Alison Gray’s research while affiliated with AOL and other places

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.

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.

This research was conducted to define empirically derived and clinically relevant types of children with sexual behavior problems. A theory-driven hierarchical cluster analysis was performed using Ward's method. Five distinct types of children with sexual behavior problems emerged. Significant differences were found among the five child types on a large number of historical, diagnostic, behavioral, and demographic variables, including number of victims, degree of aggression employed during sexual acting out, sexual penetration, psychiatric diagnosis, internalizing, and externalizing. Clinical relevance of the child types was examined by analyzing change scores on an objective measure of sexualized behaviors in children who had earlier been assigned randomly to one of two treatment conditions. The analysis of treatment efficacy revealed a significant main effect of child type and a significant child type by treatment type interaction. After a short time in treatment, the highly traumatized child type derived significantly more benefit from a cognitive behavioral intervention than from an expressive therapy. This study demonstrates that distinct types of children with sexual behavior problems exist, that they can be distinguished on a wide range of clinically relevant variables, and that identification of child type may be relevant to choice of treatment modalities and outcome.

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)

This research examined demographic and functional characteristics of parents of children with sexual behavior problems. Families of 72 children with sexual behavior problems completed a structured interview and several psychometric devices at intake into a treatment outcome study. As a group, caregivers manifested signs of a high level of life stress across a wide array of variables, including income, criminal arrest, family violence, sexual abuse, social support, modulation of emotion, and attachment to their child. Foster parents consistently reported significantly lower levels of stress than biological parents. Parents and families of children with sexual behavior problems appear multiply entrapped. They are highly distressed and somewhat isolated. The data convincingly demonstrate that in order to maximize the efficacy of treatment for children with sexual behavior problems, parents must be centrally involved and receive services coordinated with those of their child. Group treatment may be advisable to foster formation of a network of peer support for caregivers of children with sexual behavior problems.

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.

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.

No Yes

[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)