Effective Policies and Practices Adopted by the ATSA Executive Board of Directors on October 30, Introduction Sexually abusive behavior by adolescent youth is a serious problem, accounting for more than one-third of all sexual offenses against minors1 and causing serious harm or even devastating consequences. As such, these youth merit careful professional attention and, at times, legal intervention. The public, its representatives, legal professionals, and clinical practitioners have a common goal of community safety and no more victims. Effective public policies and practices, informed by the most accurate facts, are essential to successfully address this problem.
Last week I wrote about clinician prejudice toward sexual offenders. As part of that writing I introduced the four main categories of sexual offenders: Violent offenders Regressed child offenders Sexually addicted offenders I also mentioned the some of the most damaging misconceptions that most people, including many psychotherapy professionals, have about sex offenders.
All sex offenders are treatable. No sex offenders are treatable. All sex offenders are sociopaths None of these beliefs is correct. The reality is that most but not all sex offenders can benefit from proper treatment. In fact, the recidivism rate is actually quite low, provided the offender is paired with the most effective form of treatment.
These individuals do not engage in their offending behaviors because of some childhood trauma, attachment deficit disorder, or similar issue.
In most cases they are either inherently sociopathic or hardwired in their sexual attraction to children. Only the most motivated—those with the least psychopathy who are also willing to also take hormonal anti-androgen drugs which drastically reduce their sex drive —have much chance of success.
Dedicated hebephiles are more likely than dedicated pedophiles or violent offenders to respond in positive ways to treatment, but even they are not great candidates.
Generally speaking, contraindications to sex offender treatment are: This is especially true if the underlying causes of their problematic behaviors are similar to the presenting issues of alcoholics and addicts—depression, severe anxiety, low self-esteem, attachment deficit disorders, unresolved childhood or severe adult emotional trauma, etc.
The vast majority of these methodologies have proven to be either ineffective or only partially effective.
Chemotherapy Various anti-androgenic hormones, most notably Depo-Provera, have a moderating effect on sexual aggressiveness. These hormones have been used as a way to enhance self-regulation of sexual behavior.
Depo-Provera shows promise in the treatment of sexual offenders as a chemical control of antisocial sexual acting out. However, the method is only partially effective, as human sex-drive lives primarily in the mind, not the body.
Thus, offenders often still want to engage in their antisocial behavior, even if they are unable to become physically aroused and carry it out. This methodology has proven to be only minimally effective, and the efficacy diminishes over time.
In other words, the further away the offender is from the aversive experience, the less effect the treatment will have.
This method appeals to many if not most sex offenders because typically, when entering treatment, they are looking to blame their behavior on anyone but themselves. It has little to no clinical use with this population beyond the building of rapport.
Modalities That Do Work As mentioned earlier, the sex offenders who respond best to treatment are the individuals who present with underlying issues similar to those of alcoholics and addicts.
So perhaps it is not surprising that the most effective treatment approaches are the ones that also work well with alcoholics and addicts— cognitive behavioral therapy CBTsocial learning, group therapy, psycho-education, prescribing SSRIs to reduce sex drive and compulsivityetc.
Most therapists working with sex offenders rely heavily on CBT, looking closely at the thoughts, feelings, and circumstances that trigger an offender to act out, while at the same time identifying ways to short-circuit the process.
In other words, offenders are taught to stop problematic sexual thoughts and behaviors by thinking about something else or by engaging in some other, healthier behavior talking with a therapist or step sponsor, going to the gym, reading a book, cleaning the house, etc.
The therapist is directive and reality-based, focusing on the here and now rather than on the exploration of childhood issues that may or may not have led to the offending activity. Initial CBT for sex offenders can be divided into three major stages: Identification of the Problem: Close questioning and observation help the clinician and patient identify the specific behaviors that make up the problematic sexual pattern.
The clinician and patient work together to define, in written terms, specific sexual behaviors that are to be eliminated. Contracts may include tasks that encourage the use of alternate coping mechanisms such as journaling, check-in phone calls, and attendance at step meetings. Oftentimes the treatment of sex offenders presents demands that cannot be met solely within the confines of an individual therapeutic relationship.
Offenders typically require external reinforcement and support if they are to implement lasting behavior change.Does treatment keep sexual offenders from reoffending?
The treatments that appeared effective were cognitive-behavioural treatments for adult sexual offenders, and systemic treatments for adolescent sexual offenders.
Sixty-seven were assigned to MST, and 60 were assigned to Cook County probation department’s existing juvenile sex offender unit and required to take part in weekly sex offender treatment groups. The offenders’ mean age was years (range 11 to 18 years). Juvenile offenders receiving sexual offender treatment had sexual recidivism rates of percent, whereas those receiving no treatment had a sexual recidivism rate of percent. Conversely, when examining outcomes from four studies, Hanson and colleagues () found no significant difference between juvenile sex offenders in the treatment. Funding be available to support continued research on the etiology, assessment, prevention, effective interventions of adolescents who have engaged in sexually abusive behavior. Risk, need and responsivity principles are adhered to when working with adolescent who have engaged in sexually abusive behavior.
Cognitive-behavioural treatments identify the habits, values and social influences that contribute to offending and teach. See NIC's Sex Offenders page for a compilation of resources capturing current research and trends in the management and treatment of sex offenders.
Links from the NCJRS website to non-federal sites do not constitute an endorsement by NCJRS or its sponsors. Funding be available to support continued research on the etiology, assessment, prevention, effective interventions of adolescents who have engaged in sexually abusive behavior.
Risk, need and responsivity principles are adhered to when working with adolescent who have engaged in sexually abusive behavior. Apr 01, · The Effective Treatment of Juveniles Who Sexually Offend. and we end with suggestions for improving the current ethical climate in the treatment of juveniles who sexually offend.
Manual for structured group treatment with adolescent sex offenders. rev. ed.
Wood ‘N’ Barnes; Oklahoma City, OK: (For more information on treatment, see Chapter 5, “Effectiveness of Treatment for Juveniles Who Sexually Offend,” in the Juvenile section.) Nevertheless, this chapter reviews these studies and their findings for the purpose of informing policy and practice at the federal, state and local levels.
The good news is violent sex offenders, fixated child offenders, and others for whom treatment is contraindicated are a minority of the overall sex .