RESEARCH
Marcel Aebi and his colleagues created the first head-to-head comparison of the differences in efficacy of offense-oriented therapy and social skills training to prevent sexual and general recidivism in adolescents engaging in problematic sexual behaviors (PSB). The study explored the effects of the treatment approach on a number of factors including: 1) self-reported treatment satisfaction, 2) on therapist-rated risk of sexual recidivism, 3) on self-reported mental health problems, sexual knowledge, and victim empathy and 4) on time to sexual and general recidivism after treatment completion.
The authors stated that “one finding of major importance is that offense-oriented CBT based on understanding of an individual’s harmful sexual behaviors appears to be more effective in preventing sexual recidivism than the training of social skills.” After undergoing the skills-based training, youth re-offended more frequently and in a shorter amount of time than the offense- specific intervention. Interestingly, youth “with foreign nationality” (e.g., born outside of Switzerland where the study was conducted) were less likely to sexually re-offend.
Other findings included that self-reported treatment satisfaction was comparable for both treatment groups; during treatment the risk of sexual recidivism decreased similarly in both treatment groups, and no treatment effects were found after 12 months regarding mental health problems, sexual knowledge and beliefs, and victim empathy. It is also interesting to note that the sexual recidivism for the offense-oriented treatment was 8.6% and for the social skills training, it was 31%. Both were significantly higher than the most recent meta-analysis by Caldwell (2016) but was expected because of the focus on higher risk youth and the inclusion of non-contact offense and no registered offense (based upon case files) that likely led to these higher numbers.
The authors suggest that encouraging adolescents to understand their own sexual offenses seemed to be a key factor for adolescents to control and eventually replace their sexually abusive behaviors. However, this finding should not negate the value of general skills-based training for these youth, skills helpful to develop more personally meaningful lives. Finally, the authors suggest that the findings support the need for individualized treatment approaches that can address specific deficits and amplify the strengths of each child.
IMPLICATIONS FOR PROFESSIONALS
Working with any adolescent can present challenges. Whether it be the legal context or ethical decision-making, adolescents are by definition a vulnerable population. At the same time, professionals often have to be highly skilled in therapeutic engagement and providing difficult feedback without harming our working alliance with each youth. These findings show that even with our focusing on motivation, trauma, and family life, it is still critical to work specifically on the issues directly related to problem sexual behaviors.
IMPLICATIONS FOR THE FIELD
This study is a good reminder that while we need to focus specifically on the client’s problematic sexual behaviors and their individual risks, we also need to ensure that they develop the important skills needed to remain or re-enter their families and communities. This study is also a good reminder of just how important and special our work is. In order to best understand, assess, and treat youth, we need to have a broad knowledge of many areas, including adolescent development, sexual development, non-sexual as well as sexual offending, family functioning, and trauma. We are at our best when we work in collaboration with others, including schools and other professionals. And most of all, we are at our best when we are helping young people to address their offending directly with the ultimate goal of developing an offense-free lifestyle and making whatever amends are possible.
CITATION:
Aebi, M., Krause, C., Barra, S., Vogt, G., Vertone, L., Manetsch, M., ... & Bessler, C. (2022). What kind of therapy works with juveniles who have sexually offended? A randomized-controlled trial of two versions of a specialized cognitive behavioral outpatient treatment program. Sexual Abuse, 10790632211070804.
ABSTRACT
There is ongoing debate about whether specialized treatment is effective to reduce sexual recidivism in juveniles who have sexually offended (JSOs). Although most treatment programs are based on cognitive behavioral therapy principles for preventing sexual offending, accordant scientific evidence is poor. Following CONSORT guidelines, the present study aimed to evaluate two versions of a short-term outpatient treatment program for JSOs in Switzerland: (a) the Therapy Program for Adequate Sexual Behaviors Version 1 (ThePaS-I), which included offending-specific skills training; (b) the ThePaS-II, which included general socioemotional skills training. Based on changes in self-reported mental health, sexual behaviors, victim empathy, and therapist-rated risk, as well as comprehensive data on sexual and general recidivism, we found some similarities regarding the effects of the two treatments. ThePaS-II showed better short-term changes in self-reported mental health than the ThePaS-I. However, JSOs in the ThePaS-I showed lower rates of sexual reoffending (but not general reoffending) after treatment than those in the ThePaS-II. Despite some methodological limitations, the current findings favor offending-specific skills-based therapy over general skills-based ones for preventing sexual reoffenses. The findings may encourage further methodologically sound studies to examine different treatment approaches for juveniles and adults who have committed criminal offenses.
If you would like a copy of the full article, please email us directly at info@masoc.net
*****
