The Effective Management of Juvenile Sex Offenders in the Community

1. The Effective Management of Juvenile Sex Offenders in the Community Section 4: Treatment

2. Key Topics for the Treatment Section Part I: Program Availability and Settings Part II: Rehabilitative Trends Part III: Goals, Frameworks, and Modalities Part IV: Common Treatment Targets Part V: Challenges and Controversies Part VI: Treatment Outcomes Section 4

3. Availability of Juvenile Sex Offender Treatment Programs Nationwide (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

4. Program Settings for Juveniles: Community vs. Residential (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

5. Continuum of Treatment Settings Range of treatment needs Psychosexual disturbance Environmental instability Risk for recidivism Community-Based Treatment Residential or Institutional Treatment Section 4

6. Benefits of Community-Based Treatment • Intervene in natural environment • Support productive involvement • Family • Peers • School/employment • Generally cost-effective Section 4

7. Benefits of Residential Treatment • Increased structure and security • Victim and community safety • Immersion in treatment Section 4

8. “Getting Tough” on Juvenile Crime • Lowered minimum age for waiver • Eliminated many confidentiality restrictions • Harsher punishments and mandatory sentences • Reduced judicial discretion (see, e.g., Fagan, Kupchick, & Liberman, 2003; Fagan & Zimring, 2000; Torbet & Szymanski, 1998) Section 4

9. Impact of Adult Dispositions on Youthful Offenders • Recidivism increases • More serious types of recidivism • Reduced access to rehabilitative services • Increased victimization and suicide rates within institutions • Lowered self-expectancies about remaining crime free (see, e.g., Fagan & Zimring, 2000; Mendel, 2000; Redding, 2003) Section 4

10. Examples of Evidence-Based Interventions • Wraparound Services • Functional Family Therapy • Multisystemic Therapy Section 4

11. Common Treatment Goals • Accept responsibility for behaviors • Identify contributing factors • Explore, utilize effective coping strategies • Develop prosocial skills and competencies • Establish positive peer relationships • Promote healthy family functioning Section 4

12. These Youth Aren’t “Specialists” • 55% had a prior non-sex offense • 61% were convicted of non-sex offenses as adults • Only 5% convicted of sex offenses as adults • Of sexual recidivists, 72% were also convicted for non-sex offenses as adults. (Nisbet, Wilson, & Smallbone, 2004) Section 4

13. Most Common Theoretical Frameworks Reported Nationwide (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

14. Multiple Modes are Important • Group time constraints • Sensitive issues and dynamics • Responsivity factors • Deviancy training concerns Section 4

15. Use of Various Modalities Nationwide (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

16. Common Treatment Targets Responsibility-taking Cognitive distortions or thinking errors Victim empathy Intrapersonal and interpersonal skills Sex education Relationship skills Healthy masculinity Arousal control Trauma resolution Family functioning Section 4

17. Treatment Targets in Programs Nationwide (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

18. Process-Related and Contextual Variables • Therapist characteristics • Treatment climate • “Approach” goals (Fernandez, 2006; Marshall, 2005; Mann et al., 2004; Thakker et al., 2006) Section 4

19. Juvenile Sex Offender Programs for Females (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

20. Treatment Targets for Females vs. Males in Programs Nationwide (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

21. Future Directions for Juvenile Female Sex Offender Treatment • Identify unique risk and protective factors • Clinical characteristics, modus operandi • Gender-responsive programs • Treatment outcome research Section 4

22. Treatment Programs for Children with Sexual Behavior Problems (Adapted from McGrath, Cumming, & Burchard, 2003) Section 4

23. Psychiatric Disorders and Juvenile Sex Offenders • Common presence necessitates screening • Can interfere with treatment engagement and response • Pharmacological interventions may be warranted Section 4

24. Potential Pharmacological Interventions and Cautions • SSRIs may be beneficial for co-occurring disorders • Side effects may include reduced preoccupations and sex drive • FDA Warning • Antiandrogens not recommended as first-line intervention for youth Section 4

25. Juvenile Programs Using the Polygraph Nationwide (McGrath, Cumming, & Burchard, 2003) Section 4

26. Recidivism Trends for Treated Youth Released from Facilities (Waite et al., 2005) Section 4

27. Treated vs. Non-Treated Youth in a Community-Based Program (Worling & Curwen, 2000) Section 4

28. MST vs. Alternative Treatment (see Borduin & Schaeffer, 2002) Section 4

29. Summary of Key Points • New and evolving field • Consider “what works” • Holistic, integrated, and comprehensive • Challenges and controversies exist • Treatment has promise Section 4