Douglas P. Boer, Vilmantė Gintaraitė Riga, 16 th March, 2011

1. Douglas P. Boer, Vilmantė Gintaraitė Riga, 16th March, 2011

2. In 2008 Prison Department under the Ministry of Justice of the Republic of Lithuania evaluated situation in Lithuania prisons and decided about the need of the treatment program for incarcerated persons who have committed sexual offences against children. SeNAT (Seksualiai Nusikaltusių Asmenų Terapijos programa) program was created by Associate Professor of Clinical Psychology Department at the University of Waikato, New Zealand, PhD Douglas P. Boer with the help of Chief of the Psychology section in Alytus correction house in Lithuania, Vilmante Gintaraite in 2009.

3. SeNAT is the unique program, specially designed for Lithuania corrections that is orientated to the very actual, sensitive and sore problem: to provide therapeutical help for the persons who have committed sexual offences against children.

4. The SeNAT program have incorporated the general principles of all other correctional programs. The main goals of the SeNAT program are the prevention of sexual offence recidivism and the safe reintegration of such persons back into the community. The main tasks of the SeNAT program include helping offenders determine their risk factors and how to control and manage these risk factors in the future.

5. The SeNAT program is based on the premise that all offenders can change negative behaviors and become law-abiding citizens. The SeNAT program is not solely focused on reducing offending behaviors, but also on building upon the offender’s positive characteristics to enhance his sense of self-esteem and competence. The end result is that offenders will learn much more than just not how to offend again, but also how to use problem-solving strategies in many areas to have a better life.

6. The SeNAT program is based on cognitive behavioral therapeutic (CBT) principles. This is the same philosophical basis of all modern sex offender programs operating internationally. The SeNAT program is delivered by institutional psychologists in cooperation with other correctional staff. All staff selected to provide the SeNAT program is expected have minimal qualifications and training to ensure high quality therapy programs across Lithuania.

7. - First, the candidate needs to admit to a significant portion of his crime. Someone in complete denial (e.g., “I was not there”, “I did not do it”, “the victim is lying”) certainly needs treatment, but is untreatable in the present program. The program requires that the offenders have something relevant to talk about! However, some level of denial or minimization of responsibility is expected. - Second, the offender needs to dedicate himself to the completion of the program and this should be acknowledged formally in a treatment agreement (consent form). Once started, it is important to complete the program as there is some research that shows that those men who drop out of treatment are actually higher risk than treatment-refusers. - Finally, the management of the prison needs to support an offender’s dedication to the program by providing a letter of approval for an offender to enroll in the program. This shows the offender that the Prison Director is making treatment a priority – that is, treatment should take priority over work for the offenders.

8. The goal of evaluation in the SeNAT program is to first identify the risk level of the offender and second, the treatment needs of the offender: • The Static-99 • The Sexual Violence Risk – 20 (SVR-20) • Twenty Treatment Targets (T3; Boer, van Rensburg, & Wilson, 2008) • Structured Clinical Intake Interview • Treatment Acceptance or Refusal Report • Offender Risk and Treatment Needs Report

9. An open program has no fixed length and can be completed by the individual offender in as little as three or four months (depending on program session frequency). In general, once an offender has completed the main criteria of autobiography, offence pattern, relapse prevention plan, and complete life plan, he will be deemed as having completed the program and will be moved to the maintenance program.

10. 1. Individual sessions 2. Group topics: 1) Orientation; 2) The Process of Change 3) Introduction to Self-Analysis 4) Autobiography 5) Discussion of Autobiographies 6) Offence Patterns 7) Discussion of Offence Patterns 8) Advanced Self-Analysis 9) Self-Control 10) Relapse Prevention Plans 11) Complete Life Plans 12) Presentation of Relapse Prevention Plans and Complete Life plans to the group. 3. Homework Assignments

11. 4. Parallel topics: • Healthy intimacy • Supportive friendships and support people • Work skills • Anger (or other emotions) management • Assertiveness training • Non-sexual friendships with women • Women’s and victim’s rights • One’s own victimization and offending • Alcohol or drug misuse (substance abuse) • Insight and relapse prevention • Hobbies • Religious beliefs • Victim awareness and victim empathy

12. Evaluation framework In 2010 the SeNAT program have been started in two correctional institutions: Alytus and Pravieniškės correctional houses. It is critical to evaluate the effectiveness of the SeNAT program to ensure that the program enhances public safety. In order to do program evaluation, the providers of the SeNAT program is working with other administrative personnel and the SeNAT program authorship team to determine those variables that are linked to effective program delivery. An evaluation framework was recommended for the program, including tracking all offenders who are currently enrolled and who have completed the program in terms of their institutional behavior, their offending post-release, their behavior while on parole, as well as pre and post-program test results. The independent agency „Global Initiative on Psychiatry“ was hired to create the SeNAT program evaluation framework and to do the primary qualitative evaluation research.