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Sex Offender Treatment Program Application 1

 

Program Overview

The Sex Offender Treatment Program is an intensive outpatient community based treatment program offered through in person office based or live online. This program is designed and individualized for the treatment of both the Adult and Juvenile population.

This program is designed for the offender who recognizes and takes responsibility for their own behavior and is willing and able to live within the limits placed upon them by this treatment program, the judicial system, and society. Examples of offending behaviors include child molestation; voyeurism; exhibitionism; frotteurism; public masturbation or lewd acts; rape and sexual assault; child pornography; obscene phone calls/letters; violations of professional boundaries; sexual harassment.

Our program follows a cognitive-behavioral approach that will provide the foundation for the most effective treatment with the population and will be based upon the Sex Offender Containment Model, a comprehensive approach to sex offender management, drawing on the expertise and special knowledge of all the agencies, partners and individuals working with individuals to manage properly.

Program Goals

◦ Active involvement in the treatment process
◦ Accept responsibility for behaviors
◦ Develop awareness and understanding of consequences related to sex offending
behaviors
◦ Be able to demonstrate empathy and compassion
◦ Develop healthy relationships and social support network
◦ Develop relapse prevention strategies Treatment is composed of education and
therapy through group process, individual therapy, and couples/family therapy as
appropriate.

The duration of treatment is based upon the person’s needs, motivation level or timeline established by the court order.

Cost

Individual Counseling Sessions: $100

Group Therapy Sessions: $75

Section Divider

Sex Offender Treatment Program Application

 

Please answer the following questions to the best of your abilities. These questions are to help the therapist with the therapy process. This information is held to the same standards of confidentiality as our therapy

Section I

Section II

Attorney Information

Section III

If Previously Incarcerated – Complete Section III

Parole Officer

Psychosexual Evaluation / Risk Assessment

Click or drag files to this area to upload. You can upload up to 6 files.
Upon admission to the Sex Offender Treatment Program, each individual will be required to complete and sign: Treatment Contract; document that outlines expectations of the treatment program, detailing requirements and consequences if the contract is broken. Safety Plan; a document that outlines the structure and required boundaries that must be met inorder to participate in the program.

TREATMENT AGREEMENT

Counseling for deviant sexual behavioral is a highly specialized treatment program. It is a privilege for those who take treatment of their sexual problems seriously and want to change their behavior.

Below are the requirements that must be agreed upon in order to participate in this treatment program.

I will be open and honest about my past and present sexual thoughts, fantasies and behavior with my counselor.

I am committed to changing my unhealthy and deviant sexual behaviors as evidenced by the following behaviors:

a. No pornography

b. No deviant or unhealthy sexual behavior.

Sexual contact and fantasies will be within the confines of an equal, honest, committed, consensual and appropriate relationship.

I will not use any illegal drugs or alcohol while in treatment. I understand and agree to random drug testing at the discretion of my counselor while participating in the program. I also understand I am responsible for any cost associates with said test,

I will participate in individual counseling as recommended by counselor (biweekly).

I will participate in group therapy as recommended by counselor (biweekly).

If I have access to or use cell phones or devices that has the ability to send or receive photos or pictures I will agree to have monitoring software installed on the device.

I will NOT use any computer or computer-related devices without monitoring software being placed on devices. I will agree within 48 hours of my first appointment, I will place one of the following internet filters listed below on ALL electronic devices (phones, tablets, laptops and desktop computers) that I have access to.

I will list my therapist as one of my accountability partners (abevill@bevillandassociates.com) or (kculp@bevillandassociatesllc.com)

Recommended:

Accountable 2 You
https://www.accountable2you.com/?code=4450365

Use of any other software requires the approval of my therapist.

I will agree to any assessments which include risk assessment and / or psychological assessments recommended by my therapist. I understand there may be additional cost that I will be responsible for paying the assessments.

I will not access social networking sites.

Payment Information

Credit Card Information

Credit Card Authorization ( All clients must maintain a current credit card on file).

I, authorize the maintenance of valid credit card information to guarantee my chosen payment option. Charges will appear on your credit card statement as “Bevill and Associates LLC.”

Payment Guarantee

I understand that I am individually responsible for all incurred charges, even if I direct you to bill another person. If I direct charges to be billed to another person, I represent that I am authorized to give you such direction. If I have directed you to bill charges to another person who fails to make payment promptly when due, I will promptly pay on demand. I understand that if I commit to joining a weekly therapy group, In the event that I dispute a credit card charge without first trying to resolve my concern directly with Bevill and Associates LLC I agree to reimburse Bevill and Associates LLC. $25 per disputed transaction to compensate Bevill and Associates LLC for the costs incurred in trying to recover disputed funds. I understand there is a 24-hour cancellation policy and that I will be charged without providing 24 hours advance notice to cancel a session.I have read, understand and agree to the information, authorization and guarantee stated above.

Complete This Section If You Have Blue Cross Insurance

Blue Cross Insurance Information

 

Bevill and Associates LLC only accepts Blue Cross Blue Shield plans. Please note some Blue Cross plans provide mental health coverage through a secondary insurance carrier in which Bevill and Associates LLC may not be in-network.

Make an Appointment: (205) 610-9319 | info@bevillandassociatesllc.com

This website and its content has been prepared by Bevill and Associates LLC for general informational purposes only and does not constitute personal medical or mental health advice.

If you think you may have a medical or mental health emergency, please call 911. Viewing the information on this website is not intended to create and does not constitute a therapeutic relationship.

© Copyright 2017, Bevill and Associates LLC All Rights Reserved

Privacy Policy | Website by Brighter Vision

  • Counseling Services
    • Individual Counseling
    • Couples and Relationship Counseling
    • Adolescence – Teenage Counseling
    • Family Counseling
    • Addiction Counseling
    • Forensic Counseling
    • Online – Video Counseling
    • Group Therapy
  • Online Appointment Scheduling
  • Our Practice
    • Covid-19 Response
    • Bevill and Associates Clinical Team
    • Employment Opportunities at Bevill and Associates Behavioral Health
  • Forms and Practice Information
    • Client Portal
    • New Client – Intake Forms
    • Release of Confidential Information
    • Referral Form
    • Fees and Insurance
    • Contact Us
    • Directions To Our Office
    • Your Privacy
  • 72 Hour Appointment Promise
  • Resources
    • Common Questions
    • The Source To Healing and Hope Blog
    • Resource Videos
    • Client Education & Resources
    • Books Resources
    • Assessments
    • Accountability & Filtering Software
    • Current News in Psychology
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