n

I ) Although he may have made significant'progressin his pasttherapy,it is this examiner's
opinion that to maximize Mr. Wolferts' treatment'gainsit would be best for him to be
in a program that specializes in working with sexual addiction where he can take
advantageof group therapy with others who have problems with sexual acting out,
psycho-educationalskills coursesspecifically designedfor those who act out sexually,
etc. The personality styles and defensivestylesof those who act out sexually tend to be
markedly different from the averageanxious or depressedclient that most general
therapistsare experiencedwith.

completean outpatientprogramof therapyin a
2) Mr. Wolferts shouldsuccessfully
treatment
agency.Thisprogramshouldinclude:
recognized
sexualaddiction/abuse
a) Individual therapy
b) Group therapywith otherswho have sexualaddiction.
skills courses(e.g.victim empathy,anger
c) Involvementin variouspsych-educational
sexualeducation,etc.)
mimagement,assertiveness,
d) Marital therapy (as needed)
e) Family therapy (as warranted)
0 Polygraphtesting to determinethe natureandextentofany other inappropriatesexual
behaviorand to help Mr. Wolferts acceptfull responsibilityfor his actions
g) Sexual reorientation treatment utilizing feedback from penile plethymographyto
assisthim in 'normalizing' or leaming to control his sexualarousalpattems
Treatment should be oriented toward establishing more functional interpersonal
relationships,acknowledging his responsibilityregarding his sexual acting out and
controllinghis sexualimpulses.Treatmentshouldalsobe confrontive,highly structured,
reality basedand shouldbe conductedby a mentalhealthprofessionalwho is sufficiently
trainedin the areaofsexual offenses.
3 ) Mr. Wolferts' intemet activity shouldbe monitoredin order to reducehis exposureto
sexuallyexplicit materialand chatrooms. This is often accomplishedthrougha couple
of different methods. Somehave found it effective to not have a computerin a secluded
part of the house. Instead,they keepthe computerin the family room where accessis out
in the open. Intemet filtering programscan alsobe placedon the computer(althoughthis
is only truly helpful in addition to monitoring), or get intemet accessfrom a provider
that filters the internet for them. Perhapsthe most effective method involves regular
checking of internet history and backup files by ft someoneelse as well as frequent
(every 90 to 120 days)monitoring by meansof polygraphexaminations.

4) A psychiatric consultation appearsto be warrantedto further evaluateand monitor Mr.
Wolferts' psychological functioning and determinewhetherosvchotropicmedication
symptomsandhis potentialrbr suicidalbehaviorit'such
may help aileviatehis clepressive
errrotron&lstatescontinuetbr ntore thm l2tJ daysfrom now..

DSM IV DIAGNOSTIC IMPRBSSIONS:
Anxietv Disorder
Generalized
AXIS I: 300.02
C. Y. Roby,Ph.D.'P.C. and Associates
(801)225-5451A:\Wolferts,Brien Eveluation04-ll-2003

L4

l2
R/O 300.3

ObsessiveCorhpulsiveDisorder

AXIS II:

7gg.g
R/O 301.9

DiagnosisDefened on Axis II
PersonalityDisorderNOS (DependentFeatures)

AXIS III:

Deferred

AXIS IV: Problemswith primary supportgroup
Problemsrelatedto the socialenvironment
AXIS V:

GAF: 60 (current)

C. Y. Roby,Ph.D.
Clinical Psychologist

C. Y, Roby, Ph.D.,P.C. and Associates
(80f) 225-5451AiWolferts, Brian Evaluetion04-ll-2003

b0