DSH - Coalinga: Treatment

The treatment program is structured into four Modules:

1. Treatment Readiness

   • Facilitates the participants’ transition from the prison culture to the treatment environment.
   • Prepares participants to take an active role in their therapy.
   • Uses didactive methods to educate participants on such topics as hospital attitudes, interpersonal skills, anger management, mental disorders, victim awareness, cognitive distortions, and relapse prevention

2. Self-Regulation: Building a Better Life

   • Shifts participants’ focus from education and preparation to personal therapy.
   • Teaches coping strategies, behavioral skills, prosocial thinking, and emotional awareness, to increase self-control.
   • Requires that the participants:
     • Acknowledge and discuss past sexual offenses;
     • Express a desire to reduce their risk of re-offending;
     • Agree to participate in required assessment procedures;
     • Be willing and able to conduct themselves appropriately in a group setting.

3. Treatment Integration and Community Preparation

   • Integrates the skills participants learned during Phase II into their daily lives.
   • Broadens and deepens their skills in relapse prevention, coping with cognitive distortions, and developing victim awareness.
   • Causes participants to examine their daily experience in unit life and to practice their behavioral interventions through extensive use of journals and logs.
   • Requires that participants:
     • Accept responsibility for past sexual offenses;
     • Articulate a commitment to abstinence, that is reflected in current behavior;
     • Understand the trauma resulting from their sexual crimes;
     • Are able to correct deviant thoughts;
     • Demonstrate ability to manage deviant sexual urges and impulses;
     • Show good ability to cope with high risk factors for re-offending;
     • Cooperate with institutional supervision;
     • Display skills necessary for self-regulation;
     • Demonstrate ability to maintain appropriate relations with female staff;
     • Display skills necessary to avoid emotional identification with children.

4. Community Reintegration

   • Develops a detailed Community Safety Plan developed in conjunction with the offender's assigned Conditional Release Program (CONREP).
   • Involvement of family members and significant others in the relapse prevention plan.
   • Focuses on how the skills in relapse prevention, managing cognitive distortions, victim empathy, and coping strategies will generalize and transfer to the community setting.
   • Treatment teams must determine that participants:
     • Can fully describe the negative impact of abuse on their victims;
     • Acknowledge and accept past sexual offenses;
     • Articulate commitment to abstinence;
     • Correct all cognitive distortions;
     • Able to control deviant sexual urges and interests;
     • Can describe a complete range of prospective high-risk factors and internal warning signs;
     • Cope with risky situations and thinks in ways that reduce his likelihood for re-offending in their daily lives;
     • Follow rule and comply with requirements of supervision;
     • Display no inappropriate impulsivity or inappropriate emotions;
     • Relate well with women and able to avoid emotional identification with children;
     • Conditional Release Program in the county of commitment is willing to accept participant into outpatient treatment and supervision.

5. Community Outpatient Treatment under CONREP

   • IS administered by Liberty Healthcare in the offenders’ county of commitment.
   • California Superior Court approves and orders placement into this final phase of treatment.
   • Transfers the site of ongoing treatment from CSH to the community setting.
   • Provides intensive on-going supervision and monitoring to facilitate early detection of relapse and ensure community safety.

California law requires that the Department of State Hospitals develop a structured treatment protocol to assess the participants’ treatment progress and to ensure protection of the public. Key elements include:

• The Director of the DSH submits a recommendation to the court for a person’s release, only when the professional staff is convinced that the person will no longer commit acts of violence.
• The program is designed to treat and confine persons only as long as their disorders continue to present a danger to the health and safety of others.
• Basic medical needs are provided within the treatment facility. If a medical specialist is needed or the medical condition requires hospitalization, this will be provided for by local community resources.
• At all times, staff members and correctional officers accompany any person receiving medical services outside of the treatment facility.
• The state hospital's visiting policies include specific visiting hours, visitor screening requirements, and a safe, well-monitored environment.