Counseling and Treatment plan

The scenario

The scenario chosen for the final project is that of Raquel. Raquel is a 16 year old mother of two who comes to the community corrections centre after being referred to the therapist by the courts. She was convicted of prostitution and simple drug possession. This is apparently her third legal charge as a minor, the first one happening when she was 13 and the other happened when she was 15 years old. At age 13 when she was arrested for shoplifting and alcohol possession by a minor, and at age 15 she was arrested for vandalism. Raquel’s family comes from Costa Rica, and a relative brought her up after her mother died when she was 1. She does not know her father. Raquel appears to be a troubled teenager with a reputation for child sexual relations, violence, prostitution, and drug use. This essay attempts to create a counseling and treatment plan for the offender with multiple related factors.
Offender category (ies) and treatment considerations

Offender classification and categories and their assessment are distinct processes that take place in prison systems and community correctional centers. These processes take place from the admission of offenders to correctional facilities through their sentence completion, release and post-incarceration. The classifications, assessment and treatment considerations have three main goals which are; to ensure protection and community safety of the public, identification of offender needs and matching them with their treatment and management, and to improve correctional operation while cutting on costs and recidivism (Hanser, Mire, & Braddock, 2011).

In the US, juvenile offenders are classified as low risk, moderate risk and high risk offenders for any new offense behaviour. The classification is based on various factors that are associated with the offense behaviour. These factors include age at first referral, prior referrals, family dynamics, school behaviour, peer relationships, history of abuse or neglect, history of parental incarceration, substance abuse, referrals for assault, and history of out of home placement (Supreme Courts, 2014). Raquel had her first legal charge as a minor when she was 13 years old when she was arrested for shoplifting and alcohol possession as a minor. Her second legal charge was when she was 15 years old and was arrested for vandalism.

Her first and prior referrals were when she was a young teenager, and considering that at 16 years old, she has three legal charges, this places her at high risk juvenile offender. Raquel comes from a Costa Rican family lineage, and she lives with her aunt, daughter, and son in government-assisted housing in Minneapolis. She also has several aunts and uncles in the Minneapolis area. Her mother died when Raquel was 1 year old, and her father is unknown. Raquel’s family has a strong ethnic identity rooted in the family’s Costa Rican lineage. In addition to her aunt and her children, she has several aunts and uncles in the Minneapolis area. However, Raquel is the only member of her family who has an arrest history. This family dynamic makes Raquel a moderate risk offender.

Raquel does not have a history of abuse or neglect as there is no history of physical, emotional or sexual trauma. However, she had sexual relations with a boyfriend when she was in the seventh grade and this place her in the moderate risk offender level. There is also no history of parental incarceration as she is the only family member with an arrest history. This makes her a low risk offender. Raquel was arrested for alcohol possession by a minor when she was 13, and she has a strong marijuana smell in her clothes when she reports to the centre. There is definitely some element of substance abuse, and this makes her a high risk offender. She was also arrested for vandalism when she was 15 and the local police believer that she belongs to a gang group. Due to this referral for assaults, Raquel is a high risk offender. Her childhood has been uneventful, but since the eleventh grade, her behaviour has been deteriorating. Her peer relationships also appear to be wanting as one of her children has a 15 year old father and she does not know the father of her other child. Raquel also tells the therapist that her only goal is to hang out with her friends, take care of her children and receive benefits. This school behaviour and peer relationships makes her a high risk offender (Supreme Courts, 2014).
Raquel is a moderate risk offender and the treatment option for this type of offenders is multisystemic therapy for juvenile offenders. Multisystemic therapy involves the use of a combination of empirically-based treatment approaches to address multiple variables that affect juvenile behaviour. Multisystemic therapy can be ideal for Raquel as it can improve her ability to make good decisions when choosing her actions and her peers (Thacker, 2014).

Multicultural factors evident in the scenario and how they affect treatment
Multicultural factors are very important in offender treatment mainly because they enable counselors to address all factors contributing to criminal behaviour or offense. In Raquel’s case, there are various multicultural factors that are evident. Raquel is 16 years old, and she is a mother of two. She also comes of a Costa Rican family lineage and was not brought up by her parents. As much as she was brought up around her aunt and other close family members, she obviously might have lacked parental attention and affection. Being a teenager and a girl from a Costa Rican lineage also puts her at a high risk of committing crime. She also has a criminal past as she has had three legal charges for different crimes, including shoplifting, alcohol possession, vandalism and now prostitution and simple drug possession. Addressing these multicultural factors in counseling and treating the offender can be beneficial (Thacker, 2014).

It is important to consider multicultural factors in the treatment of the offender because of the increasing acknowledgement of the impact of contextual factors in crime. According to Wright, Pratt, Lowenkamp, and Latessa (2011), criminal behavior can only be understood in terms of cultural context. Many prisons, community correctional centres, and other correctional facilities in the world tend to consider contextual factors when it comes to treatment and community support. The cultural identity of an offender is related with his or her family and community. For example, Raquel’s behaviour could be as a result of the social relationships that she has with her family and community. Poor social relationships or cultural identity could explain the reason why Raquel has been engaging in criminal activities. Strengthening the offender’s cultural identity can therefore go a long way in the treatment of the offender. This means that if the cultural identity of an offender is strengthened, then their social relationships would also be strengthened. Addressing the multicultural factors and needs in an offender can therefore be helpful in the treatment of an offender and desistance from crime (Hanser, Mire, & Braddock, 2011).

One development in mental health and psychology is the development and use of strength-based approaches. Strength-based approaches involve the use and development of an individual’s strong points, which are all the strong and positive points of a person. A strength-based approach also engages an individual in a collaborative treatment that he or she can be fully involved. In Raquel’s case, strength-based approaches could focus on all of her strong points considering all her multicultural factors. For instance, the counsellors can work with the offender to identify her strong points related to gender, age, culture, or family and use it for the correctional process. Since she was brought up around her extended family, involving the family in her counselling and treatment process can be very efficient. Using a strength-based approach has a lot of validity as it focuses on building the skills of an offender as a start point of offender treatment. Strength-based approaches are relevant in the multicultural factors in the offender treatment because the cultural identity of the offender could be a strong point (Barton, & Mackin, 2012).

An example of a strength-based treatment approach is the Good Lives Model (GLM) that conceptualizes individuals in terms of various psychological components that are considered to be good such as inner peace, happiness, or spirituality. According to this treatment approach, in order to start the offender treatment process, it is important to understand the basic needs of the offender and develop ways of meeting the needs. GLM is relevant in cultural identity when it comes to offender treatment, particularly in terms of spirituality. GLM considers spirituality to “finding meaning and purpose in life” and the cultural identity of the offender could be important in finding this purpose and meaning (Willis, Yates, Gannon, & Ward, 2013).
Treatment approach (es) and programs

Addressing criminogenic risk factors is the main goal of offender treatment and counselling. These factors are associated with criminal behaviour, and they are used to classify offender categories (Ward, & Stewart, 2003). Therefore, the treatment should address the offender’s psychiatric, psychological, physical, and criminogenic needs. In all prisons and correctional centers, there are four primary treatment categories. These include education, recreation, counseling, and psychotherapy. Offenders generally have a profound record of failure as they usually have lower literacy levels than the rest of the population. Research has also proven a relationship between inadequate education and criminal offenses. Being able to treat the educational needs of the offender can help in the rehabilitation of the offender, lower the recidivism rates and improve community adjustment (Ward, & Stewart, 2003).

Raquel failed the seventh grade and was subsequently placed in “special classes” because she “does not see the point in going to school” as her “life is all messed up, so there really is no point to try. This offender clearly identifies herself as a failure when it comes to her education. Therefore, the education program for offender treatment should address her educational needs by ensuring that she has access to education and literacy programs. If possible, the offender should be allowed to participate in education outside prison. If education has to take place within the correctional facility, the community should be as fully involved as possible. The educational treatment approach should aim at developing Raquel as a whole person considering her social, economic and cultural background. Creative and cultural activities should also be considered in the offender’s treatment plan as this can help the offender develop and express herself better (Voorhis, & Salisbury, 2014).

Recreational programs could also offer significant benefits for this type of an offender. Recreational programs do not require an offender to be able to read and write, and even the physically disabled offenders can engage in recreational activities. Some recreational programs like outward bound and therapeutic wilderness programs have been used among juvenile offenders. These programs provide an outdoor experience usually taking place in a one week or two week duration, and then juvenile offenders engage in physical conditioning, technical training, safety training, and team training. This program focuses on teaching the youth that they are capable of doing more and that they can trust and help others. Exercise therapy and especially strenuous physical activity has been proven to have positive psychological benefits to adolescents and people who have alcohol and substance abuse problems (Voorhis, & Salisbury, 2014). Exercise therapy can therefore be quite beneficial to Raquel.

Counselling programs can also be used for the offender as a treatment program. Counselling provides a cohesiveness that helps other institutional programs to run smoothly. Counselling helps offenders to adjust to and function in correctional facilities and prisons with minimal frustrations. Traditionally, counsellors conduct individual or group counselling sessions to address a wide range of issues, including drug and substance abuse, sexual offending, prostitution and anger management. However, counselling treatment is usually secondary to crisis intervention and maintenance functions. This means that counselling programs should be used with other treatment options as some offenders genuinely want change while others do not (Hanser, Mire, & Braddock, 2011).

Psychotherapy treatment programs involve counseling sessions conducted by professional counselors and psychotherapists to help the offender understand and control their behaviour. Psychotherapy can be done for individuals or through groups. Apart from counselling sessions, a psychotherapist can prescribe medication for offenders. Group psychotherapy is beneficial for juvenile offenders as it helps them in understanding and controlling their behaviour. Psychotherapists encourage openness and honesty on the part of the offender, and this makes it easier for the offender to address personal issues (Voorhis, & Salisbury, 2014).
Legal and ethical issues

Working in correctional facilities, particularly in dealing with criminal offenders and substance abuse presents various dilemmas on personal beliefs, judgement, and values. The history of how society views people who are incarcerated is characterized by emotions, biases, and misperceptions that have affected the treatment of offenders. For instance, it is not strange for offenders to be viewed negatively in the community just for being incarcerated. Because of the emotional nature of the offender counselling and treatment, counsellors should have different tools needed to explore legal and ethical dilemmas objectively. This, in addition to examining personal reactions to situations, can enable counsellors to proceed with the treatment ethically (Hanser, Mire, & Braddock, 2011).

There are a number of legal and ethical issues that should be considered in the treatment of the offender. One of the ethical issues is that the offender was arrested for prostitution and she has tested positive for HPV. HPV is transmitted through sexual activity, and since the offender already has an issue with prostitution, this can evoke personal feelings and judgements for counsellors and in the community. It is possible for Raquel to feel judged or discriminated against based on her sexual past, prostitution, the STI, and the fact that she has two children who have different fathers only at the age of 16. The counsellor should therefore maintain confidentiality, discrimination and ensure that the offender is able to access the needed counselling and treatment.

Another issue is balancing personal and professional standards. Counsellors in correctional facilities ought to balance what they consider right with what is considered right based on professional standards. For instance, substance abuse treatment professionals in correctional facilities who are social workers should be familiar with codes of ethics and may have to integrate their personal beliefs with the professional code. There are also some agency standards that conflict with an individual’s personal beliefs. While dealing with Raquel, counsellors should consider professional standards as well as personal beliefs in conducting counselling and treatment. Counsellors should therefore always weigh what may feel right based on personal values as well as professional standards (SAMHSA, 2005).

Another issue that could arise is justice whereby the counsellors would have to maintain impartiality and equality. Justice means that a professional would treat all their clients equally and give everyone the appropriate services. However, it is human nature not to treat everyone equally, and there would be instances when counsellors would have favourite clients or would want to limit contact with some clients. While it is human nature to be biased, it is important to understand when and how it affects one’s ability to practice justice so that no client is deprived of treatment. While dealing with Raquel’s case, it is possible to have some bias based on the context of the offender as well as the crimes she has committed. It is therefore important for counsellors to ensure that they treat the offender impartially and equally with other offenders. The offender should be able to fully access all the services needed for her treatment.

Another issue that one might consider in the treatment of the offender is the principle of autonomy whereby an individual has the right to live their lives as long as they do not interfere with the lives of others. The principle of autonomy respects an individual’s worth and promotes self-determination and governance. However, the offender is incarcerated and so she has limited rights. In addition, Raquel has advised the therapist that she does not wish to participate in any form of treatment and that her only goal is to hang out with her friends, take care of her children, and collect “benefits” because she is a “dud”. Some of these sentiments could bring harm to her and the people around her and so applying the principle of autonomy could be tricky for the counsellor. In such a situation, the therapist could play a key role in determining what is best for the offender (SAMHSA, 2005).
Measuring treatment outcomes

In order to measure treatment outcomes of an offender, various approaches can be used. These include long term, post treatment, follow-up measures and personality or attitude change. The most common approach used to measure treatment outcomes among juvenile offenders is the use of cognitive behavioural approach. This approach helps in evaluating the social problem solving skills, regulated impulsive behaviour and reduced rate of re-offense among juvenile offenders. The main measure of treatment outcome is recidivism, whereby the offender does not go back to committing crime. Cognitive behavioural therapy generally produces a mean reduction of recidivism among juvenile offenders by 25 per cent (Lösel, & Schmucker, 2005).

For Raquel’s case, the treatment should ensure that the offender does not go back to prostitution, use of drugs and vandalism. An effective approach should ensure that the offender is able to develop social solving skills and that she is able to make better decisions about her life and education. Some of the impulsive behaviours by the patient should also be minimized so that the offender does not commit the same crime.

The therapist can do follow-ups to assess re-offense. The therapist could also use arrest and conviction records to assess re-offense as committed by the offender. However, not all victims report all accounts of victimization and so the therapist can do follow ups on the offender as well as in the community to assess the behaviour of the offender in the community. For instance, the offender should be able to go back to school or find a job, and stay away from vandalism, prostitution and drug use and possession. The therapist should also pay close attention to the offender’s behaviour as many offenders would fake their behaviour in order to appear as if they are changed (Ridgeway, 2014).

In conclusion, Raquel is a moderate risk offender and her treatment should be systemic. Therapist and counsellors should consider all the multicultural factors that are present in Raquel’s case before proceeding with the treatment. Considering multicultural factors would enable the therapist to address all the factors that contributed to the criminal offense. The treatment programs that are ideal for this type of offense include education, recreation, counselling and psychotherapy as these would enable all issues to be addressed. There are various legal and ethical issues that the therapist should consider while treating the offender, including misperceptions and biases regarding the offence committed by the offender, balancing personal and professional standards, justices, and the principle of autonomy. The therapist should be able to create a balance between personal values and professional standards so as to ensure that the offender is treated fairly and without discrimination. In order to assess the outcome of the treatment, the therapist can assess recidivism which involves the likelihood of committing the offenses again. In summary, the primary goal of correctional counsellors and therapists is to address prison adjustment, family concerns, substance abuse, trauma, education, social wellbeing, and the risk of future reoffending. The treatment of Raquel in the correctional facility should therefore ensure that this treatment goal is met.




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