Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program

Scientific Rating:
3
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program has been rated by the CEBC in the area of: Sexual Behavior Problems in Children, Treatment of.

Target Population: Children with sexual behavior problems. Boys and Girls ages 3 to 6 years of age and their caregivers.

For children/adolescents ages: 3 – 6

For parents/caregivers of children ages: 3 – 6

Brief Description

Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program is a family-oriented, cognitive-behavioral, psychoeducational, and supportive treatment group designed to reduce or eliminate incidents of sexual behavior problems:

  • The program is an outpatient group treatment program for children ages 3 to 6 years and their parents or other caregivers. Recommended group size is 5-7 children per group.
  • The program can be provided to individual families when group is not an option.
  • The treatment is provided as a closed-ended group.
  • The group is 12-14 sessions long.
  • Collaboration with child protective services, school personnel, and others involved is highly recommended.

Caregivers are taught about sexual development, how to supervise the children, teach and implement rules in the home, communicate about sex education, and reduce behavior problems utilizing behavior parent training strategies. Children are taught private part rules and abuse prevention skills in the context of safety rules. Boundaries, emotional regulation, coping skills, and basic impulse control strategies are taught and practiced during and between sessions.


Program Goals:

The goals of Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program are to:

  • Eliminate or reduce problematic sexual behavior
  • Improved child behavior via better parental monitoring, supervision, and behavior management skills
  • Improve parent-child interaction and communication
  • Improve coping, self-control, and social skills

Essential Components

The essential components of Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program are:

  • Modeling, observing, and providing constructive and corrective feedback on skills
  • Structured program and providers who use a directive approach
  • Addressing components with Children and Caregivers
    • Rules about sexual behavior
    • Boundaries
    • Abuse prevention skills
    • Emotional regulation and coping skills
    • Impulse control and problem solving skills
    • Sex education
    • Social skills and peer relationships
  • Addressing additional components for caregivers
    • Behavior parent training to prevent and respond to sexual behavior problems as well as other behavior problems
    • Sexual development and child development including moral development
    • Dispelling misconceptions regarding the behavior and implications to the child
    • Support

Child/Adolescent Services

Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program directly provides services to children/adolescents and addresses the following:

  • Sexual behavior problems, general behavior problems, and internalizing symptoms
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Program requires weekly parent/caretaker attendance and active participation, monitoring and supporting child application of skills between sessions, and ongoing assessment of child progress in treatment.

Parent/Caregiver Services

Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program directly provides services to parents/caregivers and addresses the following:

  • Parent/caregiver of a child with sexual behavior problems. Limited understanding of sexual development, sexual behavior problems, and parenting strategies that improve boundaries and reduce sexual behavior problems. Parental stress.

Delivery Setting

This program is typically conducted in a(n):

  • Outpatient Clinic

Homework

Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program includes a homework component:

Each week the child and caregiver have activities that have them apply or practice the skills/information taught.

Languages

Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: Preschool Program does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Group rooms including one room large enough to hold all the families for the parent-child group component.
  • Co-therapists for each child group is recommended. One therapist could do the caretaker/parents group.
  • Personnel to conduct the intake assessments.
  • Supervisor/director of the program.
  • Therapeutic materials, such as books, puppets, etc.

Minimum Provider Qualifications

Supervisor and lead therapists are recommended to be licensed mental health practitioners with previous experience in treatment for children and their caregivers for children with behavior problems and children who have been maltreated.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Onsite or at OUHSC

Number of days/hours:

Depends in part on training and experience of staff to be trained. Typically there are 4 days of initial training, ongoing consultation (preferred live observation of program via polocom), and at least one booster training visit.

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Silovsky, J. F., Niec, L., Bard, D., & Hecht, D. (2007). Treatment for preschool children with sexual behavior problems: Pilot Study. Journal of Clinical Child and Adolescent Psychology, 36, 378-391.

Type of Study: One group pretest-posttest design
Number of Participants: 85

Population:

  • Age range — 3 to 7 years
  • Race/Ethnicity — Not Specified
  • Gender — Not Specified
  • Status — Participants were children presenting co-occurring trauma symptoms and disruptive sexual behaviors referred from child protective services and other agencies or programs.

Location / Institution: Oklahoma Department of Human Services

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated a 12-week group treatment program for preschool children with interpersonal sexual behavior problems (SBP). Caregivers completed the Child Sexual Behavior Inventory III (CSBI-III), Child Behavior Checklist (CBCL), Parenting Stress Index – Short Form (PSI-SF), and the CSBP Preschool Group Satisfaction and Social Validity Questionnaire (CSBP-PGSQ) and clinicians completed and assessed children using the Diagnostic Interview Schedule for Children (DISC-IV), Abuse Dimensions Inventory, Peabody Picture Vocabulary Test – Third Edition (PPVT-III), and Treatment History Form at intake, pretreatment and posttreatment. In intent-to-treat analysis, a significant linear reduction in SBP due to number of treatment sessions attended was found, an effect that was independent of linear reductions affiliated with elapsed time. Under the assumption that treatment can have an incremental impact, more than one third of the variance was accounted for by treatment effects, with female and older children most favorably impacted. Caregivers reported increase in knowledge, satisfaction, and usefulness of treatment. Limitations included the lack of a control or comparison group.

Length of post-intervention follow-up: None.

References

Silovsky, J. F. (2009). Taking Action: Support for Families of Children with Sexual Behavior Problems. Vermont: Safer Society Press.

Silovsky, J. F. & Niec, L. (1998). Group treatment for preschool children with problematic sexual behavior. Program manual. Unpublished treatment manual.

Silovsky, J. F., Swisher, L., Widdifield, Jr., J. (in press). Children with Sexual Behavior Problems. In P. Goodyear-Brown (ed.). The Handbook of Child Sexual Abuse: Prevention, Assessment and Treatment. John Wiley & Sons.

Contact Information

Name: Jane F. Silovsky, PhD
Agency/Affiliation: University of Oklahoma Health Sciences Center
Website: www.oumedicine.com/pediatrics/department-sections/developmental-behavioral-pediatrics/center-on-child-abuse-and-neglect/programs-and-clinical-services/children-with-sexual-behavior-problems
Email:
Phone: (405) 271-8858 or (405) 271-2931

Date Research Evidence Last Reviewed by CEBC: September 2013

Date Program Content Last Reviewed by Program Staff: April 2011

Date Program Originally Loaded onto CEBC: April 2011