 See excerpts from actual treatment materials: Steps to Healthy
Touching Roadmaps to
Recovery Pathways assorted
materials
(Warning: these materials are sexually explicit and seethe with hatred.) Comparison with treatment for conduct disorder
1. Abel, G. & Harlow, N., The Stop Child Molestation Book, Xlibris, 2001. 2. Anonymous, “Molested,” Salon Magazine, February, 1997. 3. Burton, D. & Smith-Darden, J., North American Survey of Sexual Abuser Treatment and Models 2000, Brandon, VT: Safer Society Foundation, 2001. 4. Chaffin, M. & Bonner, B., "Don't Shoot, We're Your
Children": Have We Gone Too Far in Our Response to
Adolescent Sexual Abusers and Children With Sexual Behavior Problems?",
Child Maltreatment, vol. 3, no. 4 (Nov.), 1998, pp.
314-316. 5. Kahn, T.J., Pathways: A
Guided Workbook for Youth Beginning Treatment,
Brandon, VT: Safer Society Press, 1999. 6. Kahn, T.J., Roadmaps to Recovery: A Guided Workbook for Young People in Treatment, Brandon, VT: Safer Society Press, 1999. 7. Righthand, S. & Welch, C., "Juveniles Who Have Sexually Offended," U.S. Office of Juvenile Justice and Delinquency Prevention, March 2001. 8. Shaw, J., Practice Parameters for the Assessment and Treatment
of Children and Adolescents Who Are Sexually Abusive of Others, Journal
of
the American Academy of Child and Adolescent Psychiatry, 38(12
Suppl):32S-54S, 1999. 9. Steiner, H. & Dunne, J.E., “Summary of the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Conduct Disorders,” Journal of the American Academy of Child and Adolescent Psychiatry, 36(10suppl), 1997. 10. Young, A., “Sex Therapy 'Nightmare' Or Cure?”, Arizona Republic, July 26, 1992,
Final edition, p. A1. 11. Zimring, F.E., An American Travesty: Legal Responses to Adolescent Sexual Offending, Chicago: University of Chicago Press, 2004.
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HUMILIATION AS THERAPY The methods
described on this page are used in a one-size-fits-all approach on all
children or adolescents
labeled as having sexual behavior problems, regardless of whether their
acts were consensual experimentation, consensual romantic
relationships, or actually coercive behavior. These methods are
also used for non-contact behavior such as peeping, indecent exposure,
making sexual advances, or viewing pornogaphy. A popular
treatment workbook for young people 11-21 years old puts it this way: Some clients have touched younger children
in sexual ways. Other clients have acted out in other sexual ways by
exposing their private parts or by spying on other people. Some
clients have been physically violent or forceful in making another
person do sexual things. Other clients have gotten into trouble
for sexual harassment, or they are too preoccupied with sex and
pornography. Regardless of your specific problem, Pathways is for you.5 Cognitive restructuring Cognitive restructuring attempts to convince children and teenagers that their prohibited sexual behaviors, regardless of whether they were consensual or coercive, were harmful and reprehensible. The approach is based on the assumption that all such behaviors are aggressive and result from distorted beliefs and thoughts called "cognitive distortions." The child's failure to believe that his behavior was coercive and harmful is considered a cognitive distortion. The American Academy of Child and Adolescent Psychiatry describes cognitive restructuring this way: This is an attempt to correct the cognitive distortions and the irrational beliefs that support the sexual offending behavior and to replace them with reality-focused and culturally acceptable beliefs.8 While identifying and eliminating cognitive distortions are part of mainstream cognitive-behavioral therapy, the term "cognitive distortion" has a very different meaning here. In mainstream therapy, it refers to misinterpretations of events or other people's actions as signs of one's own inadequacies, which lead to depression and poor self-esteem. However, juvenile sex offender therapists use the term to refer to what they believe are fundamental defects or abnormalities in the minds of these children that are criminal in nature.5 These include the presumed chronic tendency to deny, rationalize, and minimize the perversity and destructiveness of their feelings, thoughts, and actions.2, 4, 5, 6, 8 In effect, identifying and correcting cognitive distortions in mainstream therapy is a humane act that leads to a healthy self-concept, while the process in juvenile sex offender therapy is exactly the opposite. (For more information about sex offender treatment providers' misunderstanding of cognitive distortions and criminal thinking patterns, see these letters from a reader who experienced treatment and researched the topic.) Thus, peer group sessions and workbook assignments require participants to provide detailed descriptions of the sex acts they engaged in, to acknowledge how devastating they were, and to accept blame for all harm that occurred to all people involved. The children and adolescents are also often required to describe the devious methods of "grooming" they used to manipulate their victims into complying with their request for sexual activity. Because of the assumption that all children with sexual behavior problems lie, treatment providers also expect them to reveal that they have committed other sex crimes previously unreported. These disclosures are required repeatedly throughout the treatment process, in an atmosphere of shaming and castigation. Failures to disclose more crimes to the satisfaction of the therapist or peers lead to accusations of denial or minimization.2, 5, 6, 8 “Between my two sons...there
was no penetration, no force, no threats...My youngest son confessed in
tears that he'd enjoyed it...Our son tells the same
story over and over again...nothing has changed, nothing new has come
forth. For this reason he is perceived as being more recalcitrant than
the other boys, 'frozen' in his denial...all are tarred with the same
brush. All are child molesters in the world's eyes now, and it's an
unforgivable sin.” 2
Group sessions and workbook assignments also require all participants to admit that they engage in criminal thinking patterns, and to identify those patterns in their lives. They must also repeatedly describe their on-going sexual feelings and fantasies (and sometimes masturbatory habits) in detail, and admit they are dangerous. If they fail to do so, again, therapists and group members confront them--sometimes very aggressively--for suffering from cognitive distortions.2, 4, 5, 6, 8 These kinds of adversarial methods are never recommended in treatment programs for children and adolescents who commit violent non-sexual acts (i.e., those with conduct disorder, who commit such acts as aggravated assault, use of weapons, cruelty to people or animals, robbery, or arson).9 The field of psychology provides no scientific evidence of their therapeutic benefits. Their only purpose seems to be for self-castigation and humiliation. Cognitive restructuring is used by approximately 84% of programs for juvenile sex offenders and 68% of programs for younger children with sexual behavior problems.3 Victim Clarification Another approach that is not
part of treatment for those who victimize others non-sexually,9
but is used for juveniles with
sexual behavior problems, is that of helping them understand the damage
they have done to their victims. This might seem to be an
appropriate method for youth who have committed an aggressive
offense--sexual or non-sexual--but again, it is used only for sexual
misbehavior, and it is used for sexual misbehavior which is consensual,
where there is no
victim.2, 7 Only “40 percent of the juveniles from a
sample of 91 displayed expressive aggression in their sex
offense(s)...Becker and her colleagues noted that the juveniles in
their sample included adolescents who engaged in consensual sexual
behavior with a peer-aged relative...most interventions designed to
address sibling sexual behavior assume a victim-perpetrator model...it
is progressively less appropriate (and may be damaging) when sibling
cases involve inappropriate mutual sexual behavior or, especially,
age-appropriate sex play." 7 Victim
clarification work is often extreme, requiring the youth to
do the following:2, 5, 6
Relapse
prevention/Assault cycle Relapse prevention is based on the assumption that all
undesirable or illegal sexual behaviors constitute an addiction,
regardless of whether they are consensual or coercive. Thus, its
approach is taken from the twelve step model of Alcoholics Anonymous
(AA). Repeating prohibited sexual behavior is referred to as a
relapse, and children and teenagers are taught to recognize those
things that lead to a relapse in order to prevent such behavior in the
future. The method requires them to identify and describe their
feelings, thoughts, and actions before their sexual behavior.
These precursors are referred to as "danger signs" or part of the
"sexual assault cycle." Treatment attempts to teach young people
to intercept these dangerous sexual thoughts and feelings, to imagine
their negative consequences, and to change their behavior.5, 6, 8
This approach is used on all juveniles with sexual behavior problems in
spite of a lack of empirical evidence supporting its use: ...most
programs
have learning about the “sexual assault cycle” at their core,
but despite the fact that the sexual assault cycle has been in use in
sex offender treatment for nearly 20 years, the model has not been
empirically validated...The prevailing view is that early clinical
intervention is needed to break the cycle of sexual deviance, and that
intervention should take the form of lengthy, offense-specific,
peer-group therapy. There is not a shred of scientific evidence to
support this stance...although
the
cycle may fit many juveniles who have committed sex offenses, it
does not explain the abusive behavior of all such offenders, including
those described as "naive experimenters'"... 7 The approach also requires the child to admit that, like the alcoholic, he has a life-long condition that cannot be cured. A treatment workbook for 11-21 year-olds tells its young readers, "Completing Pathways will not 'cure' you of your problem--there is no cure--but it will teach you how to recognize and control your problem behaviors." Its final exam contains the following questions: 5. What have you learned about your sexual urges, and
how have
you learned to control your deviant sexual fantasies?
6. How do your thinking patterns contribute to your victimizing other people, either in a sexual way or a non-sexual way? 10. What is it about you (your personality) that allowed you to commit a sex offense in the first place? 13. What are the factors that might eventually lead you to having sexual behavior problems in the future?5 In the same way that the
AA member
says to the group, "I am an alcoholic," the child must take on a
permanent identity as a sex offender: We
have encountered young teenagers (13 to 15) who, as part of their
treatment, have been compelled to recite daily lay-outs or creeds
including phrases such as 'I am a pedophile and am not fit to live in
human society...I can never be trusted...everything I say is a lie...I
can never be cured'...We have listened to teenage boys hesitantly
confess that they admitted to offense histories and deviant fantasies
they did not have, simply because it was expected and required before
they would be eligible for release from residential programs. Our
impression is that these incidents cannot be dismissed as isolated
examples of overly zealous practice but are directly derived from an
uncritical application of prevailing treatment models.4 "I'm
furious about what that hospital has done," said the mother of a
12-year-old girl who spent six weeks in the program. "My daughter was
the victim of sexual abuse. They never once focused on that, but they
definitely nailed her as a child molester, as a pedophile"...Therapists
insisted that the girl was a rapist. The girl wouldn't admit that, but
her therapists persisted until one day she tried to kill herself, the
mother said. "They found her in the bathroom with a plastic bag over
her head," she said. "At the beginning of the (group-therapy) meetings,
they'd make her identify herself as a perpetrator. To this day, she's
traumatized by it, she cries about it. They kept telling her she'd do
it again and there was no way she could prevent it." 10 There are three crucial differences between AA and the
approach here, however. First, of course, the AA member is an
adult who has freely chosen to participate, while the child or
adolescent "offender"
has been forced into treatment. Secondly, the stigma of being a
sex offender is dramatically more intense than that of being an
alcoholic. Thirdly, while the alcoholic needs only avoid drinking
alcoholic beverages the rest of his life, at least some of these
children are thought to require life-long tracking, supervision,
registration, restrictions on movement and employment, and community
notification of their presence.1, 5, 11 Relapse prevention is used by 89% of juvenile offender programs and 77% of programs for younger children.3 Conclusion None of the harsh
adversarial approaches described here are used on even the most violent
conduct-disordered child or adolescent (or adult non-sexual offender,
for that matter). In fact, these methods are not based on any
empirical evidence in either psychology or criminology: The
field has evolved conventional wisdoms that, like all conventional
wisdoms, became accepted as fact when repeated and reinforced often
enough. In some cases, they may shade into dogma. These might include
beliefs, for example, that sex offender-specific treatment is the only
acceptable and effective approach...that denial must be broken; that
hard, in-your-face confrontation is synonymous with good
therapy;...that deviant arousal, deviant fantasies, grooming, and
deceit are intrinsic features;...that the behaviors always involve an
offense cycle or pattern...that they have a compulsive incurable,
life-long disorder; and that these youngsters are such dangerous
predatory criminals that neighborhoods must be notified of their
presence. Despite their wide acceptance, it is our opinion that clear,
empirical scientific support for each and every one of these
conventional wisdoms is either minimal or nonexistent.4 These methods present the
child or adolescent with a picture of
himself as a permanently defective and dangerous person with criminal
thinking patterns, deviant sexual feelings, and a history of committing
heinous acts worse than physical assault or cruelty--in short a
subhuman unworthy of the supportive therapies and ethical protections
given to other troubled children. He shows no signs of a
compulsion, or being predatory, no signs of anything except a
deep-seated shame and remorse, and the desire to suppress his own
blossoming sexual nature...I've learned another rule. I should give my
son all my anger. I should direct this undying rage at him—rage for the
fear, the guilt, the lost privacy, the exposure and grief. It is his
fault, and I must not forgive...I am to give all this to a boy, who is
not allowed to have any goodness in him anymore.” 2
--Anonymous, published in Salon magazine No
wonder, then, that some treatment providers consider it acceptable to
make crude attempts at changing these young people's sexual feelings
and fantasies through
methods similar to those used 50 years ago to "cure" homosexuality. Continue
to
Arousal
Reconditioning
Examine Sample Treatment
Materials |
When experts are wrong Casualties of war Diagnosis Lack of knowledge Confused definitions Criminalization Invalid instruments Treatment Humiliation as therapy Arousal reconditioning Dangerous drugs Sriking comparisons Sample materials Convos with providers Ethical violations Deja vu |