Sexually Abusive Youth

1. Sexually Abusive Youth Emili Rambus, Psy.D. Associates in Psychological Services Jackson Tay Bosley, Psy.D. NJ Association for the Treatment of Sexual Abusers

2. What we know about sexually aggressive youth • Overrepresented in population • 30-80% report victimization • 30-60% educationally classified • More amenable to treatment • Easier to treat (!!??) • Most desist behavior with age and treatment • Small number maintain hurtful behaviors into adulthood

3. Who are they? What is the best way to deal with the issue? Quick answers: 1. Heterogeniety 2. Treatment backed by legal mandate

4. Heterogeniety • Wide variety of behaviors that bring these youth to our attention • Wide variety of concomitant problems that these youth have • Wide variation in responses to intervention

5. Wide variety of behavior(s) • 9 y/o babysitter • 13 y/o sexual harasser • 15 y/o babysitter/fondler • 16 y/o babysitter/OS 3 victims • 17 y/o consensual sex with 13 y/o • 17 y/o forced sex with peers • 18 y/o many young victims

6. Wide variety of problems • No other issues • DD and aggressiveness • Long & extensive criminal hx • Substance abuse • “Unmanageable” in community • No parental support • All of above (except first)

7. Variety of responses to disclosure/intervention • Denial of event(s) • Guardedness • Refusal to talk • Legalistic responses • Admission with explanation • Admission without explanation • Remorse and guilt for offensive behavior

8. What they have in common • Broke the law & got caught (2C-14.) • Aggravated Sexual Assault • Sexual Assault • Aggravated Criminal Sexual Contact • Criminal Sexual Contact • Other crimes (designated by court) • Consequences (Megan’s Law)

9. Age of consent in NJ • In NJ: 16 is the general age of consent, but… • 13, 14 and 15 year olds can consent to be sexual with someone up to 4 years older than themselves (to the date).

10. Assessment • A comprehensive assessment is required to establish treatment needs • Beyond general assessment of individual functioning, extensive information re: all charged offenses is needed. “Discovery Material”

11. Issues in assessment • Needs assessment • To determine treatment needs • To establish treatment amenability • Risk assessment • Likelihood of sexual recidivism • Likelihood of criminal recidivism • Dispositional planning

12. Needs Assessment • Specifics of the inappropriate sexual behavior • Do not use client report exclusively • Collateral data essential • Concomitant problems • Criminality • Family issues • DD, substance abuse, others

13. Risk Assessment • Risk • These are the internal characteristics/issues that speak to the predisposition to commit sexual offenses • Risk Management • These are the external factors that mitigate this risk • Good parental role models • Adequate supervision

14. Risk Assessment (cont.) • Unstructured clinical assessments are not accurate • Empirically guided clinical assessments are more accurate • Best Practice is to use structured assessment tools

15. Structured Assessment Tools • Sexually offensive behavior • Juvenile Sex Offender Assessment Protocol-Second Edition (J SOAP-II) • Estimate of Risk of Adolescent Sexual Offender Recidivism (ERASOR) • Aggressive/antisocial behavior • Structured Assessment of Violence Risk in Youth (SAVRY)

16. Other Tools • Registrant Risk Assessment Scale • Juvenile Risk Assessment Scale • Juvenile Sexual Offense Recidivism Assessment Tool (J-SORRAT-II) • Juvenile Risk Assessment Tool (J-RAT)

17. Risk factors for juveniles(Clinical) • Multiple offenses • Offending while on supervision • Offending in a public place • Deviant sexual interests • Antisocial orientation/peers • Impulsivity • Clinical presentation • Langstrom, et. al. (2000), Prescott (2001)

18. Risk factors for juveniles(Actuarial) • Psychopathy/antisociality • Deviant sexual drive • Intellectual deficits • Functional deficits • Substance Abuse • Personal history of victimization • Negative treatment outcome • Epperson, et.al. (2004)

19. Offense-specific treatment • Legally mandated • Tailored to the individual • Cognitive-behavioral focus • Offense-focused • Denial-common, major treatment issue • Self-awareness • Skill building, arousal, empathy

20. Offense-specific treatment(cont.) • Structured group therapy • Time-limited modules • Address commonly noted issues • Individual treatment • Family therapy • Enhance supervision • Establish positive role models

21. Offense-specific treatment(cont.) • Tools • Safety plan • Sexual assault cycle • Skills acquisition • Philosophy • Relapse prevention • Accountability • Necessity of good supervision

22. Recidivism rates (Juveniles) • Sexual recidivism rates for juveniles are generally low, but vary considerably • 1.7% to 19.6% • Varies with definition and follow-up time • Non-sexual recidivism rates for juveniles are much higher, but vary considerably • 17.1% to 90% • Sampling bias

23. Treatment effects on recidivism • One methodologically sound study • N=148, 6 year follow-up • 72% reduction in recidivism (sexual) • 41% reduction in recidivism (non-sexual, violent) • 59% reduction in recidivism (non-sexual, non-violent) • Treated rate 5%, untreated 18% • Worling and Curwen (1999)

24. Recidivism rates (Adults) • Sexual recidivism rates for treated adult sexual offenders % • Incest very low 4 • Pedophiles (F victim) low to mod 15.6 • Pedophiles (M victim) mod to high 19.7 • Rapists mod to high 20.1 • Exhibitionists high 23.4 Alexander, M (1999) SO treatment efficacy revisited. SA-JRT, 11.2

25. Etiology • Multiple individual explanations: • Proximal causes (triggers) • Distal causes (underlying contributors) • Empirically: • Deviant sexual arousal • Antisociality

26. What we know about sexually abusive juveniles • Context is important • Family effects (violence, deviance) • Peers (criminality, gangs) • Note co-morbid disorders • Substance abuse • ADHD • Conduct/Oppositional Defiant Disorder • Developmental/cognitive limitations • Mood disorders/PTSD

27. Megan’s Law • NJ Statutes do not make a distinction between adults and juveniles adjudicated for sexual crimes. All fall under the mandates of Megan’s Law.

28. Megan’s Law • Registration and community notification provisions are implemented the same for adults and juveniles, with a few exceptions.

29. Megan’s Law • All offenders are assessed for the risk they pose to the community through the use of the Registrant Risk Assessment Scale (for adults) and the soon-to-be-implemented Juvenile Risk Assessment Scale (for juveniles).

30. Megan’s Law • Tier One offenders register only (with the police department) • Tier Two offenders register and local organizations are notified • Tier Three offenders register and are subject to door-to-door notification

31. What works: • Accountability • Invitation to responsibility • Corroboration/collaboration • With parents • With probation/parole officers • Respectful interactions • Empathic understanding and rapport

32. What doesn’t work • Non-offense specific “counseling” • Abusive confrontation • Strict adherence to a “one-size-fits- all model” • Neglecting contextual (family and peers) issues

33. Impact of work on treatment providers • Comfort level with sexuality • Supervision, supervision, supervision • Parallels impact of sexual abuse • Power and control, anger • Hypersensitivity to issues • Toxicity • Vulnerability/helplessness • Self-care vs. burnout

34. Contact Information • Emili Rambus, Psy.D. (908) 526-1177 x48 • taybosley@aol.com • www.atsa.com Assn. for the Treatment of Sexual Abusers • www.njatsa.org NJ Chapter of ATSA • www.csom.org Center for Sex Offender Management • www.njsp.org NJ State Police (registry) • www.stopitnow.org • www.safersociety.org • www.ageofconsent.com