Topic: Sexual Behavior Problems Treatment (Children)
Definition for Sexual Behavior Problems Treatment (Children):
Sexual Behavior Problems Treatment (Children) is defined by the CEBC as the treatment of behaviors involving sexual body parts that are developmentally inappropriate or potentially harmful to themselves or others initiated by children ages 12 and younger. Sexual behavior problems may range from problematic self-stimulation (such that it causes physical harm or damage) to nonintrusive behaviors (such as preoccupation with nudity, looking at others) to sexual interactions with other children that include more explicit behaviors than sex play (such as intercourse) to coercive or aggressive sexual behaviors, with the latter behavior being of most concern, particularly when paired with large age differences between children. When sexual behavior problems appear to be trauma-related symptoms that originate from sexual abuse the child has experienced, the behavior may be termed “sexually reactive.”
It should be noted that although the term “sexual” is used, the reasons for engaging in such behavior vary and are rarely related to sexual gratification or stimulation. Instead, these behaviors tend to be related to other factors, such as curiosity, impulsivity, anxiety, trauma-related symptoms (e.g., re-experiencing symptoms of post-traumatic stress disorder), and attention-seeking.
Interventions for sexual behavior problems that have been systematically evaluated predominately fall in one of two categories: (a) treatments targeting sexual behavior problems and (b) treatments targeting the effects of child sexual abuse including sexual behavior problems.
- Target population: Children ages 12 and younger who demonstrate behaviors involving sexual body parts that are developmentally inappropriate or potentially harmful
- 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, either on their own or as a component of treatment for child sexual abuse
- In order to be rated: There must be research evidence (as specified by Scientific Rating Scale) that examines outcomes related to sexual behavior for the child, such as changes in the child’s 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.
Two Programs with a Scientific Rating of 2 - Supported by Research Evidence:
- Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age ProgramChildren (boys and girls ages 6 to 12 years of age) with sexual behavior problems and their caregivers
- Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT)Children with a known trauma history who are experiencing significant posttraumatic stress disorder (PTSD) symptoms, whether or not they meet ...
Five Programs with a Scientific Rating of NR - Not able to be Rated:
- Interventions for Children with Sexual Behavior Problems: Research, Theory and TreatmentChildren aged 7-12 years who have sexual behavior problems and their parent(s)/caretakers
- Problematic Sexual Behavior – Cognitive-Behavioral Therapy for Preschool ChildrenBoys and girls ages 3 to 6 years with sexual behavior problems and their caregivers
- Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART)Children ages 4-11 who have a history of child sexual abuse (CSA) and are exhibiting problematic sexual behavior (PSB)
- 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 ...
- When Children AbuseChildren from 5 to 12 years of age who have been identified by any number of sources for exhibiting inappropriate sexual behavior ...
Why was this topic chosen by the Advisory Committee?
The Sexual Behavior Problems Treatment (Children) topic area is relevant to child welfare because there are children in the child welfare systems who exhibit sexual behavior problems and who would benefit from treatment to help manage these behaviors. Children may exhibit age-inappropriate sexual behavior, including inappropriate sexual contact with another child. These children can benefit from treatment that promotes learning and maintaining appropriate boundaries, and managing their inappropriate behavior. This treatment acknowledges the child’s own abuse history (if present) and how the abuse has impacted their relationships with others.
Debra Zanders-Willis, Director
Child Welfare Services
County of San Diego
San Diego, CA
Jane F. Silovsky, PhD, Associate Professor
Center on Child Abuse and Neglect, Developmental and Behavioral Pediatrics
Department of Pediatrics, University of Oklahoma Health Sciences Center