Treatment Modalities

At Cove PREP, we provide services for each resident through a variety of treatment modalities.

Through Cognitive-Behavioral treatment, residents learn to understand the history, feelings, thoughts, and behaviors that become part of a dysfunctional cycle and the effects of those behaviors on their victims. The opportunity to change behavior is created once residents learn to recognize and identify the feelings and distorted thoughts and beliefs that allow sexual offending to occur.

Process-Oriented (psychodynamic) treatment is designed to help residents develop a level of insight and awareness into the impact that their own history has on their relationship with others. As the resident develops personal awareness he becomes more capable of participating in pro-social relationships with others. Process oriented treatment allows the resident to become aware of the origin his own feelings, thoughts, behaviors and the effects that his behavior has on others.

Psycho-educational treatment is aimed at skill development, and focuses on teaching residents anger management, social skills, communication skills, consent, boundaries, the law, pre-offense/offense cycle, and cognitive distortions (also known as "thinking errors").

Dialectical Behavioral Therapy (DBT) is a systematic model that teaches individuals specific skills to improve self-management. DBT has been found to be effective with individuals who display problems with managing emotions, behavior and interpersonal relationships. Residents report this component of treatment as being particularly helpful in giving them new and specific tools to handle their emotions and interpersonal relationships. Family education & therapy services are provided through phone contact and family sessions. Parents or guardians are encouraged to participate in treatment with residents. As appropriate, family members may also be encouraged to be involved in outside counseling to address other personal or family issues. The primary goal of Cove PREP's family work is to help the family understand the resident's sexual offense patterns, and to help the family indentify and address patterns that will support the resident successfully addressing their sexually abusive behavior. Arousal reconditioning: Deviant arousal has been identified as one of the highest risk factors for recidivism in offenders. Therefore, direct intervention to address these patterns and assist residents in developing appropriate replacements is needed. A variety of specific interventions are made available to residents to assist them in controlling or changing thoughts, fantasies and arousal patterns.

Psychiatric Care and Medication Management: Frequently, youth with histories of sexually abusive behavior also present with one or more mental health diagnoses. Common diagnoses include: ADHD; Depression; Bi-polar Disorder; Post-traumatic Stress Disorder; Oppositional-Deviant Disorder, as well as a variety of other diagnoses. While Cove PREP’s primary treatment focus is addressing sexual offending issues, it is imperative that any existing psychiatric conditions be stabilized in order to enable the resident to effectively engage in and benefit from treatment.

Course & Content of Treatment
Sexually based therapy begins with education on basic concepts, including consent, boundaries and legal definitions of sexual offenses. Cognitive Distortions (i.e. “thinking errors”) are addressed simultaneously to assist residents in overcoming the common distortions used by sexual offenders to justify or excuse their sexually inappropriate behavior. Residents are educated on the Pre-offense and Offense Cycles and residents map out their personal offense cycle to demonstrate a clear understanding of what triggered their sexual offenses. Residents then prepare a detailed history of their sexual behavior to enable the resident and clinical staff to develop a clear picture of the patterns of sexual activity in which the resident has engaged. Residents present their disclosure to their therapy group as part of taking public responsibility and ownership of their offenses.

Once residents have demonstrated these core competencies, therapeutic focus moves to targeting their specific offense pattern and ways to break their patterns of offending. This occurs through identifying specific “exit strategies” for each step of their pre-offense and offense cycles. Additionally, residents are provided training to block inappropriate sexual thoughts and fantasies through the use of Covert Sensitization. Completion of Covert Sensitization typically takes 6 to 8 weeks, depending on the number and complexity of the resident’s offense pattern(s). Covert Sensitization is a technique that teaches residents to link inappropriate sexual thoughts and fantasies with anticipated negative consequences; and to mentally rehearse substituting appropriate thoughts and actions linked with desired positive outcomes. After completing a course of covert sensitization, residents typically report a decrease, but not elimination, of inappropriate fantasies.

Residents are then informed about the availability of additional Arousal Reconditioning techniques that assist them in further reducing or eliminating deviant sexual thoughts and fantasies. For residents under the age of 16 (or older in some states) the therapist also contacts the parents or legal guardian to explain the other techniques and interventions available. Informed consent is obtained from the resident and parent/legal guardian if appropriate.

Cove PREP does not utilize any aversive conditioning techniques. Polygraph testing is available for use on a case-by-case basis.