J-TRANE - Juvenile Treatment Responsivity and Needs Evaluation

Version 5 - (For youth ages 10-18 currently involved in sex offender specific treatment)

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The J-TRANE - Juvenile Treatment Responsivity and Needs Evaluation is an 18 item standardized structured clinical instrument designed for male and female youth ages 10-18 currently involved in treatment for sexually abusive behavior. This tool has not yet been validated and should not be used as a tool to determine sexual re-offense risk level. It is not designed to be used with adults or younger children, although may have some benefit to other age groups. The J-TRANE assessment tool was designed to be scored on a regular basis with youth during their treatment process to assist the clinical practitioner and treatment team in determining treatment needs and responsivity level. It is recommended that the J-TRANE assessment tool be used on a monthly basis during the treatment process and scored and reviewed by the therapist and the treatment team. The treatment team potentially consists of the youth, youth's parent(s), foster parent(s), relative(s), caregiver(s), significant other(s), social worker(s), probation officer(s), teacher(s), mentor(s) or anyone with whom the youth identifies or is a positive support in the youth's life. It was developed using Microsoft Excel 2010 and later technology and uses Microsoft Excel 2010 and later functionality to automate scoring while presenting scored results in an educational and understandable way to youth and their families.

The J-TRANE assessment tool was developed as a clinical tool to utilize with youth and their families so they can see their progress in treatment over time. The assessment was created based on the notion that youth and families who can see their progress over time are more likely to own their treatment and work towards treatment progress. Much of the assessment is drawn from empirical evidence and current literature. The J-TRANE assessment tool includes a treatment level evaluation, supervision response evaluation, "Home/School/Community" score, "Treatment" score, "Response Override" options, an "Overall Progress" score and a list of "Identified Protective Factors". It is color coded and includes pie graphs to help youth and their family members understand how they are progressing in treatment and what areas still require more work. The assessment "Scoring Sheet" is fully automated by the Excel program after the Items are scored in the "Assessment Items" worksheet by the therapist and treatment team. There are 2 assessment domains included in the instrument: Home/School/Community and Treatment; each consisting of 9 separate items. There are also two options to archive the assessment scoring worksheet and progress worksheet.

The J-TRANE assessment tool is an empirically guided approach to understanding treatment needs, progress and supervision response. The assessment can be thought of as a tool to enhance a goal driven and strengths based team approach to the treatment process while building on the strengths of youth and their families. The author does not make any guarantees with regards to the accuracy of the treatment needs, progress, and supervision response scales as predictors of future behavior. There is no way to precisely predict whether an individual will commit a sexual re-offense. Predictions regarding a youth's risk for a sexual re-offense should be determined using a combination of different assessments, as well as clinical judgment.

How it Works


The J-TRANE assessment tool comes bundled with 4 separate Microsoft Excel 2010 or later worksheets which include: Assessment Items, Scoring Sheet, Progress, and Identified Protective Factors. The assessment requires scoring of the "Assessment Items" worksheet by the therapist and treatment team and information such as client and therapist names and comments must be entered into the "Scoring Sheet". It is recommended that the assessment be completed on a monthly basis. It is important for youth to understand their progress and supervision response on a regular basis throughout the treatment process so they understand their progress and the things they need to work on. It is recommended that the treatment team (which includes the youth) score the first section of the assessment entitled: "Assessment Domain 1 - Home/School/Community" which includes assessment items 1-9, and that the therapist score the second section of the assessment entitled: "Assessment Domain 2 - Treatment" which includes assessment items 9-18. It is helpful to review the full Scoring Sheet with the treatment team on a regular basis during the treatment process. The Scoring Sheet and Identified Protective Factors calculations are automatically made by Microsoft Excel. At the bottom of the Scoring Sheet there are two buttons: "Archive Assessment" and "Archive Progress". Clicking on the "Archive Assessment" will create a copy of the Scoring Sheet and name it in the workbook as the date of the Scoring Sheet. This method should be used if you are not keeping paper records of the Scoring Sheet and provides as a way to back up the scoring data in the Excel workbook. The "Archive Progress" button will automatically transfer the scoring data to the "Progress" worksheet in a column with the date of the Scoring Sheet shown as the first row in that column. The Progress worksheet allows for up to 12 sets of archived scoring data to be entered and saved each year. On the "Progress" worksheet there is a button in upper right corner entitled "Copy and Reset" which will make a copy of the current "Progress" worksheet and save it in the work book and will reset all the scores on the "Progress" worksheet.

When you first open the J-TRANE assessment tool in Microsoft Excel 2010 or later you may need to click on "Enable Editing" at the top of the Microsoft Excel window depending upon your particular software setup. The worksheets are accessible through Microsoft Excel 2010 or later at the bottom of the page in the left corner. Click on the worksheet you wish to read, edit, and/or print. The "Scoring Sheet" should be copied for treatment team members each time it is updated. Treatment team members should also receive a copy of the "Assessments Items" worksheet early in the treatment process so they understand the scoring process of the "Scoring Sheet." The "Assessment Items" worksheet need not be provided every time the "Scoring Sheet" is scored or updated so long as the treatment team members understand the scoring definitions. The "Identified Protective Factors" list are all items with a rating of 4 or more and can be provided to members of the treatment team as determined by the therapist.

"Assessment Items" Worksheet


This is the worksheet that the therapist must score in order for the Excel program to automatically update the Scoring Sheet and Identified Protective Factors worksheet. It includes all of the items, definitions and scoring options. It should be made clear early in the treatment process to the treatment team that a youth's behaviors impact numerous areas with regards to scoring therefore treatment level and supervision response level can increase or decrease over time. See Figure 1 below to determine where on the Assessment Items worksheet to score results.

Figure 1:


Scoring Sheet


This worksheet will automatically be scored by the Excel software program upon completing the "Assessment Items" worksheet. The therapist will need to add the client and therapist names to the "Scoring Sheet." The "Scoring Sheet" also has a comments section at the bottom to which it is recommended that the notes from the monthly treatment team meeting are added. This can be done by clicking in the middle of the bottom of the "Scoring Sheet" and a text box will appear for you to type the meeting notes. The "Scoring Sheet" also has definitions of fields on the worksheet. To see the definition of a field or item just click on it.

It is recommended that the therapist print the "Scoring Sheet" and provide a completed copy of the worksheet to each of the treatment team members, including the youth, each time it is changed or updated. Youth who take their treatment seriously will usually show an interest in the Scoring Sheet to see their levels and points.

Identified Protective Factors Worksheet


Protective factors are conditions or attributes (skills, strengths, resources, supports or coping strategies) in individuals, families, communities or the larger society that help people deal more effectively with stressful events and mitigate or eliminate risk in families and communities. The J-TRANE assessment tool lists protective factors identified in the assessment which are automatically updated on the Identified Protective Factors worksheet by Microsoft Excel upon completing the "Assessment Items" worksheet. The client name and date will transfer from the "Scoring Sheet". The Identified Protective Factors worksheet contains all the assessment items with an identified rating in the minimal need category.

Domain 1 - Home/School/Community


The scoring of this domain is on a 0-5 scale with 0 being a "high need" and 5 being a "minimal need". The scoring colors are coded as red for a score of 0-1 (high need), yellow for a score of 2-3 (moderate need) and green for a score of 4-5 (minimal need). The scoring is strengths based and earning more points results in a higher treatment level and contributes to a lower supervision response level. It is recommended that this section be scored on a monthly basis by the treatment team. See Figure 2 below for information about scoring.

Figure 2:


Domain 2 - Treatment


The scoring of this domain is on a 0-5 scale with 0 being a "high need" and 5 being a "minimal need". The scoring colors are coded as red for a score of 0-1 (high need), yellow for a score of 2-3 (moderate need) and green for a score of 4-5 (minimal need). The scoring is strengths based and earning more points results in a higher treatment level and contributes to lower supervision response level. Domain 2 - Treatment should be scored by the clinician.

Supervision Response Override


The J-TRANE assessment tool allows a supervision response override. A supervision response override can be considered for numerous reasons such as when it may need to be increased manually where a youth indicates their plan to re-offend or in response to other assessment results such as a risk assessment. It may also be appropriate to reduce the supervision response level manually when health, living situation or other circumstances exist.

Supervision response override allows the therapist to choose an alternate response level by checking the checkbox next to the appropriate supervision response level. If a supervision response override is chosen then it will be noted as a response override under the supervision response level section in red. The therapist is required to make a note in the comments section of the "Scoring Sheet" if a response override is indicated.

Caution should be used when comparing supervision response to risk level. It’s very important to keep in mind that the accuracy of clinical judgment in determining risk has been researched and widely debated over the years and some research has indicated that unaided clinical judgment is no more accurate than flipping a quarter. There is also evidence to suggest that manual adjustments to numerically scored assessments may decrease the accuracy and reliability of risk prediction. To date, no single characteristic or risk factor has been found to directly affect risk level during the treatment process. Although the J-TRANE assessment tool has been designed to assist practitioners in determining an appropriate supervision response level, it should be noted that the tool is not a risk assessment and has not yet been validated. See Figure 3 below for identification of the Supervision Response Override check boxes.

Figure 3:


Treatment Level


Treatment level is based on both the overall score as well as the need ratings for items 2-17. If the need rating for any item 2-17 is scored a 0 or 1 then treatment level is automatically calculated as "Treatment Level 1". If there are no items 2-17 scored a 0 or 1 regarding high need than treatment level is based on the overall score of all items 1-16 as noted. Level 1 is a score of 0-58, Level 2 is a score of 59-73 and Level 3 is a score of 74-90. Youth can progress or move backwards in treatment levels depending upon their behaviors and trust level. See Figure 4 below to identify the Treatment Level indicator on the scale.

Figure 4:


Supervision Response Level


The J-TRANE assessment tool was designed to measure how well a youth is doing in their treatment and what level of supervision response should be provided. The response level is meant to assist the practitioner, social worker, probation officer, caregiver(s), treatment team, etc. in determining the supervision level of the youth. The supervision response scale is directly related to the treatment level scale. As the level changes so does the treatment response level. Level 1 = High supervision response, Level 2 = Moderate supervision response and Level 3 = Low supervision response. As youth progress to higher levels of treatment and address needs, the supervision response level will decrease. The clinician and treatment team must determine what type of privileges and supervision level will be required for a particular youth as they reach different treatment and supervision response levels. It is recommended that decisions about supervision be made on an individualized basis. Caution regarding risk is urged as it is certainly possible for youth to score "Low supervision response" in the tool and still sexually re-offend. The supervision response levels are defined as follows (See Figure 5 below):

  • High Supervision Response - requires youth to have a high level of supervision. An electronic monitor device or door alarm may be utilized. Special consideration must be made about alternative placement if appropriate supervision and safety cannot be assured in the youth's current living situation. Youth should not be allowed unsupervised around younger or vulnerable children. Any supervised situations with other children must be approved in advance by the treatment team and the person(s) doing the supervising should be involved in the treatment team process so they are fully aware of the treatment concerns and supervision rules.
  • Moderate Supervision Response - requires youth to have a high level of supervision although some privileges and contact with minors can be approved in individual circumstances by the treatment team. Youth may be allowed periods of time unsupervised as determined by the treatment team.
  • Low Supervision Response - Youth in the Low Supervision Response category have made enough progress in treatment that a high or moderate level of supervision is no longer required. Privileges such as hanging out with friends unsupervised or doing things in the community without constant supervision may be approved on an individualized basis.


Figure 5:


Each item is automatically scored on the "Scoring Sheet" by the Excel software in 2 separate ways which includes overall points (0-5) and need (high, moderate and low). Some items relate to both treatment level and supervision response whereas other items relate more to treatment level and less with supervision response. There are no items that relate to calculation of the supervision response level alone. The first item of Domain 1 entitled "Family Relationships/Supports" relates to supervision response level as it pertains to overall points and not as it pertains to the need category. For example, if item 1 is scored a 0 or 1 (high need) it will not affect supervision response level directly but rather indirectly by the points it contributes to the overall score. In contrast, if any item 2-17 is scored in the high need area (0-1) then supervision response level is automatically calculated as "high". All items contribute to the overall score required to reduce supervision response. Item 1 is not completely included in supervision response level due to the nature of the item and the fact that some youth will not have family supports and this does not necessarily mean they should remain at a high supervision response level.

Item number 18 in Domain 2 entitled "Relapse Prevention" is similar to item 1 noted above. The scoring of this item as a 0 or 1 will not affect the supervision response level like items 2-17. Item 18's need is not included in the calculation of the supervision response level due to the nature of the item and the fact that most youth will not have a completed relapse prevention plan until later in treatment. The therapist has the ability to override the supervision response level (see "Supervision Response Override" section below) if the youth's relapse prevention work is not adequately completed during the treatment process or for other reasons deemed appropriate by the treatment team. If any item 10-17 is scored in the high need area (0-1) then supervision response level is automatically calculated as "High".

Supervision response level is based on a combination of total points on items 1-18 and the existence of "high need" scores on items 2-17. If any item 2-17 is scored 0 or a 1 then high supervision response level is automatically indicated. If items 2-17 are scored 2 or higher then supervision response level is based on overall points for all items 1-18 consistent with the treatment level scoring. That is High supervision response level is 0-58, Moderate supervision response level is 59-73 and Low supervision response level is 74-90. Youth can progress or move backwards in supervision response levels depending upon their behaviors and trust level.

Progress Worksheet


Once the Scoring Sheet has been completed you will notice a button at the bottom right of the scoring sheet (see Figure 6 below) entitled "Archive Progress". Once clicked, this will automatically transfer the scores to the "Progress" worksheet in the next available column (up to 12 columns). The Progress worksheet allows for up to 12 sets of scoring data to be transferred from the Scoring Sheet and will display a Sparkline at the far right side of the Progress worksheet as data is entered. Sparkline progress for each item will only display after a minimum of 2 sets of data are archived from the Scoring Sheet.

Figure 6:


At the top right of the Progress worksheet is a button (see Figure 7 below) entitled "Copy & Reset". Once clicked, this will make a copy of the Progress worksheet and place it in the same workbook entitled "Progress (current date)". It will also reset the date in the Progress worksheet for future use.

Figure 7:


Archive Functionality


The J-TRANE has a new feature as of version 5 which archives the Scoring Sheet and will copy the worksheet and place it in the same workbook entitled "Scoring Sheet (current date)". The archive function is located at the bottom left of the Scoring Sheet and displayed as a button entitled "Archive Assessment" (see Figure 8 below).

Figure 8:


About


Original Release Date: February 2015
Version: 5.2 release May, 2015

The J-TRANE assessment tool was created and is updated by Tom Cleereman, MSW, LCSW. Tom is a Clinical Social Worker for the Manitowoc County Human Services Department in Manitowoc, WI where he has been employed since 1998. He has worked exclusively with children and families since 1991. Since approximately 2000 he has worked exclusively with youth who have sexually harmed and their families. Tom is both a clinical and research member of The Association for the Treatment of Sexual Abusers who specializes in the effective assessment, treatment and risk management of adolescents who perpetrate sexual violence.

The J-TRANE assessment tool is free to use and distribute. The author encourages those using the tool to provide feedback in order to keep the tool updated. A list of some limitations and strengths regarding the J-TRANE is listed below. If you have a limitation or strength to add to the list please use the contact information below. If you are looking for a tool that is friendlier to your particular practice use the contact information below. You can contact Tom Cleereman or provide feedback regarding the J-TRANE assessment tool by visiting JuvenileSexOffenders.com. Or e-mail at contact@juvenilesexoffenders.com.

Usage Tips


The J-TRANE assessment tool is used regularly for youth who have sexually offended in Manitowoc, WI in the Gateways Treatment Program and it has proven to be quite useful with youth and their families. One limitation (noted below) is the need to run the J-TRANE assessment tool in Excel 2010 or later. If you are not familiar with Excel don’t worry; using the tool is simple and questions can be directed to Tom Cleereman at contact@juvenilesexoffenders.com. Included below are some tips when using the tool.

The Gateways Treatment Program provides intensive individual, family and group therapy for youth who have sexually offended and their families. For the many youth this tool has been utilized with there is a clear intent on most youth’s parts to improve scoring results.
  • When first using the tool print the "Assessment Items" worksheet for youth and their families.
  • In Gateways there are monthly treatment team meetings and members of the youth’s treatment team are provided copies of the "Assessment Items" worksheet. Youth keep a copy of this form in their treatment binders to refer to.
  • Carefully review the assessment items with all treatment team members so that each member understands how points are scored and what must occur to improve scoring.
  • Each month a treatment team meeting is scheduled during which the youth, significant others such as family members, the clinician, foster parents, school personnel, social worker, probation officer, other treatment or service providers, etc. are invited. During this staffing the Youth reports in about his or her scores on the "Assessment Items" worksheet and the team discusses positives and negatives of the previous month in 4 separate areas: Home, School, Community and Treatment. The team agrees on the scores for the "Home/School/Community" domain.
  • When a youth scores themselves as a "3" for example the clinician or other team member can appropriate ask the youth what he or she needs to do to raise the score over the next month and this information is often recorded in the "Comments" section of the Scoring Sheet. One example that could help raise the "Treatment Functioning/Progress" score is helping the youth develop goals around behavior or completion of specific treatment work.
  • For the most part, youth are very involved in this process and work to earn points, levels and privileges.
  • The Gateways Treatment Program also uses a "Privilege Request" form for youth who would like to request privileges such as riding bike, walking to school, going to an event, playing a sport, spending time with a friend, going to the library, being granted internet access, etc. This form is presented at the treatment team staffings and openly discussed and addressed. The privilege request form requires the youth to list the details of the request, the safety plan to be used and how they are doing in treatment and why they feel they have earned the request. Sometimes these requests are denied, granted or adjusted before being granted and since the whole treatment team is available discussion can then ensue as to who will be responsible for ensuring safety and supervision. This too recorded in the Comments section of the scoring sheet.
  • The clinician will attend the staffing with a laptop or computer and score the J-TRANE during the staffing. Scoring Sheets will then be printed for each team member.
  • Occasionally, the Identified Protective Factors will be printed and shared with team members if the clinician feels there would be some benefit to this. The progress worksheet can also be shared to show team members patterns in behavior or as a strengths based tool to show progress.
  • There are some items such as "Demonstrates Being Responsible" and "Trustworthiness" that may need extra explaining. In Gateways, before a youth can get a 4 or 5 rating scale on these two items he or she must be showing responsibility and gaining trust in unsupervised activities which tends to occur well into the treatment process.
  • The treatment team process can also be very empowering for incest victims. When progress has been identified to the extent the team feels it would be appropriate, siblings and sibling victims are also invited to the monthly treatment team meetings so they can have a voice and see how the identified client is progressing. Gateways staff have found this to empower the youth in the program to do better, empower victims to be involved and has also resulted in the clinician checking in with siblings to ensure rules around supervision and safety are being followed.
  • Social workers and/or probation officers have been known to use scores and risk areas as topics for goals to be reached before certain privileges. For example, one youth in the Gateways treatment program recently was informed by their court social worker that he needs to work towards a level 2 and moderate risk level in order to be off an electronic monitoring device. This particular youth took charge of his treatment and asked specific questions about what he needed to do to improve his scoring results to be successful with this goal and he was successful.
  • The tool allows youth to see a "light at the end of the tunnel" and has been a truly remarkable resource in the treatment process.
  • Once you complete the J-TRANE you can click "Save As" and rename the file to the youth’s name so that way when you open the youth’s filename at the next staffing you will have that youth’s particular treatment workbook to refer to and score and archive for the following staffing.


Acknowledgements


The following people should be acknowledged for their inspiration, efforts, and/or contributions in formulating the J-TRANE assessment tool (in alphabetical order):

  • David Foster, BSW
  • Manitowoc County Human Services Department Youth & Family Services Unit
  • Phil Rich Ph.D.
  • Sue Righthand, Ph.D.
  • Anna Salter, Ph.D.
  • Rodney Zahn, BSW


Limitations of the J-TRANE


  • Not an assessment for sexual re-offense risk
  • Not currently validated
  • Title not real clear about being a tool for youth who sexually offend
  • Items may not apply to all situations and programs
  • Currently requires Microsoft Excel to score the items


Strengths of the J-TRANE


  • Graphical presentation for youth and families is easy to understand
  • Items are empirically supported
  • Strengths based nature - goal to increase level and points, tool indicates what youth need to do in positive terminology to earn more points
  • Ideal for tracking progress
  • Good tool for comparisons
  • Level system keeps youth interested in earning points
  • Assists clinicians and treatment team members in considering treatment risk
  • Supervision response override functionality
  • Can be used for both males and females
  • Youth and families understand where they are in the treatment process and what they need to accomplish
  • Identified Protective Factors section added in version 4.2
  • Archive functionality added in version 5
  • Progress Report added in version 5
  • Empowers the family to have a voice and be involved
  • The complete Excel file is less than 100 kilobytes


J-TRANE How To Video:



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