Transcript Sexually Abusive Youth

Sexually Abusive Youth
Emili Rambus, Psy.D.
Associates in Psychological Services
Jackson Tay Bosley, Psy.D.
NJ Association for the Treatment
of Sexual Abusers
What we know about sexually
aggressive youth
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Overrepresented in population
30-80% report victimization
30-60% educationally classified
More amenable to treatment
Easier to treat (!!??)
Most desist behavior with age and treatment
Small number maintain hurtful behaviors into
adulthood
Who are they?
What is the best way to deal with
the issue?
Quick answers:
1. Heterogeniety
2. Treatment backed by
legal mandate
Heterogeniety
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Wide variety of behaviors that bring these
youth to our attention
Wide variety of concomitant problems that
these youth have
Wide variation in responses to intervention
Wide variety of behavior(s)
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9 y/o babysitter
13 y/o sexual harasser
15 y/o babysitter/fondler
16 y/o babysitter/OS 3 victims
17 y/o consensual sex with 13 y/o
17 y/o forced sex with peers
18 y/o many young victims
Wide variety of problems
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No other issues
DD and aggressiveness
Long & extensive criminal hx
Substance abuse
“Unmanageable” in community
No parental support
All of above (except first)
Variety of responses to
disclosure/intervention
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Denial of event(s)
Guardedness
Refusal to talk
Legalistic responses
Admission with explanation
Admission without explanation
Remorse and guilt for offensive behavior
What they have in common
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Broke the law & got caught (2C-14.)
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Aggravated Sexual Assault
Sexual Assault
Aggravated Criminal Sexual Contact
Criminal Sexual Contact
Other crimes (designated by court)
Consequences (Megan’s Law)
Age of consent in NJ
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In NJ: 16 is the general age of consent,
but…
13, 14 and 15 year olds can consent to be
sexual with someone up to 4 years older
than themselves (to the date).
Assessment
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A comprehensive assessment is required to
establish treatment needs
Beyond general assessment of individual
functioning, extensive information re: all
charged offenses is needed. “Discovery
Material”
Issues in assessment
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Needs assessment
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To determine treatment needs
To establish treatment amenability
Risk assessment
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Likelihood of sexual recidivism
Likelihood of criminal recidivism
Dispositional planning
Needs Assessment
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Specifics of the inappropriate sexual
behavior
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Do not use client report exclusively
Collateral data essential
Concomitant problems
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Criminality
Family issues
DD, substance abuse, others
Risk Assessment
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Risk
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These are the internal characteristics/issues that speak to
the predisposition to commit sexual offenses
Risk Management
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These are the external factors that mitigate this risk
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Good parental role models
Adequate supervision
Risk Assessment
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(cont.)
Unstructured clinical assessments are not
accurate
Empirically guided clinical assessments are
more accurate
Best Practice is to use structured
assessment tools
Structured Assessment Tools
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Sexually offensive behavior
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Juvenile Sex Offender Assessment ProtocolSecond Edition (J SOAP-II)
Estimate of Risk of Adolescent Sexual Offender
Recidivism (ERASOR)
Aggressive/antisocial behavior
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Structured Assessment of Violence Risk in Youth
(SAVRY)
Other Tools
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Registrant Risk Assessment Scale
Juvenile Risk Assessment Scale
Juvenile Sexual Offense Recidivism
Assessment Tool (J-SORRAT-II)
Juvenile Risk Assessment Tool (J-RAT)
Risk factors for juveniles
(Clinical)
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Multiple offenses
Offending while on supervision
Offending in a public place
Deviant sexual interests
Antisocial orientation/peers
Impulsivity
Clinical presentation
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Langstrom, et. al. (2000), Prescott (2001)
Risk factors for juveniles
(Actuarial)
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Psychopathy/antisociality
Deviant sexual drive
Intellectual deficits
Functional deficits
Substance Abuse
Personal history of victimization
Negative treatment outcome
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Epperson, et.al. (2004)
Offense-specific treatment
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Legally mandated
Tailored to the individual
Cognitive-behavioral focus
Offense-focused
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Denial-common, major treatment issue
Self-awareness
Skill building, arousal, empathy
Offense-specific treatment
(cont.)
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Structured group therapy
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Time-limited modules
Address commonly noted issues
Individual treatment
Family therapy
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Enhance supervision
Establish positive role models
Offense-specific treatment
(cont.)
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Tools
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Philosophy
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Safety plan
Sexual assault cycle
Skills acquisition
Relapse prevention
Accountability
Necessity of good supervision
Recidivism rates
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(Juveniles)
Sexual recidivism rates for juveniles are generally
low, but vary considerably
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1.7% to 19.6%
Varies with definition and follow-up time
Non-sexual recidivism rates for juveniles are much higher,
but vary considerably
17.1% to 90%
Sampling bias
Treatment effects on recidivism
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One methodologically sound study
N=148, 6 year follow-up
72% reduction in recidivism (sexual)
41% reduction in recidivism (non-sexual, violent)
59% reduction in recidivism (non-sexual, non-violent)
Treated rate 5%, untreated 18%
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Worling and Curwen (1999)
Recidivism rates
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(Adults)
Sexual recidivism rates for treated adult
sexual offenders
%
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Incest
Pedophiles (F victim)
Pedophiles (M victim)
Rapists
Exhibitionists
very low
low to mod
mod to high
mod to high
high
Alexander, M (1999) SO treatment efficacy revisited. SA-JRT, 11.2
4
15.6
19.7
20.1
23.4
Etiology
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Multiple individual explanations:
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Proximal causes (triggers)
Distal causes (underlying contributors)
Empirically:
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Deviant sexual arousal
Antisociality
What we know about sexually
abusive juveniles
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Context is important
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Family effects (violence, deviance)
Peers (criminality, gangs)
Note co-morbid disorders
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Substance abuse
ADHD
Conduct/Oppositional Defiant Disorder
Developmental/cognitive limitations
Mood disorders/PTSD
Megan’s Law
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NJ Statutes do not make a distinction
between adults and juveniles adjudicated for
sexual crimes. All fall under the mandates of
Megan’s Law.
Megan’s Law
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Registration and community notification
provisions are implemented the same for
adults and juveniles, with a few exceptions.
Megan’s Law
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All offenders are assessed for the risk they
pose to the community through the use of the
Registrant Risk Assessment Scale (for
adults) and the soon-to-be-implemented
Juvenile Risk Assessment Scale (for
juveniles).
Megan’s Law
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Tier One offenders register only (with the
police department)
Tier Two offenders register and local
organizations are notified
Tier Three offenders register and are subject
to door-to-door notification
What works:
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Accountability
Invitation to responsibility
Corroboration/collaboration
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With parents
With probation/parole officers
Respectful interactions
Empathic understanding and rapport
What doesn’t work
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Non-offense specific “counseling”
Abusive confrontation
Strict adherence to a “one-size-fits- all
model”
Neglecting contextual (family and peers)
issues
Impact of work on treatment providers
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Comfort level with sexuality
Supervision, supervision, supervision
Parallels impact of sexual abuse
Power and control, anger
Hypersensitivity to issues
Toxicity
Vulnerability/helplessness
Self-care vs. burnout
Contact Information
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Emili Rambus, Psy.D.
(908) 526-1177 x48
[email protected]
www.atsa.com
Assn. for the Treatment of Sexual Abusers
www.njatsa.org NJ Chapter of ATSA
www.csom.org
Center for Sex Offender Management
www.njsp.org
NJ State Police (registry)
www.stopitnow.org
www.safersociety.org
www.ageofconsent.com