Adolescents

You may be reading this website because your teenager has been involved in problematic or illegal sexual behavior with another person, possibly another child you know. You are not alone. We are here to help you better understand why this happened and how to move forward.

Typical Vs Problematic Sexual Behavior

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If your teen has engaged in illegal sexual behavior with another person, you might be in crisis and wondering what to do. You may be feeling Anger. Shame. Confusion. Shock. We can help you learn more about adolescents – aged 13 to 18 – who are engaging in problematic sexual behavior or are committing illegal sexual acts as defined by state or jurisdiction laws.

Teens sexual development is a dynamic process during this time in their life. Though each family may have it’s own expectations or ideas for what is appropriate and right for their teen, it is developmentally appropriate for most teens to be interested in romantic relationships, begin to explore attraction and sexuality, and engage in consensual sexual behaviors during adolescence. In contrast, problematic sexual behavior (PSB) includes, but is not limited to, non-consensual sexual behaviors, sexual acts with someone much younger than the teen, viewing, sending, or sharing own or other minor's nude photographs, or excessive pornography use. This topic might feel difficult to discuss and even consider. We’re here for you. Others have gone through this and come out stronger. 

For more information about sexual development in teenagers see: Teaching sexual health. You may also download the Taking Action book, designed to Support Families of Adolescents experiencing PSB.

 

Understanding Adolescents and Problematic Sexual Behavior: Who Engages In Problematic Sexual Behavior and Why?

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How Can This Happen?

Pinpointing a single reason is difficult. Many things could have contributed.

Curiosity / Experimentation

Many teenagers are curious about sex, and they may experiment with younger children out of curiosity. They might not fully understand the seriousness and potential consequences. Youth benefit from support throughout adolescence to understand healthy relationship skills, consent, sexual development, and decision-making.

Impulsivity / Immaturity

Some teenagers are more impulsive and immature than others. They may act before thinking through what will happen next. That may lead to poor decision-making and risky behaviors. In some cases, teens may have a diagnosis like Attention Deficit Hyperactivity Disorder- (ADHD), in other cases, a formal diagnosis may not be present. But most teens struggle with impulsivity and immaturity

Trauma

A history of unresolved and addressed trauma impacts youth's social and emotional well-being, as well as perceptions of the world. Witnessing violence, experiencing violence, and/or sexual abuse of violence hinder well-being and can impact social judgment and interactions.

Delinquency / Aggression

Breaking rules and engaging in delinquent behaviors may have been part of the teen’s history. Their problematic sexual behavior may be part of a pattern of general problematic behavior.

Trauma Exposure

Experiences of trauma can impact a teens perception and understanding of the world. Their beliefs about what is appropriate behavior can be negatively impacted including understanding about consent, boundaries, control, relationships, intimacy, and friendship. Though most youth who have experienced trauma do NOT develop behavior concerns, for some teens there can be a link to problematic and harmful sexual behavior.

Other Factors:

Psychological problems, exposure to sexual materials or behaviors, sexual abuse, and problems with sexual attraction to children also are potential factors.

Each situation is unique. Determining the contributing factors can take time. Working with a treatment provider can help your teenager get back on track and move toward a safe and productive future.

Teen males are most likely to be charged or accused of illegal sexual behavior in the United States. However, females make up about 10 percent of all arrests for sexual offenses. 

There's no one type of teen who engages in problematic sexual behavior. Teens who engage in PSB have varied backgrounds, family systems, intellectual functioning, socio-emotional functioning, and mental health history.

Because teens who engage in problematic sexual behavior do so out of a combination of strong curiosity, opportunity, and lack of knowledge regarding consent, the law, and possible impacts of their behavior. there is no ‘one type of teen’ that may find themselves in this situation. Teens with PSB come from all backgrounds, socioeconomic statuses, races/ethnicities, and family types.

Though it is possible for teens to have sexual interest specifically in younger children, this is very rare. Most teens who engage in problematic sexual behavior towards young children do not report having sexual interest in the other child, but rather were experiencing sexual arousal or curiosity and acted impulsively on someone who was around them.

Click here to learn more about vulnerabilities.

What Parents Can Do

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When you find yourself in this situation, it is important for you to know that you are not alone. This Survival Guide was developed by other caregivers in your shoes.

Other parents have experienced similar emotions and reactions to yours. With the right support systems you can move from distress to a sense of hope and to a better future.

It can help to know that problematic sexual behaviors in teens typically lessen with the right type of treatment and when families are actively involved in services. Through such treatments, future problematic sexual behaviors can be prevented.

Children with problematic sexual behaviors can learn to better respect themselves and others. They can learn to demonstrate healthy boundaries and behaviors, even when the reasons for the problematic sexual behaviors remain unclear.

Tips to Remember
  1. Try to stay calm.
  2. Reassure your child you care about them.
  3. Enlist a trusted friend and/or attorney to help you make decisions.
  4. Provide close supervision.
  5. Develop and implement a plan to keep all family members safe.
  6. Inform those who need to know.

Characteristics of Best-Practice Treatment

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Treatment Providers

Treatment for illegal sexual behavior is most typically provided by professionals from mental health disciplines, such as social work, psychology, and psychiatry. It is recommended that providers

In some areas, treatment is provided by juvenile justice personnel, who are typically probation officers. These treatment providers work under the supervision of the juvenile justice system. They have received training in treating adolescents with illegal sexual behavior. The recommendations we suggest above for mental health professionals, such as specialized training and knowledge of the literature, also apply to juvenile justice personnel.

Some states have special certification requirements for individuals who treat adolescents with illegal sexual behavior.

Approaches to Treatment

Our Caregiver Partnership Board developed this tip sheet with their advice on what to look for in treatment (English and Spanish).

Several treatment approaches are currently being used to treat adolescents with illegal sexual behavior. The judge or probation officer may recommend, or order, an adolescent to be part of a specific program or the parents may have a choice of providers. The availability of treatment programs may impact the decision made. In some cases, the legal/juvenile justice system may pay for the treatment. In other cases, it will be the parents’ responsibility. These are decisions that need to be discussed with your child’s attorney or a representative of the court/juvenile justice system.

When families have a choice of treatment providers, caregivers need to have information about the various approaches of treatment to decide what would be best for their teenager and family. Questions for parents to consider, as they weigh this decision, are the following:

  • Is the provider licensed to provide mental health services in the state, or is the provider working in an agency under supervisors who are licensed?
  • Does the provider have adequate knowledge about youth with illegal sexual behavior? Does the provider know the types of information provided on this website?
  • Is the provider familiar with the research and literature about adolescents who have engaged in problematic or illegal sexual behavior?
  • Does the provider attend annual trainings for this population and have membership in professional organizations? 
  • Does the provider know which approaches to treatment are the most effective? 

A good treatment program would be one with experienced, licensed therapists, who have a productive working relationship with the court, probation staff, and CPS, and with a reputation for providing effective services to these adolescents.

A questionable program is one that utilizes therapists with limited knowledge and experience with adolescents who demonstrate illegal sexual behaviors, professionals without a license, providers who perceive all adolescents with illegal sexual behavior as high risk for reoffending, and uses treatment designed for adults and are not developmentally appropriate for adolescents. Parents should evaluate how well their program works. Ideally, a program would offer information about the percentages of teens that re-offended after completing their treatment program. Parents should be able to expect that the program provides assessments of the adolescent’s treatment needs before, during and at the end of treatment.

Several approaches have been used to treat adolescents with illegal sexual behavior. Depending on the particular case, one or more of the interventions described below will typically be used.

Multisystemic Therapy – Problematic Sexual Behavior (MST-PSB)

Multisystemic Therapy (see MSTPSB) is an approach to treatment that has the strongest research support in decreasing general delinquent behavior, substance abuse, and illegal sexual behavior by adolescents. The treatment provider is available 24 hours a day, 7 days a week and works closely with the youth and his parents. MST does not include going to a clinic for therapy for an hour a week. In this approach, the therapist has only a few clients and spends a lot of time with the teen, his parents, other family members, and peers. The therapist primarily works with the parents and youth in the home to target problematic behaviors. They often also work with the caregiver and teen in community settings to improve the teen’s behavior, school achievement, and social activities. Treatment with MST-PSB takes about six to nine months, is performed in the community, and directly involves the caregivers. It is important to note that MST-PSB is not available in all areas and that there are conditions that need to be met in order for a youth to qualify for treatment. However, if MST-PSB is available in your community, it may be very helpful for your adolescent and family. 

Cognitive Behavioral Group Therapy

Cognitive Behavioral Group Therapy is a psychoeducational approach to treatment that is conducted in groups of six to eight adolescents. This approach addresses issues such as taking responsibility for the illegal behavior learning legal, appropriate sexual behavior increasing involvement in prosocial activities and with non-delinquent peers and preventing future illegal sexual and nonsexual behavior. Adolescents attend weekly 1 to 1.5 hour group sessions in the community for 8 to 24 months, depending on the program’s requirements. Parents are encouraged or required to attend and participate in a weekly educational support group. The parent group is recommended because caregiver participation has been found to significantly improve treatment outcomes. This treatment approach is widely accepted and used for adolescents.

Family Therapy

Family therapy is used to directly address the illegal sexual behavior or to focus on problems within the family that influence the youth’s progress in treatment. Family therapy usually involves all members of the family and may be particularly useful in cases where the sexual behavior occurred within the family. When a victim is a family member, then the timing of including all members in family session must take into consideration the progress the youth with problematic sexual behaviors and child victim has made in treatment and the wishes of the victims. Family therapy may be used as the primary approach to treatment or may supplement other therapies such as when the family is involved in the reunification process.

Individual Therapy

Individual therapy may be provided if other forms of treatment, such as MST-PSB or group therapy, are not available or if the adolescent has other psychological problems that need to be addressed. In this approach, a therapist typically meets with the adolescent on a weekly basis for an hour to address issues related to their illegal sexual behavior. If the youth has other psychological problems, such as depression, these would also be addressed in the individual sessions. In these cases, it is recommended that the teen’s caregivers be included in the treatment on a regular basis. The caregiver can provide important information on the teen's behavior at home, at school, and in the community. The therapist can discuss issues of behavior management, supervision, and progress in treatment during the sessions.

Residential Treatment

There are times when an adolescent is demonstrating more severe sexual behaviors that have not responded to treatment in the community, or that compromise the safety of those in his home and possibly, the surrounding community. In these situations, the adolescent may also have mental health diagnoses such as Oppositional Defiant Disorder, Conduct Disorder, Depression, Post- Traumatic Stress Disorder and/or drug and alcohol abuse. Residential Treatment Centers are designed to treat adolescents who are in need of a secure living environment, are experiencing multiple difficulties that may include complex family problems, and likely have behaviors that have not responded well to mental health treatment that has been provided in the community. Adolescents stay at the facility, and length of stay can vary tremendously to up to two years. Approach to services also varies but is often designed to promote positive behavior change and address mental health needs. During their stay, they attend individual and/or group psychotherapy and are provided with psychiatric medication management. Some Residential Treatment Centers have their own programs to treat problematic sexual behaviors and others refer their clients to programs at outpatient settings in the community. Though often challenging to take place due to distance, family involvement is critical during the adolescent’s stay and caregivers are encouraged to participate in ongoing family therapy as well as other therapy programs that are recommended.

Inpatient Psychiatric Treatment

When teens have concerning psychiatric issues that are not responding to community based approaches, they may require psychiatric hospitalization to address their treatment needs. The hospitalization can be short or long-term, depending on whether the purpose is to stabilize the youth or to address more severe psychiatric problems. Some hospitals conduct treatment programs for adolescents with illegal sexual behavior as part of the youths’ overall treatment plan, which may include group cognitive-behavioral treatment. Youth who are hospitalized should be discharged when their mental health disorders have stabilized, they have made progress in treatment, and they are responsive to adult supervision. They may be released to continue treatment in a community-based program and have ongoing monitoring of their mental health disorder.

Length of Treatment

The length of treatment varies from program to program and depends on

  • The seriousness of the sexual behavior
  • Whether the youth has other delinquent behavior and
  • The youth’s and family’s active participation and progress in treatment

Adolescents who are in community-based treatment programs and live in the community are treated in shorter-term, less-intensive programs that usually meet once a week for one to two hours and last from 8 to 24 months. Some adolescents need long-term, intensive treatment in a restricted placement. Programs in these settings typically use a “levels system” by which the youth’s progress is measured and rewarded as he moves through the levels to discharge. As mentioned earlier, if you have questions or concerns about the program, it is recommended that you discuss these with the program director or your teen's probation officer or attorney.

To learn more about connecting to treatment go here

Tips to Remember
  1. Mental Health providers should be license and have experience in this area of practice.
  2. It is recommended that the youth's caregivers be actively involved in the treatment program.
  3. Treatment should account for the adolescent’s risks, needs, protective factors, and supports.
  4. Treatment should be developmentally appropriate and encourage pro-social behaviors and peer relationships.

Common Questions/Concerns

Most parents have unanswered questions about teens who engage in illegal sexual behavior. Most parents must sort through a lot of wrong information as they try to get a better understanding of their teen’s behavior. What follows are answers to questions most commonly asked by parents, based on the best and most reliable information we have now.

For more information on typical vs problematic sexual behavior in adolescents/teens, explore this page of our website:

Maybe, but many youth with problematic sexual behavior have NOT also been sexually abused. It is more common for youth with PSB to have experienced other forms of maltreatment (such as neglect and witnessing domestic violence). However, it is possible. It is helpful to ask your children about how they may have learned the sexual behavior. Further, it is healthy for families to have ongoing conversations with children about what are safe and unsafe touch, what sexual abuse is, and who/how to tell if they feel uncomfortable or are concerned about sexual behavior of others. Due to concern about possible abuse including sexual abuse, a forensic interview may be conducted. For more information about forensic interviews see https://susiesplace.org/forensic-interviews/. Many times with teens, there is not sufficient concern about experiencing sexual abuse. Other factors appear to have contributed to the problematic behavior. See Understanding Adolescents and Problematic Sexual Behavior: Who Engages In Problematic Sexual Behavior and Why? For more information.

Current research shows that most youth with problematic or illegal sexual behavior do NOT go on to be adult sex offenders. In fact, recidivism (having additional incidents of problematic or illegal sexual behavior), is quite low in this population, even without treatment. With evidence-based treatment, recidivism rates are quite low, mostly close to 3-7% chance that youth go on to engage in future problematic sexual behavior. See Connection to Treatment for more information.

Children and teens are most often engaging in PSB opportunistically, meaning they act impulsively when an opportunity arises to try something sexual and or experience a sexual feeling. As such, who your child engaged in sexual behavior with is often less important than being able to engage in the act itself. Teens, particularly, are often in caregiver/babysitting roles or have opportunities to be alone with younger children they know (family, friends, neighbors, etc.). Teens may take advantage of these opportunities, but are often not seeking them out. This is significantly different from adults with pedophilia, who have specific attraction to pre-pubescent children and seek out opportunities to engage in sexual behavior with that age group. Few youth are exclusively sexually interested in younger children. For more information on individuals attracted to young children see https://www.helpwantedprevention.org/

Similar to the answer above, a child or teen’s sexual orientation (who they are attracted to) cannot be determined from their problematic sexual behavior itself. Most youth engage in PSB by taking advantage of an opportunity provided to them, rather than seeking out someone they are explicitly attracted to. Many youth engage in PSB with other youth of the same-sex but do not experience specific attraction to them.

Teenage years are a time in which youth explore identity in multiple ways - what their interests are and what is important to them. Youth may engage in same-sex sexual behavior due to specific attraction and/or to explore their own sexuality. Behavior during teenage years among consenting, developmentally appropriate peers is not a problematic sexual behavior.

Some youth who engage in problematic sexual behavior may also be gay, lesbian, bisexual (LGB+). Being LGB+, is NOT a risk factor for engaging in problematic sexual behavior. Youth who are LGB+ are actually at higher risk of experiencing victimization than non- LGB+ youth and are not any more likely to engage in PSB.

All kinds of families. The families may have biological parents, step-parents, grandparents, foster or adoptive parents, or kinship parents. The families have many different levels of income and education and they represent all ethnicities. Many of these families are functioning well and have typical family problems. Other families experience high levels of stress along with a history of problems with maltreatment, substance abuse, domestic violence, and/ or unstable employment. There is no one type of family or one type of teen that engages in PSB.

When confronted with a major behavioral incident, many youth may deny what happened or only tell part of what happened. It’s a natural response for most youth due to fear, shame, and/or concern for judgment and consequences. Some youth tell the truth right away, others deny for short periods of time, and others deny for very long periods of time. Some youth say the longer they wait to tell the truth, the harder it is to tell the truth later. A child/teen’s natural fear response of denial does NOT mean they are bad kids, lack empathy, and/or are more likely to go on to engage in more harmful sexual behavior. Many youth begin to open up about what happened once they are involved in appropriate treatment and are in a supportive therapeutic environment. It is common for youth to disclose about their PSB gradually over time, rather than all at once.

Do Teen Girls have Problematic Sexual Behavior?

At present, researchers have limited information on adolescent girls with problematic or  illegal sexual behavior toward children. This lack of information is due to a number of reasons. Girls’ have significantly fewer illegal sexual behaviors than adolescent boys. Girls’ illegal sexual behavior is considered to be underreported to law enforcement and Child Protective Services. Also, most of the research has been based on small numbers of girls. As such, the research may not accurately represent this group as a whole. Here are some of the important aspects of what we know now

  • Adolescent girls commit a range of illegal sexual behaviors, ranging from limited behaviors based on curiosity to repeated, aggressive acts
  • Some adolescent girls co-offend with adolescent males
  • The most common sexual offenses by adolescent girls are nonaggressive acts, such as fondling, that occur in an activity such as babysitting
  • Adolescent girls account for about 10 percent of all arrests for sexual offenses by youth under age 18 and 1 percent of forcible rapes
  • The most frequent victims are children who are between the ages of 4 – 6 years old and who are acquaintances or relatives of the teen
  • Most adolescent girls are well-functioning with limited behavioral problems while some have higher rates of behavioral health diagnoses such as PTSD, depression, anxiety or delinquent histories
  • Compared to boys, most adolescent girls with illegal sexual behavior have a more extensive and severe history of physical and sexual abuse. The girls were abused at younger ages than boys and were more likely to have been abused by multiple perpetrators
  • The rate of future sexual offenses by adolescent girls is not known
Tips to Remember
  1. Most adolescents do not have future illegal sexual behavior.
  2. Adolescence is a developmental period of experimentation, risk taking, excessive self-focus and evolving cognitive development.
  3. There is not one "type" or profile of adolescents who commit illegal sexual behavior.
  4. Adolescents are quite different from adults with illegal sexual behaviors.
  5. There are a variety of reasons why adolescents commit illegal sexual behavior.
  6. Adolescent girls commit significantly fewer illegal sexual acts than boys.
Resources

Resources for Parents and Caregivers