Summary of Treatment Approach
Our therapeutic approach helps each youth understand the origins of the harm they have caused, deal with any past trauma, and address other individual therapy needs. What makes our approach so effective is the strong working relationships that are developed between each young man, their therapist and all of our staff. By establishing rapport and setting clear and consistent boundaries, an optimal therapeutic environment is created, resulting in positive changes and growth.
Our therapists work with each youth to examine their thoughts, feelings, behaviors, and the relationships and patterns between them, so that he can better understand himself and the issues that created his cycle of abuse. We also work to resolve past traumatic experiences, anger, and other issues that may have led to and fueled his current difficulties. Treatment and counseling services are indivivualized to meet each child's unique needs.
Our treatment program is designed in accordance with ethical standards for general psychological practice in Pennsylvania as well as the guidelines governing the field of specialized treatment of sexually problematic behavior. We operate a team approach which emphasizes close cooperation with the probation department and/or Children and Youth agency of the referring county as well as the managed care organization. This means that each resident's probation officer (or case worker if he is a Dependent child) and managed care representative will be kept informed of his treatment progress via telephone contact, meetings, and written treatment reports. This approach best serves the balanced needs of the child’s rehabilitation, the needs of the people he has harmed, and the community at large. Residents attend a Court Hearing between two and four times per year, and his placement at Mathom House will be reviewed. His therapist will submit a report assessing his progress, discuss his treatment, and make clinical recommendation for aftercare. He or she may recommend continued treatment because he has yet to complete the program or removal from the program because he is not benefiting from or complying with the program, or graduation from Mathom House because he has completed the treatment. It is important to remember that Mathom House can only make recommendations to the court; the court ultimately decides where to place each child, and for how long. It is each child’s right to appeal to the court if he disagrees with our opinion about his treatment progress or placement status. Parents are invited to speak with their child’s Probation Officer or seek legal counsel for more insight into the workings of the Juvenile Justice system or their son’s legal rights.
Each youth and their parents/guardians will be asked to sign a Consent for Treatment form which details the limits of confidentiality. This document explains that details of each resident's therapy are kept largely confidential (there are specific exceptions to this).
The treatment program at Mathom House is rooted in group therapy. Groups are conducted every day except Friday, for 1½ or 2 hours per session. Groups typically consist of between 4 and 10 residents and 2 or more therapists. Research indicates that group therapy is the most effective way to treat those who have committed sexual offenses. Sexual offenses involve an abuse of trust and violation of boundaries within a relationship (brother, sister, niece, nephew, friend, peer, stranger) and group therapy challenges the client to relate to others in more healthy, honest respectful and assertive ways. When he comes to Mathom House, residents will join a therapy group with peers who have committed similar offenses and shared similar struggles that may include estrangement from family, shame and guilt, denial of offenses, etc. This will be an Introductory or “Intro” group.
When a new member enters the group, each client states his offenses before the new client is asked to state his. We have found that this sharing of common ground is a source of great relief to the new resident as he hears his peers take responsibility for their offenses. Typically the new member overcomes his shame and embarrassment and shares the details of his offense(s). The Intro group aims to introduce residents to the principles of sex offender therapy, foster more healthy ways of interacting with others, and lay the groundwork for later more difficult and important therapy assignments. This groundwork consists of the resident making inventory of his personal, family and sexual history. Assignments include timelines, family trees, lists of positive and negative experiences, and written accounts of offenses. When a youth completes these assignments and shows consistently positive behavior and attitude in the Intro group, he will graduate to the Advanced Group.
The Advanced Group meets 4 times per week and focuses on Chain work and offense-specific assignments also commonly known as Empathy assignments. Simply stated, the Chain work challenges youth to figure out why he committed sexual offenses and how to avoid re-offending, and the Empathy work aims to make him care enough about others and himself so he will not want to re-offend. He will learn that each offense involved dozens of steps including conscious decisions which he fully controlled. He will also learn the many harmful effects of sexual abuse for victims and their families. He will be encouraged to acknowledge his own abuse (where applicable) and learn how to cope with their emotional wounds in a way that does not harm others.
Individual therapy is an important component of treatment and aims to compliment the group work by providing an important and productive relationship for each resident. He should receive coaching from his therapist about how to progress through the therapeutic levels of the program. Often our young men need to learn new skills to interact appropriately with others and get their needs met in ways that respect others and themselves. Their individual therapist will teach and model these skills. He or she will also help their client with his assignments prior to their presentation in group.
Family Therapy is provided, with the focus of orienting the family to the behavioral and therapeutic changes and growth achieved by the resident, and/or sensitizing the resident to the harm he has caused those closest to him. This is usually in the form of periodic meetings. Later in treatment, there may be more regular sessions. The focus of sessions tends to be centered on your son’s issues i.e. offenses, returning home, and exploring feelings about any past traumas. More generalized family therapy is sometimes provided by the court on an individual basis where it appears crucial to each youth's future adjustment. In cases where family members have been victimized, their needs and interests are placed before any other considerations.
Youth will benefit from:
- Integrated CBT and DBT group and individual therapy – Evidenced-based skill areas including increasing distress tolerance, self-awareness, changing thought patterns to be realistic and goal-directed, and emotional self-regulation.
- Good Lives wellness program- Strengths-based approaches that focus upon the child’s well-being and increasing protective factors within the community.
- Traumatic stress group – A gradual exposure-based group process allowing for self-paced reprocessing of traumatic events.
- Psycho-sexual awareness group therapy – An intervention specifically relevant to juveniles who have been objectively and self-determined to harbor deviant and/or unhealthy sexual interests along with a desire to increase their healthy sexual and relational interests.
- Trauma sensitive yoga – An evidenced-based practice that increases emotional regulation by incorporating mindful awareness, motor control, flexibility, and safety.
- Relaxation training group – a longstanding end-of-week de-stressing group that includes breathing and guided imagery.
- Family Therapy – Headed by our Licensed Family Therapist, dynamics amongst key family members and client are discussed with a collaborative and problem-solving approach.
- Elective groups – Custom-designed therapeutic modules that address unique needs may include social skills training, distress tolerance, traumatic processing and anger management.
- Recreation Programming
Mathom House operates under the principles of accountability and reward. We aim to hold residents accountable for negative behavior and reward positive behavior. We have a daily system of requiring achievement of basic responsibilities, and awarding points for achieving individual behavioral goals. Negative behaviors such as antagonism, name calling, and threatening remarks are sanctioned with a negative point. Basic responsibilities include specific tasks such as chores, showers, attendance in groups, meals and school. Goals are specifically designed to target individual areas of behavior in each child. A resident may have a goal discouraging cursing, another hygiene, another accepting redirection. As he achieves his basic responsibilities and earns his points he will move closer to promotion in the level system. The level system is a 5 tiered program which rewards positive and compliant behavior with increased privileges. Residents enter the level system after a period of Assessment which begins with an orientation week and emphasizes safety and security while staff becomes acquainted with his personality and behavioral tendencies. The other tiers are Freshman, Sophomore, Junior and Senior. As young man progresses and enjoy increased freedoms and privileges, he will also be given more responsibility and held to a higher standard. This can be challenging for some, but we believe it mirrors life “on the outside”. For example a promotion at work may yield higher pay and a nicer office, but also longer hours and a larger job description.
Behavioral management protocols are used for responding if youth exhibit negative behaviors. Interventions are implemented to address these behaviors and are tailored to meet his therapeutic needs. Our behavioral management strategies follow a progressive, intervention model including redirection through verbal requests, staff-directed time out, and therapeutic restraint. Therapeutic restraint would only be used if a youth is a danger to harm himself or others. All of our staff are trained in verbal de-escalation and Crisis Prevention Intervention (CPI).