
• Second, the ideal way to do it RARELY
happens
• Third, and most importantly………………
THE PRIMARY FOCUS SHOULD BE ON THE
NEEDS OF THE VICTIM, NOT THE
OFFENDER
But what a challenge…..
How do you place
the needs of the
victim over the
needs of your own
client????
Did I mention?????
YOU CAN’T DO THIS ALONE!
So, who are the players and what are their roles???
The Courts
DYFS
Probation/Parole
YCM/CMO
School
The Family
The Mental Health Clinician of the victim
The Mental Health Clinician of the JSO
And make sure you get consent to communicate with all of
the above players. For me, it means five separate
signatures for release of information at the time of
intake.
The Courts
• For the offender, usually order ‘no victim
contact.’
– Which means, if you want to do family reunification,
you have to petition the court to modify that order.
• Or, they are otherwise involved with DYFS and
approve ‘supervised contact’ before the victim is
ready.
– Which means, you have to advocate against your
client to get the court to order ‘contact as per the
recommendations of treatment providers.’
The Department of Youth and
Family Services….
• May have been involved with the case from the onset of the report
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of sexual abuse.
May have had several changes in caseworkers since the origin of
their involvement so the current caseworker may not be any more
knowledgeable of the case than you are.
May have as their primary goal ‘to close the case’.
May be able to access other resources that you cannot.
May be nothing but an inconvenience.
May be a great aide in getting and monitoring the other services the
family needs.
May be the only other resource you have.
• Remember, you can’t do it alone.
The Care Management Organization
and/or Youth Case Management
• Sometimes they’re involved and sometimes they’re not.
• When they are, they’re motive is to close out as soon as possible
(They’ve often been involved for ninety days before you even get
the case) .
– In the additional ninety days they may be involved, you need to get
what you can from them while the full burden of the case transfers onto
your shoulders.
– You need to try to get them to extend any in-home services for as long
as possible.
– You need to get them to terminate in a healthy, appropriate way so as
not to cause further trauma (They are often the first mental health
providers to intervene with the family, which often gets quite attached
to their services or to them as providers. And they often don’t realize
the import of their interactions with families/clients).
Probation/Parole
• What an asset. (wink, wink, Laura)
• Probation plays a primary role in the process.
– They are the eyes that can check out the living situation to make
sure the circumstances are safe enough to follow a basic safety
plan and to prevent unsupervised contact.
– They are the hammer to ensure that offenders adhere to
treatment.
– They are the ‘superego’ to the ‘id’ of the juvenile and the ‘ego’ of
the therapist, thereby reinforcing in real life the metaphor of
what they’re learning in therapy.
The Schools….
• Success at school for Juvenile Sex Offenders is paramount… and
hard to achieve, for both the JSO and the Clinician.
– Is the student classified for Special Education…
• If so, is the plan appropriate and meeting the educational and emotional
•
•
needs of the student?
If not, has there been a Child Study Team evaluation? Should there be?
How do you get the family to request one? How do you get the school to
agree to one?
How do you intervene with the school to deal more effectively with the
student to get him/her to experience some success? (I still don’t have the
answer to this one as it requires a case and school specific response).
• The valuable role of probation in this aspect of the client’s
functioning, as well.
• What a huge impact on the client’s life when you can get it to work!
The Clinician of the victim
• Perhaps the hardest of the roles…..They have to help a victim heal
and gain control of their own life (See, “Evicting the Perpetrator” by
Ken Singer, 2010).
• They have to process the details of the sexual abuse with the victim.
• They have to help the victim find resolution to feelings of animosity
for the abuser and positive feelings for the abuser such that they
want to have renewed contact with that person.
• They have to manage their own feelings of animosity for the abuser
to be okay with the victim wanting to have renewed contact with
the abuser.
• And they have to feel the victim will be safe, physically and
emotionally, if there is renewed contact with the victim.
And the clinician of the sexual
offender has to be the one to
manage all the other players……
and their concerns.
The Clinician of the Juvenile Sexual
Offender….
• Has to get the client to acknowledge his/her offense fully.
• Has to get the client to identify and be willing to adhere to an
effective safety plan.
• Has to get the client to comprehend the harm that he/she has
done to his victim, his victim’s family, his own family and himself.
• Has to get the client to experience remorse for his offense
beyond the consequences he/she has suffered (yet at the
same time, be able to recover from such remorse).
• Has to get the client to be able to communicate all of the above
to his/her victim in reunification sessions.
How the Hell do you do THAT?
…And manage all the other
players, and keep the victim in
mind as the person whose
needs are primary, when the
offender is your client???????
•
It’s impossible! Just don’t do it alone!
What I do…..the five modules.
• Social skills/Anger Management…
• Sexual Respect…
• The Sexual Assault Cycle…
• Victim Empathy
• Relapse Prevention
Victim Empathy…..
• The debate about empathy and it’s role…There’s
•
•
•
no evidence, but we all know it’s true.
How to get empathic responses from our
juvenile sexual offenders.
The letters…to someone who hurt you, the
apology letter and the letter to yourself from
your victim….
The letter from Sean the Survivor.
Relapse Prevention…
• The Relapse prevention module.
• The ‘Woodsman’.
• Defense Mechanisms vs. attitudes/beliefs
and thoughts. The Catch 22.
• Healthy Living and the applicability of the
model to everything in life and NOT just
sexual offending.
Meta-Cognition
Internal conflict creates stress & anxiety
Thinking about thinking
Thoughts
Defense
Mechanisms
Super
Ego
Id
Cognitive distortions
Self-talk
Attitudes
Beliefs
Ego
Sex offender label
Probation
Megan’s Law
Treatment
Perceptions
See, hear, smell,
taste, touch
Interaction with
the outside world
Meta-Cognitions
Avoid
Seemingly
unimportant decisions
B
e
h
a
v
i
o
r
s
Feelings
External conflict
from the demands
of the outside
world creates
stress & anxiety
Healthy Living
Thinking
about
doing
Escape
High risk
situations
Lapse
Giving up
Relapse
Hinds, 2008
The Reunification… Foundations
• The victim’s had treatment (hopefully, but not
•
•
always) and is ready to meet with the abuser (as
okayed by the victim’s therapist).
The offender has accepted responsibility and can
communicate that.
The parents have accepted what happened,
their own role for allowing it to happen, while
still allowing their son/daughter to accept full
responsibility for the offense.
The Reunification Therapy Session
• The offender expresses gratitude for the victim being there and total
control to leave if it’s too uncomfortable.
• The offender expresses remorse/guilt and an apology for what
he/she did and a willingness to talk in detail about the offense if the
victim wants. (Many recommend going into detail about the
offense, but I’m not so sure, especially if the victim is hesitant …
I welcome feedback about this.)
• The offender expresses full responsibility and absolves the victim of
any responsibility for what happened (including, if possible, how
he/she manipulated or coerced the victim to comply with the
inappropriate sexual behavior).
• The offender identifies the safety plan and what steps the victim
should take if he/she should ever feel uncomfortable or unsafe in
the future.
The Reunification Therapy Session
• The offender expresses a willingness to respond to any questions
the victim might have and does so (having prepared for the kinds of
questions that might be asked previously with the therapist).
• The offender promises to continue in treatment to get the help
he/she needs, to never commit another sexual offense against
anyone, ever, again.
• The offender expresses that if there is anything he or she could do,
now or in the future, to make up for the offense, that he/she is
willing to do so if the victim requests it (and the therapists agree it’s
okay).
• The offender agrees to participate in future sessions if the victim
wants them and an agreement to participate fully in family therapy
sessions as the reunification process proceeds because now we
have to address the other issues of family functioning.
The follow up and continued
surveillance of the reunified family
• Again, Probation plays a primary role in making sure
the family is compliant with the safety plan (again,
wink, wink Laura).
• Rule 11…..the need for the therapist to ask, every
session, if the safety plan is being adhered to.
• The need for the therapist to establish a relationship
of trust so he/she can intrude into the fantasies of
the client to ascertain if they include the victims or
other children (and if they do, that’s a whole ‘nother
story).
The After effects…..
• The term of probation is finished.
• The Group treatment protocol is finished.
• The client and family are ready to be
released from all the external controls that
have kept them safe.
• The fear in us still remains…….
Don’t Do It Alone……
• The message for us in doing reunification work is the
same message our clients need to get for the remainder
of their lives…..Don’t go it alone.
• If you are having problems of any kind, get help. If
you’re having thoughts about doing something
inappropriate, call someone…..If you do, you won’t
reoffend.
• And be clear, when you have your own children, they are
at risk of becoming victims or offenders. Don’t allow
yourself to ‘put on blinders’…be aware of your defense
mechanisms, your beliefs and attitudes, your thoughts,
and how they could put your own children at risk…and
don’t let them become victims, as victims or as abusers.
Discussion and commentary…..
• I don’t expect this was educational but hope
that it was a stimulus for thought and dialogue
for all of us…
– To have greater clarity about our goals for family
reunification.
– To have greater clarity for how to do family
reunification.
– To understand how to convey that the greater goal is
to prevent future generations from becoming victims
or offenders of sexual abuse.
Sources and Resources
• O’Connor, KJ (2000). The Play Therapy Primer, 2nd edition, John Wiley &
Sons, Inc., New York.
• O’Connor, KJ & Ammen, S (1997). Play Therapy Treatment Planning and
Interventions: The Ecosystemic Model and Workbook, Academic Press, San
Diego.
• Rich, P. (2003). Understanding, Assessing, and Rehabilitating Juvenile
Sexual Offenders, John Wiley & Sons, Inc., Hoboken, NJ.
• Singer, K. (2010). Evicting the Perpetrator: A Male Survivor’s Guide to
Recovery From Childhood Sexual Abuse, Neari Press, Holyoke, MA.
Contact Information
Robert G. Hinds, MA
The Jump Start Program
303 George St., Ste. 200
New Brunswick, NJ 08901
Tel: 732-235-6869
[email protected]