references to -- psychosexual evaluation

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references to -- psychosexual evaluation

Postby Marina » Fri Aug 11, 2006 9:42 am

Psychosexual evaluations

Child Sexual Abuse Investigations:
Multidisciplinary Collaborations
An Internet Resource for Forensic Investigation
of Child Sexual Abuse Cases

An Internet Resource for Forensic Investigation
of Child Sexual Abuse Cases
Table of Contents by Professional Discipline ... sion.phtml

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Forensic Issues with Non-Offending Guardians
C. Curtis Holmes and Sharon A. McGee ... dge1.phtml

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Psycho-Sexual evaluations

Julie Medlin, Ph.D. ... lin1.phtml

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Court-Mandated Treatment and Required Admission of Guilt in Cases of Alleged Sexual Abuse: Professional, Ethical and Legal Issues
Judith K. Adams

ABSTRACT: Mandated mental health treatment of persons accused of sexual abuse of children poses several professional, ethical, and legal issues. There is variation in treatment methods with limited empirical data of efficacy. Treatment is often court mandated, which raises ethical issues regarding informed consent, particularly voluntariness of participation, since participation may be coerced with threats of parental rights termination. Confidentiality in such programs cannot be assured and counselors may serve in potentially unethical dual roles of counselor and reporter of disclosures. The requirement that participants admit having abused the child may violate Fifth Amendment protection against self-incrimination. State-granted immunity from prosecution allows, but should not coerce, participants to admit guilt.

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News Article about psychosexual devices – Free Ashleigh from Jeb Bush

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Fla court case ... 20florida'

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Mental health providers - mandated treatment ... 20p271.htm

"This Article analyzes the liability of mental health professionals for services rendered to patients who are ordered by a court to undergo mental health treatment. After a brief review of relevant legal authority, this Article examines mandated treatment under the framework of quasi-judicial immunity and continues by discussing the specific duties of mental health professionals to patients undergoing mandated treatment. The Article also comments on the unique issues that arise from treatment of patients under federal benefit programs. The Article concludes by arguing that mental health professionals do not enjoy a blanket exemption from malpractice liability and by suggesting a cautious course of action for such professionals."
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"In the same way judges generally have immunity from personal liability for actions done in the course of their official duties, judicially-appointed professionals, including mental health providers, are also protected from malpractice liability when they assist in making a judicial decision.
Such judicial decisions include:
(1) de-[*pg 274] terminations of criminal competency;
(2) determinations of sufficient mental states for civil liability;
and (3) determinations of mental fitness in child custody proceedings. "

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"In criminal, civil, or CINA (child in need of services) situations, the provider should recognize that the court order generally does not specifically authorize any treatment and the patient may still refuse to consent. If the service is evaluative, the provider probably enjoys the benefits of quasi-judicial immunity.
However, if the service continues after an evaluation or there is treatment beyond evaluation, the patient must give her informed consent.
Should the patient fail to consent, the provider's role is to report the patient's non-compliance to the court, rather than to enforce the court order."

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"The Statute does not provide similar immunity for continuing care beyond the evaluation stage."
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"Court-ordered classes in anger management, life skills, and family violence prevention may be provided by a mental health professional, a paraprofessional under the guidance of a mental health professional, or a non-professional.
The mental health professional must adhere to the standard of care for her profession, as discussed above, but the non-professional has no duty of care (unless unlawfully practicing counseling). "
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"Mandated treatment changes the duties of confidentiality and informed consent owed to a mental health patient, but does not fundamentally alter the duty of care."

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When one asks a layman what duties a mental health provider owes to a mandated patient, common responses are "none" and "exactly the same as any other patient." However, neither is true. Alaska providers of mandated mental health services neither have a blanket exemption from their duties of confidentiality, informed consent, and care, nor do they have the identical duties to these patients as voluntary patients.

Mandated care modifies the duties of confidentiality and informed consent, but a provider should construe these exceptions narrowly. Providers employed by the United States may enjoy some additional protections from liability through the Federal Tort Claims Act and Feres doctrine, but these protections do not generally extend to private providers working under a federal contract. The safest course of action for a provider of mandated mental health services is to treat the mandated patient as much as possible like a voluntary patient and to adapt the provider's practices only as specifically authorized by the terms of the mandate.

To avoid liability problems, providers and institutions that routinely care for mandated patients should consider developing policies regarding confidentiality and informed consent that follow the requirements of Alaska law. Providers who only occasionally see mandated patients may want to consult carefully with the refer-[*pg 303] ring authority to determine the scope of their mandate and any limitations on confidentiality that may arise from the specific circumstance and discuss these with the patient in advance of treatment. Mandated care can be an important vehicle for helping those who would otherwise not get help. However, the mental health providers who care for mandated patients should be aware of their modified duties towards them.

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Child Sexual Abuse:
Intervention and Treatment Issues
Kathleen Coulborn Faller

Page 86

Finally, the therapist will want to help the mother understand her role in the abuse, if she has had one. The
nonoffending parent is not to blame for the victimization but in some instances may have contributed to risk of
abuse or prolonged abuse, for example, by leaving the child for long periods of time with the offender or by
discounting the child’s early disclosures.

Interestingly, a good prognosis is suggested when a mother feels very guilty and the therapist must work to
alleviate her sense of responsibility.
Conversely, a poorer prognosis is indicated when the mother sees herself
as absolutely blameless and the therapist has to point out things that the mother might have done differently that
could have prevented or minimized the abuse.
As with other issues related to the abuse, this issue may be best
dealt with in group therapy.

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Paula J. Caplan, Ph.D. states in her report:

Given the materials that I saw, it is astonishing that the father was given unsupervised access so readily and for so long and that no one who was in any position to intervene made any significant attempt (or, as far as I can tell, any attempt at all) to protect the children from further abuse, despite reports of the abuse from various sources. The absence of action to protect these children is especially alarming in light of Dr. Matherne’s conclusion that the children were “in immediate danger of irreparable harm.” Reading that, as well as the other documents, and considering that these children apparently are currently living with their father and are not allowed contact with their mother, one wonders what in the world would have to happen before the authorities would intervene appropriately. [emphasis added]

Final Note:

By its very nature, the sexual abuse of children is often difficult to detect. This is especially the case when the perpetrator is a parent, even more so when the children live with that parent, and still more so when the perpetrator is given to verbal, emotional, and nonsexual, physical violence. I cannot recall a case in which there was so much evidence from so many different sources and in which the children so consistently told the same story and showed no signs of having been encouraged by the nonperpetrating parent to lie. [emphasis added]

I know that there are many fine things about the State of Georgia, having spent some times there myself. But this case is a travesty. (See Volume 1, Appendix 13).

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U.S. Appeals Court Rejects Arousal Test for Sex Offender
By Tanya Caldwell
Times Staff Writer
posted June 21, 2006

A periodic test that measures a man's response to erotic images is "Orwellian" because it examines his mind, not just his body, and should not be used because it deprives him of more freedom than necessary, a federal appeals court ruled Tuesday.

In order to be released from prison, U.S. District Judge Dean Pregerson had ruled in 2001, Matthew Weber would have to subject himself to tests in which a pressure-sensitive electronic device is placed around the penis and the response to stimulating images is monitored, said his lawyer, Jonathan Libby.

Weber was charged with possessing child pornography on his computer, pleaded guilty and was sentenced to 27 months in prison and three years of supervised release. But he objected to the penile plethysmograph test, which has been used as part of sex offender treatment programs.

The U.S. 9th Circuit Court of Appeals agreed with him, saying the test would deprive Weber of his liberty more than "was reasonably necessary."
In a unanimous decision, a three-judge panel vacated Pregerson's judgment Tuesday and sent Weber's case back to District Court.
The test was developed by Czech psychiatrist Kurt Freund to study sexual deviance, but it was eventually used by the Czechoslovakian government to find and "cure" homosexuals, the appellate court opinion said, citing David M. Friedman's 2001 book, "A Mind of Its Own: A Cultural History of the Penis."

Weber, who was charged and convicted after a repair shop found child porn on his computer, argued that the test should be reserved for people who had molested children or tried to do so. The government countered that actual assault isn't a requirement for the test.

Libby said the test is typically tied in with treatment programs for sex offenders when they are sentenced. And every time they are, Libby and the other lawyers on his team object.

Proponents of the test have argued that its helps in sex-offender treatment programs, which could also include lie-detector testing and psychiatric medication. Thom Mrozek, a spokesman for the U.S. attorney's office in Los Angeles, said the ruling "will have no effect on our aggressive enforcement program."

But critics, including the American Psychiatric Assn., have called the test unreliable, according to the appellate court's opinion.

Libby said Tuesday's ruling doesn't outlaw the test, but he added that 9th Circuit Judge John Noonan's written concurrence in the ruling suggested that could happen eventually.

Noonan called the test Orwellian because it would not only measure Weber's genitalia but also probe his "innermost thoughts as well."

"A prisoner should not be compelled to stimulate himself sexually in order for the government to get a sense of his current proclivities," Noonan wrote in his concurrence with Judge Marsha Berzon's opinion. "There is a line at which the government must stop. Penile plethysmography testing crosses it."

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