When Sex Abuse-Reactive Conduct is Perceived as Predatory

Recently I responded to a call from someone at a Regional Center for Individuals with Developmental Disabilities, working on getting one of their clients moved from a State Hospital to a community living arrangement. Sounds good so far.

She said that “a Whole Person Evaluation” had been conducted, and the evaluator recommended that prior to placement, a specialized assessment be conducted, specifically administering two test instruments on the client, both assessing for sexual offender conduct. These both address propensity to re-offend and dangerousness.

Hmmmmmmm. I thought, what are the chances that the client was really a sex offender? The caller told me the history. This was an individual, now an adult, who was abandoned by her parents early in her life, then lived in multiple foster homes until she was finally placed at a State Hospital.

What was the possibility that during this time she had been a victim of sexual assault who later re-enacted what had been done to her? Knowing the probability was extremely high, I wondered if her trauma as a victim had been included in the “Whole Person” evaluation. I wondered if she had received therapy if the sexual assaults were discovered or reported. And I wondered if the evaluator had even considered this possibility.

So, saying NOTHING of the above, I said to the caller, “Well the tests that are being requested are for people suspected of being predators, as you know. At what ages was she sexually abused?” “Oh,” was the reply, “I have that in my file somewhere….I know she was abused a couple of times in her earlier life. Give me a minute to find it in the files.”

I said, “Well, did the evaluator consider the possibility that she was re-enacting what had happened to her, and that this conduct was a part of PTSD as a result of her own victimization?” “Uh…no. Hmmmm, that makes sense…” I said, “A ‘Whole Person’ evaluation should include her entire history, don’t you think? I would recommend using tests that look not for a specific outcome (if you use a measure to detect sexual offenders, what will you likely find?) How about more generic testing including testing for trauma?”

“Oh, hmmm, you have a point” she said. We ended the conversation with her saying that she would check with her supervisors on their request.

This conversation has caused me to think of many questions.

  1. How is it that a “Whole Person Evaluator” (I will have to find out the background, training and qualifications of individuals with this title) could miss the obvious link of previous sexual assault victimization?
  2. Beyond the evaluator how is it that those in charge of placing this client, simply followed the recommendation of the evaluator to have formal testing done on sexual offender profiling without considering the client’s known history of victimization?
  3. What seems to be the problem of skilled professionals missing the link between re-enacting what has been done to you and what you do?
  4. How is it that in the file are known instances of sexual assault, without a similar familiarity with the therapy that had been provided and its efficacy?

This causes me to wonder about the training and understanding of sexual assault within the population of individuals with developmental disabilities who reside at State Hospitals, and among the professionals providing services to them.

I am wondering how I can find out who these people are, and learn the training requirements for their positions. Since it is widely acknowledged that sexual, physical, verbal, emotional and other types of assaults are common within the State Hospital setting, what is the knowledge base required for those assisting in the re-location process.

I don’t know how to find out, but it certainly is a question begging for an answer…as are the other questions posed throughout this blog.

UPDATE: Before I had an opportunity to find answers to the questions listed above, I received a follow-up telephone call. The caller said she had checked with “the team” who agreed that “more of a whole person” assessment was needed. Saying nothing more, she inquired into the detail of how we could set up a contract for me to do an evaluation.

I am ecstatic, to say the least! An inroad! Hopefully, this encounter can lead to a different approach among those who request and review “Whole Person Evaluations” for all of those leaving the State Hospitals for community living.