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UNDERSTANDING, ASSESSING, and REHABILITATING JUVENILE SEXUAL OFFENDERS
By PHIL RICH John Wiley & Sons, Inc.
Copyright © 2003 John Wiley & Sons, Inc.
All right reserved. ISBN: 0-471-26635-3
Chapter One
The issues of sexuality, sexual conduct, and sexual offending among adolescents and children have never been more significant. Unfortunately, these issues and concerns threaten to become more significant still, as we see and tackle increasingly serious and more pervasive developmental, emotional, and behavioral problems in our children.
We live in a society in which children of all ages in the general population are increasingly more exposed to sexuality and violence on a daily basis. Under the most benign of circumstances, exposure is through the media, with an increasingly heavy focus on violence and a near endless (and still mounting) emphasis on the importance and prevalence of sex. In virtually every form of media, children are inundated with images of and ideas about sexuality and sexual behavior. In the United States, for instance, it is virtually impossible to watch prime-time television or see a movie directed toward adolescents that is free of implicit-and with increasing frequency explicit-sexual innuendo, content, and behaviors. In many cases television shows, movies, electronic games, and music recordings with explicit sexual and violent themes or overtones are aimed directly at teenagers and often have an audience that includes children from 6 years of age and up (U.S. Federal Trade Commission, 2000). Of course, most recently added to the list, and for many children perhaps the most available and flexible form of media, is the Internet and its often direct, graphic, invasive, and sometimes shocking sexual messages and content.
Under less benign and more direct circumstances, many children are exposed to sexual behaviors through the reality of their own lives and their own experiences in their communities and, in some cases, their own families. Some of these children witness sexual practices, behaviors, and violence in their own homes and communities through the lives of their parents, siblings, and other community members. For many other children, exposure is of the most direct form as they become victims of sexual abuse and violence. Sadly, in many cases when children are the victims of sexual abuse, the sexual offenders are themselves children.
Accordingly, we live in a society that is more and more focused on social interventions and on the treatment of both the sexually abused and those who abuse. Statistics of every kind tell us that of the multitude of sexual crimes committed in the United States each year, many are committed by teenagers and younger children, ranging from exposure to molestation and rape. Most times, children are the victims of these crimes committed by other children.
We approach social and behavioral problems with juveniles through treatment, with sexual-offender-specific treatment most distinguished from other therapeutic interventions by its forensic focus. That is, sexual-offender-specific treatment crosses the line between the treatment of criminal behavior and the treatment of mental health and behavioral disorders. Work with child and adolescent sexual offenders is even more complex as it deals with developmental and cognitive issues, personality development, family and community systems, a complex interplay between developing emotions and behaviors, the line between normative sex play and experimentation and the development of sexual offending behavior, psychiatric comorbidity, social learning, and often the echoes of personal trauma in the adolescent or child offender. Here, we are working with young people, troubled and troubling in behavior, still very much in the process of exploration, development, and maturation, and still very much influenced and directed by the messages embedded in the activities, relationships, social models, and larger social environment that surround them.
Relatively few individuals working in the field are well versed in all aspects of such treatment, and practitioners skilled in one area often lack knowledge and skills in another. Mental health practitioners are often overwhelmed by or simply unaware of the complex forensic, criminal, and social issues tightly wrapped up in the treatment of juvenile sexual offenders. Conversely, those well versed in forensics and criminal behaviors are often not familiar with developmental, family, mental health, or diagnostic considerations and issues. Either way, practitioners in forensic and mental health treatment may not be familiar with the special dynamics found in children and adolescents who, after all, are not merely underdeveloped adults. In addition to blending forensic psychology and adolescent mental health and behavioral treatment, there is a need to adopt the perspective offered by social psychology, which posits that individual psychology and behavior must be understood in the context of the surrounding society.
Given both the changing face of child and adolescent sexual experiences and behaviors and the prevalence of adolescent and younger sexual offending, the reality is that sexual-offender-specific assessment and treatment are being pushed onto practitioners who are poorly trained and ill prepared for the work. Current training models are often too simplistic or unintegrated, focusing on either (a) a forensic and correctional approach assuming that the clinical treatment of juvenile sexual offenders is dealt with elsewhere (in a specialized treatment program), or (b) a mental health approach that fails to recognize or incorporate a forensic mind-set and assumes that criminal issues either are not present or have been dealt with elsewhere (presumably in a prior correctional program). Here, we risk treating forensics and mental health treatment as different disciplines rather than combining the two into a single approach. Of course, specialists trained in forensic psychology, forensic social work, or forensic counseling do exist, but they are few and far between in the world of juvenile sexual offender (JSO) treatment, where the vast majority of practitioners are neither trained nor experienced in both aspects of treatment. In fact, we have few specific training programs that marry these distinct approaches into a single specialization: the forensic and mental health treatment of juvenile sexual offenders. Instead, we use the relatively few specialists trained and experienced in general forensic treatment to consult and educate or appear in court to provide expert testimony, rather than ensuring that those who treat juvenile sexual offenders are themselves fully trained in forensic mental health.
The task, then, is to develop practitioners who understand the complexities of the juvenile sexual offender, are trained in both forensics and mental health, and understand the world and behavior of the adolescent. These clinicians will understand the development of sociopathy and social deviance, the psychology and development of personality and behavior, the assessment and treatment of behavioral and mental health, and the influence of the social world on the ideas, attitudes, beliefs, expectations, social framework, and behaviors of children and adolescents. This requires that we understand the forensic principles that frame and shape this work, the interpersonal and intrapsychic dynamics that lead to and maintain sexual offending behaviors, and the issues and processes involved in the development of personal identity and mental health, and that we know how to apply our knowledge in such a complex environment.
Despite its forensic underpinning, the work of assessing and treating juvenile sexual offenders is not isolated from the mainstream of clinical work with developing or troubled children and adolescents of every kind. Rather, it is a subset of this larger field. As such, the work requires educated and trained clinicians and program managers who understand the tasks and methods of treatment, the development of normative and psychopathological adolescent behavior, and the influence of social psychology, at all times remaining informed and often directed by the forensic perspective.
Happily, work with juvenile sexual offenders has to some degree moved away from an isolated and limited form of treatment that depended and borrowed heavily from either an adult criminological model or a substance abuse treatment model. Instead, the field is developing into a far more sophisticated and informed practice that lies within, and not separated from, a broader clinical approach in which the adolescent is understood and recognized as a whole person, and not merely a sexual offender. At the same time, our work with juvenile sexual offenders requires that the mental health approach be informed and guided by a forensic mind-set that seeks to understand offending and related behaviors as meeting criminogenic needs (factors that contribute to criminal behavior), as well as needs related to personal identity, social attachment, and emotional satisfaction. In the treatment of the juvenile sexual offender, criminality, deviant behavior, public safety, social competency, personal development, and mental health are intertwined and inseparable. In addition, mental health treatment without forensics is naive; a forensic or criminogenic approach without mental health is unrealistic and punitive; and a combined forensic and mental health approach without the application of social psychology is hopeful but poorly informed and limited, and probably bound to fail.
In our understanding and treatment of juveniles we have, over the years, alternated between a nurturing-guidance approach to a criminal justice approach and perhaps are beginning to swing back somewhere toward the middle. The risk, though, in any pendulum-like application of ideas is that we become reactive rather than proactive, because pendulum thinking is limited in its flexibility and responsiveness. What we can hope for is a new direction, unfettered by a single pivot point. It involves understanding and treating the adolescent as an adult-in-the-making with unique patterns of thinking and behavior that are not simply shadows of early adulthood; recognizing the criminogenic, antisocial, detached, and socially abhorrent and deviant needs embedded in sexually abusive behavior; and working with the emotional, cognitive, and behavioral components basic to mental health and the development of sound and resilient individuals.
This is a book for practitioners of behavioral and emotional assessment and treatment and for the designers and managers of assessment and treatment programs for juvenile sexual offenders. It is designed to provide both a broad overview of and a detailed look at treatment for juvenile sexual offenders, as well as presenting a specific set of tools for working with this group of troubled children and adolescents and a framework in which to practice.
The book explores basic ideas that will help readers develop an understanding of the problems, behaviors, and factors that contribute to sexual offending among adolescents and children and provides detailed ideas and methods for assessing juvenile sexual offenders and their risk for future re-offending. It also describes methods for treating juvenile offenders, going beyond the cognitive-behavioral approaches prevalent in the treatment of sexual offenders and marrying psychoeducational, cognitive-behavioral, and psychodynamic treatments into a larger model that in turn incorporates individual, group, and family treatment into an approach that treats the whole child.
However, I do not intend this book to be simply another version of how to assess and treat juvenile sexual offenders; there are already many well-written and developed books that address these ideas, many of which are listed as references. Instead, this book looks at the same issues, concepts, and models through critical eyes and presents a clear and direct pathway to assessment and treatment in a manner that will help practitioners to become familiar with or critique the ideas of the field and perhaps go beyond them to find or create ideas of their own design that meet their own clinical orientations and experiences.
This book addresses complex issues and ideas in straightforward terms, without falling short of the high ideals, integrity, and sophistication required to be instructive, knowledgeable, contemplative, and critical enough to induce original thinking in the minds of every practitioner. This book simplifies but is not simplistic, instead urging the reader toward discerning thinking. In addition, this book is both theoretically and empirically driven, with many references to historical and current research and publications, but is neither built upon nor driven by research. It describes many standard ideas, models, and methods but supports neither the status quo or de facto conclusions nor the practice of adopting existing ideas simply because they are in use everywhere else. If anything, this book actively cautions against adopting and using such models merely because they are standard treatment fare. Models and ideas should be developed and used because they work and because we can see they work, not because they are the standards in the field. This requires the application of critical thinking in every practitioner. This is a book for practice, then, and the development of the knowledge base and informed thinking that are required for effective practice.
For the individual sexual offender, the treatment questions are what happened, how, why, and what we can do to ensure that it does not happen again. However, the larger and more looming questions ask why so many children sexually abuse other children and how this situation comes about. What social forces have led to the development of so many adolescents and children who engage in sexually abusive behavior or behavior that is sexually inappropriate or, at least, sexually precocious? Although this book cannot possibly answer such complex issues, we can approach these questions, asserting the importance of developing informed practitioners who consider and struggle with such questions and think originally while engaging in the practice of assessment and treatment. Having strong and well-informed opinions can shape both our practice at the level of the individual juvenile and the way we think about juvenile sexual offenders and execute our practice at the broadest level. Accordingly, this book asserts the importance of both knowledge and original thinking in the practitioner and addresses the need for critical thinking in everything we do as treaters of juvenile sexual offenders.
Continues...
Excerpted from UNDERSTANDING, ASSESSING, and REHABILITATING JUVENILE SEXUAL OFFENDERS by PHIL RICH Copyright © 2003 by John Wiley & Sons, Inc.. Excerpted by permission.
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