* In Re The Detention Of: Michael R. Sease, Petitioner

NOTICE: SLIP OPINION
(not the court’s final written decision)
The opinion that begins on the next page is a slip opinion. Slip opinions are the
written opinions that are originally filed by the court.
A slip opinion is not necessarily the court’s final written decision. Slip opinions
can be changed by subsequent court orders. For example, a court may issue an
order making substantive changes to a slip opinion or publishing for precedential
purposes a previously “unpublished” opinion. Additionally, nonsubstantive edits
(for style, grammar, citation, format, punctuation, etc.) are made before the
opinions that have precedential value are published in the official reports of court
decisions: the Washington Reports 2d and the Washington Appellate Reports. An
opinion in the official reports replaces the slip opinion as the official opinion of
the court.
The slip opinion that begins on the next page is for a published opinion, and it
has since been revised for publication in the printed official reports. The official
text of the court’s opinion is found in the advance sheets and the bound volumes
of the official reports. Also, an electronic version (intended to mirror the
language found in the official reports) of the revised opinion can be found, free of
charge, at this website: https://www.lexisnexis.com/clients/wareports.
For more information about precedential (published) opinions, nonprecedential
(unpublished) opinions, slip opinions, and the official reports, see
https://www.courts.wa.gov/opinions and the information that is linked there.

IN THE COURT OF APPEALS OF THE STATE OF WASHIN
In re the Detention of:
MICHAEL SEASE,
DIVISION II
No. 45512 -9 -II
OF A P 0EP;
E' J Vfc, OPI if
2Ui0l3 - 7 4
ORDER GRANTING MOTION
Petitioner. TO PUBLISH
Respondent State of Washington moves this court for publication of its unpublished
opinion filed on July 14, 2015. The Court having reviewed the record and file here, now, therefore,
it is hereby
ORDERED that the final paragraph which reads " A majority ofthe panel having determined
that this opinion will not be printed in the Washington Appellate Reports, but will be filed for public
record pursuant to RCW 2. 06. 040, it is so ordered." is deleted. It is further
ORDERED that the opinion will now be published.
DATED this 1/	day of2015
We concur:
Norgei A. C. J.
utt n, J.
Lee, J.
R
 	 	 	 	 	 	 	 	 	 	 	 	 	

FILED
COURT OF APPEALS
DIVISION 11
7815 JUL 14 AM $= 56
STATE OF .WAS'HIN.GTON
BY—
IN
Y
IN THE COURT OF APPEALS OF THE STATE OF MRGTON
In re the Detention of:
MICHAEL SEASE,
DIVISION II
Petitioner.
No. 45512 -9 -II
UNPUBLISHED OPINION
LEE, J. -- Michael Sease was civilly committed under the Sexually Violent Predator ( SVP)
Act, chapter 71. 09, in 2007. At his show cause hearing in 2013, the trial court concluded that the
State had presented prima facie evidence showing Sease still met the definition of a SVP. The
trial court further concluded that Sease had not established probable cause to believe his condition
had so changed that he no longer met the definition of a SVP. Based on the plain language of
RCW 71. 09. 090,- and the recent opinion from our Supreme Court, In re the Matter of the Pers.
Restraint ofMeirhofer, .182 Wn.2d 632, 343 P. 3d 731 ( 2015), we hold that the State established a
prima facie case showing that Sease still met the definition of a SVP, and that Sease failed to
present probable cause to believe-his mental condition had " so changed" that he no longer met the
definition of a SVP. Accordingly, we affirm.
FACTS
1. BACKGROUND
Before the offenses for which Michael Sease was civilly committed in 2007, he had several
run-ins with law enforcement and mental health professionals. Prior to dropping out of school in
the 9th or 10th grade, Sease' s records indicated he was enrolled in special education classes,
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- I1
although Sease denies this. No verified juvenile record exists for Sease, but he reports he was
caught stealing beer at the age of 15.
In 1980, when Sease- was 19 or 20 years old, he physically and sexually assaulted a 31 -
year -old woman. In 1981, Sease was convicted of shoplifting. In 1982, Sease was charged with
driving .while intoxicated, obstructing a public servant, and a liquor violation. When Sease was
about 25 years old, he was admitted to Western State Hospital after being found preparing to jump
off a bridge. At that time, Sease was diagnosed with adjustment disorder with mixed emotions
and dependent personality traits. In 1986, Sease was charged with simple assault and hit and run;
for which he failed to appear.' In 1987, Sease was arrested for driving while license suspended,
simple assault, no valid operator' s license and failures to appear on previous charges. The same
year, he kidnapped and attempted to rape a 15 -year-old girl and, less than a month later, raped a
19 -year- old woman.
For the 1987 offenses, Sease was convicted of first degree kidnapping and first degree rape.
In re Det. ofSease, 149 Wn.-App. 66, 70, 201 P.3d 1078, review denied, 166 Wn.2d 1029 ( 2009).
Sease was incarcerated for about 16 years. During his incarceration for these offenses, he received
about 250 infractions, 200 of which were major infractions. Clinicians at the Department of
Corrections believed his problems in prison were due to a personality disorder.
In 1990, following a series of self-mutilation incidents, Sease was evaluated by Dr. Thomas
Foley. Sease denied committing any sexual offenses and said his self-mutilation was an expression
of his anger for being unjustly. imprisoned. Dr. Foley'made the following diagnosis:
2
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- 11
Axis I Deferred
Axis II Antisocial Personality Disorder
Borderline Personality Disorder
Clerk' s Papers ( CP) at 269.
In 1994, Sease was evaluated by Dr. Edward Goldenberg. Dr. Goldenberg made the
following diagnosis:
Axis I Paraphilia, Not Otherwise Specified
Alcohol Abuse
Axis 11 Borderline Personality Disorder
Antisocial Personality Disorder
Mild Mental Retardation
CP at 269.
In 1996, Sease was evaluated by Dr. Barry Grosskopf. At that time, Dr. Grosskopf noted
it was Sease' s " sixth psychiatric hospitalization .... He has previously attempted suicide or
mutilated himself over 60 times." CP at 269. Dr. Grosskopf made the following diagnosis:
Axis I Alcohol Dependence 11
Axis II Borderline Personality Disorder with Antisocial Features
CP at 269.
In 2002, Sease was evaluated by Dr. -Savio Chan. When Dr. Chan asked Sease about the
discrepancies between the contents of his file and his self -reporting, Sease responded, " My life is
my business." CP at 270. Dr. Chan further noted, " It is obvious that truth to him is whatever [ is]
convenient or advantageous to him," and Sease showed " no remorse and no concern for his
victims." CP at 270.
In 2004, Sease was evaluated by Dr. Keri Clark. Dr. Clark concluded that Sease' s
personality is " marked by a complex mixture of narcissistic, antisocial, and borderline features."
CP at 270. Dr. Clark noted the " primary areas of concern are the extreme sense of entitlement,
3
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
acute sensitivity to perceived slights, lack of empathy, and fear that he will be abandoned or
ignored." Dr. Clark made the following diagnosis:
Axis 1: No Diagnosis
Axis II: Personality Disorder, Not otherwise Specified, with Narcissistic,
Antisocial, .and Borderline Features
CP at 271.
Sease was scheduled to be released in 2005, but the State successfully petitioned the court
to commit him as a sexually violent predator, and this court affirmed his commitment. Sease, 149
Wn. App. at 70. Dr. Dennis Doren completed Sease' s initial evaluation for civil commitment in
2005. At that time, Dr. Doren identified Sease as suffering from the following conditions:
Axis I Alcohol Dependence, with physiological dependence, in a controlled
environment
Axis II Borderline Personality Disorder
Narcissistic Personality Disorder
Antisocial Personality Disorder
CP at 27.
At the civil commitment trial, Dr. Doren testified that "`[ f]or each [ personality disorder],
what we look at is the pattern of behavior."' Sease, 149 Wn, App. at 71. Dr. Doren also testified:
A]ntisocial personality disorder involves a pattern of "disregard for and violation
of the rights of others." ... A person with a borderline personality disorder has a
pattern of instability in any of four areas: emotions, thinking, interaction with other
people, or ability to control impulses. The pattern for narcissistic personality
disorder is " that they have disdain for everybody. else. Nobody is as good as they
are. They are, above. They should be treated specially.... Other people are,
basically, worthless."
Sease, 149 Wn. App. -at 71, n. 6 ( internal citations omitted). Dr. Doren further testified:
E] ach of [ Sease's] personality disorders caused him serious difficulty in
controlling his behavior" and that the antisocial personality disorder and borderline
personality disorder " predispose him to commit criminal sexual acts and make him
M
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
likely to commit a criminal sexual act in the future if not confined." [ Dr. Doren]
noted that not all people with these disorders manifest sexually violent behavior but
that Sease did.. [ Dr. Doren] characterized Sease' s narcissistic personality disorder
and his alcohol dependency diagnosis as " other risk considerations" for reoffense.
Sease, 149 Wn. App. at 71- 72 ( internal citations omitted) ( footnote omitted).
Pursuant to RCW 71. 09. 070, Sease' s detention is reviewed annually. Dr. Robert Saari
conducted Sease' s first annual review. At that time, Dr. Saari identified Sease as suffering from
the following conditions:
Axis I Rule OutEll— Paraphilia, Not Otherwise Specified, Nonconsent
Alcohol Dependence .
Axis II Narcissistic Personality Disorder with Borderline and Antisocial Traits
Rule Out Borderline Intellectual Functioning
Rule Out Cognitive Disorder, Not Otherwise Specified
Rule Out Dementia Due to Head Trauma
1 A "rule -out" diagnosis means the doctor did not have sufficient evidence at the time to make a
certain diagnosis. As our Supreme Court noted,
The phrase " rule out" does not appear in DSM—IV and is not part of the vocabulary
of DSM. However, it is a common expression in psychiatric diagnosis and is often
seen in reports, especially from professionals with medical training or experience
in medical settings: There is often some confusion among nonphysicians as to the
meaning of this expression. " Rule out" is typically used to identify an alternative
diagnosis that is being actively considered, but for which sufficient data has not yet
been obtained. For instance, the diagnostic statement " Alcohol Abuse, rule out
Alcohol Dependence," suggests that the examiner has definitely concluded there is
a drinking problem; that there -is definitely evidence supporting Alcohol Abuse; and
that the more serious problem of Alcohol Dependence may be present,, but the
available evidence is inconclusive. " Rule out" can be thought of as a reminder or
instruction to continue seeking the information which would allow a diagnosis to
be conclusively identified or eliminated from consideration (for the present).
Meirhofer, 182 Wn.2d at 640 n.3 ( quoting ALVIN E. HOUSE, DSM—IV DIAGNOSIS IN THE SCHOOLS
33 ( 2002), available at http:/ibooks. google. com/ books?id=MtS2LjuU5AIC& q= 33# v= snippet&
q=33 & f=false).
5
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- 1I
CP at 63. The report stated that " Sease would meet the full criteria for Antisocial Personality
Disorder if he more clearly had symptoms of Conduct Disorder prior to the age of 15 years." CP
at 62, n. 13.. Dr. Saari' s report included the following graphic to explain the symptoms of the three
pertinent personality disorders:
Narcissistic Personality Disorder a) grandiose sense of self-importance, b) strong
sense of entitlement, 'c) interpersonally exploitative and manipulative, d) lack of
empathy, e) arrogant, haughty behaviors.
Antisocial Personality Disorder —a) failure to conform to social norms with respect
to lawful behaviors, b) some degree of deceitfulness, c) impulsivity, d) irritability
and aggressiveness, e) lack of remorse.
Borderline Personality Disorder —a) some degree of abandonment sensitivity and
abandonment fears, b) recurrent suicidal behavior, gestures, threats, and -self-
mutilating behaviorO, c) affective instability, d) inappropriate, intense anger.
CP at 62. Dr. Saari said that in his opinion, " Sease' s narcissistic personality disorder is the primary
mental disorder that places him at risk for future sexual violence." CP at 61
2. CURRENT REVIEW
a. Dr. Newring' s 2013 Annual Review
In his September 2013 evaluation, Dr. Newring diagnosed Sease with the following
Axis I: Alcohol Dependence, In a Controlled Environment
Cognitive Disorder, Not Otherwise Specified
Rule Out -- Paraphilia, Not Otherwise Specified, Nonconsent
Axis II Narcissistic Personality Disorder with Borderline, Antisocial, Sadistic, and
Paranoid Features
Borderline Intellectual Functioning
CP at 256. Dr: Newring prefaced the diagnoses with:
Mr. Sease does not appear to have had a meaningful and durable change in his
behavior and disposition during the current review period. While he sees himself
as having made some incremental gains in empathy and peer relations, Mr. Sease' s
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
diagnostic constellation from the previous year appears consistent with his current
behavior and functioning.
CP at 256. Dr. Newring also stated that Sease had " made some progress in his treatment as a sex
offender although major barriers remain evident." CP at 262.
Describing Sease' s rule -out diagnosis of paraphilia, Dr. Newring said there is not enough
available information "to conclude that he meets criteria for a paraphilia [ sic] despite elements of
planning, victimizing strangers, and using physical force and threats with respect to two of his
victims." CP at 256. The insufficiency of the information is attributable, in part, to Sease' s,
refusal to openly discuss significant aspects' of his sexual behavior." CP at 257.
Describing Sease' s narcissistic personality disorder with borderline, antisocial, sadistic and
paranoid features, Dr. Newring states, " There is little doubt that Mr. Sease presents with a
significant overall pattern of personality dysfunction that has severely impacted his ability to
function without substantial difficulties both in the community and within institutional settings."
CP at 257.
Dr. Newring also addressed the discrepancies in the reviewing doctors' diagnoses over the
years. He noted that when Dr. Doren conducted his commitment evaluation in 2005, Dr. Doren
contended that Mr. Sease' s Borderline Personality and Antisocial Personality, though not his
Narcissistic Personality, predisposed him to commit sexual violent acts since they represent serious
difficulty in controlling his behavior." CP at 257. He also noted Dr. Saari' s report for the 2008-
09 review, where Dr. Saari " asserted that Mr. Sease' s overall pattern of personality dysfunction
was essentially narcissistic although he had prominent borderline and antisocial features." CP at
257.
7
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
Dr. Newring conducted an actuarial risk assessment using the Static -99R scoring system..
On the Static -99R, Sease scored in the " nominal moderately high risk category ( score of 5) for
being charged or convicted with another sexual offense." CP at 257. Dr. Newring wrote:
Compared to all other adult sex offenders[,] Mr. Sease' s score falls into the 81. 4 to
89. 7. percentile. This means that 81. 4 to 89. 7 percent of sex offenders score at[,] or
below[,] Mr. Sease' s scores.... His relative risk ratio is 2.23 times higher than the
average sexual offender. When compared to sex offenders classified as Pre -
Selected High Risk/ Need, Mr. Sease obtained a score of 19. 6%. . . for reoffending
within 5 years[,] and 27. 7% ... for reoffending within 10 years.
CP at 257- 58. About the Static -99R, Dr. Newring cautioned that it " should be considered with
other sources of clinical information," and " may under -represent true prevalence rates." CP at
258.
In addition to the actuarial risk assessment, a dynamic risk assessment was conducted. Dr.
Newring found that Sease had " not shown a durable change in dynamic risk over the current review
period." CP at 258. Dr. Newring stated that risk factors were particularly difficult to conduct with
Sease, " because -he has been so resistant to self -disclosure and related treatment." CP at 258.
Consequently, the risk factors Dr. Newring listed were derived from Sease' s interactions with his
peers and the staff of the Special Commitment Center ( SCC). Dr. Newring concluded his review
stating:
Sease' s] civil commitment, according to [ RCW] 71. 09. 060, is to continue under
the care of the Department of Social and Health Services to ensure care, control and
treatment until his condition has changed such that he no longer meets the definition
of sexually violent predator or conditional release to a less restrictive alternative . .
is determined to be in Mr. Sease' [ s] best interest and conditions can be imposed
that would adequately protect the, community.
Mr. Sease also continues to present with a mental condition( s) [ sic] that seriously
impairs his ability to control his sexually violent behavior. Secondly, it is my
opinion that Mr. Sense' s condition has not so changed such that conditions can be
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
imposed that would adequately protect the community, and a less restrictive
alternative would not, at the present time, be in his best interest.
CP at 262- 63.
b. Dr. Abbott' s Report
Dr. Brian Abbott was retained by Sease to evaluate whether Sease' s conditions had " so
changed ... that he can be released unconditionally" under RCW 71. 09. 090( 1)( a). CP at 290. In
his report, Dr. Abbott reviewed Sease' s file, including the original commitment evaluation by Dr.
Doren, and the subsequent annual reviews. Dr. Abbot opined that " Sease no longer suffers from
the mental disorder or abnormality that was the basis for his 2007 civil confinement," and that this
change in his mental disorder or abnormality appears to result from his positive responses to
continuing participation in treatment at SCC since his ... commitment date." CP at 290.
Dr. Abbott notes the numerous issues Sease has had with treatment; including his refusal
to participate in some treatments, his sporadic participation in others, and his expulsion from at
least two treatment programs. Yet, Dr. Abbott concludes, Sease has " continuously participated in
the therapeutic milieu at SCC, which consists of behavior modification treatment, social and
vocational skill development, and the sexual offender treatment program." CP at 308. Dr. Abbott
described Sease' s behavior modification treatment:
Mr. Sease has been rewarded for prosocial behavior, has received consequences for -
antisocial, narcissistic, and borderline behaviors, and he has not had these
personality traits positively reinforced. Mr. Sease has learned he receives rewards
by complying with rules and regulations as he earns increased privileges and
freedom within the therapeutic. milieu.
CP at 315.
M
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512-9- I1
Dr. Abbott also noted Sease had met with Dr. Sziebert, an SCC psychiatrist before. Dr.
Abbott did not detail when, or how many times, the two met. Dr. Abbott states that Sease appeared
to have developed a therapeutic bond with Dr. Sziebert because Sease did not make negative
comments about the doctor. Dr. Abbott also identified Sease' s employment at the SCC as a form
of treatment. Dr. Abbott concluded his discussion of treatment by listing several other forms of
treatment Sease had at one time been involved in, but did not detail the level of Sease' s
participation in those programs. At the conclusion of his evaluation, Dr. Abbott diagnosed Sease'
as suffering from."Narcissistic Personality Traits," and that condition did " not affect his emotional
or volitional capacity predisposing him to engage in acts of sexual violence." CP at 313- 14.
ANALYSIS
A. ' STANDARD OF REVIEW
The SVP Act, chapter 71. 09 RCW, presents two ways for trial courts to determine if
probable cause exists for an evidentiary hearing; "`( 1) by deficiency in the proof submitted by the
State, .or (2) by sufficiency of proof by the detainee that he or she ` no longer suffers from a mental
abnormality or personality disorder' or that any mental abnormality or personality disorder `would
not likely cause the prisoner to engage in predatory acts of sexual violence."' Meirhofer, 182
Wn.2d at 643 ( quoting In re Det, of Petersen, 145 Wn.2d 789, 798, 42 P. 3d 952 ( 2002)); RCW
71. 09. 090( 2)( c). Our review of a trial court' s determination of probable cause is " limited to
determining whether substantial evidence supports the findings and, if so, whether the findings in
turn support' the trial court's conclusions of law and judgment." In re Det. ofLaBelle, 107 Wn.2d
196, 209, 728 P. 2d 138 ( 1986). We review de novo the legal conclusions reached by the trial
court. Meirhofer, 182 Wn.2d at 643.
10
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
B. STATUTORY FRAMEWORK
Under chapter 71. 09 RCW, civil commitment is indefinite, " but the Department of Social
and Health Services ( DSHS) is required to have the condition of each person detained under the
act reviewed by a qualified professional at least annually and regularly report to the court whether
each detainee still meets the statutory and constitutional criteria for civil commitment." Meirhofer,
182 Wn.2d at 637 ( citing RCW 71. 09. 070( 1); WAC 388- 880- 031). If the secretary of DSHS
determines that the detainee no longer meets the requirements for civil commitment as a SVP, the .
secretary shall allow the detainee to petition the court for a full release or a conditional release to
a less restrictive alternative. Id.; RCW 71. 09. 090( 1). Alternatively, a detainee may petition the
trial court for a full or conditional release annually. Meirhofer, 182 Wn.2d at 637; RCW
71. 09. 090( 2)( a). When a detainee petitions for a full or conditional release, the trial court holds a
show cause hearing to determine if sufficient evidence exists to warrant a frill evidentiary hearing.
Meirhofer, 182 Wn.2d at 637- 38 ( citing State v. McCuistion, 174 Wn.2d 369, 380, 275 P. 3d 1092
2012)); RCW 71. 09. 090( 2)( x).
During the show cause hearing, the trial court "` must assume the truth of the evidence
presented,"' but " it may not ` weigh and measure asserted facts against potentially competing
ones."' McCuistion, 174 Wn.2d at 3 82 ( quoting Petersen, 145 Wn.2d at 797). However, "[ w]hile
the court does not weigh the evidence, it is entitled to consider all of.it." Meirhofer, 182 Wn.2d at
638 ( citing Petersen, 145 Wn.2d at 798). The trial court "` must determine whether the asserted
evidence is sufficient to establish the proposition its proponent intends to prove."' Id. (quoting
McCuistion, 174 Wn.2d at 3 82).
11
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- 11
As stated above, if the State presents " prima facie evidence that continued commitment is
appropriate," or if the detainee presents " prima facie evidence that there is probable -cause to
believe his or her condition has ` so changed' that release is appropriate," then a full evidentiary
hearing is warranted. . Id. (citing Petersen, 145 Wn.2d at 798); RCW 71. 09. 090( 2); McCuistion,
174 Wn.2d at 382). Probable cause exists to believe Sease' s condition has " so changed" only if
evidence exists " of a substantial change in [his] physical or mental condition such that [ he] ... no
longer meets the definition of a sexually violent predator." RCW 71. 09. 090( 4)( a).
Sease does not contend he has suffered a " physiological change" that renders him
permanently " unable to commit a sexually violent act." RCW, 71. 09.090( 4)( b)( i). Therefore,
Sease can only show he is " so changed" if there is " current evidence from a licensed professional"
that there was a " change in [ Sease' s] mental condition brought about through positive response
sic] to continuing participation in treatment." RCW 7.1. 09. 090( 4( b)( ii): The policy concern here
is, "[ t] o avoid disincentivizing treatment." Meirhofer, 182 Wn.2d at 639.
C. STATE' S PRIMA FACIE CASE
Sease contends that the State did not present prima facie evidence that he still met the
definition of a sexually violent predator. In support, Sease argues that because he no longer is
diagnosed with the antisocial and borderline personality disorders, upon which he was initially
committed, his condition has changed. We disagree.
The State presents prima facie evidence that continued commitment is warranted when " the
committed person continues to meet the definition of a sexually violent predator. RCW
71. 09. 090( 2)( c)( i). A "` [s] exually violent predator' means any person who has been convicted of
or charged with a crime of sexual violence and who. suffers from a mental abnormality or
12
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
I personality disorder which makes the person likely to engage in predatory acts of sexual violence
if not confined in a secure facility." RCW 71. 09. 020( 18).
The recently decided case of Meirhofer, 182 Wn.2d at 632, controls. Meirhofer sought
discretionary review of a trial judge' s ruling that DSHS had met its prima facie showing, and that
Meirhofer had failed to present sufficient prima facie evidence that he did not meet the definition
of a SVP. Meirhofer, 182 Wn.2d at 642. Meirhofer argued the State failed to present prima facie
evidence because the State' s expert did not diagnose him with pedophilia, for which he was
committed, but instead diagnosed him with "both mental abnormalities and personality disorders,
including paraphilia NOS ( nonconsent) and personality disorder NOS with antisocial and
borderline features:" Id. at 643- 44.
Our Supreme Court upheld the trial court' s conclusion that the State had met its prima facie
burden showing Meirhofer was still defined as a SVP for two reasons. Id. at 642. First, the court
noted it had previously affirmed commitments " based on paraphilia NOS nonconsent and
antisocial personality disorder, which are essentially Meirhofer' s remaining diagnoses." Id. at 644
citing In re Det. of Stout, 159 .Wri.2d 357, 363, 150 P. 3d 86 ( 2007)). The State' s showing that
Meirhofer had " consistently suffered from paraphilia NOS nonconsent and a personality disorder"
was " sufficient to show that Meirhofer `suffers from a mental abnormality or personality disorder'
as required for continued commitment." Id. at 645 ( quoting RCW 71. 09. 020( 18)). Second,
the court adopted the analysis it had employed in State v. Klein, 156 Wn.2d 102, 120- 21, 124 P. 3d
644 ( 2005), which allowed for evolving diagnoses based on the same symptoms.. Meirhofer, 182
Wn.2d at 644. The court in Meirhofer held, " While we cautioned that `[ d] ue process requires that
the.nature of the commitment bear some reasonable relation to the purpose for which the individual
13
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
is committed,' we found sufficient connection from the ` original diagnosis of psychoactive
substance -induced organic mental disorder . . . and the current diagnosis of polysubstance
dependence' to justify continued commitment." Id. (alterations in original) ( quoting Klein, 156
Wn.2d at 119- 20). Our Supreme Court held that " the change from a diagnosis of pedophilia to a
rule out pedophilia' , .. is not sufficient to require a new evidentiary proceeding." Id.
The Meirhofer court also field the State had met its prima facie showing that Meirhofer was
likely to reoffend if not confined. Id. at 645. Using the Static -99R actuarial risk assessment test,
Meirhofer was found to have about a 20 percent chance of recidivism after 5 years, and about a 30
percent chance of recidivism after 10 years. Id. at 640. The determination of whether someone is
likely to reoffend, is better based on both static and dynamic risk factors, as well as the expert' s
clinical judgment. Id. at 646. In Meirhofer; " the..State' s expert opined that ` there has been no
apparent change in [ Meirhofer' s] mental condition that would indicate a lowered risk for sexual
re -offense."' Id. at 646. Because this opinion was supported by the record, our Supreme Court
held the State had met its prima facie burden showing Meirhofer was likely to reoffend. Id.
Applying the Meirhofer analysis to the case before us, we hold that the State has met its
prima facie showing that Sease still fits the statutory definition of a SVP based on his current
diagnoses because an evolving diagnosis based on the same symptoms does not mean his condition
has changed. Id. at 643- 46 ( adopting Klein, 156 Wn.2d at 120- 21). In Klein, the court said:
The DSM—IV—TR candidly acknowledges, for example, that each category of
mental disorder is not a completely discrete entity. DSMIV—	TR at xxx. In other
words, the subjective and evolving nature of psychology may 'lead to different
diagnoses that are based on the very same symptoms, yet differ only in the name
attached to it. Construing RCW 10. 77. 200 to mandate release based on mere
semantics would lead to absurd results and risks to the patient and public beyond
i 14
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
those intended by the ,legislature. We decline to substitute our judgment for that.
legislative determination.
156 Wn.2d at 120- 21 ( footnote omitted).
The diagnoses that formed the basis of Sease' s commitment— borderline personality
disorder; antisocial personality disorder; narcissistic personality disorder; and alcohol
dependence— bears a " sufficient connection" to Dr. Newring' s diagnoses of narcissistic
personality disorder with borderline, antisocial, sadistic and paranoid features; cognitive disorder
NOS; rule -out paraphilia; cognitive disorder NOS; borderline intellectual functioning; and alcohol
dependence in a controlled environment. Meirhofer, at 644; Sease, 149 Wn. App. at 71. Although
Sease' s diagnoses may have changed, the underlying symptoms or mental conditions have
remained consistent and not changed. For example, consider Sease' s behavior in light of Dr.
Saari' s description of Antisocial Personality Disorder. Dr. Saari described Antisocial Personality
Disorder as involving a " failure to conform to social.norms with respect to lawful behaviors." CP
at 62. In Sease' s 2005 civil commitment evaluation, Dr. Doren stated Sease presented with
serious difficulty in controlling his behavior." Sease, 149 Wn. App. at 71; see also CP at 27.
And Dr. Newring most recently described Sease' s " ability to function without substantial
difficulties both in the community and within institutional settings" as being " severely impacted."
CP at 257. Our Supreme Court acknowledges thatthe categorizing ' of mental disorders is
subjective and evolving," and therefore, " may lead to different diagnoses that are based on the
very same symptoms." Klein, 156 Wn.2d at 120- 21. That is the case here. Therefore, we hold
that the State fulfilled its prima facie burden of showing Sease still met the definition of a SVP.
15
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
Klein, 156 Wn.2d at 120- 21. To hold otherwise, would allow semantics to put patients and the
public at a risk beyond that intended by the legislature. Klein, 156 Wn.2d at 121.
The State also met its prima facie showing that Sease was likely to reoffend if not confined.
Here, as in Meirhofer, the Static -99R actuarial risk assessment test was applied to determine
Sease' s risk of recidivism. Sease' s scores were nearly identical to Meirhofer' s. Where
Meirhofer' s had about 20 percent chance of reoffending within 5 years, Sease' s had 19. 6 percent,
and where Meirhofer' s had about 30 percent chance ofreoffending within 10 years, Sease had 27.7
percent. Meirhofer, 182 Wn.2d at 640.
In addition, Dr. Newring conducted a dynamic risk assessment test, finding that Sease had
not shown a durable change in dynamic risk over the current review period," in large part because
he was so resistant to treatment. CP at 258. Dr. Newring opined that Sease, " continues to present
with a mental condition( s) [ sic] that seriously impairs his ability to control his sexually violent
behavior," and " Sease' s condition has not so changed such that conditions can be imposed that
would adequately protect the community, and a less restrictive alternative would not, at the present
time, be in his best interest." CP at 263; Meirhofer, 182 Wn.2d at 646 (holding no apparent change
in mental condition indicating -a lower risk for sexual re -offense when static tests are combined
with dynamic risk factors and doctor' s clinical judgment).
Thus, the State presented static and dynamic risk factor analyses that showed Sease was
likely to reoffend and presented Dr. Newring' s opinion that Sease could not be safely released.
We hold the state met its prima facie burden to show Sease would likely reoffend if not confined
to a secure facility.
16
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
D. SEASE' S PROBABLE CAUSE FOR " SO CHANGED".
Sease next contends he established probable cause that his condition has " so changed" that
he no longer meets the criteria for a SVP. Br. of Petitioner at 6.' In support, Sease points to the
fact that his diagnosis has changed from what it was when he was committed, and to Dr. Abbott' s
report, which concludes that the change in Sease' s diagnosis has come about as a result of Sease' s
participation in the " therapeutic milieu" at the SCC. CP at 308. We hold Sease did not present
probable cause to believe.he had " so changed" because the SVP statute and case law require the
person' s mental condition to change, not the person' s diagnosis.
We review issues of statutory interpretation de novo." In re Det. ofBoynton, 152 Wn.
App. 442, 451, 216 P. 3d 1089 ( 2009). When interpreting a statute, we first look to the statute' s
plain meaning and assume the legislature meant what it says. Id. To ascertain the plain meaning,
each provision of the statute must be read in relation to the other provisions so as to construe the
statute as a whole. Id. at 452. Where the plain language of the statue is unambiguous, our inquiry
ends and the statute is given effect according to its plain meaning. Id.
The SVP statute states that "[ p] robable causes exists to believe that a person' s condition
has ` so changed' ... only when evidence exists ... of a substantial change in the person' s physical
or mental condition." RCW 71. 09. 090( 4)( a) ( emphasis added). The statute continues, " a trial
proceeding may be held, only when there is current evidence ... of one of the following and the
evidence presents a change in condition since the person' s last commitment trial proceeding:.. .
ii) [ a] change in the person' s mental condition brought about through positive response to
continuing participation in treatment." RCW 71. 09. 090( 4( b) ( emphasis added). Neither
diagnosis" nor " diagnoses" appears in RCW 71: 09. 090. Thus, based on the plain language of the
17
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- 11
statute, the trial court' s decision at a show cause hearing hinges on whether the person' s
condition" has so changed, not whether his or her " diagnosis" has changed.
Meirhofer supports this interpretation. In Meirhofer, the committed individual argued that
his " change in diagnosis from pedophilia to hebephilia" was " significant" because he had been
found to be [ a] SVP based on the diagnoses of pedophilia." 182 Wn.2d at 646. The Supreme.
Court rejected that argument, holding, " Any change in Meirhofer' s condition was not driven by
any `positive response to continuing participation in treatment."' Id. (emphasis added). " Instead..
it appears to be driven by dispute within the psychiatric establishment and refinement in the
relevant diagnostic criteria." Id.
Therefore, determining whether Sease established probable cause to believe his condition.
has " so changed," this court must look at the underlying symptoms that have formed the basis for
his commitment. The symptoms Dr. Doren identified at Sease' s commitment correlate closely
with what the prior and subsequent reviewing doctors have continued to see.
Dr. Doren, described the symptoms of antisocial personality disorder as involving a pattern
of "`disregard for and violation of the rights of others."' Sease, 149 Wn. App. at 71, n.6 ( internal
citations omitted). Dr. Saari similarly described the behaviors to include the " failure to conform
to, social norms with respect to lawful behaviors," " some degree of deceitfulness," " impulsivity,"
an " irritability and aggressiveness," and a " lack of remorse.". CP at 62.
Dr. Doren described a person with a borderline personality disorder as having " a pattern of
instability in any of four areas: emotions, thinking, interaction with other people, or ability, to
control impulses." Sease, 1.4.9 Wn. App, at 71, n. 6 ( internal citations omitted). Likewise, Dr. Saari
described the borderline personality disorder behaviors as including " some degree of abandonment
18.
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512 -9 -II
sensitivity and abandonment fears," " recurrent suicidal behavior," " self-mutilat[ ion]," an
affective instability," and " inappropriately intense anger." CP at 62
Finally, Dr. Doren described the narcissistic personality disorder as a pattern of showing
disdain for everybody else, where no one else is as good as they arethey are above others and
feel they should be treated specially, while other people are essentially worthless. Sease, 149 Wn..
App. at 71, n.6 ( internal citations omitted). Similarly, Dr. Saari described the behaviors as
including a " grandiose sense of self-importance," a " strong sense of entitlement," being
interpersonally exploitative and manipulative," demonstrating a " lack of empathy," and a sense
of arrogance. CP at 62.
The order of the terms by the doctors who evaluated Sease before he was committed varied
slightly, but Dr. Doren' s observations of Sease aligned with the observations of doctors Foley,
Goldenberg, Grosskopf, and Clark, who had all evaluated Sease during his time in the Department
of Corrections. Similarly, all of the doctors who have evaluated Sease since his commitment,
except for Dr. Abbott, have noted the same problematic conditions. Despite identifying the same
problematic conditions, slight variance in diagnosis terms continued at each annual review. The
recurring symptoms include Sease suffering from: a " severe dysfunction at the level of morality
and prosocial values"; " manipulation of other people to suit his own wishes' and ends"; " aggressive
behavior and exploitation of other people"; " impulsive behavior in the community and while
housed in institutional settings"; a lack of "normal inhibitions toward harming other people 'to
gratify his needs"; " tak[ ing] pleasure in dominating other people"; " callousness and lack of
empathy"; " offense -analogue behaviors." See e.g. CP at 58, 65, 208. Thus, although there were
W1
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- 1I
varying forms diagnostic labels.given, all the evaluating doctors consistently recognized the same
underlying conditions in Sease.
The only evidence Sease provided.to show his condition had " so changed" was that his
diagnoses had changed. Br. of Petitioner at 6. Dr. Abbott concluded that because he, and the
doctors administering the annual reviews, had determined that Sease did not currently suffer from
antisocial or borderline disorder, Sease' s mental condition necessarily had to have changed. Dr.
Abbott' s conclusion erroneously equates a mental condition with a diagnosis. The plain meaning
of RCW 71. 09. 090 and our Supreme Court' s interpretation of that statute refute the conflation of
those two terms. Meirhofer, 182 Wn.2d at 643- 46. Instead, a person' s mental condition can be
described by one or more diagnoses, and those diagnoses can be subjective and evolving. RCW
71. 09. 090; Meirhofer, 2015 182 Wn.2d at 646; Klein, 156 Wn.2d at 120- 21. Therefore, because
RCW 71. 09. 090 requires Sease to show that "probable cause exists to believe that [ his] condition
has ` so. changed,"' and Sease failed to show his condition changed, the trial court properly
dismissed Sease' s petition.
Because Dr. Abbott' s conclusions are not sufficiently supported by the evidence, Sease did
not establish probable cause exists to believe his condition has " so changed" that he no longer.
meets the definition of a SVP as a result of a positive response to any continuing participation in
treatment.
20
 	 	 	 	 	 	 	 	 	 	 	 	 	

No. 45512- 9- T1
We affirm.
A majority of the panel having determined that this opinion will not be printed in the
Washington Appellate Reports, but will be filed for public record in accordance with RCW 2. 06.040,
it is so ordered.
Lee,. J.
We concur:
BJargen, A.C. J.
Sutton, J.
21