Seattle University Collaborative Projects - International Academy of ...

Working to Results in the TBSAart Goosensen, Tilburg University (aartgoosensen@kpnmail.nl)Karel Oei, Tilburg University (t.i.oei@tilburguniversity.edu)The number of psychiatric detention TBS has decreased from 226 to 99 since 2004. The mostimportant reason is that the duration of the treatment has exploded (4 years in 2000 to 9 years in2012). In court this dilemma has often been solved in a resourceful way. At the moment half ofthe (un)conditional termination patients are still in the clinic. And after one year conditionaltermination subsequently results in an unconditional termination. A qualified interaction betweentreatment and risk assessment for release is hardly known. To arrive at a recognizable treatmentmethod for all actors in the TBS-sector, treatment is aimed at the dynamic risk factors of theHKT-30. The physical journey and release plan are fixed within four months, as is the exit target(also in terms of HKT-30). Competences per discipline or module are balanced out against riskfactors to support the decision of how to treat tension between the actual score and target score.Therefore the treatment plan can be explained in less words; the professional understands thesense of “his” risk factor. This and more has been developed in the route card, valued by the Ist(inspection) as best-practice.Side effects of Androgen Deprivation Therapy in the TBSJelle A. Troelstra, Van der Hoevenkliniek, Utrecht, Netherlands (jtroelstra@hoevenkliniek.nl)Karel Oei, Tilburg University (t.i.oei@tilburguniversity.edu)The goal of Androgen Deprivation Treatment in sex offenders is to reduce the availability oftestosterone. If the testosterone level declines, a man produces less estrogen. The resulting dropin estrogen production leads to mental and physical complaints. These are complaints thatresemble climacteric complaints: mood swings with depressive complaints, sweat attacks (hotflushes) and osteoporosis. The decline in testosterone can reduce muscle mass and may causecomplaints of fatigue. Using progestagene substances such as cyproterone acetate or MPA cancause weight gain and breast enlargement (gynecomastia) as adverse side effects. To preventosteoporosis, patients use calcium tablets, vitamin D and a bisphosphonate. Bone densitymeasurement by DEXA scan takes place at regular intervals. The psychiatrist supervising thetreatment will constantly make comparative assessments of the desired effects and the burdens ofadverse reactions that may occur. When a patient has a desire to have sex with an approvingadult partner, there will not be much resistance from the team that treats the patient. For a patientwith hypersexuality or a patient with a non-exclusive paraphilic sexual preference, such a sexualdesire can fit within a positive life plan. When such a patient starts a relationship with an adultpartner one can consider a milder form of antilibidinal medication.386