Mandated Treatment Services for Forensic Clients

Our clients arrive for treatment with a variety of needs and presenting concerns. If left unidentified and untreated, these concerns often contribute significantly to an individuals’ initiation into, and maintenance of, the criminal lifestyle. Within the framework of the Risk, Need, Responsivity (RNR) model CPA utilizes a wide range of assessment methods to diagnose and treat clients involved in the criminal justice system. This includes initial clinical interviews at intake, review of collateral information, formal psychological assessments, and ongoing behavioral observations. In addition, clients are often exposed to a combination of treatment modalities and providers who work collaboratively to develop and continually re-evaluate diagnostic impressions and treatment goals.

Our assessments and interventions are empirically driven in order to provide the most efficient and cost-effective services. After an assessment of criminogenic factors (e.g., criminal history, antisocial personality traits, nature/level of affiliation with antisocial individuals, substance abuse, history of [non]compliance with supervising agents and treatment providers), thorough review of collateral data, and collaboration with supervising agents, the client is prescribed a treatment regimen designed to manage their current risk and reduce future risk of recidivism and relapse. This typically includes a variety of treatment modalities including combinations of group therapies, individual therapy, and referral for psychiatric medication management services.

CPA offers Post-Sentence Domestic Violence Evaluations for:

• Male Offenders

• Female Offenders

• LGBTQ+ Offenders

A Domestic Violence Evaluation per the DVOMB standards, for a post-sentence referral, requires review of offense reports (police or PSR), mandatory completion of assessments for domestic violence (Colorado’s DVRNA and a secondary DV assessment), mental health inventories/assessments, substance abuse assessment, and cognitive and competency screens (Mini Mental Status Exam), at a minimum. At CPA, we also include screens for brain injury, adverse childhood experiences (ACEs), and hope.

These evaluations require issuing a separate evaluation report in addition to our standard admission summary, and a Domestic Violence specific treatment plan. An additional service plan for substance abuse treatment may also be required depending on a client’s substance use treatment needs.

Based on DVOMB standards, evaluations identify a client’s treatment level determination of A, B, or C which impacts treatment dosage. Level B or C placements require additional treatment contacts outside of their required DV Group.

CPA offers formal evaluation for psychopathic traits to address concerns related to impulsive and aggressive tendencies, low empathy, lack of attachment and social connectedness, persistent violent offending, and other relevant factors correlated with poor amenability to treatment for individuals with high levels of psychopathy. The evaluation process includes an in-depth collateral records review, structured clinical interview, and the administration of psychological assessment, and contemplates recommendations for intervention based upon an individual's clinical presentation.

Mental Health Evaluations are offered when there are concerns related to someone's mental health and additional diagnostic testing is needed to determine underlying conditions. Generally, the clinical evaluation is determining whether or not there may be Severe and Persistent Mental Illness (SPMI) and/or specific personality dynamics present.

A cognitive-behavioral group based on the CALM (Controlling Anger and Learning to Manage It) curriculum developed by Van Dieten, Winogron, and Grisim out of Canada. This group is designed to help clients understand the difference between anger and aggression, improve emotion regulation skills, learn how to identify the anger process, triggers and effective coping skills. The curriculum is skill-based and relies on the assumptions that aggression is learned and individuals can learn to control their emotions and behavior despite their level of anger.

A curriculum-based and process-oriented parenting group designed to address child and family related criminal behavior and dysfunctional familial systems. Group content focuses on addressing antisocial thinking patterns, antisocial behavior/low impulse control, family of origin and attachment issues, intergenerational patterns, sociocultural factors, and/or potential responsivity concerns related to a clients’ family systems. As with our other group therapies, sessions are not time-limited and new clients can enroll at any time. This is CPA’s only co-ed treatment group.

This group is for clients whose primary criminogenic need is criminal thinking. This is often the best fit for individuals who have a lengthy criminal history but do not meet the criteria for substance abuse, anger management, or criminal culture. In addition to criminal thinking, this group covers basic mental health issues, emotion management, dealing with adversity, and improving communication skills. If the supervising agent has difficulty determining a client’s criminogenic need, it is often related to a client’s judgment, impulse control, or problem solving, all of which are covered in this group.

A cognitive behavioral group for clients whose primary criminogenic needs are antisocial associates and antisocial attitudes. This group focuses on the “addiction” to the excitement of the criminal lifestyle, environmental factors contributing to criminal behavior, and how to build a prosocial network. In addition to gang members, this group is appropriate for clients with no gang involvement but who have been convicted on drug possession or distribution but who demonstrate no substance abuse disorder, but rather are “adrenaline junkies.”

Treatment Currently Offered for Male and Female Domestic Violence Offenders, as well as LGBTQ+ DV Offenders

This group is designed to address individuals who have engaged in interpersonal violence in relationships. It meets full Domestic Violence Offender Management Board (DVOMB) requirements for psychoeducation and process therapy for individuals who need to fulfill treatment requirements for crimes labeled as domestic violence in Colorado. It utilizes a variety of evidence-based curricula for interpersonal violence while adhering to the DVOMB’s Standards on Competencies for domestic violence treatment. It engages a multifaceted approach to interpersonal violence through the development of skills related to boundaries, communication, use of time-outs, use of scales for gauging anger, the role of locus of control, one’s personal cycle of violence, power, and control, the intergenerational components to violence, and the impact of developmental trauma on the cycle of violence.

ARCHES Program

(Residential Dual Diagnosis Treatment - RDDT)

Achieving Recovery and Changing Habits to Empower and Succeed

The ARCHES program is run at Arapahoe County Residential Center (ACRC). It is a Residential Dual Diagnosis Treatment (RDDT) program designed to address substance abuse and mental health concurrently, and is offered separately to both men and women. Referred clients are pre-screened for admittance to the program to ensure their needs will be addressed through participation in ARCHES. If they are accepted into community corrections and subsequently meet eligibility criteria for RDDT, clients complete an intake evaluation in order to develop an individualized treatment plan and goals.

The women’s treatment program is composed of:

• Weekly ARCHES Substance Abuse group

• Weekly Dialectical Behavior Therapy (DBT) group

• Weekly Seeking Safety group

• Weekly Individual Therapy

The men’s treatment program is composed of:

• Weekly ARCHES Substance Abuse group-

• Weekly Dialectical Behavior Therapy (DBT) group-

• Weekly Thinking 4 a Change (T4C) group

• Weekly Individual Therapy

Clients stay in the ARCHES Program for a minimum of six months, dependent upon treatment progression. Upon successful completion, the clients participate in a small graduation ritual during group, and an aftercare plan is developed to support their continued progress on their identified treatment goals.

Moral Reconation Therapy (MRT) is a cognitive-behavioral treatment intervention normed on the forensic population, well researched over the past 30 years, and demonstrated to be an efficacious, evidence based practice. The aim of MRT is assisting individuals with reducing their risk for recidivism by providing them skills to think critically using moral reasoning to inform their decisions and affect prosocial changes in their thinking and behavior. This therapy has been demonstrated to be most effective treating highly resistant individuals with little motivation to change their thinking and behavior, as well as individuals with antisocial personality characteristics.

A cognitive-behavioral group based on the Strategies for Self-improvement and Change (SSC) curriculum developed in Denver by Kenneth Wanberg and Harvey Milkman. Clients will identify triggers underlying substance abuse, as well as develop individualized plans for change and relapse prevention. The program includes homework assignments and is based upon stages of change and motivational interviewing techniques. It is a process-based group designed to help clients reduce their risk of relapse while transitioning into the community. This group runs one time a week for two hours.

This group is for clients who experience an interaction between their substance use and anger management problems (e.g., becoming more aggressive when using drugs/alcohol or using drugs/alcohol to manage their anger problem). Goals include: understanding the connection between anger and alcohol/drug use, learning triggers for aggression, avoiding discomfort with substances and disconnecting the link between mood and use of drugs/alcohol. This group is designed for clients for whom the interaction between substance abuse and anger management is problematic. Clients with significant anger management or substance abuse issues independent of each other would be best suited in a substance abuse group and/or anger management group.

For clients with more severe substance abuse problems, clients in this treatment attend two groups per week. The groups focus on both psycho-education and process therapy. The psycho-education components are taken from Phase I of Strategies for Self-Improvement and Change, developed in Denver by Kenneth Wanberg and Harvey Milkman. Clients attend group twice weekly for a minimum of 12 weeks, followed by 24 weeks of once weekly groups. Once they have successfully completed the minimum 48 weeks of EOP treatment, the clients will be stepped down into a lower level of care.

Intensive Outpatient is a higher level of substance abuse treatment designed for clients with significant substance abuse concerns. Groups run for three hours, three times per week so it's more sessions per week and for longer time periods than ASAM Level 1 services. The State minimum for IOP is 12 weeks. Clients, therefore, could expect to be in IOP for approximately 12 to 16 weeks dependent upon their progress. At that point, they will have been assessed to determine whether they appear ready for a reduction in treatment to an EOP or WOP group (depending on their other treatment needs), or whether they have continued to struggle with substance use and warrant referral for a higher level of care.