Help for parents
Understanding the issue
Criticism from experts
Juvenile sex law
Organizations and links
Research on youth sexuality
from actual treatment materials:
Steps to Healthy
a workbook for ages 5-12
a workbook for ages 6-12
a workbook for ages 11-21
G. & Harlow, N., The Stop Child Molestation Book,
American Academy of
Child & Adolescent
& Duff, J., “Conduct
Disorder in Children and Adolescents,” Doncaster, VIC,
Australia: Behavioural Neurotherapy
Kahn, T.J., Pathways: A
Guided Workbook for Youth Beginning Treatment,
Brandon, VT: Safer Society Press, 1999.
Kahn, T.J., Roadmaps to
Guided Workbook for Young People in
Treatment, Brandon, VT: Safer Society Press,
& Cunningham, C., Steps to Healthy Touching, Indianapolis:
Rottnek, F., & Abby, S.L., “Conduct Disorder: Diagnosis
and Treatment in Primary Care, American Family
Physician, April 15, 2001.
Shaw, J., “Practice
Assessment and Treatment of Children and Adolescents Who Are Sexually
of Others,” Journal of the American Academy of Child and
Psychiatry, 38(12 Suppl):32S-54S, 1999.
& Dunne, J.E., “Summary of the
Practice Parameters for the
Treatment of Children and Adolescents with Conduct Disorders,”
the American Academy of Child and Adolescent Psychiatry,
Zimring, F.E., An American
Travesty: Legal Responses to Adolescent
Offending, Chicago: University of Chicago Press,
About the author
The table below compares treatment for
adolescents who have sexual behavior problems with those who have a
committing violent (non-sexual) crimes and are
diagnosed with conduct disorder. Notice that the harsh and adversarial
methods (including attempts to control thoughts and feelings) used on
youth with sexual behavior problems are not even used with children who
commit violent crimes.
| Child/adolescent with
| Child/adolescent with
| Target behaviors –
breaking and entering
destruction of property
use of dangerous weapon
cruelty to people or animals
|preoccupation with sex/pornography
obscene phone calls
consensual sex play with sibling or
consensual sex with younger
suggesting sexual activity to
|Threshold for treatment
|Pattern must be present over 6 month period.
There must be clinically significant impairment in social, academic or
|Often after only one incident.
No requirement of impairment.
| Characteristics of client
||These are not
assumed for all patients; individual differences are recognized:
Inability to appreciate others'
Little guilt or remorse
Views others as malicious
|These are assumed
for all "offenders" even if not actually present:
Denies behavior or its harmfulness
| Treatment priority
|| Least restrictive intervention that
fulfills patient needs
|| Protection of community
| Therapist-client relationship
(excerpt on assessment)
- no need to confront to overcome denial etc.
- client is called "patient" or "child" rather than "offender"
- no data gathered from victims.
- no physiological measurement of client's feelings or thoughts
“Although the order of obtaining data
may vary, the evaluator should interview both the patient and the
parents, separately and together, to obtain history. It also may be
desirable to interview other family members and professionals familiar
with the patient. Releases for
contact with medical, school, social
service, and juvenile justice personnel should be obtained as
indicated…DSM-IV target symptoms may not be apparent or acknowledged
during the patient interview,
but may be detected by interviewing
parents and other informants.”
(Steiner & Dunne)
sources of information include medical and psychological reports,
offense reports, victim statements,
services reports, and
probation reports. The collateral information should be obtained before
the individual interview; otherwise one is left relatively unprepared
before the offender's normal
proclivity to minimize and deny…Because in
many cases laws have been transgressed, the offender is often less than
forthcoming...The interviewer confronts
denial, and the
apparent omissions of important information… Some authors have
recommended the use of phallometric testing, the measuring of penile
erection in response to various stimuli, as a way to determine
sexual behavior problem
supervision and limit-setting
helpful: Usually a combination
of behavioral and explorative.
fear that patient will manipulate
appropriate academic placement.
supervised peer & community activities.
Replace deviant peer group with socially appropriate one.
Teach parents use of consistent, non-harsh discipline with clear rules,
Encourage parents to monitor whereabouts of children, and supervise
exposure to violent entertainment.
Encourage parent-child play.
To build an accountability system.
To teach parents about sexually abusive behavior, risk and protective
factors, and characteristics of sexual abusers.
To teach parents styles of interaction and management of their
children's sexual behavior.
Control of sexual impulses
Social skills training
illegal sexual act in
detail (including planning, method, and aftermath).
Pressure to disclose more crimes.
Describe all hurtful and selfish non-sexual behavior.
Describe family history of selfish, hurtful, or illegal behavior.
Use of polygraph (lie detector).
victims, their reactions
and feelings, and all possible effects on them.
Relive own actions from victim's perspective.
Education about effects on indirect victims (family & friends of
victim & self).
Describe in detail every incident of own
Listen to stories of victimization.
Education about effects on victim.
identify criminal thinking
patterns (denial, minimization, rationalizing, etc.).
Disclose all thoughts/feelings before, during, and after crime.
Replace dangerous feelings and thoughts with right ones.
Change sexual fantasies through behavioral reconditioning (Covert
sensitization, aversion therapy, masturbatory satiation, or other
sexual arousal reconditioning).
thoughts and feelings
and non-sexual, including
fantasies and masturbation habits:
By therapist through required daily journals.
Reported to therapy group weekly.
By polygraph (lie detector) and/or plethysmograph attached to genitals
Take on identity as offender.
Identify cycle of dangerous feelings & behavior.
Identify tempting, dangerous situations.
Analyze tendency to overcome inhibitions and victim resistance.
Identify maintenance behaviors.
Develop relapse prevention plan.
movement & jobs.
Continued monitoring of thoughts, feelings, and behavior.
Registration and tracking.
See sample materials
used in treatment
with treatment providers
experts are wrong
Casualties of war