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Outpatient Treatment Considerations for Mentally Ill Clients With Problem Sexual Interests, Behavior, or Offending (MI-PSIBO) (From Handbook of Sex Offender Treatment, P 41-1 - 41-18, 2011, Barbara K. Schwartz, ed. - See NCJ-243091)

NCJ Number
Ruth E. Lewis, Ph.D.
Date Published
18 pages
This chapter addresses outpatient treatment considerations of mentally ill clients with problem sexual interests, behavior, or offending (MI-PSIBO) as well as economic considerations.
The chapter identifies and discusses issues to consider as well as specific practical interventions and approaches when planning and providing treatment for MI-PSIBO clients. Given the differences between psychotic and non-psychotic offenders and the complex relationship between mental illness and sex offending, this chapter identifies and discusses the practical treatment considerations for MI-PSIBO clients. These offenders can be divided into several subgroups; however, this chapter addresses treatment considerations for clients with problem sexual interests, behavior, or offending and any of the following DSM-IV Axis I disorders (American Psychiatric Association, 1994): schizophrenia, schizoaffective disorder, major depression with psychotic features, and bipolar disorders. For each of these diagnostic groups, a dual diagnosis of substance abuse or post-traumatic stress disorder (PTSD) may also be present. Although "ideal" treatment approaches will be discussed, funding limitations posed by the current economic crisis and subsequent far-reaching budget cuts are also acknowledged to be a factor in treatment capabilities for MI-PSIBO clients. Outpatient treatment for this population involves the integration of mental health treatment services and problematic and/or criminal sexual behavior. The importance of the use of a treatment team for a comprehensive treatment program is noted. The "Timing of Treatment Components" is discussed in a separate section, with attention to pre-treatment considerations, medications, evaluation, and the development of a therapeutic alliance. A section discusses "An Expanded Cognitive-Behavioral Model" for MI-PSIBO clients. The remaining two major sections of the chapter discuss "Monitoring Treatment Progress" and "Other Treatment Considerations." 33 references