The information in this program outline is provided by the program representative and edited by the CEBC staff. The Sexual Abuse Counseling and Prevention Program (SACPP) program has been reviewed by the CEBC in the area of: Sexual Behavior Problems in Adolescents, Treatment of, but lacks the necessary research evidence to be given a Scientific Rating.

• Type of Maltreatment: Sexual Abuse
• Target Population: Young people aged 10-18 who have engaged in sexually abusive behaviors

SACPP is a counseling and treatment service that works holistically with families affected by child sexual abuse. It is designed to engage with the broader system around the child/young person – including schools, health services, out-of-home care providers (such as foster care and residential care), and other services providers. Young people who have engaged in sexually abusive behaviors require the ongoing support of their family and community to ensure their risk of re-offending is minimized. Therefore an ecological approach to working with adolescents is essential.

The goals of the Sexual Abuse Counseling and Prevention Program are to:

• help children to grow up and lead healthy, successful lives.
  
• address the underlying causes of the sexually abusive behavior.
  
• facilitate young people developing healthy sexuality, thus reducing their risk of harming others in the future.
  

After a young person has been referred to SACPP, a counselor will maintain contact with the parent/caregiver and provide the parent/caregiver with support while he/she awaits a service. Following this, the young person will be allocated a counselor. A Risk Assessment will occur over 6 to 8 sessions. The young person will be assessed on their level of risk re-engaging in sexually abusive behaviors, their therapeutic needs and their suitability for the program. Following the assessment, recommendations are made. Often young people will be invited to participate in the group therapy program. The group therapy program consists of a series of modules that have specific aims and objectives.

These include:

• Taking Responsibility/Cycle of Offending
• Victim Awareness
• Fantasy Control
• Relationships, Masculinity and Sexuality
• Relapse Prevention
• Emotions and Communication

The following emotions and feelings are addressed in the counseling with the child:

• Shame: Young people may feel shame about their behavior because they know they did the wrong thing.
• Embarrassment: Young people might feel embarrassed by their behaviors and the idea of discussing them with others.
• Fear: Young people may fear what is going to happen next. They may fear punishment, rejection and being labeled by others.
• Helplessness: Young people may feel helpless to stop their behavior.
• Anger: Young people may feel angry towards others for disclosing their behavior. They may also feel angry at professionals and others for wanting to address their behavior.
• Sadness & Depression: Negative feelings associated with their behaviors may leave young people feeling overwhelmed and struggling to cope. This may lead to sadness and depression.

Parents/Caregivers are encouraged to meet with counselors who will help with the following:

• Anger at the child and/or themselves
• Fear of what will happen next
• Guilty that they are somehow responsible for their child’s sexually abusive behaviors
• Shock in thinking that it is usually only adults who are sexually abusive
• Confusion about how and why their child’s sexually abusive behavior has occurred
• Frustration with their child as well as the police, legal and welfare systems
• Denial that their child has done what has been alleged
  

The following assessment scales are used during the assessment process for adolescents receiving treatment for sexually abusive behaviors:

• Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II)
• Millon Adolescent Clinical Inventory (MACI)
• Trauma Symptom Checklist
• Adolescent Dissociative Experiences Scale (A-DES)

Sexual Abuse Counseling and Prevention Program (SACPP) was designed with a child component that addresses the following presenting problems and symptoms:

• Trauma related symptomology (flashbacks, nightmares, fears/anxieties, bedwetting, etc.)
• Attachment issues
• Problematic sexualized behaviors
• Inappropriate sexual behaviors 
• Sexual development
• Sexually harmful behavior
• Sexually abusive behavior
• Relapse prevention

Age range: 10 – 18

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parents are provided their own counselor to enable them to discuss any issues regarding how the sexually abusive behavior of their child has impacted upon them. They also explore and develop strategies for supporting their child in treatment and beyond.Parents are also involved in dyad sessions with their child to strengthen attachment, enable them to bear witness to their child’s experiences and to promote dialogue between them which is healthy and supports recovery.Family therapy work also occurs between the child, parents and other significant family members to address issues of family dynamics that exacerbate the symptoms of child sexual abuse.

Sexual Abuse Counseling and Prevention Program (SACPP) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

• Emotions felt by parent/Caregiver of a child who has sexually abused
• Lack of education and provision of support resources regarding child sexual abuse
• Impacts of a parents own experiences of child sexual abuse on their parenting capacity, particularly in relation to parenting young people who have caused sexual harm similar to the harm they may have experienced themselves as children
• Impacts on parents of their child’s sexually abusive behaviors
• Parent-child attachment issues
• Relationship issues between parent and child who has engaged in sexually abusive behavior
• Lack of management strategies for implementing safety plan and risk management plans in the home

Sexual Abuse Counseling and Prevention Program (SACPP) was designed to be conducted in a group setting; but has not been tested for use in a group setting.

Recommended group size:

3-6

Recommended Intensity:

It is recommended that young people attend individual treatment sessions of 50 minutes per session at least once weekly. Group programs generally run once weekly during school term for 12 months for young people engaging in sexually abusive behaviors. Clients eligible for group treatment usually attend group in addition to engaging in individual work, thus attending the program twice weekly for the duration of group work.

Recommended Duration:

18 months for young people engaging in sexually abusive behaviors or 12 months for group treatment programs for young people with sexually abusive behaviors.

This program is typically conducted in a(n):

• Outpatient Clinic

Sexual Abuse Counseling and Prevention Program (SACPP) includes a homework component:

Strategies for managing an issue are often identified in session and clients are requested to “try them out” at home and report back in the following session as to success of the strategy. Also, there are times when it is appropriate as part of the treatment for clients to have specific conversations with family members/teachers/etc. outside of session and these tasks are set and agreed upon in session, then reported back.

Sexual Abuse Counseling and Prevention Program (SACPP) does not have materials available in a language other than English.

The typical resources for implementing the program are:

• Sound-proofed counseling rooms appropriately equipped with play therapy and art therapy equipment suitable for working with children
• Group therapy rooms capable of comfortably accommodating up to 10 people
• Art therapy tools – paints, clay, paper, canvas, glue, glitter, and so forth
• Play therapy tools – dolls, sand trays, figurines/symbols, themed and un-themed puppets, themed and un-themed dress ups in children's sizes
• A/V equipment for use in individual and group sessions – TV, DVD player
• Family therapy rooms, equipped with observation screen and A/V equipment
• Highly skilled and experienced therapists trained in children's counseling techniques
• Experienced leadership to provide supervision and support for therapists
• Resources to provide group supervision and critical incident debriefing for therapists as required
• Comprehensive policies and procedures detailing Client Services delivery, risk management and child protection reporting procedures
• Consent forms clearly detailing services for clients to ensure informed consent
  

Practitioners: A degree in Social Work or Psychology, with post-graduate qualifications in a counseling related field (such as art therapy, play therapy, Gestalt, Family Therapy, Counseling).

Supervisors: A degree in Social Work or Psychology, with extensive experience (i.e., more than 5 years) providing therapeutic services to children affected by sexual abuse.

There is a manual that describes how to implement this program; but there is not training available for this program.

This program has been reviewed and it was determined that this program lacks the type of published, peer-reviewed research that meets the CEBC criteria for a scientific rating of 1 – 5. Therefore, the program has been given the classification of "NR - Not able to be Rated." It was reviewed because it was identified by the topic expert as a program being used in the field, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers. Some programs that are not rated may have published, peer-reviewed research that does not meet the above stated criteria or may have eligible studies that have not yet been published in the peer-reviewed literature. For more information on the "NR - Not able to be Rated" classification, please see the Scientific Rating Scale.

Child Welfare Outcomes: Not Specified

Currently, there are no published, peer-reviewed research studies for Sexual Abuse Counseling and Prevention Program (SACPP).

No reference materials are currently available for Sexual Abuse Counseling and Prevention Program (SACPP).