Assessment, Treatment, and Supervision of Youth who have caused sexual harm by: Tom Hall LISW Bryce Pittenger, LPCC Joe Mirabal, JPPO

Transcription

1 Assessment, Treatment, and Supervision of Youth who have caused sexual harm by: Tom Hall LISW Bryce Pittenger, LPCC Joe Mirabal, JPPO Overview of field: Old Paradigm Those especially males--who have been sexually abused are going to become offenders. Once an offender, always an offender. Offenders including children and adolescents-- do not respond positively to treatment. Only solution is to lock them up and throw away the key. Only other solution is castration. If male and acts out with same sex, must be homosexual. Old Paradigm Must come from highly dysfunctional families. There is no specific family profile. No unique family pattern has been identified The characteristics of are diverse and may or may not be considered dysfunctional. 1

2 Old Paradigm Were sexually molested as children. Many were not sexually victimized as children. Will become adult sexual offenders. Current research shows that the sexual re-offense rate for those who receive treatment is low in most US settings. Studies suggest that the rates of sexual reoffense (5 14%) are substantially lower than the rates for other delinquent behavior (8 58%). Research proves In fact, the risk of child or juvenile reoffending once they have had treatment is lower than the risk of sexual harm by children or juveniles who have not acted out. They are just as likely to become victims as they are to reoffend. In one study, seven percent of those adjudicated for sexual offenses reoffended and six percent of those not adjudicated committed sex offenses. Research proves Another study showed that 85% of all future sex offenses will be committed by children & adolescents not identified as sex offenders. Another misconception involves the concept of specialness, meaning that this population is so difficult to deal with that only those certified to work with sex offenders should do so. 2

3 Old Paradigm These youth are similar in most ways to adult sex offenders. They are different from adult sex offenders in that they have lower recidivism rates, engage in fewer abusive behaviors over shorter periods of time, and have less aggressive sexual behavior. Research proves Juveniles are also, obviously, developmentally different than adults. They are different from adult sex offenders in that they have lower recidivism rates, engage in fewer abusive behaviors over shorter periods of time, and have less aggressive sexual behavior. Brains are still developing. It is thought that the male brain is fully developed by the age of 26. Research proves The vast majority of individuals who have been abused DO NOT go on to cause sexual harm. The vast majority of youth do respond to treatment and do not go on to cause more sexual harm. Interestingly, these youth are at high risk to commit conduct-type offenses. 3

4 Current research The home is the most violent place in America. Trauma including physical, sexual, and emotional abuse, and neglect has profound immediate and long term effects upon a child s development, including attachment difficulties, self-esteem, academic problems, poor peer relationships, anger, developmental delays, and increased dependency. Current research Abuse definitely effects whether or not a person sexually offends. But to what degree, we do not know. The children who are both abused and witness abuse particularly domestic violence--generally have the biggest problems. Current research Certain research has revealed that: Witnessing domestic violence and experiencing significant physical abuse combined with neglect may put an individual at higher risk to sexually offend. Domestic violence is showing to be one of the key factors in sexual offending behavior. 4

5 Current research Empirically Supported Risk Factors Deviant sexual interest; prior criminal sanctions for sexual offending; sexual offending against more than one victim; sexual offending against a stranger; social isolation; uncompleted sex offense specific tx. Current research Promising Risk Factors Problematic parent-adolescent relationship; Attitudes supportive of sexual offending. Current research Possible Risk Factors: High stress family environment; Impulsivity; Antisocial interpersonal orientation; Interpersonal aggression; Negative peer associations; 5

6 Current research Sexual preoccupation; Sexual offending against a male victim Sexual offending against a child; Threats, violence, or weapons in sexual offense; Environment supporting reoffending. Emotion Regulation Arousal and dysregulation have to do with affect. Mood General state of how a person is feeling. Affect How that feeling is expressed. Regulated/Dysregulated behaviorally/emotionally. Co-Regulated What we do to help person become regulated. What is normal? Development sexuality Age appropriate knowledge and understanding Of sexual touch, gender roles, and biology Ecological pond: what are our kids exposed too> 6

7 Ecological Pond Onset of puberty* Socio-economic maturity** ? ??? * Female menses; ** Skills to be successful adult Neurobiology Yeah, we know about sexual development and hormones, But what s going on in the brain? Second onslaught of Rapid growth and pruning New cells and neural pathway... Period of less stability and more impulsivity Moody, unpredictable,..mistakes are made! Reconstruction designed to accomplish what it is being used for (for better or worse)... Evaluating behavior Is it a Problem? If so..... What Kind of Problem? 7

8 Sexual behavior might be a problem for many reasons It might be a problem for the person who is doing it because it puts the person at risk in some way: (health, reproduction, exploitation, stigma, illegal,lowers self image or efficacy) It might be a problem for others because it makes them uncomfortable; violates norms, standards, or values; breaks rules or regulations. OR, it might be a problem because it is abusive and/or illegal These are very different problems!.but knowing the kind of problem helps identify reasonable interventions. Defining Abusive Behavior 1. Consent vs. Cooperation - Compliance 2. Equality: Power - Control - Authority 3. Coercion: Pressure -- Threat -- Force Normal age 12 and under Genital or reproduction conversations with peers or similar age siblings Show me yours/i ll show you mine with peers Playing doctor Occasional masturbation without penetration Kissing, flirting Dirty words or jokes within peer group 8

9 Range of Sexual Behavior of Children YELLOW FLAGS (continued): Sexual teasing/embarrassment of others Single occurrences of peeping/exposing/obscenities/ pornographic interest/frottage Preoccupation with masturbation Mutual masturbation/group masturbation Simulating foreplay with dolls or peers with clothing on (i.e., petting, french kissing) Range of Sexual Behavior of Children RED FLAGS: Sexually explicit conversations with significant age difference Touching genitals of others Degrading self or other with sexual themes Forcing exposure of other s genitals Inducing fear/threatening of force Universal goals Communication: Express thoughts, feelings and needs Empathy: Identify, interpret & validate emotions and needs of self and others Accountability: Accurate attributions of responsibility Emotion Regulation: handle emotional states without engaging in harmful behaviors to self or others Increase Protective factors: Skill building where deficits, family functional strengths, individual functional strengths, environmental functional strengths 9

10 Sexual abuse by youth 56 57% of Sexual Abuse of Boys 15 25% of Sexual Abuse of Girls 8% of Male Population 5 7% of Female Population Normal sexual behavior 14 to Explicit Conversation with Peers 2. Obscenities / Jokes 3. Innuendo / Flirting 4. Erotic Interest / Masturbation 5. Courtship / Hugging / Kissing 6. * Foreplay (petting) 7. * Mutual Masturbation 8. ** Monogamist Intercourse (Stable or Serial **) Needs intervention 1. Preoccupation / Anxiety re Sexuality 2. Pornographic Interest 3. Polygamist Behavior *** 4. Sexually Aggressive Themes / Obscenities 5. Graffiti (Chronic / Targeting individuals) 6. Embarrassing others 7. Violating Body Space / Boundaries 8. Single Occurrences: Peeping, Exposing, Frottage with Known Age-mates 9. Mooning / Obscene Gestures **** 10

11 Needs intervention 1. Compulsive Masturbation 2. Degradation / Humiliation 3. Attempting to Expose Others 4. Sexually Aggressive Pornography 5. Sexual Conversation / Contact with Significantly Younger 6. Grabbing, Goosing 7. Explicit Sexual Threats Illegal behaviors 1. Sexual Abuse, Molest, Harrassment 2. Obscene Calls 3. Voyeurism 4. Exhibitionism 5. Frottage 6. Child Sexual Abuse 7. Rape 8. Bestiality Why do youth sexually harm others? We are not able to determine specifically what causes youth to act out sexually. Research demonstrates that there are things that put youth at a greater risk to act out. It appears that somewhere in the youth s biological-social development that being sexual in some manner is the thing that is going to make them feel better. The decisions to act out are a response to traumatic events. 11

12 Why do youth sexually harm others? Curiosity Learned behavior Sexualized environment Cultural norms (ecological pond) Motivation for Sexual Behavior (Reasons Why Human Beings Want to Do Sexual Things) Only change Exploration / Curiosity (What s This All About? Self / Others) Imitation / Learning (See / Do / Practice / Teach) Sensation Seeking (Arousing When Bored / Calming When Stressed) Reinforcement: Feels Good (Arousal, Orgasm, Tension Reduction) Pleasure: Self / Other (Relationship, Intimacy, Friendship, Love) *** Reproduction *** (from Puberty to Mid-Life) Compensation / Improvement (Feel Better, Do Better, Regain Self Image / Control) Anger / Retaliation (Get Back at Others, Make Others Feel Hurt / Angry) What is a sexually abusive behavior? Defining sexually abusive behavior: Lack of Consent Lack of Equality Coercion The age of consent is 14 in NM. Therefore, anyone under the age of 14 cannot legally give consent. 12

13 Risk factors for recidivism Factors that indicate risk for recidivism by youth: History of multiple offenses, especially after adequate tx. History of repeated non-sexual offenses. Clear and persistent sexual interest in children. Failure to comply with sex offense specific tx. Self-evident disturbances of arousal and dysregulation. Verbal threats of intent to reoffend. Parental/guardian resistance to adequate supervision. Range of Response to Exploitive Sexual Behaviors LABEL AND REACT CONFRONT AND PROHIBIT REPORT AND REFER MONITOR MONITOR First Response Label The Behaviors: I See You Doing... Susie Tells Me You Did... React From A Personal Levels: It Makes Me Uncomfortable... I Think It Makes Susie Uncomfortable, Too... 13

14 Second Response Confront: I Am Concerned Because I See You Doing... Which We Talked About Before. I Told You Then That It Made Me Uncomfortable. Prohibit: You Need To Stop Doing That. Use of Polygraph The use of polygraph raises ethically sensitive questions and concerns-- especially when this practice is used with minors Treatment providers and juvenile justice authorities can and should collaborate on cases but providers need to remain mindful that it is never their role to investigate, catch, prosecute, judge, or punish. Treatment providers need to continually remind themselves of what their treatment goals are. Paternalistically we understand that stopping sexually abusive behavior before it becomes habitual is in the best interest of juveniles themselves. Unfortunately, we do not know the benefits of juvenile polygraphs, or if they even exist, because adequately designed studies have not been conducted. 14

15 It is less than responsible when a field embraces unusual, coercive, and intrusive practices with minors without simultaneously undertaking the rigorous testing needed to judge whether intended benefits actually exist. How do we teach responsible, caring, non-coercive behaviors if we cannot model that ourselves? Supervision Specialized Probation Specialized Probation agreement Collaborative team effort Safety planning Supervision Who can be supervised in the community? Who needs to be in a secure 24 hour setting? 15

16 Relationship of JPPO Corrective (non exploitive adult) Setting safe boundaries for community and Youth Monitoring progress in therapy New admissions, counts, victims disclosed while Youth is is therapy 16