Sexual Abuse: Family Education and Treatment (SAFE-T) Program

Scientific Rating:
3
Promising Research Evidence
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. Sexual Abuse: Family Education and Treatment (SAFE-T) Program has been rated by the CEBC in the area of: Sexual Behavior Problems Treatment (Adolescents).

Target Population: Adolescents who have offended sexually (intra- or extra- familial) and their families

For children/adolescents ages: 12 – 19

Brief Description

The SAFE-T Program consists of assessment and treatment services that focus on strengths and challenges so that individuals and families can make changes necessary for healthy futures. The SAFE-T Program is committed to providing opportunities for children, youth, and families to actively participate in coping with their experiences with all aspects of sexual abuse utilizing their unique strengths and resources. Recommendations from the assessment guide the development of an individualized treatment plan. Goals are developed in collaboration with the child/youth and family and will be reviewed and altered as needs or circumstances change. Individual needs are always considered and every effort is made to customize services to address the unique circumstances of each client and/or family.

The client/therapist relationship is critical for it allows for the child/youth and family to work towards their agreed upon treatment goals in a safe and supportive context. Guided by treatment needs, a combination of individual, group and family therapy may be recommended.

Training, supervision, and consultation to other professionals is offered by the SAFE-T Program with the aim of helping to increase public awareness and understanding of child sexual abuse, children with concerning sexualized behavior, and youth who have offended sexually. The SAFE-T Program is committed to conducting research in all three client areas. The program also strives to foster professional, academic, and community partnerships to promote awareness and understanding of sexual abuse.

Program Goals:

The goals of Sexual Abuse: Family Education and Treatment (SAFE-T) Program are:

  • Promote the safety and well-being of children from sexual abuse and exploitation
  • Provide clinical assessment, treatment, and support services for children and youth who have experienced sexual abuse, children who are exhibiting/have exhibited concerning sexual behaviors, adolescents who have sexually offended, and their families
  • Conduct research that will increase knowledge and understanding of sexual abuse and will contribute to improved treatment and support of children, youth, and families that have been affected by sexual abuse
  • Provide clinical training and consultation to mental health professionals and allied disciplines in the assessment and treatment of sexual abuse

SAFE-T is committed to providing opportunities for children, youth, and families to actively participate in coping with their experiences with sexual abuse utilizing their unique strengths and resources. The program also strives to foster professional, academic, and community partnerships to promote awareness and understanding of sexual abuse.

Essential Components

The essential components of the Sexual Abuse: Family Education and Treatment (SAFE-T) Program include:

  • Individual treatment combined with regular dyad, family, and group therapy
  • The following treatment is for adolescents who sexually offend. The SAFE-T Program has developed a specialized risk-assessment tool: The ERASOR (Estimate of Risk of Adolescent Sexual Offense Recidivism). Treatment is guided by the recommendations obtained from completing a compressive assessment, which include psychological and clinical evaluations. Information obtained during the assessment includes, but is not limited to the following topics:
    • Family History & Functioning
    • Developmental History
    • Physical Health
    • Intellectual, Academic and Cognitive Functioning and Expression
    • Spiritual/Cultural Issues
    • Self-Perception
    • Nonsexual Delinquency
    • Potential Traumatic Experiences & Impact
    • Sexual Development & Sexual Behaviors
    • Sexual Identity and Sexual Interest
    • Non-offensive Sexual Relationships
    • Knowledge of Consent Issues & Sexual Attitudes
    • Sexual Offending
    • Victim Impact Awareness
    • Knowledge of Risk for Sexual Re-offending & Prevention Awareness
    • Parental Perception of Strengths
  • Common Treatment Topics Include (not necessarily for all adolescents):
    • Developing sexual-offense-prevention plans
    • Enhancing parent-child communication/relationships
    • Healing from childhood trauma
    • Enhancing social relationships/intimacy
    • Enhancing pro-social sexual attitudes
    • Increasing accountability for sexual offenses
    • Enhancing healthy sexual interests
    • Developing a support network
    • Enhancing affective expression/regulation
    • Enhancing awareness of victim impact
    • Enhancing self-esteem

Child/Adolescent Services

Sexual Abuse: Family Education and Treatment (SAFE-T) Program directly provides services to children/adolescents and addresses the following:

  • Sexual behaviors and development; sexual offending behaviors; problems with cognitive functioning, social functioning, and/or emotional functioning; victimization history (if applicable); sexual attitudes (if applicable); nonsexual delinquency; self-concept; problems with family functioning
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: The SAFE-T Program also focuses on providing information and support to caregivers to facilitate the processing of their own reactions to the sexual offense(s) and/or sexual victimization of their child/children. This supports their emotional and behavior healing thereby increasing caregiver’s readiness to participate in parent-child trauma or sexual offense specific sessions.

Delivery Setting

This program is typically conducted in a(n):

  • Community Agency

Homework

Sexual Abuse: Family Education and Treatment (SAFE-T) Program includes a homework component:

Homework is client and goal-specific, and is used in order to generalize skills learned in therapy (e.g., completing thought records, managing feelings, relaxation skills at bedtime).

Languages

Sexual Abuse: Family Education and Treatment (SAFE-T) Program has materials available in a language other than English:

French

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Therapy rooms, a/v equipment for case conferences, televisions/laptops for movie clips and/or power point presentations for other psycho-educational materials, art room and art supplies for art focused interventions

Minimum Provider Qualifications

Master's degree in Social Work (or equivalent), Master's in Psychology (psychometrists), PhD Psychologists with a mental health and/or clinical specialization

Education and Training Resources

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

Training Contacts:
Training is obtained:

Through workshops, conference presentations, publications, webinars, and onsite training at SAFE-T

Number of days/hours:

Variable, depending on need

Implementation Information

Since Sexual Abuse: Family Education and Treatment (SAFE-T) Program is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

The program representative did not provide information about pre-implementation materials.

Formal Support for Implementation

The program representative did not provide information about formal support for implementation of Sexual Abuse: Family Education and Treatment (SAFE-T) Program.

Fidelity Measures

The program representative did not provide information about fidelity measures of Sexual Abuse: Family Education and Treatment (SAFE-T) Program.

Implementation Guides or Manuals

The program representative did not provide information about implementation guides or manuals for Sexual Abuse: Family Education and Treatment (SAFE-T) Program.

Research on How to Implement the Program

The program representative did not provide information about research conducted on how to implement Sexual Abuse: Family Education and Treatment (SAFE-T) Program.

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

Show relevant research...

Worling, J. R., & Curwen, T. (2000). Adolescent sexual offender recidivism: Success of specialized treatment and implications for risk prediction. Child Abuse & Neglect, 24(7), 965-982.

Type of Study: Pretest-posttest control group design
Number of Participants: 148

Population:

  • Age — 12-19 years
  • Race/Ethnicity — Not specified
  • Gender — 139 Males and 9 Females
  • Status — Participants were adolescents with sexual behavior problems and histories of sexual offense.

Location/Institution: Greater Toronto, Canada area

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Sexual Abuse: Family Education and Treatment Program (SAFE-T) program in reducing adolescent sexual re-offending. Participants completed the Assessing Environments (III) Scale (AEIII), Tennessee Self-Concept Scale (TSCS), Youth Self-Report (YSR), Beck Depression Inventory (BDI), Buss-Durkee Hostility Inventory (BDHI), Socialization scale of the California Psychological Inventory (CPI), and the Multiphasic Sex Inventory-Juvenile Male-Research Edition (MSI-J-R) at intake and 12 months from intake. Results indicated that adolescents in the SAFE-T group had significantly lower re-arrest rates for sexual offenses than did adolescents in the comparison group at follow-up (ranging from 2 to 10 years postintervention). Limitations include lack of randomization to treatment and lack of follow-up using assessment measures.

Length of postintervention follow-up: Varies.

Worling, J. R., Litteljohn, A., & Bookalam, D. (2010). 20-year prospective follow-up study of specialized treatment for adolescents who offended sexually.  Behavioral Sciences and The Law, 28, 46-57.

Type of Study: Pretest-posttest control group design
Number of Participants: 148

Population:

  • Age — 12-19 years at baseline
  • Race/Ethnicity — Not specified
  • Gender — 139 Males and 9 Females
  • Status — Participants were adolescents with sexual behavior problems and histories of sexual offense.

Location/Institution: Greater Toronto, Canada area

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: The study used the same sample as Worling and Curwen (2000) and extended the follow-up by 10 years. Recidivism data were collected from a national database on the participants. Relative to the comparison group, adolescents who participated in the Sexual Abuse: Family Education and Treatment (SAFE-T) program were significantly less likely to receive subsequent charges for sexual, nonsexual, violent, and nonviolent crimes. Limitations include lack of randomization.

Length of postintervention follow-up: 10 year extension to the 2000 study.

References

Worling, J. R. (1998).  Adolescent sexual offender treatment at the SAFE-T Program.  In W. L. Marshall, Y. M. Fernandez, S. M. Hudson, & T. Ward (Eds.), Sourcebook of treatment programs for sexual offenders (pp. 353-365).  New York: Plenum Press.

Worling, J. R. (2004).  Essentials of a good intervention programme for sexually abusive juveniles.  Part two: Offence related treatment tasks.  In G. O’Reilly, W. L. Marshall, A. Carr, & R. C. Beckett (Eds.), The handbook of clinical intervention with young people who sexually abuse (pp. 275-296).  Hove, East Sussex, England: Taylor & Francis.

Worling, J. R., Josefowitz, N., & Maltar, M. (2011). Reducing shame and increasing guilt and responsibility with adolescents who have offended sexually: A CBT-based treatment approach. In M. C. Calder (Ed.), Contemporary practice with young people who sexually abuse: Evidence-based developments (pp. 320-334). Holyoke, MA: The NEARI Press.

Contact Information

Name: Tina Fridmann
Email:
Phone: (416) 744-9000 x328

Date Research Evidence Last Reviewed by CEBC: June 2017

Date Program Content Last Reviewed by Program Staff: May 2016

Date Program Originally Loaded onto CEBC: June 2011