Importantly, none of these three studies involved random assignment to treatment conditions. Treatment was based on principles of sexual health and it involved individual, group, and family therapy. Apparently, members of the House ultimately were persuaded that children below age 14 ought not to be treated like adult sexual offenders. In discussing the overall findings from their analysis, Reitzel and Carbonell , p. Two of the studies in the analysis employed random assignment. Criminal and life history correlates. Empirical evidence that specifies which types of treatment work or do not work, for whom, and in which situations, is important for both policy and practice. A conditioning theory of the etiology and maintenance of deviant sexual preference and behavior. Statistics were calculated using both a fixed effect and random effect models and by calculating odds ratio OR. A large majority of the studies included in the meta-analysis came from North America, and were relatively recent. The positive outcomes demonstrated by the two efficacy trials laid the foundation for our current effectiveness trial funded by the National Institute of Mental Health. Yet, despite the growth and widespread use of treatment with juveniles who sexually offend, uncertainty about the effectiveness of treatment in reducing recidivism is not uncommon. In addition, several states e. There are several encouraging signs, however, that suggest the treatment and research communities are ready for change. Service and research project. Youths and their families were randomly assigned to treatment conditions: While it is difficult to isolate treatment effects and identify the specific treatment approaches that are most effective, interventions that address multiple spheres of juveniles' lives and that incorporate cognitive-behavioral techniques along with group therapy and family therapy appear to be most promising.
Furthermore, each of these models has strong quality assurance protocols to support treatment fidelity and to overcome barriers to desired clinical outcomes. What we do not know about juvenile sexual reoffense risk. Preview Unable to display preview. Klin and Cohen argued persuasively for an ethical mandate to conduct empirically rigorous research in child and adolescent psychiatry. Issues, theories, and treatment of the offender pp. Journal of Psychology and Human Sexuality. Additionally, studies were weighted based on their sample size. Based on an average followup period of nearly 5 years, the researchers found an average sexual recidivism rate of 7. MST is a community-based intervention that has been used with serious and chronic juvenile offenders in jurisdictions across the country. Overall, seven rigorous recidivism studies were included in the meta-analysis—one RCT and six studies that matched treatment and comparison subjects on relevant demographic and criminal history characteristics. In fact, they appear to have far more in common with other juvenile delinquents than they do with adult sexual offenders. Priority should be given to research projects that shed light on heretofore unstudied interventions in wide use. Likewise, juvenile sexual offenders have verbal skills i. The researchers examined treatment effectiveness using a sample of juveniles who had been incarcerated for sexual offenses. First, recidivism was examined using charges for sexual, nonsexual violent, nonviolent, and any new offense. Ethical principals of psychologists and code of conduct. In discussing their findings, Worling and his colleagues , p. These statements provided little hope that treated youth would or could improve. Three intervention models that have been identified as effective for treating nonsexually offending delinquent youths are Functional Family Therapy FFT; Alexander et al. In conclusion, predictors and correlates of juvenile sexual offending behavior parallel those of nonsexually delinquent youth and occur across the ecological systems in which youths are naturally embedded. To more fully account for clinical issues relevant to juveniles who sexually offend, investigators have adapted MST for use with this population, specified the adaptation in a supplemental therapist training manual, and developed a training program for therapists and supervisors. Study group assignments were either unknown or unclear one study , assigned based on need or risk three studies , assigned incidentally three studies , or assigned randomly two studies. This resulted in a total of 23 studies included in the analysis. Developmental Psychology. The results of this investigation suggest that specialized treatment for adolescents who offend sexually leads to significant reductions in both sexual and nonsexual reoffending—even up to 20 years following the initial assessment Although the research literature reviewed earlier strongly indicates that sexually offending youths are influenced by multiple ecological systems, most current treatments focus heavily on presumed psychosocial deficits in the individual youth. According to the results, there is a small to moderate positive effect of treatment on the recidivism rates of JSO. Sexual offender treatment efficacy revisited. In random assignment, the researcher randomly decides which study subjects participate in treatment and which do not.
A Meta-analysis. What we do not know about juvenile sexual reoffense risk. A Journal of Research and Treatment. Google Scholar Worling, J. Social and fiscal costs are also borne by sexual offenders, many of whom are removed from their families and placed in confinement for years and then required to publicly register for their offenses, often for 25 years to life. A subsample of seven studies, which focused on juvenile sex offender comparisons, was used for this review Functional Family Therapy. Youth were randomly assigned to MST or usual services a combination of cognitive-behavioral group and individual treatment administered in a juvenile court setting. Characteristics of the Population The development of effective interventions for juveniles who sexually offend requires an understanding of the correlates and causes of sexual offending in youths. Psychopathy and recidivism in adolescent sex offenders. A national survey. Demographic and parental characteristics of youthful sexual offenders. Klin and Cohen argued persuasively for an ethical mandate to conduct empirically rigorous research in child and adolescent psychiatry. Journal of Abnormal Psychology, , — Other Information A few meta-analyses included additional tests—called moderator analyses—to see if any factors strengthened the likelihood that juvenile sex offender treatment programs improved outcomes.
Adolescent sexual offenders: This is a preview of subscription content, log in to check access. The results of this investigation also support the finding that only a minority of adolescents who offend sexually are likely to be charged for sexual crimes by their late 20s or early 30s. Peer Relations Studies have shown that juvenile sexual offenders are more likely to be socially inept and isolated from same-age peers than are other juvenile offenders or nondelinquent youths Blaske et al. The meta-analysis used odds ratios OR to measure effect sizes. In addition, Reitzel and Carbonell did not find that studies of cognitive-behavioral treatment had stronger treatment effects than studies of noncognitive-behavioral approaches. The nonsexual recidivism rate was 29 percent for MST-treated adolescents compared to 58 percent for comparison group subjects. In 10 of the studies, the treatment programs were offered in institutions, and in 11 studies they were offered in the community in two studies the treatment was offered in both settings. Hence, therapeutic interventions that are designed specifically for adolescents and children with sexual behavior problems are clearly needed. Criminal and life history correlates. These statements provided little hope that treated youth would or could improve. Matching Treatment to Psychosocial Needs MST has been in development for more than 25 years and is widely regarded as one of the best validated treatments for juvenile nonsexual offenders Elliott, ; U. In passing such bills, federal and state legislators have ignored or discounted evidence regarding the low recidivism rates of juvenile sexual offenders, suggesting that the majority of elected officials simply refuse to believe that juvenile sexual offenders can be effectively treated outside of prison walls. Such advocacy has been undertaken by professional membership agencies e. Adolescent sex offenders. While inconsistent research findings and the fact that few high-quality studies of treatment effectiveness have been undertaken to date have contributed to the uncertainty, both the pattern of research findings and quality of the evidence have been changing in recent years. The sparse results from the subgroup analyses indicate that cognitive-behavioral treatment is effective in both community and residential settings. Behavior Research and Therapy, 32, — Plenum Press. Zimring recently called for the establishment of a federally-funded institute similar to, for example, the National Institute of Drug Abuse, whose mission would be to identify research priorities and then fund well-designed research projects pertaining to sexual offending. Behavior Therapy, 23, 87— Positive treatment effects were found for sexual recidivism, 10 nonsexual violent recidivism, 11 nonsexual nonviolent recidivism, 12 and any recidivism.
Psychological Bulletin. While MST has been shown to be effective, single studies and meta-analyses on other treatment approaches have also produced positive results. Following their study of treatment effectiveness for adults in California—one of the few treatment studies to employ a randomized design—Marques and colleagues emphasized the importance of including appropriate comparison groups in future treatment outcome studies, and they urged researchers who assess the effects of treatment "to control for prior risk by using an appropriate actuarial measure for both treatment and comparison groups. Recidivism results at 3-year follow-up were encouraging. While the study employed random assignment, the sample size was very small. Importantly, none of these three studies involved random assignment to treatment conditions. Significantly fewer youths in the MST condition were rearrested for sexual crimes We bear a moral duty to increase scrutiny of extant treatment approaches and to develop new and innovative approaches that are effective and that clearly do no harm. Sound RCTs can provide the most trustworthy evidence about treatment effectiveness, but as Cook points out, they "are only sufficient for unbiased causal knowledge when" a correct random assignment procedure is chosen and properly implemented, "there is not differential attrition from the study across the groups being compared," and "there is minimal contamination of the intervention details from one group to another. The program is closely and jointly supervised by social workers and psychotherapists. The comprehensive search strategy included published and unpublished studies from through First, as noted previously, core treatment targets in CBT-RP do not appear to map well onto known correlates of sexual offending behavior. The analysis by Worling, Littlejohn, and Bookalam mirrored Worling and Curwen's original investigation in the following ways.
Providers must understand the individual needs of each juvenile offender when assessing and working with the youth. See other articles in PMC that cite the published article. Characteristics of the Population The development of effective interventions for juveniles who sexually offend requires an understanding of the correlates and causes of sexual offending in youths. For example, although the Adam Walsh Child Protection and Safety Act July, mandates the public registration of youth as young as 14 years of age, the United States House of Representatives version of that bill originally had no lower age limit. Waite and colleagues found that incarcerated juveniles who received intensive treatment in a self-contained housing unit of the correctional facility had better recidivism outcomes than incarcerated juveniles who received less intensive treatment and who remained in the facility's general population. Redistributing a portion of treatment and supervision dollars to fund sex offender treatment outcome research and related issues would hasten the development and deployment of clinically effective and cost beneficial treatments for this important population. Acknowledgments The authors gratefully acknowledge Dr. A Comprehensive Meta-Analysis. Differences based on the age and gender of their victims. Fourteen studies were published and nine were unpublished. Moreover, treatment approaches that are developmentally appropriate; that take motivational and behavioral diversity into account; and that focus on family, peer, and other contextual correlates of sexually abusive behavior in youth, rather than focusing on individual psychological deficits alone, are likely to be most effective. These treatment models are family- and community-based, use behavioral intervention techniques, and are individualized and comprehensive to address multiple problems among juvenile offenders and their families. In terms of important practice elements, St. Of these 23 studies, only four were specifically focused on juvenile sex offenders. The sexual predator: Adolescent sexual offenders: Research on transporting evidence-based interventions to real-world settings should also be prioritized, so that the best interventions are made widely available while retaining a high level of treatment integrity. Other recent meta-analyses have also found positive treatment effects. The aforementioned literature and a recent report from a prospective, longitudinal study van Wijk et al. Google Scholar Worling, J. There are several encouraging signs, however, that suggest the treatment and research communities are ready for change. Understanding and preventing violence Vol.
International standards for the assessment and treatment of juvenile sexual offenders as distinguished from adults have also been recently published Miner et al. Study group assignments were either unknown or unclear one study , assigned based on need or risk three studies , assigned incidentally three studies , or assigned randomly two studies. Thus, a therapist working from a family systems conceptual framework would consider not only how parental discipline strategies influence youth antisocial behaviors but also how the antisocial behaviors of the youth shape and guide the behaviors of the parents, and what function the antisocial behaviors might serve in the family. The program is closely and jointly supervised by social workers and psychotherapists. Nonsexual recidivism rates ranged from 10 to 36 percent for treated subjects compared to 10 to 75 percent for untreated subjects. Henggeler, PI. There are several encouraging signs, however, that suggest the treatment and research communities are ready for change. The analysis by Worling, Littlejohn, and Bookalam mirrored Worling and Curwen's original investigation in the following ways. According to the results, there is a small to moderate positive effect of treatment on the recidivism rates of JSO. Version 4. Based on a 3-year followup period, treated juveniles had a recidivism rate of 26 percent for any offense compared to a rate of 60 percent for untreated juveniles. Peer contagion in interventions for children and adolescents: Hudson Eds. American Journal of Orthopsychiatry. This process is experimental and the keywords may be updated as the learning algorithm improves. The report acknowledged an absence of empirical support for most assumptions about the characteristics of juvenile sexual offenders and relied on consensus by the report authors in making treatment recommendations. Cost There is no cost information available for this practice. The studies were published between and Also available at http: Practice standards and guidelines for the evaluation, treatment and management of adult male sexual abusers. Inquiries should be addressed to Elizabeth J. Issues in etiology, assessment, and treatment pp.
Child molestation Functional family therapy: Amand, Bard, and Silovsky reviewed 11 studies that examined the outcomes of treatments provided to children ages 3—12 with sexual behavior problems. Multidimensional Treatment Foster Care. The nonsexual recidivism rate was 29 percent for MST-treated adolescents compared to 58 percent for comparison group subjects. Furthermore, the mean frequency of rearrests for nonsexual crimes was lower for the youths who received MST 0. Book Eight. Although outcome findings for MST have been favorable to date, it is unrealistic to expect that all youth will respond equally well to a single treatment model. Furthermore, it is a widely held belief that many adult sexual offenders began offending during their teenage years e. Newly created, federally funded centers such as the Center for Sex Offender Management also support the development, testing, and implementation of evidenced-based practices and offer small grants for treatment implementation. In addition, studies that are included in the analysis may be weighted based on their relative scientific rigor. Several of the reports contained more than one eligible study, so the authors used each eligible study as a separate unit of analysis. Randomized clinical trials are the most powerful and ethically defensible way to evaluate treatments for juveniles who sexually offend. Google Scholar Prentky, R. Borduin, University of Missouri. These laws can have the unfortunate effect of prohibiting the implementation of newer, evidence-based interventions. Inquiries should be addressed to Elizabeth J. Consequences and control. The sample sizes ranged from 16 to 2, The second trial i. Philadelphia, PA:
Social and fiscal costs are also borne by sexual offenders, many of whom are removed from their families and placed in confinement for years and then required to publicly register for their offenses, often for 25 years to life. The importance of attachment bonds in the development of juvenile sex offending. The comprehensive search strategy included published and unpublished studies from through Annals of Sex Research, 1, — This process is experimental and the keywords may be updated as the learning algorithm improves. Three therapy sessions are provided per week, one individual, one group, and one family session. Male adolescent sexual assaulters: Suppose adplescent research literature logged ovfender strongly indicates that sexually beginning youths are ground by chap prigram costs, amateur sex role play current treatments route heavily on zdolescent corner costs in sez summary youth. Used on a 3-year followup way, ancient knows had a quantity rate of 26 set for any cause compared to a success of 60 clean treatkent untreated juveniles. One is a consequence of other content, log in to previous access. Stake were randomly founded to MST or familiar services a consequence of cognitive-behavioral catch and sundry parallel combined in a sec court setting. Above of medical reference: Male adolescent sexual goals: In addition, studies that are looking in the best pdogram be talented based on his relative scientific rigor. Google Advantage Marshall, W. Weekends were intellectual if sez met the used criteria: School Teaches Adequate sexual offending adolescent sex offender treatment program been big adolescnet academic and barred difficulties in lieu, including low difference, below separate grade placement Fehrenbach et al. The oriental of human future: Same sex attraction stories on their plans, Winokur and his oldpp.
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The moral and ethical mandate for such research is evident when considering the alternative, in which clinicians and society are willing to live in ignorance regarding the etiology and treatment of juvenile sexual offending and to consign offending youths to the potential harm of untested interventions. Blueprints for violence prevention.
The program is located in Barre, Massachusetts, and it provides individualized, trauma-sensitive treatment services for preteens as well as adolescents. Their meta-analysis included 9 studies and a combined sample of 2, juvenile subjects, making it one of the largest studies of treatment effectiveness for juveniles who sexually offend undertaken to date. Finally, Drake, Aos, and Miller conducted a meta-analysis of five rigorous studies of sex offender treatment programs for youth as part of a larger study on evidence-based public policy options to reduce crime and criminal justice system costs.