Standards And Guidelines For The Provision Of Services To Sex Offenders

INTRODUCTION

Sex offenders continue to be one of the most pressing public safety concerns, both within the general public and the correctional community. According to the Correctional Service of Canada, this is an issue of enormous significance facing correctional authorities.

In 1994, the Service created and staffed the first Corporate Advisor Sex Offender Programs. The advisory structure which had been established to help guide the Service’s efforts in past years was disbanded and replaced with a committee of Correctional Service of Canada clinical, research and administrative staff who were tasked with developing the basic infrastructure of a cohesive sex offender strategy.

A broad based review of current program offerings and treatment modalities has been undertaken by the Committee subsequent to regional program reviews and consultation with practitioners. The National Committee drafted a Statement of Principles, standards for the delivery of services, as well as assessment and treatment guidelines. Research issues and an accountability framework have also been addressed.

This document represents the results of the Committee’s efforts and extensive consultation with participants at the March 1995 Conference entitled: "Intervention with Sex Offenders: Towards a National Strategy", as well as Unions, Legal Services, the Correctional Investigators office, Corporate Advisors and offenders.

As Chairperson of the National Committee on Sex Offender Strategy, I would like to acknowledge the collegial spirit, enthusiasm, diligence and endurance of this Committee, who, together with Senior Project Managers and strong Corporate support, have brought this document to completion. Over the next year, release of the Standards and Guidelines for the Provision of Services to Sex Offenders, together with a new CD on Sex Offenders, will mark the beginning of the implementation process. These documents should provide the requisite framework for Service Providers and administrators to continue their difficult but necessary work with a large, diverse and challenging sex offender population.

Sharon Williams, Ph D., C. Psych,
Chairperson and Corporate Advisor,
Sex Offender Programs

STATEMENT OF PRINCIPLES

The Correctional Service of Canada contributes to the protection of society by managing the risk of re-offence through identification, assessment, treatment and maintenance programs for sex offenders.

1. Identification and assessment of sex offenders shall focus on offender risk/need, responsivity/treatability and the management of risk.

2. The timing, duration, focus and intensity of services will be based on an offender’s level of risk, need, responsivity/treatability, motivation and other relevant factors.

3. Participation in services provided to sex offenders shall be voluntary and based on informed consent. Offenders should accept full accountability for their own behaviour throughout the provision of services.

4. Services provided to sex offenders are an integral part of the Correctional Plan, developed and carried out by a multidisciplinary team with the active participation of the offender.

5. The Correctional Plan shall include a continuum of intervention strategies which may extend beyond the end of sentence.

6. Sex offender programs shall be founded on sound theory and research. Interventions offered to Aboriginal offenders may also incorporate Aboriginal healing approaches. All interventions will focus on reducing the likelihood of reoffending.

7. Development of innovative methods in the assessment, treatment and management of sex offenders shall be encouraged in order to improve program delivery, in accordance with the Service’s policy on research.

8. Service providers and multidisciplinary team members shall be qualified and trained in accordance with their duties.

9. Services provided to sex offenders shall be reviewed and evaluated on a regular basis to ensure they meet professional, ethical and correctional standards.

10. To ensure public protection, the Correctional Service of Canada will work towards partnerships with the community to develop joint interventions and maintenance programs.

The following Standards apply to all service providers:

Competence in Practice

Providers of clinical services to sex offenders must:

a) possess particular knowledge, experience, ability and personal suitability. These qualifications will be assessed in the staff/contractor selection process and will be monitored throughout program involvement,

b) develop a network of contacts within the resources available locally. This becomes particularly important in the community,

c) be aware of current research and should take part in ongoing professional development,

d) adhere to the generally accepted standards of practice and professional conduct,

e) perform duties with integrity by reliably and consistently delivering on promises and honouring commitments,

f) be aware of and sensitive to the stressors that can result from working with sex offenders,

g) bring unprofessional or unethical behaviour to the attention of the colleague in question, the colleague’s supervisor or professional body depending on the gravity of the concern,

h) treat all sex offenders with respect and dignity, regardless of race, gender, disability, sexual orientation or preference, or socioeconomic status, and

i) not make unsubstantiated claims about prediction of risk and program efficacy.

Informed Consent and Limits of Confidentiality

a) Participation in sex offender programs shall be voluntary and based on informed consent. The offender shall be given an opportunity to accept, decline, or withdraw from the service after the potential consequences of such a decision are explained.

c) Prior to the delivery of service, the provider must ensure the offender understands that information provided is confidential to the extent listed below.

a) The service provider must inform the offender:

i. of the nature and purpose of the contact with the offender;

ii. that psychological reports prepared by CSC employees and/or consultants under contract for the CSC, are the property of the Service;

iii. that personal information may be used for the purposes of case management including release decision-making and the supervision or surveillance of the offender in the institution or the community;

iv. that psychological information relevant to release decisions or the supervision or surveillance of offenders must be given at the appropriate time to the National Parole Board, relevant provincial jurisdictions, provincial parole boards, the police and any body authorised by the CSC to supervise offenders;

v. that psychological information must be shared with the police where CSC believes on reasonable grounds that an inmate who is about to be released on warrant expiry poses a threat to any person after release and where that information is relevant to the perceived threat.

d) "Informed consent", including the limits of confidentiality, must be documented in accordance with CSC policy.

Conflict of Interest

Service providers shall not establish relationships which conflict with the ethical guidelines of their particular profession, and/or Code of Conduct and policy of the CSC.

Termination of Service

Offenders must be notified of disruption or termination of clinical services. When clinical services are terminated the reasons shall be documented in writing.

Psychophysiological Measurements

In addition to exercising professional judgement in selecting and using test stimuli, stimulus materials must have been legally obtained.

Aversive Procedures

Aversive procedures must be safe and follow scientific guidelines.

Pharmacological Interventions

Pharmacological interventions must be administered by a qualified health care practitioner.

ASSESSMENT GUIDELINES

Sex offender assessment is a systematic and dynamic process which evaluates offenders throughout their sentence. Its purpose will determine timing, focus, format and content. All assessments shall focus on offender risk, need, responsivity/treatability and on the management of risk, utilising a variety of assessment methodologies in an integrated process.

Assessment shall take into account both culture and gender differences.

Assessment of sex offenders takes place at:

• Admission,

• Pre-treatment,

• In-treatment,

• Post treatment,

• Follow-up,

• Pre-release, and

• Post-release.

Information gathering includes, but is not limited to:

• file reviews,

• collateral contacts,

• clinical interviews,

• psychological testing,

• psychophysiological techniques,

• behavioural assessment.

The absence or contradiction of information should be noted in the assessment report.

File reviews include, but are not limited to:

• pre-sentence/pre-disposition reports,

• police reports,

• victim impact statements,

• psychological and psychiatric reports, and

• the Judge’s reasons for the sentence.

Collateral contacts include interviews with:

• spouses and/or significant others,

• criminal justice personnel,

• mental health professionals, and

• any other person who can provide a further perspective on the individual.

Clinical interviews involve face-to-face interaction with the offender. Often, these interviews may be semi-structured, such as those used to score assessment instruments.

Psychological tests may be used to provide information on:

• mental ability,

• personality,

• neuropsychological functioning,

• potential risk,

• attitudes, and

• treatment targets.

Psychophysiological techniques such as phallometric evaluation, may be used to provide specific information regarding sexual arousal to various standardised stimuli such as: age and gender preference, and interest in sexual violence relative to consensual sexual interactions.

Behavioural assessments based on clinical observations, the offender’s self-monitoring reports and structured role-play scenarios may be used to provide information on social functioning and communication.

ADMISSION ASSESSMENT

Upon admission to federal custody a sex offender is defined as anyone who has:

• been convicted of a sexually motivated crime, and /or

• admitted to a sex offence for which they have not been convicted

All new offenders receive a standardised assessment known as the Offender Intake Assessment. In addition, sex offenders undergo a Specialised Sex Offender Assessment.

Together, these assessments provide a summary of sex offender treatment needs, perceived risk to reoffend, responsivity/treatability and the targets for interventions.

This summary is integrated into the offender’s Correctional Plan and reflects the focus, intensity, duration, timing, sequence, and location of treatment and/or maintenance services.

Offender Intake Assessment is based on the following components:

Community Intake Assessment

• Critical Concerns (e.g., adjustment difficulties),

• Forensic Records,

• Police Records,

• Institutional Records,

• Release Suitability, and

• Needs Analysis (e.g., employment, family, marital).

Initial Assessment

• Sentence Administration,

• Security,

• Medical History and Examination,

• Mental Health, and

• Suicide Risk and Potential.

Criminal Risk Assessment covers

• Criminal History Record (Youth Court, Previous Adult, Current Convictions),

• Sex Offence History,

• Detention Criteria,

• Statistical Information on Recidivism (S.I.R.-Revised 1) Scale, and

• Any Other Related Factors.

Case Needs Identification and Analysis

• Employment (education, work record),

• Marital/Family Relations,

• Associates,

• Substance Abuse,

• Community Functioning,

• Personal/Emotional Orientation, and

• Attitudes.

Psychological Assessments

See Commissioner’s Directive 840 on Psychological Services.

Supplementary Assessments

For example, Educational/Vocational, Substance Abuse, Medical/ Psychiatric.

Criminal Profile

Narrative description of the current/past offence(s) and crime cycle.

Specialised Assessment

This assessment complements the Offender Intake Assessment process and shall cover the following areas:

• History and Development of Sexual Behaviour,

• Sexual Preference(s),

• Attitudes and Cognitive Distortions,

• Social Competence,

• Medical History,

• Psychopathology, and

• Prior Assessment and Treatment Results.

Pre-treatment Assessment

The pre-treatment assessment confirms previously identified treatment targets and links them with direct service delivery.

It forms the basis to begin intervention and highlights specific treatment targets to reduce the likelihood of sexual reoffending.

Pre-treatment assessment areas may include:

• Social Desirability,

• Cognitive Distortions,

• Attitudes, Values and Beliefs,

• Violence/Anger,

• Intimacy/Relationships,

• Empathy Skills,

• Interpersonal/Social Skills,

• Psychosexual Functioning,

• Coping Skills, and

• Motivation To Change.

In-treatment Assessment

Progress is documented on an ongoing basis. Depending on the length and structure of the program this should be done as a formal assessment report or by way of progress notes.

Post-treatment Assessment

At treatment completion, dynamic factors are re-evaluated to determine whether gains have been made with respect to treatment goals. It determines the impact of treatment on the level of risk.

In addition, this assessment should outline the form of subsequent interventions, such as continued treatment, institutional or community-based maintenance programs. It should also address the management and supervision strategy.

Follow-up Assessment(s)

There is an ongoing clinical contribution to the evaluation of each sex offender’s progress in relation to their Correctional Plan.

A systematic review of both historical and dynamic factors takes place on a continuing basis, thereby contributing specific relevant information to the Correctional Plan.

Where there has not been any significant intervention, cases are reviewed every 24 months.

Pre-release and Decision- making Assessment(s)

Assessment reports may be required to assist in decisions by institutional authorities or the National Parole Board on:

• Transfers,

• Private Family Visits,

• Temporary Absences,

• Conditional Release, and /or

• Preventive Detention.

Post-release Assessment

There is an ongoing contribution to the evaluation of a sex offender while on conditional release. Post-release assessments are prepared to assist community case managers with decision-making while the offender is under supervision.

TREATMENT GUIDELINES

Treatment of sex offenders is a therapeutic and structured intervention aimed at the reduction of the risk to reoffend sexually.

While the treatment guidelines apply to all such programs, the duration, intensity and content of specific programs will vary according to the level of risk/needs of the offender.

Treatment Priority

Following comprehensive assessment, priority for treatment is driven by the following factors:

• risk to reoffend,

• proximity to probable release,

• motivation to change, and

• likelihood of treatment gains.

Continuity of Services

To ensure continuity of care from reception to end of sentence, treatment services must be available both in institutions and the community.

Programs at different locations must complement each other, providing an integrated approach to sex offender treatment.

Service Network

Service providers must be aware of available support services, especially in the community.

Program Description

Treatment programs must maintain an accurate program description including:

• Program Orientation,

• Target Population,

• Intensity, Frequency and Duration of Groups,

• Admission, Discharge and Exclusionary Criteria,

• Treatment Goals,

• Detailed Description of Program Components,

• Pre- and Post-treatment Assessment Methodology,

• Staff Identification, Roles and Responsibilities, and

• An Evaluation Framework.

Program Orientation

Treatment must be based on established therapeutic procedures which maximise likelihood of short and long-term treatment gains. Gains must be related to reduced recidivism.

Risk Management At End of Sentence

At end of sentence, the Service Provider must give the Case Management Officer an estimate of risk and suggest strategies that could be used to manage the case in the community.

Specific Needs

In conjunction with the programs outlined in the Standards, some offenders, such as Aboriginal or female offenders, may require additional components specifically designed for them. Others, such as low functioning, mentally disordered or violent offenders, may need specialised interventions .

In certain cases, such as acute psychosis, organic brain syndrome, or severe personality disorders, specialised services may be provided through a mental health unit.

Offender Denial

Where denial, or refusal to accept any responsibility for all sex offences, has prevented the offender from taking part in treatment, the Case Management Officer should address the issue of denial in the Correctional Plan.

The Correctional Plan should document:

• the need to target denial;

• the relationship between denial and other case issues; and

• the effort made to confront denial.

Treatment Goals

Using the results of Admission and Pre-treatment Assessments, the following treatment goals may be identified:

Minimisation and Rationalisation

Recognising and accepting full responsibility for their criminal behaviour and its damaging consequences.

Attitudes and Cognitive Distortions

Developing awareness of the cognitive and affective processes which underlie criminal sexual behaviour, challenging and subsequently replacing them with more adaptive ones.

Social Competence Skills

Improving the ability to communicate effectively, demonstrating empathy, being appropriately assertive, and initiating, maintaining and terminating relationships.

Sexuality

Increasing knowledge and developing responsible, healthy attitudes towards sexuality and intimacy.

Offender Victimisation

Understanding the impact of the offender’s own experiences as a victim on their criminal behaviour.

Victim Awareness

Developing awareness of and sensitivity to the impact of sex offences on victim(s).

Deviant Arousal and Fantasy

Reducing deviant sexual arousal and fantasy while maintaining or increasing non-deviant arousal.

Anger Management/ Impulse Control

Improving skills and abilities in the areas of anger management and impulse control.

Relapse Prevention

Improving the offender’s awareness and understanding of internal and external precursors, high risk situations, coping strategies and risk management techniques.

Program Placement

Program placement must be based on:

• the offender’s risk to reoffend;

• treatment needs;

• motivation to participate in treatment; and

• the ability of the program to meet these identified targets.

In the case of some low risk/low need offenders, formal sex offender treatment may not be deemed necessary.

Treatment should normally not be repeated at the same level of intensity unless clinically justified.

Program Intensity

Intensity of programs is determined as follows:

Institutional Programs

High Intensity

High intensity programs are recommended for offenders assessed as higher risk to re-offend and/or high need. These programs are usually delivered in a specialised unit.

• Exclusionary criteria should be minimal, specific and justifiable.

• Program modules should be presented daily.

• Program delivery should be from 6-8 months, with a minimum of 15 contact hours of therapy per week.

• Programs should be closed, with specific entry and completion dates.

Moderate Intensity

Moderate intensity programs are recommended for offenders assessed as moderate risk with need levels that are either moderate or high.

Moderate intensity programs may be located in institutions of varying security levels.

• Program delivery should be from 4-5 months, with a minimum of 10 contact hours of therapy per week.

• Programs may include fewer components than high intensity programs.

• Programs should be closed with specific entry and completion dates.

Low Intensity

Low intensity programs are recommended for low risk offenders whose needs may range from low to moderate. These programs are usually located in minimum security institutions.

• Program delivery should be from 2 to 4 months, with a minimum of 2 contact hours of therapy per week.

• These programs usually cover victim awareness and empathy, as well as relapse prevention.

• Low intensity programs do not usually target offenders with deviant arousal, persistent denial, or special needs unless they have been at least partially addressed in previous treatment.

• These programs may be open, with continuous intake.

Maintenance

Maintenance programs should be available for all treated sex offenders.

Maintenance programs must be available in all minimum security facilities which house sex offenders.

• Program delivery should be a minimum of 2 contact hours bi-weekly.

• Programs should focus on relapse prevention issues and reinforce the gains made in more intensive programs.

• Open groups are preferred.

• Priority should be given to moderate to high risk treated inmates who have cascaded in security level.

• The frequency and duration of participation will be determined by a multi-disciplinary team.

Community Programs

Structured

Structured programs are offered to meet the needs of higher risk sex offenders.

These programs may be offered in collaboration with provincial or municipal government programs, community agencies, hospitals, or universities.

• Program delivery should be a minimum of 2 hours per week.

• These programs are part of the continuum of sex offender treatment and should focus on specific treatment targets identified in the Correctional Plan. This includes relapse prevention and the application of identified strategies.

• For higher risk sex offenders, programs should be offered while the offender resides in a structured environment, such as a Community Correctional Centre or Community Residential Centre, that can support the community re-integration process.

Maintenance

Maintenance Programs should be available for all treated sex offenders on conditional release.

• Program delivery should be a minimum of 2 hours bi-weekly.

• Programs should focus on relapse prevention and reinforce the gains made in more intensive programs.

• Open groups are preferred.

• The frequency and duration of participation will be determined by the Service Provider(s) and the Case Management Officer.

• Priority should be given to higher risk/need treated offenders.

Treatment Modality

Group Therapy

Group treatment is the preferred treatment modality. Some offenders may require individualised treatment. Under exceptional circumstances, individualised treatment may be the sole method of treatment as a short- term strategy.

Group Leadership

In moderate or high intensity institutional programs and structured community programs, groups should be co-facilitated.

For low intensity and maintenance programs, one service provider is acceptable, but two are preferred.

Group Size

The size of the group should be linked to program intensity. The lower the intensity, the larger the group. Group size will normally fall between 6 and 12.

Continuity of Service

To ensure continuity of services, the same service provider should deliver treatment modules from the start of the program to its completion. This will optimise treatment gains and improve group cohesion.

Group Heterogeneity

Within the same level of risk/need, groups may be heterogeneous with respect to sex offence.

Participation by Family and Others

Family and/or significant others are encouraged to take part in the therapeutic process when appropriate, and where resources are available.

Their involvement should focus on promoting the development and/or maintenance of a prosocial support network, assisting the offender in avoiding and/or coping with high risk situations.

Victim Awareness

In order to increase the offender’s awareness and empathy, audio and visual material may be used.

People who have experienced sexual assault(s) may be invited to share their experiences. Their involvement should be carefully assessed and monitored.

Victim-Offender Reconciliation

Requests for victim-offender reconciliation should be reviewed and agreed upon by all affected parties, such as the victim/ survivor, the offender, the victim/survivor’s therapist, parent(s)/legal guardian, the offender’s treatment provider and the Case Management Officer. The victim/survivor has the ultimate veto over decisions affecting reconciliation.

RESEARCH GUIDELINES

Research conducted by the CSC is used to enhance and improve the way the Service carries out its mandate. Hence, there will be a strong emphasis on research that can be applied to the Service’s policies, programs and management of sex offenders.

Types of Research

The majority of research initiatives can be conceptualised along a continuum of offender management. Therefore, research will strive to:

• improve the way information is gathered on admission to federal custody,

• help staff use this information to make decisions about custody level and which programs or treatment are needed prior to release,

• design institutional and community programs critical to the ability of sex offenders to live as law-abiding citizens,

• monitor which types of sex offenders benefit from which types of programs,

• examine which release strategies are best suited to particular types of sex offenders,

• improve the gathering of information on sex offenders when they are first released into the community, and

• improve the management of sex offenders in the community.

Quality Assurance

In order to maintain a standard of quality and relevance, the conduct of applied correctional research on sex offenders requires:

• a particular combination of technical expertise and operational experience,

• an intimate knowledge of the organisational context,

• an ability to analyse and address issues from a broad knowledge base of existing research in both criminal justice and sexual deviance, and

• a commitment to scholarly excellence and the applications of research knowledge to real world problems.

Policy Direction

The research activities of the CSC, as outlined in the Corporate Operational Plan, reflect the status of both current and new initiatives. Many research projects are carried over from one fiscal year to another.

Current initiatives typically involve the development, implementation and ongoing monitoring of major offender programming or assessment initiatives.

New initiatives are designed to address the current, emerging and anticipated strategic priorities of the Service.

The Commissioner’s Directive " 009 - Research " provides the policy framework for conducting research, in general, and directs how research on sex offenders should be carried out. It covers:

• reviewing research proposals,
• establishing priorities,
• obtaining agreement with researchers,
• conducting research projects,
• offender participation in research,
• medical research, and
• the review/publication of research.

EVALUATION AND ACCOUNTABILITY GUIDELINES

Sex offender programs are part of mental health services offered to offenders. As such, they must be delivered by a qualified mental health practitioner, in keeping with professional standards.

Policy

Sex offender programs are subject to the following:

• The Standards and Guidelines for the Provision of Services to Sex Offenders;

• Commissioner’s Directive 009-Research;

• Commissioner’s Directive 702 - Aboriginal Programming;

• Commissioner’s Directive 803 - Consent to Health Services Assessment, Treatment, and release of Information;

• Commissioner’s Directive 840-Psychological Services;

• Forensic Psychology - Policy and Practice in Corrections

• Professional Codes of Ethics

Structure

At the operational unit level, overall responsibility for the delivery of sex offender programs rests with the Program Manager, Clinical Director, and Service Providers. In some settings, the same person may fulfil more than one role.

In general, Program Managers have line authority, whereas Clinical Directors oversee programs from a professional or functional authority. Service Providers deliver programs and services and may have a variety of corporate or professional designations or titles.

Qualifications

Program Managers are employees of CSC and occupy line authority positions in the organisation. Their qualifications are determined by their position.

Clinical Directors may be employees of the CSC or under contract. They shall be licensed mental health practitioners and have demonstrated competence and related work experience.

Service Providers may be employees of the CSC or under contract and shall:

• be licensed mental health practitioners,

• possess, at a minimum, a certificate as a Behavioural Science Technologist, or a Bachelor’s degree in the social sciences, or the PSC equivalency, and /or have demonstrated competence in relevant work experience, and work under the clinical supervision of a licensed mental health practitioner,

• possess suitable training to offer aboriginal healing approaches.

Volunteers must be supervised by a qualified staff member or contractor. Therefore, a volunteer may not be the sole service provider.

Responsibilities

Program Managers should:

• ensure that procedures are in place to evaluate and monitor the quality of services provided to offenders.

This includes measures of:

• timeliness of treatment,
• timeliness of completion of treatment, and
• timeliness of required reports.

Clinical Directors should:

• ensure that the quality and integrity of sex offender programs are in keeping with current professional standards,

• evaluate the performance of Service Providers, and

• advise the Program Manager on the quality of work performed.

This is accomplished by:

• being available for consultation,

• acting as a consultant, facilitator, and quality control agent for the program(s),

• either being on site or visiting each site on a regular basis (no less than bi-monthly) to assess the strengths and weaknesses of the service,

• sharing findings with the Service Providers and their line supervisor or contract manager,

• ensuring that treatment services are available, and

• submitting a summary of an annual review of the sex offender services to the Program Manager.

Service Providers deliver services to sex offenders in keeping with professional standards and Standards and Guidelines For The Provision Of Services to Sex Offenders.

Evaluation

All evaluations of sex offender services will focus on:

• the individual performance of Program Managers, Clinical Directors, Service Providers and other program staff, and

• the quality, efficiency and effectiveness of the program.

Service Providers will be evaluated on the basis of professional standards and practice guidelines, through direct supervision by the line manager, contract manager and/or Program Manager, with a contribution from the Clinical Director.

Clinical Directors shall be evaluated on the basis of professional standards and practice guidelines.

Programs will be evaluated on:

• quality of service delivery (for example, compliance to service standards),

• efficiency (for example, timeliness and completion), and

• effectiveness (for example, follow-up research on relapse and recidivism).

Evaluation Process

Assessments of Program Managers , Clinical Directors and Service Providers shall include information stemming from the following:

• results from external reviews and research,

• feedback from other stakeholders and staff,

• results from inquiries and investigations, and

• offender feedback,

Areas to be assessed include:

• professional standards and qualifications of practitioners and staff,

• quality and timeliness of pre-release (risk) assessments,

• treatment objectives and intervention strategies,

• documentation and reporting on treatment progress and outcome,

• documentation of the disclosure of relevant information,

• prioritisation of offenders (risk, need, responsivity),

• selection criteria, screening and referral process,

• theoretical and empirical basis of program components,

• quality and timeliness of pre and post treatment assessments,

• orientation and training of staff,

• internal quality control process, and

• assessment of individual staff members’ performance.

Accountability

Service Providers are accountable for delivering appropriate assessment, treatment and relapse prevention services to sex offenders.

Clinical Directors are accountable to ensure that the quality of service delivery is in accordance with professional standards.

Program Managers are accountable to evaluate the performance of programs and subordinates, with input from the Clinical Director.

Wardens or District Directors are accountable for ensuring:

• that there are sufficient and appropriate services to meet the needs of their sex offender population, and

• that there are mechanisms to monitor, evaluate, and if necessary, improve the delivery of services to sex offenders .