Given the prevalence of sexual offending by juveniles, coupled with the potential link between sexually abusive behavior during adolescence and sexual offending later in life, a variety of interventions are widely used for juvenile sex offender management. Overall, interventions that target juvenile sex offenders aim to reduce the sexual, violent, and nonviolent recidivism of juveniles through a variety of treatment modalities (Reitzel and Carbonell 2006).
Although the treatment of sex offenders has been around for decades, treatment approaches have changed in recent years. For many years, juvenile sex offender treatment was largely based on adult sex offender treatment, as juvenile and adult sex offenders were thought to be similar. However, when research emerged indicating the developmental, motivational, and behavioral differences between juvenile and adult sex offenders, therapeutic interventions for juveniles became more responsive to the diversity of sexually abusive behaviors and the specific offending-related factors found among adolescents and children. For example, juvenile offenders, both sexual and general (nonsexual) offenders, are generally more impulsive and less aware of the consequences of their actions than adults. Therapeutic interventions for juveniles are designed to take these behavioral differences into account as well as the family, peer, and other social correlates that impact general and sexual offending for juveniles (Przybylski 2014).
Juvenile sex offender interventions are aimed at juveniles who have been referred and adjudicated for a sexual offense or have committed illegal sexual acts that would lead to adjudication, if prosecuted. Offenses can include rape, child molestation, incest, and exhibitionism.
Juvenile sex offenders have more in common with other juvenile delinquents than they do with adult sexual offenders (Przybylski 2014). As a result, juvenile sex offender treatment can range from interventions specifically tailored for sexual offenders to interventions targeting general offending behaviors.
One theoretical approach to the treatment of juvenile sex offenders is to consider sexual offending a special case of general offending; that is, applying principles of general offending to sexual offending (Hanson et al. 2009). Another approach is human service interventions, which tend to have an impact on general offending behavior and follow the principles of risk, need, and responsivity. In other words, treatments are most likely to have an impact if they treat offenders who are more likely to reoffend (i.e., at greater risk), target characteristics related to reoffending (i.e., criminogenic need), and match the treatment to the offenders’ abilities and learning styles in regard to responsivity (Hanson et al. 2009). An example incorporating the responsivity principle into treatment is a cognitive–behavioral intervention that addresses issues such as denial, accountability, and victim empathy.
There are various types of juvenile sex offender treatment interventions or modalities, such as cognitive–behavioral, cognitive–behavioral/relapse prevention, psychotherapeutic (sexual trauma), and multisystemic therapy.
Cognitive–Behavioral Therapy (CBT)
CBT is usually conducted in a group therapy setting and involves addressing the irrational thoughts and beliefs of offenders that lead them to engage in antisocial behaviors (Aos et al. 2006). CBT programs include elements that seek to help offenders correct their deviant thoughts by practicing opportunities to model and engage in prosocial and problem-thinking skills and behaviors (Aos et al. 2006).
Cognitive-Behavioral Therapy/Relapse Prevention (CBT-RP)
Relapse prevention is based on social–cognitive psychology and incorporates relapse-prevention strategies with cognitive behavioral strategies to prevent or limit relapses. Treatment approaches assess the environmental and emotional characteristics of situations that could lead to relapse. After these situations are identified, a therapist works with the individual’s responses to these situations, while also analyzing the factors that caused them. The therapist then develops strategies to target weaknesses in the individual’s cognitive and behavioral repertoire (Larimer, Palmer, and Marlatt 1999).
Psychotherapeutic (sexual trauma)
Programs that fall into this category involve the use of insight-oriented therapy that can be done either individually or in a group setting (Aos et al. 2006). These programs usually take the form of traditional therapy practices, such as talk therapy, and explore the underlying causes and thoughts related to offending behaviors. Psychotherapeutic interventions for juvenile sex offenders can target the trauma that the juveniles may have experienced in the past, helping them to understand their illness and better manage their symptoms (National Institute of Mental Health 2014; Przybylski 2014).
Multisystemic Therapy (MST)
Treatment settings are different for interventions (depending on whether the juvenile has been adjudicated and sentenced to out-of-home placement or community-based treatment), but could include detention center/youth residential facilities, community-based (outpatient) treatment centers, or a combination of settings. The format for sex offender treatment also varies, but could include individual therapy, group therapy, individual and family therapy, or a combination. Intervention activities and lengths can vary by program type as well, with some interventions including postdischarge, follow-up monitoring services.
MST is a community-based intervention that has been used for serious and chronic juvenile offenders. MST for sexual offenders is designed to reduce the occurrence of sexual offenses by targeting the underlying problematic behavior: primarily by addressing a youth’s socialization processes and interpersonal transactions. Treatment is provided within the youth’s natural environment (typically where the youth lives). As a result, the treatment provider works closely with the youth’s family and the community, such as peers, teachers, or probation officers. By working with the youth’s family, MST aims to empower the parents by providing them with the skills and resources needed to raise their adolescent (Borduin, Schaeffer, and Heiblum 2009).