Topic: Sexual Behavior Problems Treatment (Adolescents)
Definition for Sexual Behavior Problems Treatment (Adolescents):
Sexual Behavior Problems Treatment (Adolescents) is defined by the CEBC as the treatment of sexual behavior problems in adolescents regardless of the adolescents' involvement in the legal system or the presence of specific case characteristics (e.g., violence/aggression). Many labels have been used to capture some youth in this population, including "adolescent sex offenders," "sexually aggressive youth," and "juvenile sex offenders" to name a few of the most common labels. These labels were considered too narrow for this topic area. For example, not all youth who engage in sexually aggressive behaviors are "offenders" in the legal sense and not all juvenile sexual offenders have engaged in aggressive or nonconsensual sexual behaviors (e.g., many are so-called status offenders who engaged in consensual sexual activities with peers). Moreover, these labels have the unfortunate and unnecessary effect of labeling the youth, rather than the behavior. Adolescents with sexual behavior problems comprise a heterogeneous group of youth, none of whom should be characterized primarily by his or her sexual acts.
For the purposes of this topic area on the CEBC website, sexual behavior problems will be defined as any of the following:
- Sexual acts committed with another person of any age that were against the victim's will; were without assent/consent; or involved aggression, exploitation, or threats.
- Sexual acts committed with another person who was unable to provide assent, including children less than 12 years of age and 5 or more years younger than the older youth, or peers or adults with cognitive, intellectual, or other disabilities.
- Sexual acts without another person but involving child pornography in which the images depicted sexual targets under 12 years of age and assumingly five or more years younger than the adolescent (as distinguished from images that depict peers assumingly the same age of the viewer); solicitation of younger children via the Internet or other technology, with or without the intention of ever meeting to engage in sexual behaviors; or non-contact sexual offenses (e.g., exhibitionism, voyeurism) and self-directed sexual behaviors (e.g., masturbation) that occur in public or semi-public places and that persist even after intervention (as distinguished from behaviors that resolved with initial correction).
- Target population: Adolescents ages 12 to 18 years who have engaged in one or more instances of inappropriate (including, but not limited to, illegal) sexual behaviors
- Services/types that fit: Outpatient, day treatment, and residential services in individual or group formats
- Delivered by: Mental health professionals
- In order to be included: Program must specifically target sexual behavior problems as a goal
- In order to be rated: There must be research evidence (as specified by the Scientific Rating Scale) that examines outcomes related to sexual behavior for the youth, such as recidivism or changes in youth behavior, symptom levels, and/or functioning
Programs in this Topic Area
The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.
One Program with a Scientific Rating of 1 - Well-Supported by Research Evidence:
- Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB)Youth between 10 and 17.5 years of age (and their families) when the youth has engaged in sexually abusive behavior toward others; ...
One Program with a Scientific Rating of 3 - Promising Research Evidence:
- Sexual Abuse: Family Education and Treatment (SAFE-T) ProgramAdolescents who have offended sexually (intra- or extra- familial) and their families
Five Programs with a Scientific Rating of NR - Not able to be Rated:
- HOPE ProgramSexually reactive children (age 12 and up) and sexually abusive children and adolescents; also used for adult sexual offenders
- Pathways Fourth EditionAdolescent males and females with sexual behavior problems, ages 12-18
- Sexual Abuse Counseling and Prevention Program (SACPP)Young people aged 10-18 who have engaged in sexually abusive behaviors and their families
- Sexual Offender Detention Alternative (SODA)Children age 13-18 who have been referred by the Courts, Probation, Child Protective Services, etc. for sexual offenses
- Trauma Outcome Process Assessment Model (TOPA)Sexually abused children and adolescents and children and adolescents who have sexual behavior problems or manifest sexually abusive behavior including ...
Why was this topic chosen by the Advisory Committee?
The Sexual Behavior Problems Treatment (Adolescents) topic area is relevant to child welfare because many children in the child welfare system who have been victims of sexual molest often become sexual predators or exhibit other sexually inappropriate behaviors as they reach adolescence. These children usually experience multiple placement moves and it becomes increasingly difficult to find a foster family or relative family placement since their behaviors put other children at risk, thus requiring a residential treatment or group home for placement. As a result, these children grow up in foster care without a permanent, loving home. Without treatment, these children face the risk of committing a sexual offense that will result in their entry in either the juvenile or adult justice system.
Danna Fabella, MSW
Linkages Project Director
Child and Family Policy Institute of California
Elizabeth J. Letourneau, PhD, Associate Professor
Department of Mental Health, Bloomberg School of Public Health
Johns Hopkins University