Youth with Sexual Behavior Problems Treatment/Practice Model
The Center for Child and Family Advocacy, Inc.’s Juvenile Sex Offender Treatment Program is certified through the Ohio Department of Youth Services. CCFA provides treatment to all Youth with Sexual Behavior Problems. The main goals of treatment are to prevent further sexual victimization and teach pro social skills which allow the child the opportunity to resign from a lifestyle of abusive behavior. In order to accomplish this, the “whole” child is treated, not just the sexually reactive or sexually abusive behaviors. Children are more than the sum of their behaviors. Therefore, treatment must focus on a range of behavioral, social, familial, and cognitive domains. As a result, our integrated treatment model is multi-disciplinary and incorporates the use of outpatient therapy, group therapy, as well as home-based therapy, or a combination of services, depending on the youth’s individualized needs.
Upon the initial contact of the agency by the parent/guardian of the youth a Diagnostic Assessment will be scheduled. At the scheduled Diagnostic Assessment, the juvenile client and the parent/guardian will meet with a clinician and participate in the assessment process. The parent/guardian will be required to sign releases for the referral source, law enforcement agencies, court, children services, or any other party who may be able to provide relevant information to aid in the assessment process. Upon completion of assessment, the clinician will provide both guardian and juvenile with a client handbook and complete orientation checklist. CCFA utilizes a number of risk assessment and evaluation tools at the time of intake/admission and over the period of time that the youth is in treatment. The Juvenile Risk Assessment Tool (J-RAT) is used for sexually reactive children and adolescents who have engaged in sexually abusive behavior, ages 12-18. Topics include, but are not limited to, the following: purpose of assessment/reason for referral; identifying information; placement and/or treatment history; youth’s presentation and cooperation; legal status; significant life events; family history; family mental health and substance abuse history; developmental history; relevant medical information; past/current medical and psychiatric medications; cognitive functioning and psychological evaluations; school functioning; social functioning; problematic non-sexual behaviors; history of substance use; history of victimization/trauma; sexual development/offending history; risk for reoffending; current diagnosis; and clinical assessment and recommendations.
The admission criteria for those interested in group therapy will include the following: the client meets criteria for a current DSM diagnosis and a minimum of two (2) of the following criteria:
Client has committed a sex offense; or has deviant sexual thoughts and/or fantasies
Counseling may be voluntary or court-ordered
Client is able to establish and follow agreed-upon goals
No apparent risk factors for harm to self or others that hinder the client’s ability to remain in the community
Once a thorough assessment has been completed, the clinical staff determines the most appropriate course of treatment for the individual youth. In JSO group treatment, the following workbook is utilized: Stages of Accomplishment Workbook. Stages is composed of 4 stages. The overview of each stage is listed below:
Stage 1: Introduction to Treatment
Chapter 1: Introduction to Treatment
Chapter 2: Participating in your Treatment
Chapter 3: Understanding Sexually Abusive Behavior
Stage 2: Understanding Yourself
Chapter 1: Learning about Treatment
Chapter 2: Feelings, Thoughts, and Behaviors
Chapter 3: Understanding and Managing Feelings
Chapter 4: Attitudes, Beliefs, and Values
Chapter 5: Thinking Errors
Stage 3: Understanding Dysfunctional Behavior
Chapter 1: Dysfunctional Behavior Cycles
Chapter 2: Phases of Dysfunctional behavior Cycle
Chapter 3: High Risk Situations and behaviors
Chapter 4: Behavior Management, Staying Safe, and Preventing Relapse
Stage 4: Hitting the Target. Making Permanent Change
Chapter 1: Thinking About Others: Empathy and Caring
Chapter 2: Victim Awareness and Clarification
Chapter 3: Community Service
Chapter 4: Learning to Communicate
Chapter 5: Healthy Relationships
Chapter 6: Epilogue: Your Final Words
Healthy Choices: Creative Ideas for Working with individuals identified as having sexual behavior problems with Developmental Disabilities along with Responsible Choices Program are curriculums used with individual clients with developmental disabilities. These curriculum focus on triggers, stressors, high risk situations, healthy coping skills, negative and positive consequences and behavioral chains. While the concentration is similar to the standardized treatment areas, these curriculums differentiate treatment lessons and tools enabling the individual client to achieve the highest level of functioning in treatment.
While Stages provides the core curriculum for treatment other topics covered in treatment include: anger and stress management, identification of and healthy expression of feelings; boundary-setting skills; exhibiting pro-social behaviors; sex education; healthy relationships; problem-solving and decision-making skills; and victim empathy. In treatment of older youth, other topics and services provided: independent living skills, housing; employment assistance and job interviewing skills; and budgeting.
The Center for Child and Family Advocacy, Inc. believes in a multi-disciplinary team approach in the provision of sex offender treatment. In order to best facilitate this necessary process, a thorough monthly evaluation will be completed for each group member. The evaluations will then be forwarded to the individual’s referral agency such as the court systems, probation or parole departments, or Job and Family Services Departments. Group members’ progress in treatment, issues addressed, concerns regarding their treatment process, and additional recommendations are reflected in the monthly evaluation. The CCFA believes that this collaboration between agencies will not only provide the best possible treatment to the client, but will help to provide safety to their victims and community.
Reasons for Termination
Poor attendance or repeated tardiness
Abusive, threatening or disruptive behavior at group meetings
Alcohol or drug abuse or failure to follow through on a referral for alcohol or drug services
Arriving at group under the influence of drugs or alcohol
Complete unwillingness to accept feedback
Failure to take a minimal level of responsibility for abusive behaviors
Breaking restraining orders
Failure to comply with probation or parole orders
Failure to cooperate with program rules and requirements
Failure to pay program fees
The clinicians facilitating the juvenile sex offender treatment at The Center for Child and Family Advocacy, Inc. are currently licensed counselors and social workers through the State of Ohio. Clinicians also receive on-going training related to the assessment, treatment, and prevention of sexually abusive behaviors. Clinicians have access to the Association of Treatment of Sexual Abusers’ Sexual Abuse: A Journal of Research and Treatment. The clinicians are supervised by the Clinical Services Director, who is attends trainings on sexually abusive behaviors on an on-going basis.
The youth with sexual behavior problems treatment group meets on a weekly basis for 90 minutes per session. The goals for this group are: to have participants accept full responsibility for their offense(s); identify support persons; understand victim impact; develop victim empathy; identify and manage their triggers, stressors, and high risk situations; and understand how their thoughts affect their feelings, which affect their behaviors.
Groups are open-ended and will consist of two (2) or more group members with a maximum number of 12. Groups will be gender specific; there will be a male group and a female group.
Attendance, participation, completion of written homework and demonstration of achievement of the identified goals of this group will be mandatory to receive a successful discharge. The length of time to complete each identified “unit” of Stages curriculum/treatment process is determined on an individual basis. While some youth will possibly complete and present a unit on a weekly basis, others may require a longer period of time for unit completion due to various factors which may include: cognitive limitations, lack of motivation, or timely completion of materials. Family members may be encouraged to participate in the youth’s treatment. Specific sessions may be scheduled to include the family members; these sessions will be conducted outside of the group setting.
Fees for Service
The cost for group therapy is based on the ADAMhs Board sliding fee scale; available to residents of Defiance, Fulton, Henry, and Williams Counties. All forms of Medicaid are also accepted for payment of services at The Center for Child and Family Advocacy, Inc.