JUVENILE:_________________________________________________________ CASE #: __________________________ DIV/JUDGE: ________________________ WESTERN COLORADO REGION SEXUALLY ABUSIVE YOUTH (SAY) TREATMENT CONTRACT 1. INTRODUCTION Involvement in our treatment program for sexually abusive youth requires cooperation with the multi-disciplinary team. The goal for treatment is “NO more victims.” The following is a list of minimum conditions that are to be met during treatment. They are subject to revision according to your progress in treatment. Your signature, as well as your parent or guardian’s signature on this document signifies an understanding of each item. Once the contract is signed and returned to us, you will be expected to follow all the requirements without any exceptions. This contract remains in effect until the multi- disciplinary team determines that you have successfully completed treatment 2. ORIENTATION AND EVALUATION 2.1 I understand that a full psychological/sexual evaluation will be scheduled after I have entered a plea of guilty or been found guilty in a court of law if that evaluation has not been done. I shall provide the agency with any evaluations that have been done. 2.2 I shall sign and return this contract prior to beginning treatment. I shall follow rules of this contract. 2.3 I shall be expected to complete all written tests and assignments. 3. TREATMENT REQUIREMENTS 3.1 I understand that I am required to attend and participate in all scheduled sessions. 3.2 It is my responsibility to encourage my parents, guardians, or other significant adult(s) to be involved in the treatment program. 3.3 If I am sick or there is a medical emergency, an approved adult must call the agency and supervising officer. 3.4 I must be on time for each group. 3.5 I recognize that I must progress by meeting treatment goals. I must ask questions and I must be attentive. Simply attending Is not enough. it Is my responsibility to take the initiative to report to my counselors and supervising officer the progress I am making. 3.6 Members of my family, persons whom I have offended, and significant others may be invited to group. I will know ahead of time when someone is coming. Supervising officers may attend group without prior notification. I shall be required to answer many questions about my sexual past and about my current sexual behavior. I shaft openly and honestly discuss the complete details of the sexual abuse for which I am charged and/or have disclosed. 3.8 I understand that I have a right to refuse treatment, and further, I understand that such refusal may result in a more restrictive placement. A refusal for treatment must be submitted in writing. -2- 4. RESTITUTION 4.1 I recognize that an important purpose of the treatment program is to repair the damage to the victim (s), the community, and to myself so far as possible. 4.2 I shall pay restitution to the victim(s) as ordered by the court. 4.3 I shall participate in disclosure sessions with my multi-disciplinary team and with the victim(s) when appropriate. 4.4 I shall prepare for the clarification process for the person(s) whom I offended and will present the clarification to the person(s) whom I offended when it is deemed appropriate by the multi-disciplinary team. 5. CONDITIONS OF SUPERVISION 5.1 I shall not violate any local, state, or federal law or any order of the court. 5.2 I shall follow the registration requirements of C.R.S. 18-3-412.5. I have received a copy of the registration form. 5.3 I shall follow the requirements of C.R.S. 18-3-415 and 18-3-415.5 regarding being tested for the human immunodeficiency virus (HIV). 5.4 I shall follow the requirements of C.R.S. 19-2-924.5 and 19-2-925.5 regarding having a blood test to determine genetic markers (DNA). I shall pay the required fee to the Sex Offender Identification Fund for this test. 5.5 I shall attend and actively participate in evaluations approved or requested by the supervising officer and/or treatment provider(s). 5.6 I shall attend and actively participate in a treatment program approved by the supervising officer. I shall make progress and successfully complete the program to the satisfaction of the supervising officer and the treatment provider(s). 5.7 I shall submit to any program for psychological or physiological assessment at the direction of the supervising officer and/or treatment provider(s). This may include the polygraph, Abel screen, and/or plethysmograph to assist in treatment planning and case monitoring. 5.8 I shall be financially responsible for all programs, assessments, and any testing that is required of me unless I have made prior arrangements through the supervising officer or treatment provider. 5.9 I shall not change treatment programs without prior approval of the supervising officer. 5.10 I shall sign releases of Information to allow the supervising officer to communicate with other professionals Involved In my treatment program and to allow all professionals involved to communicate with each other regarding my case. This will include releases of information to the treatment provider of any victim(s). 5.11 I shall not go on overnight visits away from my home without prior approval of my supervising officer, caseworker, and/or treatment provider(s) and only after development of a safety plan. 5.12 I shall not leave the State of Colorado without written permission from the supervising officer or the court. I shall have a safety plan approved by group for each different trip. 5.13 I shall report to the supervising officer at reasonable times, as directed by the court or the supervising officer. 5.14 I shall permit the supervising officer to visit me at reasonable times at home or elsewhere without prior notice. 5.15 I shall answer all reasonable inquiries made by the multi-disciplinary team. 5.16 I shall report any law enforcement contacts to the supervising officer immediately. I shall also report them to multi-disciplinary team members at the next meeting. 5.17 I shall be required to notify third parties (e.g., school officials, other treatment providers) of my criminal or delinquency record, as directed by the multidisciplinary team. 5.18 I shall not use or possess a firearm, a dangerous or illegal weapon, or an explosive or incendiary device. -3- 5.19 I shall not consume or possess any alcohol or use any unlawful controlled substances. I shall submit reports regarding alcohol/drug treatment to my multidisciplinary team. 5.20 I shall submit to substance testing at the direction of the supervising officer and it may be at my own expense. 5.21 I shall obtain counseling or treatment for drug abuse, alcohol abuse, or a mental condition and shall remain in a specified residential facility if necessary for that purpose as required by the court or the supervising officer. I may be responsible for the costs of the program. 5.22 I shall maintain a full-time program approved by the multi-disciplinary team and/or the court. 5.22.1 I must attend school full time OR 5.22.2 I must work full time OR 5.22.3 I must have a combined program of school and work. 5.23 I shall not leave home or placement without consent of my parents, guardians, or legal custodians. I shall have a group-approved safety plan for each different activity or place that I go. I shall abide by a curfew that is established by the multi-disciplinary team. 5.24 I shall not frequent any areas nor associate with any persons named by the court or the supervising officer. 5.25 I shall comply with any other requirements of the multi-disciplinary team in order to meet the conditions Imposed by the court. 6. NO CONTACT ORDER 6.1 PERSONS WHOM I OFFENDED: I shall not have any contact with person(s) whom I offended until my treatment providers and supervising officer has given me permission. 6.1.1 I am required to pass a sex history polygraph prior to being granted permission for contact with victims. 6.1.2 A request by a victim Is required before I may have contact with him/her. 6.1.3 Permission will be given In writing by the supervising officer and/or multidisciplinary team before the contact takes place. 6.1.4 It Is my complete and full responsibility to avoid contact with person(s) whom I offended. 6.1.5 I am responsible to avoid situations where accidental contact may occur with person(s) whom I offended. I recognize that No Contact means no contact in any form such as: * Personally/ Visually * Verbally (talking to) * Physically (touching or being in the same place or near the other person.) * By telephone * Written correspondence * Contact through another person including E-mail Gifts given or received (I may not ask anybody else to give persons whom I offended any gifts which I have chosen or purchased. ) 6.1.6 Contact with any victim(s) will be made when, where, and how the containment team and victim’s treatment provider decides it will be made. -4- 6.2 PERSONS WHO ARE MORE THAN TWO YEARS YOUNGER THAN I: 6.2.1 I will not be in the presence of children more than two years younger than I unless approved by the Court or the multi-disciplinary team. 6.2.2 I will not have any other kind of contact with any child who is more than two years younger than I, including immediate and extended family members unless approved by the Court or the multi-disciplinary team. Immediate family includes brothers, sisters, or any children living in the same home with me. Extended family includes cousins, aunts, uncles, and any other relatives. I recognize that “No Contact” means any contact in any form such as that described in 6.1.5. 6.2.3 If I have contact (even accidental) with other children from whom I am restricted In 6.1 and 6.2.2, it is my responsibility to immediately remove myself from the situation. I shall discuss this contact with my supervising officer immediately and with my treatment provider in the next treatment group after the contact takes place. 6.2.4 Any employment, school activities, extra-curricular activities, volunteer activities, and community events must be approved in advance by the multi- disciplinary team. My employers may be notified about my offense(s). School officials will be notified about my offense(s). 6.2.5 I shall not possess, view or subscribe to any pornography including any supplied through the mall, computer, or television, nor go to any place where pornography is available. I shall not utilize “900” or any other telephone numbers which are intended for sexual purposes. 6.2.6 I shall not baby-sit or be in a position of trust, I.e., tutoring, mentoring, or teacher’s assistant. 6.2.7 I shall not have access to the Internet until I have a safety plan that allows Internet access and that has been previously approved by the multidisciplinary team. 6.2.8 I understand that Internet access includes all modem-accessed material(s), any materials downloaded to disks, CD’s, Palm Pilots or any other electronic devices or duplicating machines. 6.2.9 I shall not use vision enhancing or tunnel-focusing devices unless I have a safety plan approved by the supervising officer and treatment provider(s). These devices Include binoculars, telescopes, spotting scopes, hollow pipes, and any other focusing devices. 6.2.10 I must be supervised by an approved adult and have a safety plan approved by the multi-disciplinary team when 1 go to: * Any Toy Stores * Video Arcades * Pet Stores * Amusement Parks * Skate Parks * Swimming Pools * The Mall * Convenience Stores * Hobby Stores * Video Rental Stores * Grocery Stores * City, State or National Parks * Any other shopping districts * Wal-Mart, K-Mart, Target or any discount / department stores -5- 126.96.36.199 shall report to the treatment provider when I have been to any of these places and to the supervising officer/caseworker as directed. 6.2.12 If I violate any part of this no-contact order, I will report the violation at the first group after the violation. I must call my supervising officer within 48 hours of the violation. 7. POLYGRAPH: 7.1 I understand that I will submit to polygraph examinations as directed by my treatment provider. I recognize that the polygraph examination will be used to verify my honesty and my cooperation. I know that “no significant reaction” results will be an Indication of my progress in treatment. 7.2 The polygraph examination requires me to answer questions about possible supervision violations and about the description of my sexual history and my sexually abusive behavior. A failed polygraph will delay my movement forward in the treatment program. 7.3 Several failed polygraphs may contribute to my dismissal from the treatment program. I will be given the opportunity, previous to each polygraph examination, to share pertinent information in group therapy so that I can successfully complete the examination. 8. CONFIDENTIALITY AND COMMUNICATION: 8.1 I understand that it is mandatory that information regarding specific individuals discussed and exchanged in any part of the treatment process be kept confidential by me. This is necessary for my protection, the protection of other group participants, and to protect members of my family and the families of persons whom I offended. A breach of confidentiality will be considered grounds for dismissal from the program. 8.2 I authorize the release of any and alt treatment information to the courts, laws enforcement agencies, the department of human services, the prosecuting attorney, supervising officers, other treatment specialists, the Division of Youth Corrections, probation, and any other parties reasonably related to my supervision. I understand this authorization for Release of Information is necessary to obtain the privileges attached to community supervision. 8.3 I understand that l have the right to refuse to waive confidentiality, and further, I understand that such a refusal may result in a more restrictive placement. A refusal to waive confidentiality must be submitted in writing. 8.4 I will comply with all conditions of my supervision as ordered by the court and/or parole board and directed by my supervising officer. 8.5 I will comply with the consequences outlined for me by my supervising officer, treatment provider, caseworker, parent/guardian, or any other member of the multi-disciplinary team for any violation of this contract. These consequences are specified in section 9 of this contract. 8.6 I understand that any disclosures made that constitute criminal and/or delinquent behaviors may result in prosecution. 9. DISMISSAL BASED ON NON-READINESS: 9.1 I understand that violation of any of the terms of this agreement may result in dismissal from the program. This dismissal will be reported to my multidisciplinary team and will result in a probation/parole violation. 9.2 I understand that I will be required to apply for readmission to the program based upon the decision of my multi-disciplinary team. -6- I have read the above information and my signature below indicates that I fully understand what is expected of me while I participate in the treatment program. I have asked all the questions that I need to ask so that I can sign this with full knowledge and understanding of what I am signing. I understand that compliance with this contract is an additional condition of my probation, parole, and/or commitment. Judge DATE CLIENT SIGNATURE DATE PARENT/GUARDIAN SIGNATURE DATE PARENT/GUARDIAN SIGNATURE DATE TREATMENT PROVIDER SIGNATURE DATE TREATMENT PROVIDER SIGNATURE DATE CASEWORKER SIGNATURE DATE SUPERVISING OFFICER SIGNATURE DATE OTHER DATE OTHER DATE DEFINITIONS: ABEL SCREEN: A physiological assessment giving an objective measure of deviant sexual interests. This is a computer driven test that gives the operator an objective reaction time measure of deviant sexual interests. CLARIFICATION: Victim clarification is a process designed for the primary benefit of the victim. This process requires the sexually abusive youth to be accountable to the victim for his/her offending behaviors in an effort to relieve the victim of any responsibility for the sexual abuse and to clarify what occurred in language the victim can understand. The youth may also be required to provide answers to questions posed by the victim. COMPLETION OF TREATMENT: Completion of court mandated sex offense-specific treatment based on the accomplishment of the treatment goals and outcomes. MULTI-DISCIPLINARY TEAM: A variety of professionals working together to evaluate, monitor, and treat sex offenders. These professionals may include, but are not limited to, treatment providers, psychologists, psychiatrists, department of human services caseworkers, school personnel, parole officers/client managers, probation officers, law enforcement, victim therapist, and guardian ad litems. Containment team may also include family members, foster parents, or those serving in the capacity of the best interests of the community, family, and child. PLETHYSMOGRAPH: A physiological assessment that measures erectile responses in males to both appropriate and inappropriate stimulus material. POLYGRAPH: A diagnostic Instrument and procedure designed to assist in the treatment and supervision of sexually abusive youth by detecting deception or verifying truth of statements by persons under supervision or treatment. SEX HISTORY POLYGRAPH: Refers to verification of completeness of the offender’s disclosure of his/her entire sexual history OFFENSE SPECIFIC POLYGRAPH: Refers to testing the accuracy of the offender’s report of his/her behavior in a particular sexual offense. MAINTENANCE/MONITORING POLYGRAPH: Refers to testing the verification of the offender’s report of compliance with supervision rules and restrictions. PORNOGRAPHY: The presentation of sexually arousing material In literature, art, motion pictures, Internet, or other means of communication or expression. PROGRESS IN TREATMENT: Observable and measurable changes in behavior, thoughts, and attitudes which support treatment goals and healthy, non-abusive sexuality as Identified In the treatment plan. SAFETY PLANNING: A written action plan that addresses risks and plans prevention strategies that the sexually abusive youth and/or others can use to minimize those risks In current situations. SUPERVISING OFFICER: A probation or parole officer/client manager or Department of Human Services case manager.