No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Relapse prevention with sexually aggressive adolescents and children: Expanding treatment and supervision.
Abstract
[describes the implementation of relapse prevention (RP)] model in assessing and treating juvenile [sex] abusers / RP has served three distinct functions in sex offender treatment: (1) an Internal, Self-Management Dimension used to enhance the client's self-control; (2) an External, Supervisory Dimension used by a "prevention team" of professional and collateral contacts [including mental health personnel, probation officers and family members] who monitor the juvenile's behaviors and who model appropriate behaviors; and (3) a conceptual framework, which integrates highly specific therapeutic interventions within a unifying theory / each of these functions of RP is discussed (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... The first specialized treatment program, the California-based Support Program for Abuse-Reactive Kids, was developed in 1985 under the direction of Kee MacFarlane at the Children's Institute International, a private non-profit organization for the treatment of child abuse (Araji, 1997; Johnson, 1993b). Since then, this program has been adapted by other authors, and other programs have been developed in the U.S., Canada, and Australia (Ballester & Pierre, 1995; Berliner & Rawlings, 1991; Bonner, Walker & Berliner, 1999; Burton et al., 1998; Cunningham & MacFarlane, 1991 Friedrich, 1990; Hindman, 1994; Johnson, 1993b; Johnson & Berry, 1989; Gil, 1993c; Lane, 1991; Lane & LobanovRostovsky, 1997; Services à l'enfance et à la famille, 1995). In general, programs to treat children with sexually problematic behaviour have the same end goals: to stop the problematic behaviour from getting worse, to prevent future victimization and the appearance of other aggressive behaviours, and to foster the development of more appropriate social and personal comportment (National Adolescent Perpetrator Network, 1993). ...
... While group therapy is by far the most frequently employed method for treating children with sexually problematic behaviour, individual therapy is also used when necessary (Ballester & Pierre, 1995; Berliner & Rawlings, 1991; Bonner et al., 1999; Burton et al., 1998; Cunningham & MacFarlane, 1991; Friedrich, 1990; Hindman, 1994; Hoyle, 2000; Johnson, 1993b; Johnson & Berry, 1989; Gil, 1993c; Lane, 1991; Lane & Lobanov-Rostovsky, 1997 ; Service à l'enfance et à la famille, 1995). When used in tandem with group therapy, individual therapy helps the child form a relationship of trust with the therapist, deal with previous trauma, and work on internal conflict resolution (Burton et al., 1998; Gil, 1993c; Service à l'enfance et à la famille, 1995). ...
... While group therapy is by far the most frequently employed method for treating children with sexually problematic behaviour, individual therapy is also used when necessary (Ballester & Pierre, 1995; Berliner & Rawlings, 1991; Bonner et al., 1999; Burton et al., 1998; Cunningham & MacFarlane, 1991; Friedrich, 1990; Hindman, 1994; Hoyle, 2000; Johnson, 1993b; Johnson & Berry, 1989; Gil, 1993c; Lane, 1991; Lane & Lobanov-Rostovsky, 1997 ; Service à l'enfance et à la famille, 1995). When used in tandem with group therapy, individual therapy helps the child form a relationship of trust with the therapist, deal with previous trauma, and work on internal conflict resolution (Burton et al., 1998; Gil, 1993c; Service à l'enfance et à la famille, 1995). According to Burton and his colleagues (1998), children more readily speak about their sexually problematic behaviour during individual sessions and are more likely to ask questions about sexual development and sexuality. ...
This article presents an overview of treatment programs for children aged 6 to 12 who present sexually problematic behaviour. The first part of the paper describes the treatment programs; the second part addresses the assessment of these treatment programs' effectiveness, followed by a critical analysis of the assessments themselves; and the article concludes with a discussion of new directions in research concerning children with sexually problematic behaviour.
... In 1991, Vermont's CPS agency held 135 open cases on children and adolescents whose records demonstrated that they had engaged in sexually abusive behaviors against others. Of the 135 youths, 51 (37.8%) were between 6 and 12 years old (Gray & Pithers, 1993). These 51 children were responsible for 13.2% of all child sexual abuse cases substantiated in Vermont in 1991. ...
... SAST was a modified relapse prevention approach including an external supervision and advocacy dimension called the prevention team. The prevention team was composed of the child, the child's caregivers, their treatment providers and treatment groups, and selected advocates within the child's and caregiver's world who were educated in respectful methods of providing reinforcement for the family's abuse prevention lifestyle (Gray & Pithers, 1993). APT offered an array of interventions including assertiveness, self-esteem, decision making, positive sexuality, and relationship skills, but it did not involve a prevention team. ...
Child abuse has reached epidemic proportions in America. Rather than invoking health promotion strategies to protect children, the social priority appears to be extreme punishment of adult sex offenders. Although incarceration of the most severely entrenched adult sex offenders is a necessary element of a comprehensive prevention strategy, it is highly questionable whether it should receive the current emphasis. In developing prevention strategies, it may be important to note that nearly 40% of all child sexual abuse is performed by youth less than 20 years old, with 6- to 12-year-old children being the source of 13-18% of all substantiated child sexual maltreatment. Despite these findings, children and adolescents have received remarkably little attention in the research and clinical literature, and existing social policy has impeded an effective response. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... If juvenile offending is widespread, if juvenile sex offenders are unique from other juvenile delinquents, and if juvenile sex offenders are at high risk for sexual recidivism, then more treatment programs are needed, and these programs should target sex offender-specific characteristics, similar to programs offered for adult sex offenders, and should retain youth in treatment for long periods of time to reduce the likelihood of recidivism. Clinical interventions aimed at juvenile sex offenders do appear to be based on interventions developed specifically for adults (e.g., Becker, 1990) and follow from theories of sexual arousal, relapse prevention, and cycles of abuse (Becker & Kaplan, 1993;Gray & Pithers, 1993;Ryan, Lane, Davis, & Isaac, 1987). Treatment components that are common across programs target primarily individual characteristics, including deviant sexual arousal, denial and minimization of sex crimes, cognitive distortions, victim empathy, modus operandi, substance use, and anger management (Freeman-Longo, Bird, & Fiske, 1995;Knopp, Freeman-Longo, & Lane, 1997). ...
The past two decades have seen a movement toward harsher legal sanctions and lengthy, restrictive treatment programs for sex offenders. This has not only been the case for adults, but also for juveniles who commit sex offenses. The increased length and severity of legal and clinical interventions for juvenile sex offenders appear to have resulted from three false assumptions: (1) there is an epidemic of juvenile offending, including juvenile sex offending; (2)juvenile sex offenders have more in common with adult sex offenders than with other juvenile delinquents; and (3) in the absence of sex offender-specific treatment, juvenile sex offenders are at exceptionally high risk of reoffending. The available data do not support any of the above assumptions; however, these assumptions continue to influence the treatment and legal interventions applied to juvenile sex offenders and contributed to the application of adult interventions to juvenile sex offending. In so doing, these legal and clinical interventions fail to consider the unique developmental factors that characterize adolescence, and thus may be ineffective or worse. Fortunately, a paradigm shift that acknowledges these developmental factors appears to be emerging in clinical areas of intervention, although this trend does not appear as prevalent in legal sanctions.
... Adolescent sexual offenders who demonstrate a recent escalation in either anger or negative affect are more likely to present a higher risk of continued sexual aggression. Negative affect such as sadness, anger, boredom, loneliness, frustration, and feelings of worthlessness, abandonment, and rejection have been cited as immediate precursors to adolescent sexual offenses (e.g., Gray & Pithers, 1993;Richardson & Graham, 1997;Steen & Monnette, 1989;Way & Spieker, 1997). There is currently no empirical support for this factor with respect to the prediction of sexual recidivism for adolescents; however, this may be the result of the fact that it has never been investigated. ...
... Almost all authors concluded that interventions for juvenile offenders may have greater efficacy than interventions for adult offenders. Gray and Pithers [33] point out that "the abundant energy and youthful resources of adolescents were believed to offer vast hope for change at later stages of growth." It is noted that the address of the international literature about adolescent sex offenders is directed to treatment and rehabilitation of this population other than punishment. ...
Abstract
Violence against women and minors is a worldwide problem that has not yet been sufficiently acknowledged. There are many obstacles especially when sexual abuses have to be evaluated. These problems are present both when victims of sexual abuse are evaluated and when sex offenders are dealt with, especially when the offenders are juvenile sex offenders (JSO).
These issues give cause for great concern about prognosis, and the resulting psychosocial implications, and call for a special effort from the scientific community in identifying appropriate prevention and treatment methods.
This chapter is divided into two parts. The first part deals with the forensic and psychiatric features, such as diagnostic and therapeutic/rehabilitative strategies for JSO, while the second part analyzes the legal–medicine aspects related to rape/sexual assault in a European context
... 22.181) tot de conclusie dat cognitief gedragtherapeutische programma's de meest robuuste effecten laten zien.Behandeling is bij voorkeur gestructureerd en omvat diverse componenten, ook wel modules genoemd. Behandelmodules zijn onder meer beschreven doorBecker & Kaplan (1993),Pithers et al. (1995),Becker & Hunter (1997) enRighthand & Welch (2001).Gray & Pithers (1993) beschreven een terugvalpreventiemodel voor seksueel agressieve jongeren. Dit model is gebaseerd op de premisse dat de antecedenten van seksueel misbruik geïdentificeerd kunnen worden en dat de jongere maatregelen kan treffen om te zorgen dat hij niet in een hoogrisicosituatie belandt. Als dit toch gebeurt, dient hij zich aan die situati ...
... En effet, avant la fin des années quatre-vingt, tout geste sexuel posé par des enfants était perçu comme des gestes d'exploration et, par conséquent, inoffensifs (Johnson, 1988). Or, l'état des connaissances actuelles révèle que les comportements de ces jeunes peuvent être aussi agressifs et abusifs que ceux des adolescents ou des adultes (Araji, 1997 ; Chaffin et al., 2002 ; Cunningham et MacFarlane, 1996 ; Gray et Pithers, 1993 ; Hall et Mathews, 1996 ; Hall et al., 1998 Hall et al., , 2002 Johnson, 2002). Selon Pithers et Gray (1998) ...
Résumé
L’objectif de cette étude exploratoire vise à évaluer la participation et l’évolution de 43 enfants présentant des comportements sexuels problématiques ayant participé à un programme d’intervention de groupe. L’évolution des enfants est évaluée à l’aide d’instruments standardisés, administrés avant et après l’intervention de groupe, mesurant diverses dimensions, notamment les comportements sexuels, les problèmes de comportement intériorisés et extériorisés, les habiletés sociales, etc. Les résultats révèlent que dans l’ensemble, toutes variables confondues, les enfants s’améliorent entre le début et la fin de l’intervention de groupe. Plus spécifiquement, les analyses de variance à mesures répétées montrent des améliorations significatives au niveau des comportements sexuels problématiques, des comportements intériorisés et des habiletés sociales. Cette étude suggère que l’intervention de groupe peut s’avérer une modalité d’intervention pouvant répondre aux besoins spécifiques de ces enfants.
... The treatment process entails the explication and definition of each phase of the sexual assault cycle, i.e., the unique characteristics of each offender's cycle so that the offender will be aware of the triggers which initiate the cycle so that he will be alerted and employ new strategies for interrupting the sexual assault cycle (Ryan et al., 1987). Some of the emotional states which have been found to be important emotional triggers are boredom, social or sexual embarrassment, anger, fear of rejection, and numbness (Gray and Pithers, 1993). Proulx et al. (1996) found that "negative moods and conflicts" such as anger, loneliness, and humiliation coincided with deviant sexual fantasies and increased masturbatory behavior. ...
The assessment and treatment of children and adolescents with sexually abusive behavior requires an understanding of normal sexual development. A multiplicity of biological and psychosocial factors determines the child's sexual development, gender role, sexual orientation, patterns of sexual arousal, sexual cognitions, sexual socialization and the integration of sexual and aggressive patterns of behavior. The individual's sexuality evolves in concert and as a result of interaction with family, ethnic, social and cultural influences. These parameters summarize what we know about the epidemiology and phenomenology of sexually abusive youth and provide guidelines for the assessment and the selection of treatment interventions for these youths. Essential considerations in the assessment and treatment of sexually abusive youth, as well as the different categories of sexually abusive youth that should be recognized and which influence treatment decisions are presented. The spectrum of currently available psychosocial
... Proposals for the evaluation of YSOs have been forwarded in professional reviews by Becker and Hunter (1997), Gray and Pithers (1993), Greer (1997), Kahn and Chambers (1991), Knight and Prentky (1993), and Lane (1997). However, empirical studies specifically addressing the prediction of sexual recidivism in adolescent or young adult sex offenders are still scarce (cf. ...
Several authors have emphasized the need for empirically derived instruments for reoffending risk assessment among young sex offenders (YSOs). The authors screened the literature on sex offenders for clinically or empirically motivated variables related to criminal recidivism, identifying 22 putative risk factors. All Swedish YSOs (aged 15-20) subjected to court-ordered forensic psychiatric investigations from 1988 through 1995 and available for follow-up (n = 46) were included (mean time at risk = 5 years). Base rates for sexual and general recidivism were 20% and 65%, respectively. Previous criminality, early onset conduct disorder, psychopathy, and use of death threats and weapons at index sex crime proved predictive of general but not sexual recidivism. Factors indicative of sexual deviance (early onset sexually abusive behavior, male victim choice, more than one victim) and poor social skills were associated with elevated risk for sexual reoffending. However, replication in independent samples is needed to corroborate these preliminary findings.
... The goal of this specialized approach was to learn how to intervene with juvenile sex offenders to prevent the development of ingrained deviant sexual interests and beliefs. Gray and Pithers (1993) point out that bthe abundant energy and youthful resources of adolescents were believed to offer vast hope for change at later stages of growthQ (p. 289). ...
The accurate and appropriate assessment and treatment of juvenile sex offenders is necessary for public safety and for the juvenile's own development. A growing body of literature has reported on specialized assessment instruments and treatment strategies for use with juvenile sex offenders. The current article reviews the evidence regarding the reliability and validity of various assessment instruments and outcome research regarding treatments with this population. With regard to assessment, the authors conclude that the most promising area of specialized assessment is risk assessment. With regard to intervention, the authors argue that despite methodological limitations, research on the treatment of juvenile sex offenders suggests that treatments are successful in creating change. Specifically, cognitive behavioral treatment and mulitsystemic therapy have demonstrated decreased recidivism compared to a control group. Recommendations regarding future research for the area and implications with respect to uniqueness of this population are considered.
... Ryan & Lane, 1997). These interventions rely heavily on the sexual abuse cycle as a framework for understanding the abusive behaviour (Ryan, 1999) and have, in turn, been based on interventions originally designed for adult sex offenders (Chaffin & Bonner, 1998;Stickrod Gray & Pithers, 1993). ...
... Well aware of the clinical and criminal heterogeneity among young sex offenders (YSOs), several authors have advocated the development of empirically based typologies for this offender group (Becker et al., 1986;Fehrenbach et al., 1986;Davis and Leitenberg, 1987;Barbaree et al., 1993;Gray and Pithers, 1993;Becker and Hunter, 1997;Sipe et al., 1998). Such typologies could be helpful in the identification of different aetiological factors, improve the specificity of treatment, and aid the assessment of risk for criminal recidivism. ...
Data concerning all young (15-20 years, n = 56) sex offenders (YSOs) subjected to forensic psychiatric investigation in Sweden during 1988-1995 were used in an attempt to construct and validate an introductory YSO typology based solely on offence characteristics. A 5-cluster solution received optimal support from cluster analysis of 15 offence-related variables. A few historical and clinical characteristics varied across clusters. Survival analyses revealed that the clusters differed with respect to sexual but not to violent or general reconviction rates.
Cet article propose une description de la problématique des enfants présentant des comportements sexuels inappropriés. La première partie présente la sexualité des enfants sous l’angle des stades de développement sexuel et de critères cliniques et développementaux permettant de distinguer l’exploration sexuelle saine des comportements sexuels problématiques. La seconde partie est consacrée à l’examen de diverses classifications des comportements sexuels problématiques qui permettent de situer les comportements sexuels d’un enfant de part et d’autre d’un continuum allant de l’exploration sexuelle à l’agression. La troisième et dernière partie traite des facteurs de risque expliquant l’émergence des comportements sexuels problématiques chez les enfants. En conclusion, l’article identifie les limites des connaissances actuelles relativement à la compréhension des manifestations sexuelles chez les enfants et propose quelques pistes nouvelles de recherche.
Er seksuelle lege mellem børn eksperimenterende eller udnyttende? Giver det anledning til bekymring, når et barn udviser seksuel adfærd, eller er det helt »normalt«? Der er et grænseområde mellem børns almindelige indbyrdes seksuelle lege og seksuelle overgreb børn imellem. Referencerne i denne artiklen er internationale undersøgelser af henholdsvis børns almindelige seksualitet i førskolealderen og skolealderen og problematisk seksuel adfærd mellem børn i samme alder. Børns almindelige seksualitet kan indeholde masturbation, blottelse, undersøgelse af egne og andres (børns og forældres) genitalier med og uden manuel berøring. Det er også almindeligt, at børn tilsyneladende ikke udviser en seksuel aktivitet. Når der er seksuelle overgreb børn imellem, vil der ofte være en magtforskel mellem børnene. Der kan forekomme vold eller trusler, og den seksuelle aktivitet vil ofte ligge udenfor almindelige sexlege mellem børn. Oralt, analt og vaginalt samleje er meget ualmindeligt i førskole-alderen og heller ikke almindeligt i 6-12 års alderen.
The material and approaches used in the manual within the context of the interventions are intended to provide structure to the therapeutic work and serve as aids for getting the content across. The following concepts (and abbreviations) will be used:
Darlegt werden die einzelnen Module des BEDIT-A anhand der empfohlenen Reihenfolge, wobei die Arbeit mit Bezugspersonen, die Behandlung komorbider Störungen bzw. der zusätzliche Einsatz medikamentöser Behandlungsoptionen für den gesamten Therapieprozess gültig sind. Pro Modul wird der theoretische Hintergrund erläutert, die therapeutischen Ziele werden definiert und anschließend die Interventionen zur Umsetzung vorgestellt.
Approximately 20% of all rapes (Brown et al. 1984; Morenz and Becker 1995; Pastore and Maguire 2007) and 30–50% of child molestations are carried out by youth under 18 years of age (Brown et al. 1984; Ryan 1999). Studies of adolescent sex offenders have shown that the majority commit their first sexual offense before 15 years of age and not infrequently before 12 years of age (Barbaree and Marshall 2006; Rubenstein et al. 1993). The younger the age of the victim, the more likely they are to have been victimized by a juvenile rather than an adult (Snyder and Sickmund 2006). Preadolescents are being referred for sexual behavior problems in increasing numbers (Araji 1997). Many juvenile sex offenders (JSOs) have more than one victim, and clearly, if they begin a pattern of sexual offending as juveniles and continue sexual offending as adults, JSOs can have many victims. Studies show that JSOs average eight to nine sexual offenses, with four to seven victims (Shaw et al. 1993). Reported crime statistics underestimate the extent of juvenile sexual offenses (Moore et al. 2004).
Sexual abuse and sexual assault continue to be major social problems in our society. Finkelhor and colleagues (1990) reported on the prevalence of sexual abuse in a national survey of adult men and women. Twenty-seven percent of all females and 16% of males surveyed reported that they had been sexually abused prior to age 18. Pithers and colleagues (1995) note that sexual abuse has both emotional and financial consequences. The majority of females seeking outpatient mental health services report a history of sexual abuse at some point in their lives (Frontline, 1988). In terms of the financial costs to society, Pithers et al. (1993) reported that in the state of Vermont, the annual cost of responding to child sexual abuse can be estimated at $42 million.
Adolescents who sexually offend present difficult and complicated demands for clinicians. The gravity of sex offending cannot be ignored, however, because adolescent offending does not necessarily presage adult offending, intervention must not preclude normal developmental opportunities. However, most adult persistent offenders begin offending during adolescence. Thus, clinicians have to provide effective treatment for the potentially serious adult offender while preventing negative second order effects that might create iatrogenic developmental consequences. The essential conclusions about the etiology of juvenile sex offending are that the processes are multi-factorial, complex and developmentally organized. Based on this analysis, assessment of the individual adolescent is critical to establishing an articulated treatment plan and five domains are identified as critical areas for the clinical picture. These are: (1) offender’s victimization and abuse history; (2) social skills deficits, social isolation, and attachment difficulties; (3) deviant sex arousal and/or sexual preoccupation; (4) aggression and general delinquency; and (5) an exaggeration of “normal” adolescent sexual curiosity or exploration in a context of opportunism and weak supervision. Given the complexity of developmental pathways, no single model for intervention provides a sufficiently comprehensive approach for the treatment for juvenile sex offenders. Instead, treatment should be organized by a risk-need-responsivity paradigm that provides a useful algorithm for clinical treatment formulation. Additionally, the intervention must eventuate in the development of a non-stigmatized identity for the developing adolescent. Based on the notion that a risk-need-responsivity analysis should inform treatment, clinicians need to have a strong grasp of developmentally sensitive assessment, competency in navigating the social and legal contexts in which adolescent offenders are found, and be able to serve as a social and legal advocate based on a solid understanding of the empirical findings about adolescents who have sexually offended.
The authors investigated the impact that 5 selected risk factors have on the treatment outcome of adolescent male sex offenders. The results indicated that the greatest risk factor among sex offenders was having a mother who had a substance abuse problem.
This paper reports the results of a cluster analysis on demographic, maltreatment, and psychometric data gathered from 127 children with sexual behaviour problems upon intake into a longitudinal treatment outcome study. Five distinct subtypes of children with sexual behaviour problems were identified: Nondisordered; Abuse Reactive; Highly Traumatized; Rule Breakers; and Sexually Aggressive children. Characteristics of the child subtypes may permit identification of children at high-risk of juvenile delinquency or adult criminality.
Juvenile delinquency is a major social issue today which threatens to become more acute with anticipated demographic shifts and reductions in public support for the poor. Effective strategies for the prevention and reduction of delinquency among poor and at‐risk youth are much needed. The Family Network Partnership is a small community‐based delinquency prevention program in Hattiesburg, Mississippi. The program joins the city housing authority, the community policing team, the youth court, and the local state university in efforts to address delinquency in a local public housing project. The program uses three primary strategies: (1) intervention with youth already involved with the juvenile justice system; (2) skill‐building among youth prior to court involvement; and (3) community capacity building. This paper describes the Partnership's background, principles and program, and outcomes to date. With qualification, the Partnership is offered as a model for replication in similar communities.
Discussed is a comprehensive, ecologically based paradigm applicable across cultures and created to assess the effects of abusive traumatic experiences, the Trauma Outcome Process Assessment (TOPA) model (Rasmussen, 1999, 2004, 2007; Rasmussen, Burton, & Christopherson, 1992). The TOPA model comprehensively assesses the risk and protective factors and trauma outcomes that contribute to self-destructive and/or abusive behavior in youth. TOPA interventions integrate structured cognitive-behavioral treatment exercises with expressive methods (Rasmussen, 2001). TOPA may help sexually abusive youth to decrease maladaptive behavioral responses to traumatic experiences and integrate past traumas with other life events.
Research over the past 20years indicates that adolescent sex offenders account for a significant number of child sexual abuse perpetrators. Studies indicate that this group has a variety of severe family problems, including neglect and physical and sexual abuse. Academic and behavior problems, psychopathology, and social isolation tend to characterize adolescent sexual offenders. The research also indicates that juvenile sexual offenders are a heterogeneous population with diverse characteristics and treatment needs. A number of typologies have been developed to classify various types of offenders, but more empirical research is needed. Because of the diversity of the population, careful assessment is needed before treatment plans are developed and implemented. Most treatment programs have been modeled after treatment programs found to be effective with adult sex offenders, but new programs are aimed more specifically at juveniles. Based on the research, recommendations are made with respect to important target areas for treatment.
The Millon Adolescent Clinical Inventory (MACI) profiles of 82 adolescent male sexual offenders aged 13–19 in a community-based treatment sample were analysed to identify different subtypes of offender based on personality variables. Four groups were identified by cluster analysis: a withdrawn, socially inadequate type (n = 25); an antisocial and externalising type (n = 11); a conforming type (n = 20); and a passive-aggressive type (n = 26). Between-group comparisons showed that the proportion of adolescents reporting physical abuse by their parents was significantly different across the four groups. Subgroup membership was unrelated to victim age, victim gender, and offender history of sexual victimisation. Adolescents who had been victims of sexual abuse were significantly more likely to have had a male victim than those offenders without a history of sexual victimisation. The results of this study provide evidence for the heterogeneity of adolescent sexual offenders in terms of personality characteristics and psychopathology, while also suggesting potentially different aetiological pathways and different treatment needs.
New nomenclature is presented identifying two subsets of sexually abusive youths currently not defined in the literature or in existing models or risk assessment tools: sexually violent youth (YSV) and predatory sexually violent youth (YPSV). Distinctively and qualitatively different, these youths are more dangerous, manifest higher levels of coercion (e.g., threats of bodily injury, use of weapons), or are predatory sexually violent toward strangers or casual acquaintances. Discussed is the innovative, empirically guided risk assessment tool Multiplex Empirically Guided Inventory of Ecological Aggregates for Assessing Sexually Abusive Children and Adolescents (Ages 19 and Under) (MEGA) (Miccio-Fonseca, 2006a41.
Miccio-Fonseca , L. C. August 2006a. Multiplex Empirically Guided Inventory of Ecological Aggregates for Assessing Sexually Abusive Children and Adolescents (Ages 19 and Under)—MEGA, August, San Diego, CA: Author. View all references) for assessing the level of risk for all youths (male and female) under the age of 19 years, including YSVs and YPSVs.
Descriptive and treatment outcome studies regarding sexually aggressive prepubescent boys are lacking. Preliminary data, however, are available from five studies on this difficult-to-treat population. This article has multiple goals: 1) to summarize descriptive and treatment outcome data of problematic sexual behavior in children; 2) to describe general considerations regarding treatment for sexually aggressive prepubescent male children; 3) to address two traditional clinical goals (e.g., eliminating perpetration behavior and enhancing victim empathy) for treating sexual aggression; and 4) to broaden the concept of empathy as a treatment goal. In addition, useful activities are described and available resources are referenced for practitioner use.
There are two schools of thought for providing play therapy to children: non-directive and focused. This paper reviews the rationale for both non-directive and focused approaches to play therapy. The authors discuss why nonduective therapy alone may be ineffective in treating sexually abused children and abuse-reactive children. A prescriptive approach is proposed that combines the rapport building component of nondirecdve play therapy with focused techniques (i.e., cognitive-behavioral therapy, metaphors, bibliotherapy, and art therapy). The authors discuss how this integrated approach can meet the therapeutic needs of sexually abused and abuse-reactive children.
This study addresses the prediction that dropout from a UK specialized residential treatment program for adolescent sexual abusers can be determined from pre-treatment variables. Participants were 49 adolescents aged 12–16 years, who had sexually abused children, peers/adults or both. Of the variables examined, 25 showed a significant association with treatment dropout. A scale, consisting of 20 items, was designed to predict treatment dropout. As a measure it showed internal consistency (alpha = 0.84) and predictive validity. Treatment dropout was linked to a greater risk of recidivism: offences of a general; violent; and combined violent or sexual nature. Missing data confounded the overall small sample size; therefore, a brief checklist of factors associated with dropout was produced as a guide for treatment managers and clinicians.
This article presents a historical overview of research on sexually abusive youth. The evolution of the field over the past 30 years is discussed-from the initial development of treatment interventions to contemporary efforts of professionals to move from traditional, adult-oriented interventions toward developmentally sensitive assessment strategies and practice models. Focus is on two critical areas: risk assessment and trauma-informed care. The article reviews contemporary research on risk assessment tools, stressing the need for validated tools that can accurately assess youth and follow changes in risk over time. Etiological models for understanding effects of trauma (Trauma Outcome Process Assessment and Family Lovemap) are presented. Discussed are new ecologically based therapy models for working with sexually abusive youth that approach the youth holistically and are attuned to youths' needs, including providing interventions to address effects of past trauma.
Although Internet can be a terrific solution for education and recreation for young people, it can become very dangerous for their physical and emotional well-being since they are possible targets of unwanted sexual solicitation. Pedophiles use the Internet to traffic child pornography, and in order to locate children to abuse, to engage in inappropriate sexual communication with young people and to communicate with other pedophiles. Professionals concerned about children’s and adolescent’s mental health should always be prepared to minimize the distress following this kind of online sexual solicitations.
Group programmes for adolescent perpetrators of sexually abusive behaviour can take many forms. This paper describes how a group programme has evolved as a result of the experience obtained from running four groups for adolescent perpetrators. While all groups have had a common core, each has been different and the programme has evolved from group to group. Each group programme has been adapted to the needs of group members and it is argued that flexibility is essential in designing group programmes. The core phases of the group programme are described and an initial evaluation is provided.
A descriptive statistical study was performed to assess the characteristics of youth who began committing sexual offenses in childhood. The youth in this study ranged in age from 12 to 15. They had been committed to the Virginia Department of Juvenile Justice for sexual offenses and met the criteria for residential sexual offender treatment. Three instruments were used in this study. A questionnaire was independently administered to each youth by an examiner and corroborated, when possible, by information in the youth's file. The questionnaire was supplemented by the Hare Psychopathy Scale—Revised and by information from the Risk Assessment Interviewing Protocol for Adolescent Sex Offenders. The results suggested that deviant sexual behavior may begin in early childhood, with some offenders developing patterns of offending prior to the onset of adolescence. These youth committed a median of 69.5 sexual offenses each, with each offender having a median of 16.5 victims. They used either force, threats, or violence in the large majority of their contact offenses. They predominantly came from multiproblematic families, were abused in early childhood, and were exposed to pornographic materials at a young age. The results suggest that children have the capacity to commit serious sexual offenses similar to those of older juvenile and adult offenders. The clinical implications of this study are discussed.
While the number of relapse prevention (RP) programs has expanded from just two in 1985 to currently being the most widely used intervention approach, Marlatt has suggested that with the population the model was originally developed for, there is no evidence for its superiority compared to other approaches. However the sex offender adaptation of RP has evolved into a multifaceted intervention that does not simply enhance self-management and then rely on good intentions. The model can rationally structure treatment components, involve the community in ongoing supervision, and assist an offender to improve his self-regulation. Finally, recent emphasis has been placed on increasing empathy for sexual abuse survivors prior to the RP component in order to enhance an offender's motivation to acquire and use the self-management techniques.
This article is the first report from a 5-year demonstration project examining the comparative efficacy of specialized and
traditional treatments with children who have exhibited sexual behavior problems. Baseline data concerning the demographics,
psychological adjustment, and victimization and perpetration histories of 72 6 to 12-year-old children who have engaged in
sexual misbehavior are reported in this article. Information regarding the caregivers and extended families of these children
is also presented. The data clearly demonstrate that families of children with sexual behavior problems are marked by an array
of characteristics indicative of parental and familial distress, including high rates of (1) violence between parents; (2)
sexual victimization and perpetration with the extended family; (3) physical abuse of the children who have exhibited sexual
behavior problems; (4) children who have witnessed violence between their parents; (5) parental arrest; (6) denial of responsibility
for perpetration of sexual abuse by members of the extended family; (7) poverty; (8) special educational services; (9) prior
therapy for children; and (10) clinical scores on behavioral rating instruments. In particular, several significant differences
emerged between younger children (6–9 years) and older children (10–12). Younger children had (1) been sexually and physically
abused at an earlier age; (2) been more likely to have witnessed physical violence between parents; (3) performed problematic
sexual behaviors at an earlier age; (4) a higher annual rate of problematic sexual behaviors; (5) had a higher percentage
of hands-on sexual behaviors; and (6) had higher scores on measures indicative of sexual behavior problems (e.g., Child Sexual
Behavior Inventory, Child Behavior Checklist—Sexual Problems Subscale). Based on these data, treatment recommendations are
made for families containing children with sexual behavior problems. Given the extensive data suggesting parental characteristics
that could serve as mediating variables in the sexual behavior problems of their children, effective intervention requires
the involvement of the children's caregivers. The comparative efficacy of specialized and traditional treatments for these
families will be reported in subsequent articles.
Treatment of sexually abused and abusing youth requires careful program planning and implementation. Led by its Quality Improvement Council and with considerable staff involvement, Waco Center for Youth in Waco, Texas developed a dual-track approach to treatment of this underserved, often misunderstood, adolescent client population. The sexual abuse survivors' program focuses on the issues of trust, safety, self-esteem, assertiveness, and education. The sex offender program is built on the concepts of self-responsibility; diminishing cognitive distortions; identification of stressors, and their relationship to the offending cycle; and relapse prevention. The staff of Waco Center for Youth are engaged in ongoing analysis of behavioral indicators for successful treatment of sexually abused and abusing adolescents.
Baseline data are reported on the demographics, psychological adjustment, victimization, and perpetration histories of 127 6- to 12-year-old children who have engaged in developmentally unexpected sexual behaviors. Information regarding the children's caregivers, and their extended families, is also presented. Data were collected during intake of the families into a longitudinal treatment outcome study.
A comprehensive battery of psychometric devices and a structured interview were completed with 127 children with sexual behavior problems and their primary caregivers at intake to a treatment outcome study.
More than half of the children engaging in developmentally unexpected sexual behaviors had been abused both sexually and physically by more than two different perpetrators. One-third of the people who had maltreated these children were less than 18 years old. These children had acted out against an average of two other children. High levels of distress in the children and their caregivers were evident across a number of psychometric and historical variables.
Children with sexual behavior problems exhibited a number of functional impairments commonly associated with maltreatment, including learning and psychiatric disorders. Their caregivers and families manifested several characteristics that deter children's recovery from maltreatment, including an impaired attachment between parent and child. The scope of the children's problems requires that treatment extend beyond the therapist's office to include schools and other agencies or individuals with whom the child and families have regular contact.
The assessment and treatment of children and adolescents with sexually abusive behavior requires an understanding of normal sexual development. A multiplicity of biological and psychosocial factors determines the child's sexual development, gender role, sexual orientation, patterns of sexual arousal, sexual cognitions, sexual socialization, and the integration of sexual and aggressive patterns of behavior. The individual's sexuality evolves in concert and as a result of interaction with family, ethnic, social, and cultural influences. These parameters summarize what we know about the epidemiology and phenomenology of sexually abusive youths and provide guidelines for the assessment and the selection of treatment interventions for these youths. Essential considerations in the assessment and treatment of sexually abusive youths, as well as the different categories of sexually abusive youths which should be recognized and which influence treatment decisions, are presented. The spectrum of currently available psychosocial and biological treatments will be summarized.
This study compares a defined sample of male adolescents (n = 36) with regard to their personal development, family characteristics and the types of offence they committed. Adolescent sex offenders with (n = 16) and without (n = 20) a history of sexual abuse who had offended against children were investigated during ongoing criminal proceedings by means of questionnaires and intelligence tests. The most important characteristic that distinguishes the two groups from each other is the more frequent absence of the parents of adolescents who committed sexual offences against children and had a history of sexual abuse. The consequences to be drawn from these results with regard to aggressive sexual delinquency in adolescence are discussed and suggestions are made with regard to further avenues of investigation.
Assessments of juvenile sexual offenders that are intended to aid in dispositional decisions occur at a multitude of decision points within the juvenile justice system. Despite the ubiquity of decisions that include considerations of risk, relatively little empirical work has been done on the development and validation of a risk assessment procedure for these young offenders. In this article, we discuss our initial efforts in developing and validating an actuarial risk assessment protocol for juvenile sex offenders using a sample of 96 adolescents that had been admitted, treated, and discharged from the Joseph J. Peters Institute. We conclude with a critical discussion of problems associated with evaluating risk in this population, and of deficiencies and revision requirements in the present protocol.
The assessment of criminal recidivism risk among adolescents who have offended sexually is a complex task with significant implications for the adolescent and the community. We reviewed the empirical and professional literature on factors associated with criminal recidivism in adolescents who have offended sexually. Supported, promising, possible, and unlikely risk factors are presented and findings are contrasted against the extensive data available for adults who offend sexually and adolescent criminality in general. Limitations with the existing literature are noted, such as shortage of validated risk factors for qualitative aspects of reoffending and research specifically with females and ethnic minorities. Recent attempts to combine evidence-based risk factors with case-specific clinical considerations into structured professional or empirically guided judgment formats are presented. We conclude with suggesting practical strategies for the assessment and communication of recidivism risk.
Although there is very little research in the area of including parents in juvenile sex offender treatment, one of the factors that might be worth exploring is how the parental relationship may aid in successful relapse prevention. Since the family environment is a potential risk factor for adolescent sex offenders, integration of relapse prevention into daily family life may be a significant part of these youths' success or failure in the community. This article focuses on the concept of including parents in juvenile sex offender treatment. Issues addressed include what treatment providers can do to involve parents in relapse prevention, treatment providers' misconceptions about the inclusion of parents in treatment, a rationale for including parents in treatment, and research regarding different parenting styles.
Clinicians and other professionals evaluating, managing, and treating sexually abusive youth are frequently called upon to offer judgments regarding risk for sexual reoffense. There are currently no empirically validated methods for accurately classifying risk among this population. Therefore, those faced with this task have an obligation to consider the research on the assessment of risk and recidivism. Five methods of risk assessment are reviewed, and four scales are discussed, with directions on how to obtain them. These include the Juvenile Sex Offender Assessment Protocol (JSOAP), the Protective Factors Scale (PFS), and Estimate of Risk of Adolescent Sex Offender Recidivism (ERASOR).
Recent empirical research has shown that children with sexual behavior problems and adolescents who offend sexually are diverse populations consisting of several subtypes (Hall, Mathews, & Pearce, 2002; Pithers, Gray, Busconi, & Houchens, 1998; Worling, 2001). This article reviews the descriptive and empirical research related to identifying subtypes of children with sexual behavior problems and adolescents who offend sexually. Examples of clinically and empirically derived typologies are presented. The author discusses how data from the empirically derived typologies can be incorporated within a multidimensional assessment framework based on the Trauma Outcome Process model (Burton, Rasmussen, Bradshaw, Christopherson, & Huke, 1998; Rasmussen, Burton, & Christopherson, 1992; Rasmussen, 1999, 2001, 2002). The application of this framework in assessing and treating children with sexual behavior problems and adolescents who offend sexually is described.
ResearchGate has not been able to resolve any references for this publication.