VALLEY TREATMENT SPECIALTIES
I, Steven Sitler, hereby enter into an agreement with Valley Treatment Specialties to allow their staff to provide me with treatment services. I understand and agree to the following conditions regarding my treatment.
- I agree to be completely honest and assume full responsibility for my offenses and my behavior. I will openly and candidly discuss issues with the counselors.
- I agree to sign releases of information required to obtain information about my behavior.
- I will attend all treatment sessions and attend on time.
- I will notify the appropriate staff member as soon as possible about any situation that effects my attendance or promptness.
- I understand that the only acceptable excuse for absence is a verifiable medical emergency and that all excuses may verified by calling a third party.
- I will pay my assigned fee at the time of each session unless I have made other arrangements with the staff.
- I will not disclose any information regarding another client to anyone outside this program unless the information is required by an appropriate authority in an emergency situation where a staff member is not available.
- I will share with the group the nature of any contact I might have with another client while outside the treatment session.
- I will actively participate in group sessions to the satisfaction of staff and other group members. I understand that it is my responsibility to participate in discussions, to complete assignment and to actively make progress while involved with the program.
- I will not become verbally threatening or assaultive towards any staff member client whether inside or outside of the office.
- I will not attend any session while under the influence of alcohol or drugs.
- I will not commit any criminal offense.
- I will not have any child pornographic material in my possession at any time.
- I understand that I will be financially responsible for the costs incurred for treatment for my victim or victims.
- I understand that if I have any questions about this contract or about my involvement with the treatment program, I would specifically contact my counselor. I understand that my probation officer and my counselor will be communicating. I also understand that I should direct specific treatment questions to the counselor and specific questions about probation requirements to my probation officer or the Court.
- I understand fully and completely that participation in this program may require polygraph examinations and that I will be expected to be financially responsible for these examinations.
I understand that new information that is obtained through a polygraph (suggesting a lack of an open and honest relationships with my counselors) will cause the following:
- A written warning will be submitted to me and a copy sent to my probation officer or the Courts.
- I will retake the polygraph within 30 days and pay for the second one as well.
- If I fail the second polygraph, a letter stating my unsatisfactory involvement in be treatment program will be submitted to me and a copy sent to my probation officer or the Court. This may be viewed as a violation of my treatment contract to satisfactorily complete treatment.
- I understand fully and completely that I am required to make continuous progress through the treatment program. I understand that I am expected to actively participate in the group process by initiating my own involvement in treatment. I understand I required to do more than attend groups and be financially required to take an active part in working toward repairing the damage done to my children and/or victims.
- I understand fully and completely that when I have reached a place in my treatment process I will be required to become involved in the Valley Treatment Specialties treatment program aftercare program of treatment by attending the Treatment Program Aftercare Group. I understand that my involvement with the Valley Treatment Specialties Treatment program will be a requirement throughout the course of my probation or ordered counseling period. I understand that I will be required to actively cooperate and participate in this organization throughout the remainder of my parole or probation period or ordered counseling period.
- I understand fully and completely that should I fail to make progress in the treatment program or should I fail to follow the guidelines set down for me in the treatment program, the following steps will be taken:
- A verbal reprimand will be administered to me in the group process regarding my failure to respond to treatment.
- A formal written reprimand will be submitted to me and a copy sent to my probation and parole officer or the Courts should I continue to fail in the treatment process. The written reprimand will also indicate a timeline which I will be given to amend the difficulty.
- If failure continues, a formal dismissal from the treatment program will then be submitted to the probation and parole officer or the Court outlining my failures and reasons for expulsion from the treatment program.
I also agree to the following special conditions:
I understand that my probation/parole officer or the Court will be notified immediately of any violation of this contract. I also understand that local or state departments may be contacted if necessary to maintain victim or community safety. I also understand and agree that any violation of the conditions of this contract may be grounds for termination from the program at the discretion of the staff. I agree that the staff may terminate my treatment for any other problem behavior not outlined above.
(Signature of Client)