Risk Assessment Case Study

The Case of Jeff:

Pedophile in Institution Jeff is a 35-year-old male who is an inmate in your maximum security facility. Jeff has recently been transferred to your facility from another facility, largely for protective reasons. Jeff has come to you because he is very, very worried. Jeff is a pedophile and he has been in prison for nearly five years. His expected release date is coming up and he may very well get released due to prison overcrowding problems and his own exemplary behavior. He has been in treatment and, as you look through his case notes, you can tell that he has done very well. But there were other inmates at his prior prison facility who did not want to see him get paroled. In fact, it is a powerful inmate gang, and Jeff had received “protection” from this gang in exchange for providing sexual favors to a select trio of inmate gang members. Jeff discloses that while humiliating, he had to do this to survive in the prison subculture, particularly since he was a labeled and known pedophile. The gang knew this, of course, and used this as leverage to ensure that Jeff was compliant. In fact, the gang never even had to use any physical force whatsoever to gain Jeff’s compliance. Jeff notes that this now bothers him and he doubts his own sense of masculinity. Jeff has performed well in treatment for sex offenders. But he has also been adversely affected by noxious sexual experiences inside the prison. You are the first person that he has disclosed this to. Further, he is beginning to wonder if he may have HIV/AIDS; he notes that he feels fatigued more frequently and that he gets ill more easily. However, he makes it very clear that he does not want to be tested until he is out of prison and he does not want his fears known to others in the prison. As you listen to his plight, you begin to wonder if his issues with sexuality are actually now more unstable than they were in prison. Though his treatment notes seem convincing, this is common among pedophiles. But what was not known to the other therapist was how Jeff had engaged in undesired sexual activity while incarcerated. This activity has created a huge rift in Jeff’s masculine identity. Will this affect his likelihood for relapse on the outside? Will Jeff be able to have a true adult–adult relationship on the outside? If not, will he be more enticed to have an adult–child relationship? Does Jeff need to resolve his concerns with consensual versus forced homosexual activity? You begin to wonder. Now as you listen, you realize that if you make mention of this, then the classification system is not likely to release Jeff, and this condemns him to more of the same type of exploitation (gang members are in this prison, too; they just are of different gangs but will eventually learn of his past and follow suit with the prior gang). Oh, and if you do say something, will Jeff feel that honesty and counseling are simply an exercise in vulnerability and betrayal? Or do you not mention this information and by the same token allow someone to be released with a highly questionable prognosis. You sit there listening to Jeff, who is on the verge of tears. You begin to wonder what you should do and what ethical and/or legal bounds you need to consider.

What is the Risk Assessment for Jeff? Answer it thoroughly!

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