Professionals

This web site presents an overview of the latest research findings and best practices for professionals working with youth with PSB.

Your Guiding Principles

Situations involving problematic sexual behavior (PSB) of youth are complex and unique. That’s a central idea to keep in mind as we try to help you better understand PSB. You’re equipped with experience and expertise in your profession. This information is designed to build on your foundation with best practices to address PSB of youth.

On the surface, problematic sexual behavior of youth might resemble behaviors of adults who have committed sex crimes. But we caution you to not view youth behavior the same way. The origins, motives, and responses to intervention are distinct. Life circumstances and individual factors influence a youth’s path.

The National Center on the Sexual Behavior of Youth has developed Guiding Principles to set the standard of practice for professionals working with youth with problematic sexual behavior. These principles are designed to complement specific professional standards of practice.

Each youth’s behavior must be conceptualized with a developmental framework. Motivations and causal factors differ by developmental periods and generally have little in common with adults who commit sex offenses. Children’s social, emotional, language, and cognitive development and functioning should be considered in conceptualizing and responding to PSB of youth. A developmentally appropriate approach capitalizes on the malleability and responsivity of youth.

Effective response starts at the moment PSB of youth is identified. Once identified, best interdisciplinary practice streamlines pathways to establish safety of all children, conduct assessment, engage in recommended intervention, and implement community response.

Children and adolescents displaying problematic behavior are unique individuals. You must examine the individual youth and family’s needs, risks, vulnerabilities, strengths, and other characteristics that facilitate positive intervention responses. The best safety plans, placement, treatment, and community responses are objective and tailored to the situation.

“Juvenile sex offender,” “perpetrator,” and similar terms can lead to misconceptions, harsh decision-making, and discrimination. We recommend people-first language that labels behavior rather than the youth. Consider “children with problematic sexual behavior” or “adolescents with problematic or illegal sexual behavior.” Attention should be given to the labels used and the longevity of the information within documentation systems to avoid inappropriately stigmatizing and negatively impacting future decision making. Consider efforts to document the behavior in the context of the setting and time rather than labeling the child.

Family members, peers, and other community members have fundamental influences on youth’s growth, development, decision-making, and behavior. Effective interventions directly involve parents and caregivers. They establish safety and support the youth’s healthy development. Your goal is building social bonds, positive support, and peer groups. We want to promote healthy development.

PSB of youth can have a rippling impact on the other children involved, family members, and others in the social system. There is great complexity in situations when PSB of youth occur within a family. The needs of all family members should be considered. Decisions about supervision, safety planning, intervention, and placement are made with understanding of the needs, wishes, protective capacity, risks, vulnerabilities, and responsivity to interventions of all family members.

Promoting safety and addressing the needs of all the children, including child victims and siblings, are critical. Collaborative responses of law enforcement, child protective services, juvenile justice, attorneys, school personnel, health and behavioral health professionals, child advocates and others are better than multiple unilateral actions. Integrating the family’s voice is critical. Collaborative coordinated approaches improve outcomes for youth and families, and it promotes sounder policies and procedures.

High quality, holistic assessments use evidence-based practices and positively engage youth and their families. They examine case-specific needs, problems, and strengths. They define individual, family, and community targets for reducing risks and promoting healthy development. They reflect current functioning and circumstances. They include reassessments as the child develops. They integrate information from multiple sources. 

Targeted interventions are designed to eliminate problematic behaviors, reduce trauma impact, enhance well-being, and make family interactions healthier. Treatment is informed by assessment, matches the most urgent needs, and facilitates protective factors. Needs are often complex, but avoid tackling too much at once by requiring multiple services at the same time. Too many interventions at once can overwhelm families and be less effective. Prioritizing is key.

A continuum of care is needed that flexibly meets the needs of the youth with PSB, child victims, and family members. Interventions provided should be no more restrictive than what is needed for community safety and child well-being. Community and home-base interventions are generally safe and effective. They present opportunities for healthy and pro-social development. When out-of-home placements and more restrictive interventions are necessary for safety or behavioral health reasons, these placements should be as short in duration as possible. Transition and reintegration plans should start with admission while maximizing caregiver/family involvement.

Professionals have significant impact on the children, youth, and families. Relevant coursework, degrees, supervision and advanced training ensure professionals are qualified to work with youth and families. Professionals must have essential training in child and adolescent development and problematic and illegal sexual behavior of youth. Continuing education and training helps professionals stay current with empirical research on the PSB of youth, evidence-based practices and best policies. Professionals employ guidelines and ethical standards (such as, the Association of the Treatment and Prevention of Sexual Abuse Standards and Guidelines). Professionals recognize and practice within the scope of their profession and abilities.

Sound and effective public policies and practices are grounded in the best available research. Research is ever-evolving and thus, policies should respond accordingly. When new practices or policies are piloted or implemented, ongoing evaluation is needed to examine impact. Public policies found to be harmful should be rectified.

 

Note: We wish to acknowledge the contributions Dr. Sue Righthand and of the Oklahoma Workgroup on Problematic Sexual Behavior of Children to the updates of the guiding principles

 
Overview and Definitions

Sexual Development and Behavior

Humans are innately sexual beings, and sexual development begins in utero and continues throughout the lifespan. However, the expression of sexual behavior relies on social learning, as well as physiological and psychosocial reinforcement. It is important to acknowledge that cultural context determines attitudes and beliefs regarding sexual behavior and what is considered appropriate. This cultural variability is evident in diverse state laws, various religious or cultural perspectives, and a range of family beliefs. Consequently, parents or caregivers may not necessarily approve of sexual behavior that is considered normative or typical. When we use the term "normative sexual behavior," we refer to what is common or typical for a specific developmental age, rather than what a particular group or individual desires.

Overview

Normative Sexual Behaviors

Normative sexual behaviors are behaviors that involve parts of the body considered to be “private” or “sexual” (e.g., genitals, breasts, buttocks, etc.). These behaviors may be referred to as “sex play,” and are normally part of growing up for many children and adolescents. They are not considered to be harmful by most experts. For more information click here.

childhood sexual

Problematic Sexual Behaviors

Problematic Sexual Behaviors are deviations from normative or typical sexual behavior. They are child-initiated behaviors involving sexual body parts (i.e., genitals, anus, buttocks, or breasts) and are developmentally inappropriate and/or potentially harmful to themselves or others. Problematic sexual behaviors may involve behaviors that are entirely self-focused such as excessive masturbation, or behaviors that involve other children, such as touching other children’s genitals or sexual intercourse. Normative sexual behaviors may become problematic sexual behaviors when it increases in frequency and doesn’t respond to parenting strategies. Problematic sexual behaviors are a set of behaviors that are not normative, are considered unacceptable by society, and can cause impairment in functioning. For more information click here.

Why do children engage in sexual behaviors?

Professionals must consider the reasons why children engage in normative or problematic sexual behaviors. Although the term "sexual" is used, the intentions and motivations for these behaviors in children often are unrelated to sexual gratification. Rather, the behaviors may reflect curiosity, imitation, attention-seeking, anxiety, reenacting trauma, self-calming, loneliness, boredom, or anger. Problematic sexual behaviors are not always “caused” by having been sexually abused. Problematic sexual behavior may be related to other types of trauma, such as experiencing physical violence. Click here for more information about causes of problematic sexual behavior in children.

Adolescence is a time of life rapidly changing and evolving experiences with changes in physical, social, emotional, cognitive, and sexual development. Learning how to manage sexual arousal is an important milestone for many youth in puberty. As a result, when adolescents focus their sexual behavior on prepubescent children, do NOT assume their motivations reflect exclusive sexual arousal to young children—such interests are rare in teens. When teens engage prepubescent children in sexual behavior, such actions may be a response to a perceived opportunity rather than suggestive of problematic attraction to young children. Factors that contribute to a teen demonstrating problematic or harmful behavior are complex and vary.

Sex Play

Sex play between children, where behaviors and play activities are focused on body parts and functioning, is a normal part of child development. This play involves children exploring each other’s bodies and gender roles. It is natural for children to have curiosity about sexual behavior, their own and others’ bodies, and to show interest in sexual activities. Sex play is different from problematic sexual behavior. Sex play occurs between children of similar age, size, development, and abilities. Children typically know and play with each other regularly, such as siblings, other children in the family, neighbors, or friends, rather than among strangers. The children involved in sex play may be of the same or different genders. As children get older and more aware of the social rules, their sexual behavior, including sex play, becomes hidden and is generally not known to caregivers. Sexual play is periodic, by mutual agreement, and lighthearted. When any child is in distress or does not agree to the behavior, or when the sexual behavior becomes planned, frequent, or intrusive, there are causes for concern.

Normative Sexual Behavior

Normative Sex Knowledge and Behaviors by Age

Physical Development in children in the preschool years is a time of growth and developing competency in gross and fine motor coordination. Supervision and guidance for children in this age group is needed because their judgment and problem-solving skills are just beginning to be developed. They are constantly moving and learning through involvement in activities.

Sexual Knowledge

  • Children as young as 3 years of age can identify their own gender, and then soon after can identify the gender of others. Initially, distinctions between genders are based on visual factors found in their culture (such as hairstyles, size, or clothing), though by age 3 or 4 many are aware of genital differences. Gender roles are not set this early, and children display a range of behaviors culturally associated with either or both genders.
  • Preschool children's understanding of pregnancy and birth tends to be vague until about age 6.
  • Knowledge of adult sex behavior is most often limited to behaviors such as kissing and cuddling until about age 6 years when perhaps a quarter of children report knowledge of more explicit adult sexual behavior.

Sexual Behavior

Preschool children are curious in general and tend to actively learn about the world through listening, looking, touching, and imitating. Preschool children's general curiosity about the world manifests with questions as well as exploratory and imitative behaviors including sexual body parts. These sexual behaviors often occur in public and include:

  • Looking at others when they are undressing or nude
  • Intruding on others' physical boundaries (e.g., standing too close to others)
  • Showing private parts (e.g., being "silly" or not knowing rules about privacy)
  • Touching their own genitalia
  • Touching adults' breasts (particularly their female caregiver's)

Some children dress or play in ways culturally considered to be of the opposite sex--this is normal and not considered a sexual behavior. Children's touching of their own private parts is not the same behavior as what adults view as "masturbation."

They may touch their private parts if they itch or if they are exploring their own body. Young children seek experiences that are calming and pleasant, such as, they suck their thumb, they rub on soft blankets, and they periodically touch their private parts because it feels good.

There are several sex behaviors that are NOT normative in preschool children. These include intrusive, planned, or aggressive sex acts, putting their mouth on another child's sex parts, and pretending toys are having sex.

Physical Development

Girls often begin puberty earlier than boys and breast development can start as early as 7 or 8 years of age. Boys and girls progress through five stages of puberty but the onset and length of time in each stage varies based primarily on race and gender. Early or delayed onset of puberty can have a significant impact on the social adjustment of youth.

Sexual Knowledge

Knowledge of pregnancy, birth, and adult sex activity expands greatly during the school-age period and may influence sexual behaviors. By age 10, most youth have a basic understanding of puberty, reproductive processes, and childbirth. The accuracy of children's knowledge depends on their exposure to correct informal and formal educational material.

Sexual Behavior

School-age children's sexual behaviors become more guided by societal rules.

  • Sexual behavior, including sex play, continues to occur throughout the school-age period. The behavior tends to be more concealed, and caregivers may not be aware of the children's behavior.
  • School-age children become increasingly more interested in media and are more likely to seek out television and pictures that include sexual behavior and nudity. (American Psychological Association report on the impact of media on the sexualization of girls.)
  • Self-touch and masturbatory behaviors occur among girls and boys equally, with an increase in frequency particularly among boys during this developmental period.
  • Modesty emerges during this developmental period, particularly with girls who often become shy and private about undressing and hygiene activities.
  • Sexual attraction to same age peers increases near the end of this developmental period with interactive behaviors typically beginning with playful teasing of others. Few children are involved in more explicit sex activities including sexual intercourse at the end of this developmental period (on average 6% of children under 13 years of age report sexual intercourse.

Adolescence may be conceptualized as a dramatic time of child development spanning the second ten years of life. Puberty and other significant physical, social, emotional, and intellectual changes, and sexual development, mark this ever fluctuating and sometimes emotionally unstable period of life. Significant brain development occurs during adolescence with rapid growth and related cognitive, social-emotional, and behavioral changes continuing until the early to mid-twenties.

Physical & Sex Development

During adolescence, pubertal development continues. For most youth, physical growth is complete by mid adolescence.

Adolescent sexual development includes not only physical changes, but the development of oneself as a sexual being. Adolescents are becoming increasingly aware of their sexual attractions and interests, including sexual orientation and gender identity.

Young Adolescents

School children and young adolescents ages 9 to 13 may experience a substantial increase in sexual thoughts and feelings. One's first feelings of sexual attraction may occur as early as 9 to 12 years of age with onset of sexual fantasies occurring several months to one year later. This development may be followed by a "surge" of sexual interest and attractions. The physiological changes associated with puberty include increased levels of sex hormones further impact feelings of sexual arousal, attraction, and fantasies. Nocturnal emissions and the onset of menstruation are signs that the adolescent has reproductive capability.

Middle and Late Adolescence

By middle adolescence, which generally includes youth between 13 and 16 years, physical puberty may be almost complete. During this time sexual thoughts and feelings as well as sexual behavior expand further. In late adolescence, which typically includes 17 to 19 year olds, sexual thoughts, feelings, and activities may continue to significantly increase.

For example, youth may become involved in a relationship that includes sexual intimacy. Brain development does not cease at age 18 or 19 and significant social-emotional and intellectual growth relevant for healthy and pro-social behaviors can be expected to continue.

Developmental differences between young adolescents and older adolescents have been noted in brain growth, as well as in their social, emotional, and behavioral repertoires. Despite these overall patterns, it also is important to consider the tremendous variation in developmental milestones among teens.

Further, there may be "mismatches" in the rates of development across domains for individual youth. For example, a girl may begin puberty at 9 but not yet have developed the higher order cognitive skills necessary for managing social and sexual situations that may arise. Thus, age is not always the best indicator of social maturity and good judgment.

Differences between adolescents' cognitive and social functioning and those of adults are of great importance. When compared to adults, adolescents:

  • Are more impulsive.
  • Are more likely to take risks.
  • Have poorer judgment.
  • Are less able to consider the future consequences of their actions.

Adolescents may also be less capable of accurately identifying the emotions or intentions of others, resulting in misinterpretations that can contribute to inappropriate responses or behavior. For example, if a boy touches a girl's breast in the hall at school and she says, "Stop that!" but laughs as she says it, he may be unclear what she means.

Professionals must keep in mind that adolescents are trying to understand the rapid sexual development of their feelings and bodies. Adolescents may have advanced sexual knowledge and experience but may be well behind in abstract thinking and understanding the impact of their behaviors on others. As adolescents mature, they are able to understand and interpret their own sexual feelings and the emotions and behaviors of others.

Sexual Knowledge

The extent and accuracy of an adolescent's knowledge about sexual matters is determined by a variety of factors including parent-child relationship quality, family attitudes and knowledge, the availability of school-based sex education programs, Internet and publicly available written literature, and cultural factors.

  • Peers are a "go to" resource for most teens and, frequently, are a source of inaccurate and misleading information, such as overestimates of the degree to which others in the group are engaging in sexual activity.
  • Exposure to sexual and violent stereotypes, such as movies and music that depict girls and women as sex objects and portray manliness as associated with sexual conquests, may promote distorted attitudes about normal and healthy sexual behavior.
  • Open communication between adolescents and their parents/caregivers concerning sexuality and healthy sexual behavior is a key to facilitate the acquisition of accurate information. Early communication provided before the initiation of sexual behavior is important to lay the foundation for future dialogue.

The extent to which other information sources provide accurate and sufficient information varies considerably. Education and accurate information ensuring that sexual activities are consensual and consistent with relevant state laws may be limited or lacking.

Sexual Behavior

During early adolescence there is an increase in sexual behaviors which often involve self-exploration and masturbation. Some experimentation may involve opposite or same gender peers. While these behaviors often occur with mutual agreement, they may be motivated by self-interest more than reciprocal in nature. Same gender sexual activity may be related to curiosity, opportunity, or sexual orientation. Sexual orientations are not considered sexual behavior problems.

The frequency of sexual activity increases in mid-adolescence. Many males begin masturbating to ejaculation between ages 13-15 years; the onset of masturbation in females is more gradual.

In contrast with early adolescence, mid adolescent sexual relationships may involve increased emotional intimacy and not be as self-focused. With late adolescents, the frequency of sexual activities increases.

Most sex is within dating or romantic relationships, but much occurs outside these relationships as well. Sex outside romantic relationships generally is more likely in boys and is associated with other risk factors, although casual sex among late adolescents and young adults ranging from kissing to sexual intercourse, such as "hooking up," has become more common.

In sum, throughout adolescence, sexual activities may include the following, with the more advanced behaviors more likely in older adolescents:

  • Sexually explicit conversations with peers
  • Obscenities and jokes within cultural norm
  • Sexual innuendo, flirting, and courtship
  • Interest in erotica; pornography use, and sexting*
  • Solitary masturbation
  • Hugging, kissing, holding hands
  • Making out, fondling*
  • Mutual masturbation*
  • Oral sex or intercourse with consenting partner*

Problematic Sexual Behavior

Problematic Sexual Behavior

There is no clear line that separates normative from problematic sexual behavior. Sexual behavior in childhood and adolescence falls on a continuum, from normative, to cautionary, to harmful.

childhood sexual

Problematic sexual behaviors include a wide range of behaviors:

  • Harmful or excessive self-touch or self-stimulation (such that it causes physical harm or damage, is excessive, and/or occurs in public despite interventions)
  • Non-intrusive and repetitive sexual behaviors (such as preoccupation with nudity, surreptitiously looking at others when they are naked, frequently showing private parts to others, preoccupation with pornography, especially child sexual abuse images or violent media, sexting, offensive sexualized language)
  • Sexual touching without permission or consent, such as poking, rubbing or squeezing
  • Sexual interactions with others (such as, digital-genital contact, oral-genital contact, sexual behavior that involve penetration) which are developmentally inappropriate or illegal
  • Distributing youth produced sexual images, such as through texting
  • Sexual contact with animals
  • Coercive or aggressive sexual contact or penetration

Guidelines for Identifying Problematic Sexual Behaviors

Professionals should be concerned when children's sexual acts or behaviors have one or more of the following characteristics:

  • Occur frequently or more frequently than expected
  • Take place between children of widely different ages or developmental stages (such as a 12-year-old who acts out with a 4-year-old, or a 15-year-old with a 10-year-old)
  • Occur between children of different capacity, for example, disparate physical size and strength or intellectual abilities or a position of authority
  • Are associated with strong, upset feelings, such as anger or anxiety/fear
  • Cause harm or potential harm (physical or emotional) to any child
  • Do not respond to typical parenting strategies (such as, instruction and supervision)
  • Involve coercion, force, or aggression, or threats thereof, of any kind

Problematic sexual behaviors are in contrast with normative sex play. Yet, some statistically normative sexual behaviors are considered problematic or even illegal due to familial, religious, cultural, or societal variations in attitudes regarding acceptable sexual behaviors in youth. Sometimes, sexual behaviors that do not involve others and occur in private, such as masturbation, may be concerning for some individuals or groups. However, sexual behaviors that do not involve others are not considered problematic, unless they are injurious, preoccupying, or interfere with other aspects of healthy development.

What do professionals need to know about sex laws?

Professionals are expected to know the laws and state statutes pertaining to sexual offenses and problematic sexual behavior. As professionals, it's important to not only know the laws, but also advocate for improved laws that address sexual behaviors in youth.

Professionals play an important role in informing parents and caregivers about the differences between normative, problematic, harmful, and illegal sexual behaviors in youth. Professionals should be able to distinguish legal from illegal sexual behavior, know what types of behavior constitute illegal behavior, and understand the laws pertaining to these behaviors.

Technology is advancing at a more rapid pace than laws are implemented and/or regulations are created. For example, many states do not have laws that adequately address youth produced sexual images resulting in charges that are very punitive and harsh given the action taken by the youth.

Many states are aware that current laws do not address this issue but have not created laws to address this concern. Given the technology available to youth, it is very important to discuss these issues with parents including giving them resources to implement parent controls and information about the types of electronic equipment that access the internet.

Laws differ across jurisdictions as to how old a youth must be before they may legally consent to sexual behaviors, for example, in most states the age of consent is 16, with some states youth as young as 14 may consent with another older youth.

For more information click here.

Professionals can help teens understand the laws and consequences when it comes to sexual behavior. Teens normally understand that some sexual behaviors can lead to trouble, but often they don't realize how much trouble. For example, teenagers may be aware that showing pornography to a 10-year-old would get them in trouble with parents or teachers but may not know that this behavior would result in delinquent charges, registration as a sexual offender, or even imprisonment.

Professionals, parents, and caregivers are responsible for knowing and conveying to children and adolescents' information on sexual development, sex education, healthy relationships, intimacy, consent, and the laws, including age of consent laws. Education can facilitate preventing problematic or illegal sexual behavior before it starts. Interventions for the youth, child victims, and their family can help the child victims heal and the youth with problematic and/or illegal sexual behaviors (including aggressive sexual behaviors) get on track for healthy and prosocial development.

Initial Considerations

What are some initial determinations in the case planning and clinical decision- process?

  • Are all the children who were involved in the sexual behavior currently safe and supported?
  • What actions are needed to create and maintain safety and support for the children and families?
  • Who is best to engage, inform, and support the family through the process including the assessment?
  • Given the results of the assessments, is community based intervention indicated for the youth with PSB and for the impacted children and siblings? If more intensive interventions are indicated, what is the least restrictive placement and treatment environment appropriate for the youth? How will the caregiver(s) be engaged in the services?
  • What approach to treatment would be best to address the priority service needs and build protective factors?
  • How can the case planning, services, and approach to the family be culturally responsive?

Who is responsible for making decisions about the treatment and case planning?

  • Decision-making responsibilities will depend upon the professionals’ roles and responsibilities.
  • The child welfare and child protective service professionals are responsible for assessing and addressing child safety and protection from abuse. Law Enforcement and Juvenile justice professionals are charged with determining if a law has been broken and what pathway (e.g., adjudication, diversion, deferred prosecution) will facilitate public safety and youth rehabilitation. Health and behavioral health professionals assess for well-being, relevant vulnerabilities, risks, needs, and protective factors, facilitate safety planning, and recommend and provide therapeutic services to the children and families.
  • School personnel will assess, implement, and monitor safety plans and promote positive social-emotional well-being and academic progress of the students.
  • Best practices involve collaborative communication and efforts among all professionals and caregivers throughout the process.
Key Points
  1. Safety is the first priority in case planning and clinical decision making.
  2. Assessments drive family treatment and case planning and inform progress in services.
  3. Treatment planning and interventions ensure safety, address risk and protective factors, and other intervention needs using appropriate evidence based interventions.
  4. The case planning and clinical decision making process can vary for children and teens- professionals must be aware of these differences as they relate to safety, placement, and treatment plans.

Safety First

Consider all members of the household when developing safety plans with the caregivers. An effective safety plan involves creative strategies that lead to healthier choices. If a home is unsafe with the child there, consider alternative community placements if assessment indicates this can be done safely. Children are more likely to thrive when connected to supportive anchors with peers and adults in the home, school, and community. Check in regularly to be sure they’re staying on track, and revising the safety plan as factors change.

How can I make sure that case planning and clinical decision making promote the safety of the child first?

  • Your priority is the safety of ALL the children involved. When the problematic sexual behaviors involve other children in the home, you must examine their emotional impacts, well-being, and preferences. Consider caregivers' protective behaviors, supports, needs, and wishes.
  • If the behavior happened outside the home and involved extended family members, neighbors, or family friends, your safety assessment should be broader.

What about the safety of siblings?

  • Children impacted by their siblings' problematic sexual behavior can have a range of responses.
  • Some children may have ongoing anxiety, including post-traumatic stress disorder (PTSD). Other siblings may not experience fear or concern about their sibling, particularly if the behavior occurred once, was not intrusive, and responded to immediately with being believed and protected. Decisions require assessment with and input from the caregivers and children.
  • If separation is necessary, consider timing, visitations, and a plan for reunification. (See: Visitation and Reunification). Other siblings may not experience fear or concern about their sibling, particularly if the behavior occurred once, was not intrusive, and responded to immediately with being believed and protected. Decisions require assessment with and input from the caregivers and children.

What do I need to know about safety planning?

Safety planning begins at the time of referral. Safety strategies include creative ways to use technology, strategic placement of furniture, and changes in daily routines that increase safety and enhance the likelihood of success. Strategies to facilitate safety often require maintaining close, visual supervision.

What should be included in a safety plan and how do I engage the caregiver(s)?

  • Safety plans address vulnerabilities and build on protective factors of the children, caregivers, school, and community. These resources provide information about factors to consider and questions to ask to facilitate safety planning.
  • Caregivers are key to the success of home safety planning. See the detailed safety planning.

What happens when youth are not safe to remain in the home?

  • If it is not safe for the youth to remain in the home, consider alternative community placements such as extended family, kinship care, or foster care before placing them in a restrictive care environment if the child's responsivity to supervision warrants community placement.
  • Most often, removing the youth with problematic sexual behavior from the home is preferable to removing the other children, especially the impacted child(ren).
  • Consider less restrictive alternatives before out-of-home placement. And if that placement is within the community, such as a foster care home, the new caregivers should have background information about the behaviors, supervision needs, and safety plans.
  • Continual assessment of progress should occur to make recommendations about reunification

For additional information and resources see:

Level of Care & Placement

A continuum of care and placement options is needed that flexibly meets the needs of the youth with PSB, impacted children, siblings, and caregivers. Interventions provided should be no more restrictive than what is needed for community safety and child well-being. Most youth with PSB can remain in the community.

Level(s) of clinical care include:

  • Outpatient
  • Day treatment
  • Inpatient care
  • Residential care can be costly and less effective. "In many cases youth would benefit from a lower level of care (outpatient) if foster and relative care are available and/or the child is able to stay in the home with an appropriate safety plan.”

Who decides where a youth is placed?

Often, that depends on agency and system criteria. Placement parameters vary by state or region. Juvenile justice decisions are impacted by legal charges and adjudication decisions and planning.

Is it possible for youth to remain at home?

  • In many cases yes, depending on if there are impacted children or other vulnerable children in the home. Youth behavior and responsivity to caregiver support and supervision are important considerations.
  • For youth who are unable to live at home while undergoing treatment, the next option might be living with other family members or family friends – but away from siblings and other children who might be vulnerable. Beyond that, child welfare agencies may consider foster care an option.

What if siblings are in the home?

Sibling safety is always a priority. Special care is necessary when they’ve been victims. In these cases, the multidisciplinary team supporting the youth and family must consider sibling safety and wellbeing when working with the caregivers for safety planning.

What if the youth require a higher level of care and safety supports?

  • If the behavior is severe, remaining in the community might not be safe. Short-term residential treatment or hospitalization may be required.
  • Some youth may be placed in a locked treatment center or juvenile correctional facility.
  • Community reentry planning begins immediately and continues throughout placement.
  • Involving the youth’s caregivers in treatment is imperative and must begin before the youth is discharged to enhance the transition back into the community.
  • In some cases, youth may no longer have an identified caregiver (such as when parental rights have been terminated). The multidisciplinary team should collaborate to identify residential and mentorship options to support long-term well-being as they age. Options could include kinship, adoptive, or foster homes, group homes, and transition housing support programs.

Reunification depends on progress assessments. It should be well-planned and allow room for continual updates based on therapy, supervision, and guidance. Clinical and case management involves matching the risk and needs with the best placement and treatment options.

Adolescents

Adolescence is a time of significant growth and development that ebbs and flows. Teens can have both a sense of invisibility and vulnerability. Their ability to consider the future, think abstractly, understand others' perspectives, and understand long term consequences is growing but not fullAdolescentsy developed. Peer relationships are of utmost importance and yet are fraught with uncertainty. All of this is fueled by easy access to technology and sexual content. Although research indicates that youth want access to accurate information on relationships, sex education, consent, and the rules and laws that guide these decisions, few receive quality content. Further, addressing problematic sexual behavior in teenagers is more complex because the behavior may also be illegal, depending on the laws in the jurisdiction. Background information about adolescents' sexual behavior can be found here.

Normative sexual development information can be found here.

What are best practices in identifying and responding to problematic sexual behavior of youth?

Research indicates that teens with problematic or illegal sexual behaviors have three or more service systems involved in the response. Siloed systems can increase stress and hinder family engagement and progress. Best practices implement a strong, collaborative approach with:

  • Child Protective Services
  • Child Advocacy Centers
  • Law Enforcement
  • Juvenile Justice Agencies (probation, Juvenile / Family Court, Prosecution)
  • Mental Health Providers
  • Medical Providers
  • Schools
  • Service agencies that work with youth

What if the assessment indicates the teen does not have problematic sexual behavior?

  • Concerns raised about the teen's sexual behavior may indicate a need for sex education or other supports for healthy relationship building skills. Brief education may be useful for the family.
  • The assessment can provide guidance on next steps. It might reveal other difficulties, including other problematic behaviors, untreated mental health disorders, or significant family conflict.

What are some considerations for understanding teen behaviors and treatment?

Understanding how problematic sexual behaviors fit within the context of other behaviors, mental health difficulties, environment, and other risk and protective factors will influence treatment and case planning decisions.

Here are some considerations:

  • What is the context of the sexual behavior?  What individual, family, and situational factors impact the onset and maintenance of their problematic sexual behaviors? 
  • Do they demonstrate problematic sexual behaviors as part of a larger pattern of conduct problems and delinquent behaviors?
  • Do they have a complex trauma history impacting their sexual development and behavior?
  • Do they have atypical sexual interests, antisocial attitudes, and delinquent behaviors?

What situational or transitory factors are related to problematic sexual behaviors?

For many teens, problematic sexual behaviors are related to situational factors, such as:

  • A normal surge of onset sexual interest and impulses.
  • Lack of knowledge or misunderstandings about society’s rules regarding sexual behavior and not appreciating the wrongfulness of sexual misconduct.
  • Insufficient adult monitoring.
  • Inadequate sex education and support to build healthy relationship skills.
  • Substance use.
  • Exposure to sexual behavior through media or on the internet.
  • Obstacles to age-appropriate peer relationships and social isolation.
  • Negative peer influences.

Teens with Attention Deficit Hyperactivity Disorder (ADHD) in the absence of other delinquent behaviors, may also fall into this category.

Some teens may have other difficulties like learning disabilities, intellectual disabilities, or developmental disabilities, such as autism, or fetal alcohol syndrome. They may have difficulties with impulse control and decision making. They may impulsively touch others’ private parts or violate physical boundaries.

Teens who have these difficulties sometimes respond to normal sexual feelings inappropriately. They may not have learned the rules or laws. They may struggle with reading or understanding others’ feelings. They may act in ways that are sexually inappropriate or even illegal. 

Most youth with ADHD, developmental disabilities, or other mental health challenges or disorders do not engage in problematic sexual behaviors. 

Treatment and case planning must consider the teen’s abilities, support, and learning style. 

Disruptive Behavior Disorder or Delinquency

What if the problematic sexual behavior is part of a larger disruptive behavior disorder or delinquency pattern? 

  • Some teens engage in disruptive or aggressive behaviors that include violating laws or the rights of others. PSB may be part of a larger repertoire of concerning activities. Youth who engage in antisocial and delinquent acts often meet the criteria for Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Disruptive Behavior Disorder Not Otherwise Specified (NOS), or Attention Deficit Hyperactivity Disorder (ADHD).
  • Common behavior patterns for youth with ODD or CD include outbursts or aggression in response to limit-setting, as well as provocative behaviors intended to annoy or harass others. Their behavior might follow similar triggers, such as rejection. This behavior could take the form of harassment.
  • Sometimes, illegal sexual behaviors may relate to antisocial attitudes that justify these behaviors. Maybe they feel entitled to sex and are willing to use force.
  • Others might commit statutory offenses that don’t always involve force, aggression, or even physical contact.
  • And others may demonstrate severely nonsexual aggressive and dangerous conduct that has been ongoing from an early age, with intermittent sexual offenses. 

Most youths with delinquent behaviors do not exhibit problematic sexual behavior. A multisystemic intervention, such as Multisystemic Therapy for Problematic Sexual Behavior  (MST-PSB), is an evidence-based approach that could help.

Trauma and Adjustment Disorders

Are problematic sexual behaviors related to traumatic experiences?  They may be directly or indirectly related to traumatic experiences. A common belief is that a child with problematic sexual behaviors has been sexually abused. While that is true for some teens, it is not universal. In fact, experiences of exposure to violence (physical abuse, domestic violence, bullying and community violence) has been more common. Youth with complex trauma histories often have more complicated clinical presentations requiring integrated treatment plans to address their multiple needs.

For more information about children’s response to trauma, visit the National Child Traumatic Stress Network (nctsn.org)

Atypical Sexual Interests and Serious Delinquency

Do problematic sexual behaviors reflect atypical sexual interests?

  • In rare cases, the behaviors may reflect atypical sexual interests involving much younger, prepubescent children or coercive sexual activities. 
  • Sometimes, these atypical interests may resemble sexual traumas experienced by the youth – perhaps reinforced by multiple incidents or masturbatory activity – and physiological arousal responses involving pleasurable sensations or orgasms in pubertal youth. 
  • Because sexual interests and patterns of sexual arousal are still developing in teens, a diagnosis of Pedophilia is rarely and only used if the teen if 16 or older, and clearly meets the diagnostic criteria - as noted in the Diagnostic and Statistical Manual of the American Psychiatric Association - (DSM-V).

What if teens have problematic sexual behavior with atypical sexual interests?

  • A small number of teens may display preoccupation, excessive sexual behavior, and/or atypical sexual interests. For them, sexual behaviors are the focus of treatment.
  • They have difficulty managing their sexual arousal appropriately. They may demonstrate problematic sexual behavior across various contexts, such as at their school or home.
  • Assessment and interventions must explore the antecedents, behaviors, and consequences of the behavior as well as triggers and causes.
  • They might have inaccurate and distorted beliefs about sexual behaviors. They might not even recognize the behavior is inappropriate.
  • Occasionally, these teens experience persistent arousal associated with inappropriate sexual interests, such as sexual arousal involving significantly younger children, themes of violence, or coercion.
  • The Help Wanted program provides important guidance on preventing and responding to atypical sexual interests towards children (https://www.helpwantedprevention.org/). As does Talking for Change - https://talkingforchange.ca/
  • WhatsOK is a website (whatsok.org) and a helpline (whatsok.org/ask) that offers free, confidential support and resources to youth and young adults (ages 14-21) with concerns about their own or a friend’s sexual thoughts, feelings, and behaviors.

What if the problematic sexual behavior is both atypical and delinquent?

In rarer cases, teens may demonstrate significant, early-onset, delinquent, and aggressive behaviors and sexual preoccupation or deviant sexual interests. These teens often present multiple, pressing treatment needs – often including co-occurring mental health challenges and disorders. 

  • Interventions should be prioritized to maximize the safety of all involved and reduce immediate risk factors. Interventions may initially require short-term residential placement and intensive services.
  • After a comprehensive assessment, interventions need to target erroneous attitudes and beliefs related to problematic sexual behaviors.
  • Interventions that facilitate impulse management and other identified risk factors are needed.  
  • Behavior management and collaborative, multisystemic safety plans involving parental and other adult supervision are needed to facilitate safety upon re-entry to the community. 

Other Diagnostic Considerations

Assessment sometimes reveals learning difficulties and mental health problems – or a significant history of trauma or maltreatment. How these factors interact with PSB will determine risk factors and treatment needs.

What are some diagnostic considerations for youth with learning problems?

  • Teens with problematic sexual behavior may have learning disorders or developmental difficulties. Some teens may have developmental delays, intellectual disabilities, or pervasive developmental disorders that impact not only learning but functioning across multiple domains. 
  • Providers should tailor interventions to match a teen’s learning style and capabilities.
  • Teens with memory difficulties will likely need opportunities to have multi-modal learning material and have frequent repetition and practice.
  • Many teens could benefit from additional support and structure in their home environment, including cues from their caregivers to use their new skills. 

What are some diagnostic considerations related to problematic sexual behavior?

  • “Problematic sexual behavior” is not a diagnosable condition, but it is clinically concerning.
  • At times, problematic sexual behaviors represent an isolated or temporary problem.
  • Sexual behaviors may be part of a pattern of delinquent activities or one of several disruptive behavior disorder symptoms.
  • They might involve breaking the rules and violating physical boundaries. They may be consistent with other symptoms of disruptive behavior disorders, such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, or Disruptive Behavior Disorder Not Otherwise Specified (NOS).

For more information about youth responses to traumatic life experiences, visit the National Child Traumatic Stress Network.

Treatment Planning and Interventions

What are some considerations for effective treatment planning and interventions?

Effective treatment plans will follow assessment. Ensure safety. Identify risks, intervention needs, and required responses.

Ongoing and timely reassessments facilitate effective treatment plans over time. Interventions are most likely effective when individual and family treatment needs are matched with high-quality services in a seamless and flexible continuum of care.

The continuum of treatment interventions includes:

  • Educational interventions.
  • Outpatient therapy (6-16 months)
  • Intensive outpatient therapy (clinic or home-based).
  • Intensive multisystemic treatments, including day treatment, residential treatment, and intensive treatment in locked facilities, such as correctional facilities.

Research suggests treatment is more effective when caregivers and teens are concurrently involved and practice new skills. Depending on the individual and family needs, community-based treatment interventions can vary in intensity. Most teens who have few risk factors associated with reoffending and solid protective factors may only require weekly outpatient treatment sessions.

How can I tailor the intervention to address multiple risk factors?

  • Youth and families with more risk factors and needs may benefit from a greater intensity of services as well as home-based or multisystemic services.
  • Home-based interventions are appropriate for youth with significant needs across multiple domains, especially ongoing problematic behaviors in their home and school environments.
  • The programs often address parenting strategies and youth problem behaviors. Sometimes, they include additional community support and coordination with other providers and settings, such as schools.
  • Multisystemic Therapy (MST) for Problematic Sexual Behaviors is an effective intervention method with strong empirical support.

What if families and individual family members have multiple needs?

Multidisciplinary teams or intensive case management services, such as High-Fidelity Wraparound, can help address multiple needs. Case managers and team facilitators must be knowledgeable about youth with problematic sexual behavior, their risks, and their needs. 

Find information about evidence-based treatments through the California Evidence-Based Clearinghouse (https://www.cebc4cw.org/) and OJJDP’s Evidence Based Program directory (https://ojjdp.ojp.gov/evidence-based-programs). Below are some examples:

  • Locate sites trained in Multisystemic Therapy for Youth with Problematic Sexual Behaviors (MST-PSB) operating under a valid program license from MST Associates (https://www.mstpsb.com/).
  • Trauma-Focused Cognitive Behavior Therapy (tfcbt.org) is designed for youth whose problematic sexual behavior is driven by trauma experiences.
  • Functional Family Therapy (https://www.fftllc.com/) is one of many treatments found to be effective treatment when disruptive behaviors are of primary concern. Modules to address problematic sexual behavior can be integrated.
  • OU Problematic Sexual Behavior - Cognitive Behavior Treatment for adolescents. To learn more and find providers (https://connect.ncsby.org/psbcbt/home.)
  • Safer Society Foundation (https://safersocietypress.org/treatment-referrals/) maintains a database of clinicians from around North America who work with sexual abusers, children with sexual behavior problems, and survivors of abuse.
  • The Association for the Prevention and Treatment of Sexual Abuse (ATSA) (https://www.atsa.com/referral) referral database promotes sound research, effective evidence-based practice, informed public policy, and collaborative community strategies that lead to the effective assessment, treatment, and management of individuals who have sexually abused or are at risk to abuse.
  • Search for a local Children's Advocacy Center located near you through the National Children's Alliance (https://www.nationalchildrensalliance.org/cac-coverage-maps/). Local Child Advocacy Centers may provide services directly or guide caregivers to treatment options in their communities.

How can foster care placements help teens with problematic sexual behavior?

For teens who are unable to remain at home, foster care placements offer alternative community-based placements.

  • For teens unable to remain at home, foster care or kinship care could be considered as community-based placements.
  • Therapeutic foster care or foster homes with services may be good alternatives to avoid exposing youth to negative peer influence in residential care – especially if the youth are not demonstrating a pattern of delinquent behavior.

When should I consider in-patient or residential treatment?

Teens with the highest level of risks and needs may require residential, hospital, or correctional placements with appropriate treatment programs.

Research suggests that while youth in some residential programs demonstrate positive gains, these gains require transitional support in the community with the caregivers for sustained positive impact. Effectiveness of residential treatment may be enhanced by using intensive, evidence-based interventions, as well as involving the family, developing pro-social skills, and transitioning to stable aftercare settings. Ongoing support must follow discharge.

Juvenile corrections programs should incorporate evidence-based interventions, too.

How can I involve caregivers in the treatment process?

Teens are beginning to separate from their parents and caregivers, but those adults remain important facets in their lives. Involving parents will help yield positive outcomes. Our Caregiver Partnership Board has developed a Caregiver Survival Guide and tip sheet on what to look for in treatment. Further, our Youth Partnership Board developed a tip sheet for caregivers sharing how important they are to teens success in treatment. These can help the caregiver feel informed and empowered to help their child.

Topics often addressed in treatment with the caregivers include:

  • Effective parenting strategies that promote positive behaviors and prevent misbehaviors.
  • Information about sexual development and guidelines for distinguishing more common sexual behaviors from those that are problematic or illegal.
  • Vulnerability and protective factors related to sexual behaviors of youth.
  • Developmentally appropriate sex education.
  • How to promote open communication about sexual knowledge and behavior.
  • How to help their teens understand relevant laws and legal consequences for illegal sexual behavior.
  • How to address relationship-building skills and ensure consenting relationships.
  • Abuse prevention skills, with emphasis on how they can protect all their children.

For additional information about adolescents with illegal sexual behavior, see the guidelines from the Association for the Treatment and Prevention of Sexual Abuse

Children

An important first step when there is concern about a child's sexual behavior is to evaluate if it is normative, cautionary, or problematic behavior.

Review the information here for more details about normative sexual behavior of preschool and school age children child sexual development section. This section provides guidance of when sexual behavior would be considered problematic When is Sexual Behavior a Problem.

childhood sexual

What if the sexual behavior appears to be normative?

Instead of ignoring the behavior, caregivers might take advantage of “teachable moments.”

  • Discreetness (“Clothes must stay on,” or “Keep private parts covered.”)
  • Privacy (“One person in the bathroom at a time.”)
  • Interacting with others (“No touching or showing private parts.”)

For more information on Caregiver's Response to Sex Play, click here.

What are some diagnostic considerations?

Problematic sexual behaviors are not diagnosable conditions. Instead, they are clinically concerning. Sometimes, the behavior is isolated. But other times, the behavior is part of a pattern of disruptive behaviors. Some children with problematic sexual behaviors have experienced trauma. The trauma can impact the children's sense of boundaries, safety, coping, and can cause symptoms in the form of problematic sexual behaviors. 

The following section provides guidance for diagnostic considerations, including disruptive behavior disorders, adjustment disorders, and post-traumatic stress disorders. See the American Psychiatric Association Diagnostic and Statistical Manual.

When would problematic sexual behaviors be an isolated concern for children?

At times children who are doing well overall have sexual behavior that started as curiosity and became cautionary or problematic. These children may have been exposed to sexualized media or behavior that in turn prompted imitative sexual behaviors which cause concern.

Is PSB a symptom of disruptive behavior disorders?

Possibly. Disruptive behavior disorders are childhood diagnoses that describe children who struggle with controlling impulses, following rules, and listening to adults who are in authority. Problematic sexual behaviors often involve breaking rules and violating boundaries. Children with problematic sexual behavior may have a disruptive behavior disorder such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Disruptive Disorder not otherwise specified (POS).

Are problematic sexual behaviors related to traumatic experiences? 

Problematic sexual behavior of children may be directly or indirectly related to traumatic experiences. A common belief is that a child with problematic sexual behaviors has been sexually abused. While that is true for some children, it is not universal. In fact, experiences of exposure to violence (physical abuse, domestic violence, bullying and community violence) have been more common.

Sexual abuse is more likely to lead to problematic sexual behavior when the abuse included one or more of the following:

  • Started when the child was young, such as preschool age.
  • Involved penetration.
  • Involved multiple people who offended the child.
  • Occurred frequently.

Children with problematic sexual behavior and trauma history may present with Post Traumatic Stress Disorder symptoms or diagnosis. Other children will present with an adjustment disorder. Children with complex trauma history often have more complicated clinical presentations requiring integrated treatment plans to address their multiple needs.

For more information about children’s response to trauma, visit the National Child Traumatic Stress Network.

What are some other diagnostic considerations?

  • Learning disorders and developmental delays may co-occur in children with problematic sexual behaviors.
  • Children with learning disabilities, intellectual disabilities, or developmental disabilities, such as autism, often have difficulties with impulse control. Interpersonal problems can be similar to children with ADHD and include impulsively touching others’ private parts or violating physical boundaries. 
  • Playmates of children with developmental disabilities are typically developmentally younger children who are functioning at a similar level of social and emotional development.
  • When older children with developmental disabilities begin to have natural curiosities and initiate sex play (particularly when puberty starts) and playmates are much younger, the resulting behavior is considered problematic.

How can I develop an individual treatment and case plan?

Individualized treatment and case planning for children with problematic sexual behaviors may include determining:

  • Whether all the children who were involved in the sexual behavior are currently safe and supported.
  • Which actions are needed to create and maintain safety and support for the children and family.
  • Whether outpatient, community-based intervention meets the child’s and family’s needs, and if not, what is the least restrictive placement and treatment environment.
  • Which treatment modules, elements, or interventions best fit the treatment needs of the child and family.
  • How should developmental and cultural considerations be integrated in treatment and case planning.

How do I select the most appropriate intervention for the child and family?

Individualized treatment planning will determine when interventions are most appropriate.

Most children with problematic sexual behaviors can be broadly grouped into the following categories:

  • Children with problematic sexual behaviors only.
  • Children with disruptive behavior disorder symptoms and problematic sexual behavior.
  • Children with PTSD or other trauma reactive symptoms and problematic sexual behavior.
  • Children who have complicated trauma histories and clinical presentations with a combination of problematic sexual behavior, PTSD, and disruptive behavior disorder symptoms.

A single integrated treatment is typically preferable to multiple separate treatments, especially when problematic sexual behaviors are secondary priorities.

To what extent should caregivers be involved in treatment?

  • Parents can help effect change. They can promote positive behavior and reduce misbehaving. Praise, time-outs, and behavior charts are possible tactics.
  • Parents and caregivers should have information about sexual development and guidelines for distinguishing between typical and problematic. They should understand why this behavior happens.
  • Often, parents and caregivers are well positioned to teach the basics about privacy, modesty, and applying rules to a variety of situations.
  • They promote open communication about sexual behavior and curiosity. They can address relationship building and intimacy.
  • Parents can also build abuse prevention skills by determining who supervises and who interacts with the home’s children.

What Makes a Treatment Program Successful?

Different types of therapies for problematic sexual behaviors in children have been evaluated. We have learned about what types of treatment are helpful for children with problematic sexual behaviors and their families. The main characteristics of effective therapy for many children with problematic sexual behavior include:

Find information about evidence-based treatments through the California Evidence-Based Clearinghouse (https://www.cebc4cw.org/) and OJJDP’s Evidence Based Program directory (https://ojjdp.ojp.gov/evidence-based-programs).

Below are some examples:

  • Outpatient treatment (where the child stays in the home and community).
  • Active and full participation in the treatment by parents and caregivers.
  • Short-term treatment of approximately three to six months. Short-term treatment is possible if the family attends sessions regularly, actively participates in available services, and practices skills between sessions.
  • Education for caregivers about how to apply rules about sexual behaviors.
  • Enhance quality of family relationships.
  • Teach parenting strategies that prevent and reduce behavior problems.
  • Address sexual education topics with their children.
  • Support abuse-prevention strategies and skills.
  • OU Problematic Sexual Behavior - Cognitive Behavior Treatment. To learn more and find providers (https://connect.ncsby.org/psbcbt/home).
  • Locate sites trained in Multisystemic Therapy for Youth with Problematic Sexual Behaviors (MST-PSB) operating under a valid program license from MST Associates (https://www.mstpsb.com/).
  • Trauma-Focused Cognitive Behavior Therapy (tfcbt.org) is an effective treatment for youth whose problematic sexual behavior is driven by trauma experiences. (https://www.sciencedirect.com/science/article/pii/S1077722917300731).
  • Parent Child Interaction Therapy (https://www.pcit.org/what-is-pcit.html; https://www.sciencedirect.com/science/article/pii/S0190740917306795) and Functional Family Therapy (https://www.fftllc.com/) have been found to be effective treatment when disruptive behaviors are of primary concern. Modules to address problematic sexual behavior can be integrated.
  • Safer Society Foundation (https://safersocietypress.org/treatment-referrals/) maintains a database of clinicians from around North America who work with sexual abusers, children with sexual behavior problems, and survivors of abuse.
  • The Association for the Prevention and Treatment of Sexual Abuse (ATSA) (https://www.atsa.com/referral) referral database promotes sound research, effective evidence-based practice, informed public policy, and collaborative community strategies that lead to the effective assessment, treatment, and management of individuals who have sexually abused or are at risk to abuse.
  • Search for a local Children's Advocacy Center located near you through the National Children's Alliance (https://www.nationalchildrensalliance.org/cac-coverage-maps/). Local Child Advocacy Centers may provide services directly or guide caregivers to treatment options in their communities.

Standards of Care

Professionals who respond to problematic sexual behavior of youth have the responsibility of making complex decisions that impact the lives of multiple community members. Youth with problematic sexual behaviors, impacted children, and family members are heterogeneous—straight forward simple rules of conduct do not apply. Professionals must consider key factors and apply appropriate responses based on scientific evidence. Professionals must seek agreement and collaboration among well-informed professionals in the field.

Guidelines and Standards of Care

Guidelines and Standards of Care for Professionals Working with Youth with Problematic Sexual Behavior

  • Recognize the importance of your work for promoting community and family safety.
  • Be aware of the potential for significant impact and life-altering consequences your practices may have on youth and their families.
  • Inform clients that professionals are mandated reporters of child abuse.
  • Ensure your clients are fully informed, in developmentally, cognitively, and culturally appropriate language.
  • Inform clients of the limits and management of confidentiality when multiple agencies are involved.
  • Respond in a just manner, being careful to consider systemic and individual responses of unconscious biases.
  • Conduct high quality initial evaluations and timely reassessments, and relevant, evidence based and supported interventions.
  • Continuously learn and grow in understanding of all areas of diversity to provide a respectful, informed, and culturally responsive approach.
  • Follow relevant practice guidelines and ethical standards (e.g., Association of the Treatment and Prevention of Sexual Abuse standards and guidelines, as well as those of their own professions).

Resources

  • In 2023, the Association of the Treatment and Prevention of Sexual Abuse Task Force on Children with Sexual Behavior Problems completed the update and 2nd addition of their report designed to guide professional practices with children ages 12 and under.  https://members.atsa.com/learn/Details/guidelines-children-with-sexual-behavior-problems-2nd-edition-194637 The 2023 ATSA report provides guidelines for treating children with sexual behavior problems. It focuses on person-first language, emphasizing the child's well-being over behavior. The report discusses various aspects including assessment, treatment approaches, and placement considerations, highlighting the importance of understanding each child's unique situation. It underscores the need for comprehensive, evidence-based practices, family involvement, and considers a broad range of contributing factors to effectively address and manage these behaviors, while ensuring the child's overall development and safety.  https://members.atsa.com/ap/CloudFile/Download/pgGxjO4p  Supplemental resources on topics such as Neurodevelopment and Children with PSB, Children’s Advocacy Centers and Problematic Sexual Behavior are  published and other topics are in development.
  • In 2017, the Association of the Treatment and Prevention of Sexual AbuseTask Force on Adolescents with Sexual Behavior Problems released professional practice standards for working with adolescents who engage in sexually abusive behavior. These standards were based on the current state of knowledge at the time and are consistent with those presented on NCSBY.org.

What qualifications are needed to work clinically with youth with problematic sexual behavior?

Clinicians should comply with generally accepted standards of practice in their mental health profession and follow the Professional Code of Ethics published by the Association for the Treatment of Sexual Abusers. Clinicians should:

  • Have appropriate training, experience, and continuing education.
  • Recognize their abilities and limitations.
  • Engage in consultation and teamwork.
  • Follow relevant professional guidelines and ethical standards.

Practitioners have an ethical obligation to become educated about relevant issues, seek out appropriate consultation, and coordinate care with other professionals involved whenever possible.

Clinicians must not have a conviction or a deferred judgment for any offense involving criminal, sexual or violent behavior or a felony that would bring into question the competence or integrity of the individual to provide sexual abuse specific treatment.

What are the ethical guidelines for professionals working with youth with problematic sexual behavior?

  • Professionals must be knowledgeable of their own profession’s ethical guidelines and standards of care as they relate to children and families, and specifically youth with problematic sexual behavior and youth involved in the courts.
  • Ethical guidelines require professionals to work within their areas of expertise, seek consultation when needed, and refer out if they are not adequately knowledgeable or proficient in a particular area. Professionals must always practice within the boundaries of their training and profession.
  • Some professions may not have ethical guidelines that directly address youth with problematic sexual behavior—in these cases, the Association for the Treatment and Prevention of Sexual Abuse guidelines for clinical professionals are a starting point for supporting ethical practices.

What training, experience and continuing education activities are important for working with youth with problematic sexual behavior?

  • Children and adolescents are not small adults. Professionals must have education and training in child and adolescent development. Relevant coursework, supervision and, especially, ongoing continuing education are important.
  • Professionals require specific training to develop core knowledge in child and teen problematic sexual behavior. Professionals must understand the heterogeneity among youth, their individual risks, strengths, and needs, and the context of the situation.
  • The nature and extent of this training needs to be commensurate with the type of activities and services provided.
  • Because laws and public policy influence decision making, professionals must be familiar with policies and laws that pertain to youth with problematic sexual behavior.
  • Professionals must recognize trauma and the potential impact on those involved and affected by the problematic sexual behavior.
  • Multidisciplinary teams help facilitate coordination of care and support professional decision making for youth and their families. Professionals must be aware of the roles and responsibilities of the other professionals involved in the response to youth problematic sexual behavior.

What are some specific areas of knowledge and expertise for professionals working with youth with problematic behavior?

Professionals must be able to answer the question, “Is the sexual behavior normative or problematic?” This requires knowledge of the following topics:

  • Range of sexual behavior exhibited by children and teens.
  • Relevant local laws.
  • Varying cultural attitudes and beliefs.
  • Healthy sexual development in children and teens.
  • How to work with youth and their families.
  • How to establish communication and parenting skills that promote healthy development.

Professionals must be able to determine if the behavior is potentially illegal or problematic and what options are available.

A number of factors impact this determination.

  • State and federal laws vary dramatically for youth.
  • Relevant laws and public policies are included below.
  • The Federal Child Abuse Prevention and Treatment Act (CAPTA) (PL 111-320) provides federal guidelines for child abuse and neglect and child protection.
  • The Adam Walsh Child Protection and Safety Act of 2006 (PL-109-248) is the federal law that is designed to protect children from sexual exploitation, sexual abuse, and other sex offenses.
  • This Act strengthen penalties for crimes against children, makes it more difficult to reach children on the internet for sexual acts, requires background checks for adoptive and foster parents, and has expanded the national sex offender registry.
  • State laws are also relevant to address problematic sexual behavior of youth. These laws include ones pertaining to abused and neglected children, family court proceedings, children’s behavioral health programs, and sexual offender registration and community notification Professionals should collaboratively determine what response options fit with the characteristics of the case (e.g., deferred prosecution, types of charges, rehabilitation, and placement). The options that would be considered best in terms of standards of care may not be readily available in the community. Efforts towards systems change may need to be considered.
  • Professionals must keep in mind that most laws related to sexual offenses were developed to apply to adult sexual offenders. Many laws do not consider the differences in adult behaviors and child or youth with problematic or illegal sexual behaviors.
  • For example, some jurisdictions are considering legislation that would address “youth produced images” (also referred to as, “sexting”) separately from child pornography. Professionals must also be aware of the rates and risks of problematic sexual behavior including:
  • Low frequency of recurrent problematic or illegal sexual behavior overall.
  • Rates of nonsexual behavior problems are more likely than sexual ones.
  • Research-based risk and protective factors that may increase or decrease the likelihood of problematic sexual behaviors.
  • [Understanding PSB in Youth, Assessment (Coming Soon)]Professionals must be knowledgeable of evidence-based interventions and characteristics of best practices, including:
  • Evidence-based behavior management interventions.
  • Interventions should be family focused and match the interventions to fit the risk, needs, and responsivity of the youth with problematic sexual behavior.
  • Be developmentally appropriate for children or teens. See the Clinical Decision-Making and Intervention (Coming Soon) sections for more information about best practices and evidence-based practice. Professionals must be aware of the impact and response to trauma experienced by the youth with problematic sexual behavior, child victims, and families. Professionals must recognize trauma and intervene when appropriate. [www.nctsn.org]

Professionals must be knowledgeable about factors relevant for decision-making when considering placement following problematic sexual behavior including the steps for timely family reunification when out-of-home placement occurs.

Are there instances when specialized training is required?

Yes. Atypical sexual interests are rare among youth with problematic sexual behavior. Professionals working with teens with persistent, atypical sexual interests should stay abreast to the latest research and practices on how to address these concerns in a developmentally appropriate manner (do not utilize strategies solely designed for adults with pedophilia). 

What are the limitations of practice?

Professionals need to be cognizant of their capacity and competence, reaching for supervision and consultation particularly when reaching the boundaries of expertise. However, it can be difficult to know what we do not know. Continuous education, consultation and support is needed. In addition to the professional knowledge and skills described above, consultation and teamwork is important for helping professionals monitor decision making, the progress of families as they work toward reunification and resolution, the identification of risk and protective factors, and safety planning.

Public Policy

What key research findings are important for guiding public policies and agency practices?

  • Greater than one-third of sexual offenses against children are committed by other youth. Approximately one quarter of the child victims are related to the youth with illegal sexual behavior, and few victims are strangers to the youth Finkelhor, Ormrod, & Chaffin, 2009. Preventing sexual abuse in the first place will significantly reduce the number of child victims.
  • Decades of research indicate that sexual recidivism of youth is generally very low overall, typically ranging from 2-15%. In fact, a recent large meta-analytic study of adjudicated juveniles not in adult court found less than 3% recidivated with a sexual offense. Caldwell, 2016.
  • Due to the generally low recidivism rate, efforts at risk prediction leads to more false positives (labeling a youth as high risk, when they are not) than accurate predictions. Thus, ethical policies and practices should attend to reducing inadvertent harm caused.
  • Youth are quite distinct from adult sexual offenders in terms of etiology, context, impact, responsivity, and outcomes of the behavior. Adult sex offending policies and practices are not developmentally appropriate for youth with problematic or illegal sexual behavior.
  • Further, youth with problematic sexual behaviors are quite heterogeneous in terms of age (3-18 years of age), causes, risks and protective factors, severity and frequency of sexual behaviors, impact on the victims, family context, and responsivity to interventions [see examples here and Adolescents].
  • Effective treatment for youth with problematic and illegal sexual behavior exist.  Unfortunately, a limited number of youth have access to receive evidence-based treatment at the level of care needed (Dopp, Borduin, & Brown, 2015). Further, victims’ access to referral and to evidence-based care is limited, as is coordinated evidence-based care for the family in intrafamilial cases implemented.
  • Youth develop and mature and most frequently stop engaging in all types of offending. Research by Caldwell and colleagues have found reduced risk of violent recidivism even with youth who have psychopathic features (Caldwell, 2011; Caldwell, 2013; Caldwell, McCormick, & Umstead, 2007; Caldwell, McCormick, Wolfe, 2012; Caldwell, Skeem, Salekin, & Van Rybroek, 2006; Caldwell, & Van Rybroek, 2005; Caldwell, Vitacco, & Van Rybroek, 2006) holistic interventions that include the youth, family, and involved social system have the most evidence of effectiveness.
  • Juvenile registration and notification policies have not been found to improve public safety. Research has indicated that registration of juveniles does not improve recidivism, and instead has deleterious impacts on case processing (e.g., increased plea bargaining) and on child well-being (e.g., suicidal thoughts and behavior, harassment, mental health, and school problems) (e.g., Caldwell & Dickinson, 2009; Letourneau & Armstrong, 2008; Letourneau, Bandyopadhyay, Sinha, & Armstrong, 2009; Letourneau, Harris, Shields, Walfield, & Kahn, 2016).
  • Interventions that employ the Risk-Need-Responsivity Model of Assessment and Crime Prevention Through Human Services are associated with reductions in juvenile and adult recidivism, including sexual recidivism.

Child Welfare

All aspects of child welfare services should integrate a focus on well-being. Addressing child and family needs related to well-being critically reduces risks and increases safety and protective factors. This section provides information on protective factors, and youth and caregiver well-being.

When would Child Welfare respond to reports of children and adolescents with problematic sexual behaviors?

State Child Welfare agencies have statutory responsibility to respond to reports of children and adolescents exhibiting problematic sexual behaviors when such reports contain allegations of or suspicions of parental/caretaker abuse and/or neglect or when state laws or policies specifically assign responsibility for problematic sexual behaviors to the child welfare agency. Problematic sexual behavior in children and adolescents is behavior that involves private parts, behaviors that are unusual and concerning given the children’s age and developmental level and are potentially harmful to themselves and others. Each state has a unique set of laws and policies to address the responsibility to respond to youth with problematic sexual behaviors.

The following circumstances may result in the child welfare agency becoming aware of a youth's problematic sexual behaviors and initiating a response:

  • Suspicion or report of abuse or neglect of a child by an adult recently or currently in the home.
  • School report of problematic sexual behavior among children, occurring in the home or problematic sexual behavior occurring at school that causes concern for the safety of children in their home.
  • Situations in which a parent or caregiver has knowledge of the problematic sexual behavior of the child and/or adolescent and has failed to take any steps to stop it –
    • Encourages or allows the child and/or adolescent with the problematic sexual behaviors to babysit or otherwise have a caretaker role with the child victim or other vulnerable children.
    • Allows the child or adolescent with the problematic sexual behavior to have unsupervised contact with other vulnerable children.
  • The youth with problematic sexual behaviors and/or victim has identified specialized treatment needs about which the parents or caregivers have been informed, and services have not been sought and/or utilized
  • A child in foster care discloses that he or she is the victim of problematic sexual behavior of a youth residing in their home.

Some states, such as Missouri, require some level of response to every report of child-on-child sexual abuse. Other states require a response to all reports of sexual behavior between siblings. Still other states require some type of response to every report of suspected abuse and neglect.

Federal Definition of Child Abuse & Neglect

Federal legislation guides individual states by identifying a minimum set of acts or behaviors that define child abuse and neglect. The CAPTA Reauthorization Act of 2010 amended the Federal Child Abuse Prevention and Treatment Act (CAPTA) (42 U.S.C.A. § 5106g) to define child abuse and neglect as follows:

  • "Parents or caretakers must engage in any recent act or failure to act, resulting in death, serious physical or emotional harm, sexual abuse, or exploitation."
  • "Parents or caretakers must engage in an act or failure to act that presents an imminent risk of serious harm."

This definition of child abuse and neglect applies to parents and other caregivers. Generally, a "child" under this definition refers to someone younger than 18 years old or not an emancipated minor.

While CAPTA defines sexual abuse and special cases of neglect related to withholding or failing to provide medically indicated treatment, it does not provide specific definitions for other types of maltreatment, such as physical abuse, neglect, or emotional abuse. Although Federal legislation establishes minimum standards for states accepting CAPTA funding, each state determines its definitions of maltreatment within civil and criminal statutes.

State Definition of Child Abuse & Neglect

States define child maltreatment differently, while the Federal government establishes the minimum standards to be applied nationwide. Definitions of child abuse and neglect typically exist in two places within each State's statutory code:

  • Civil Statutes guide individuals mandated to identify, and report suspected child abuse and determine the grounds for intervention by State child protection agencies and civil courts. You can find your state's definitions by conducting a State Statues Search on the Information Gateway website.
  • Criminal Statutes outline the forms of child maltreatment that can lead to an offender's arrest and prosecution in criminal courts.

States generally recognize four significant types of maltreatment: neglect, physical abuse, sexual abuse, and emotional abuse or neglect.

Any person can actively report suspicions of child abuse or neglect and make reports anonymously. Most reports are made by individuals known as "mandatory reporters," who are required by State law to actively report suspicions of child abuse and neglect. CPS workers generally receive these reports and either screen them in or out.

What are the specific steps in a Child Welfare Response to problematic sexual behavior of youth?

Child Welfare staff are responsible for gathering and analyzing information from as many reliable sources as possible in order to answer key questions. These answers facilitate decision making and action planning for the response.

Intake Determinations:

  • Does the information, as reported, meet the statutory definition of child abuse and/or neglect?
  • Does the report meet the agency’s criteria for some level of response?

Assessment/Investigation

  • Has the occurrence of abuse and/or neglect been determined by the documentation of credible, verifiable evidence and /or a preponderance of the evidence?
  • Are all children safe?
  • What is the level of risk for future maltreatment?
  • What vulnerabilities, risk factors, protective factors and protective capacities have been identified?

Safety Planning

  • What actions are required to make and/or keep all children safe?

Case Planning and Treatment Planning

  • What actions are required to support the family’s active participation in intervention services to promote safety, healing, and family well-being?

Typically, child welfare systems actively take the following actions:

  • They investigate reports by receiving and investigating possible cases of child abuse and neglect.
  • They support families by providing prevention services to those who need assistance in protecting and caring for their children, aiming to prevent entry into foster care.
  • They arrange for temporary safe shelter, ensuring that children live with kin or foster families when it is unsafe for them to remain home.
  • They strive to return children to their families when safety conditions have improved or find alternative permanent arrangements, such as arranging for reunification, adoption, or establishing other permanent family connections for children leaving foster care.

What Happens When a Report Is Filed

A report is screened when sufficient information suggests the need for an investigation. A report may be screened out if there is insufficient information to follow up on or the reported situation does not meet the State's legal definition of abuse or neglect. In such cases, the CPS worker may actively refer the person reporting the incident to other community services or law enforcement for additional assistance.

CPS caseworkers actively respond within a few hours to a few days after entering a report, depending on the type of alleged maltreatment, the potential severity of the situation, and State law requirements. They actively engage in conversations with parents and other individuals in contact with the child, such as doctors, teachers, or child-care providers. They may also actively communicate with the child, either alone or in the presence of caregivers, based on the child's age and level of risk.

By the end of the investigation, CPS caseworkers typically make one of two findings—either unsubstantiated (unfounded) or substantiated (founded). These terms may vary from State to State.

  • An unsubstantiated finding indicates that the caseworker actively concludes there is insufficient evidence to determine that the child was abused or neglected or that the reported incident does not meet the legal definition of child abuse or neglect.
  • A substantiated finding typically indicates that the caseworker actively believes that an incident of child abuse or neglect has occurred, as defined by State law.

For more information on the Child Welfare system, visit the Child Welfare Information Gateway.

What other professionals are involved in cases of youth with problematic sexual behaviors?

Agencies such as Law Enforcement and Juvenile Justice may also have statutory responsibility for some situations involving problematic sexual behaviors. Given this parallel responsibility; shared assessment, decision making, and recommendations for intervention and response will support families best in their efforts to successfully manage the issue of problematic sexual behavior in their home.

Treatment interventions with children and adolescents with problematic sexual behaviors and their families often involves licensed treatment providers who have specialized knowledge and experience with this population.

A multidisciplinary, coordinated, community-based system guided by best-practice response by the professionals involved in the protection of children, is recommended. Coordinated interventions can facilitate family engagement in services and enhance the safety and well-being of the community. Shared goals include:

  • Keeping all involved children safe.
  • Assessing and responding to the treatment needs of the family.
  • Assisting youth with problematic sexual behaviors in learning appropriate, pro-social behaviors.
  • Supporting and enhancing positive family functioning and parent/caregiver monitoring.
  • Ensuring community safety.
  • Safeguarding the legal rights of the identified child or adolescent.

A Child Advocacy Center (CAC) can facilitate a multidisciplinary team (MDT) in a manner to reduce the impact of trauma on children and families. Because of its close relationships with professionals in the community who are involved in child protection, a CAC is often well equipped to coordinate the MDT response to youth with problematic sexual behaviors, their child victim and caregivers.

Juvenile Justice System

Overview

The juvenile justice system faces considerable challenges when dealing with youth who commit criminal acts involving problematic sexual behavior. These challenges arise partly due to myths and misunderstandings about the youth, the risks involved, and their responsiveness to intervention.

Contrary to common belief, youth charged with sexual offenses differ significantly from adults who commit such offenses. It is crucial to take these differences into account while formulating juvenile justice policies that prioritize both rehabilitation and community safety.

  • Compared to adults who commit sex offenses, adolescents are more opportunistic, less predatory, and repeat the behavior less often.
  • Youth engage in fewer sexually abusive behaviors over shorter periods of time and have less aggressive sexual behavior than adults.
  • Youth are rarely fixed in their sexual interests; their illegal behaviors often are experimental.
  • Many adolescents charged with sex offenses can remain safely in the community during treatment. Decisions about placement in residential or correctional facilities should be limited to those with significant community safety risks and higher treatment needs.
  • Many adolescents charged with sex offenses can safely attend public school and participate in school activities such as sports, school or community-based clubs and other extra-curricular activities.
  • Mental health professionals regard illegal sexual behavior by youth as reflecting much less serious psychological problems than similar behaviors by adults.
  • More than nine out of ten times the arrest of a youth for a sex offense is a onetime event. The youth is more likely to be apprehended for non-sex offenses typical of other juvenile delinquents, if at all.
  • The recidivism rate among juveniles who sexually offend is typically 3-12% versus 8-58% for other delinquent behavior. Lower recidivism range rates are associated with youth who received appropriate treatment.

Teenagers who have engaged in problematic or illegal sexual behavior are more than just their offenses. They are students, they are sons and daughters, and they deserve to be seen in a broader context.

The language we use plays a vital role in shaping perceptions. Research has demonstrated that when the term "juvenile sexual offenders" is employed, people tend to respond punitively and harshly towards these youths, as opposed to focusing on the problematic behavior itself by referring to the individual as a youth with illegal sexual behavior. Therefore, it is important to be mindful of the terminology we use, especially when referring to the youth, their caregivers, and community members. This becomes particularly critical when engaging with caregivers, youth, and community support.

Juvenile Justice Correctional Community

Current research indicates the implementation of evidence-based practice (EBP) in community corrections results in improved outcomes and reductions in recidivism. Understanding, implementing, and operationalizing key principles of EBP ensures reduced recidivism, improved public safety, and improved outcomes for juveniles who have offended, including youth with problematic sexual behavior.

These principles encompass the following:

To ensure the effectiveness of supervision plans, it is crucial to incorporate these preceding evidence-based practice (EBP) principles as a holistic approach rather than selectively choosing individual principles. They form a comprehensive package that complements each other, working together to achieve the desired results.

Effective supervision of youthful offenders involves developing a case management/supervision plan, which encompasses the probation officer's role as a case manager, along with monitoring court-ordered supervision conditions, in most jurisdictions.

Correctional interventions and case management plans based on the Principles of Evidence-Based Practice result in reduced recidivism rates and optimal outcomes for youthful offenders.

  • The Risk Principle: Prioritize supervision and treatment resources for youth who have significant vulnerabilities and situational risk factors by implementing effective risk assessment tools, which enable more efficient allocation of resources and enhance the effectiveness of interventions. Youth who are able to respond to community-based interventions and have access to protective factors and those with problematic sexual behavior benefit from less formal interventions within the juvenile justice system. Cost-effective deferred prosecution and diversion of these youth allow for greater allocation of time and resources to higher risk offenders.
  • Need Principle: Direct interventions toward criminogenic needs, which are characteristics, traits, problems, or issues of an individual that contribute to their likelihood of re-offending and committing another crime. These needs encompass attitudes supporting sexual offending, social isolation, as well as the individual's social ecology, such as lack of adequate monitoring and negative peer influences. Successful interventions involve engaging prosocial peers and activities that foster positive and healthy relationships to reduce the risk of re-offending.
  • Responsivity Principle: Assign interventions while considering temperament, developmental age, learning style, motivation, gender, family characteristics, and culture, thereby matching the intervention to the youth and their family's learning style. This approach helps to motivate them to make positive changes.
  • Enhance Intrinsic Motivation: Enhance intrinsic motivation by probation officers relating to their clients in interpersonally sensitive, respectful, and constructive ways. Such interactions contribute to increasing the youth's internal drive for positive behaviors. The dynamic nature of motivation to change is strongly influenced by these interpersonal interactions.
  • Dosage: Minimize free and unstructured time during the first 3-9 months of supervision for youth who have high risk individual and situational factors, through effective supervision. Structured time includes providing effective treatment, educational/employment opportunities, leisure and recreational activities with approved individuals or groups, and other prosocial engagements. For youth who have protective factors and low risk factors optimal outcomes are achieved by diverting them from the juvenile justice system or reducing unnecessary supervision and services, as research consistently indicates that less correctional services and programs are more beneficial for these youth.
  • Skill Train with Directed Practice Skills: Teach skills through directed practice, where youth not only receive instruction but also engage in role-playing and practice the desired pro-social attitudes and behaviors. Treatment providers, family members, and probation officers positively reinforce these behaviors, resulting in the development of constructive behavioral patterns. Manualized curriculums such as ART (Aggression Replacement Therapy), MRT (Moral Reconation Therapy), and Thinking for a Change can effectively support both staff and youth.
  • Increase Positive Reinforcement: Increase positive reinforcement by probation officers, family members, treatment providers, and others who have direct contact with the youth, ensuring a ratio of at least four positive affirmations or rewards to every negative one. This approach proves particularly effective in the initial stages of behavior change, counteracting the tendency for youth to primarily receive negative feedback from probation officers, adult caregivers, and other individuals in their lives. This imbalance often leads to resentment and disengagement.
  • Engage Ongoing Support in Natural Communities: Actively involve pro-social support in the youth's natural communities, including extended family members, neighbors, and friends. These community-based supports provide the necessary assistance and support for the youth to make positive behavior changes.

To ensure the effectiveness of supervision plans, it is crucial to incorporate these preceding evidence-based practice (EBP) principles as a holistic approach rather than selectively choosing individual principles. They form a comprehensive package that complements each other, working together to achieve the desired results.

Effective supervision of youthful offenders involves developing a case management/supervision plan, which encompasses the probation officer's role as a case manager, along with monitoring court-ordered supervision conditions, in most jurisdictions.

Correctional interventions and case management plans based on the Principles of Evidence-Based Practice result in reduced recidivism rates and optimal outcomes for youthful offenders.

Safety Planning

Safety planning is an essential component when working with youth with problematic sexual behavior (PSB) and their families. Various professionals, including child welfare workers, treatment providers, probation officers, and family members, collaborate in creating safety plans. These plans determine whether the youth can remain in their home, live with another family member or friend, or require out-of-home placement or detention. NCSBY provides information to parents as a guide to ensure safety for all family members, which is also helpful for probation officers working with youth with PSB.

A safety plan comprises specific rules for the youth, approved activities, responsibilities of parents and family members, as well as family rules for privacy and supervision. These rules must be communicated clearly to ensure that all family members, including the youth, understand their responsibilities. Ambiguity leads to confusion and compromises safety.

In addition to the safety plan emphasizing the home and family, a monitoring plan is necessary, which includes court-ordered supervision conditions and specified treatment goals. Court-ordered conditions may include no contact with victims, no unsupervised contact with younger individuals, regular school attendance, among others. Treatment goals and expectations may involve regular participation in treatment, developing positive relationships, and accepting responsibility for inappropriate behavior, among others.

Youth adjudicated of a sex offense may be required to register, depending on the laws of the state where they reside. Registration is typically completed at local law enforcement offices, and failure to comply can result in new criminal charges with serious consequences.

Registration requirements vary significantly from one state to another, and probation officers must be familiar with the registration laws applicable in their respective state. These laws often leave little to no discretion for probation officers regarding compliance expectations for the youth.

Probation officers should also be knowledgeable about laws and procedures regarding the transfer of supervision from one state to another, as additional registration requirements may apply in the new state. It is recommended for JPOs to contact their Interstate Juvenile Compact office for information and guidance on this matter.

Furthermore, juvenile probation officers should be aware that their state's laws and policies may include requirements such as timelines for registration, public notification, DNA testing, risk assessment, residency restrictions, and electronic monitoring.

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