NEARI Press and Training Center Newsletter - Volume 11, Issue 6: October 2018
Impact of Early Intervention for Youth With Problematic Sexual Behaviors and Their Caregivers
This past month -- or perhaps we should say this past couple of years -- have been replete with public discussion about sexual assault. For those of us who have been in the field for a long time, the mainstreaming of sexual assault on traditional and social media is a fairly new development. The #MeToo movement, the nomination hearing for Brett Kavanaugh, and the "outing" of numerous public figures as having perpetrated sexual assault, have brought to the forefront of the social consciousness the issues that we have been addressing day in and day out at our jobs for years. Those heretofore quiet, concerned discussions we had with friends and acquaintances who knew about the professional work that we do are now more commonly public debates about what needs to be done to end the sexual misuse of power. While some of us may choose to use our professional expertise to influence these new conversations, other of us may feel more comfortable working behind the scenes as we always have by meeting with clients, conducting professional educational fora, and researching and writing on sexual abuse. No matter how we approach the current zeitgeist around sexual assault, this moment most certainly reinforces how crucial our roles are in preventing, responding to, and ending sexual violence. NEARI Press & Training Center is proud of the work that all of us do and gratified to be a part of it.

Were you able to catch our October 9 webinar featuring Robin Wilson, Michele Burns, and colleagues from Peel Behavioural Services to learn about the NEARI Press book  Passport to Independence: A Good Lives Model Workbook and the power of "working" the exercises in the book to focus on the Good Lives model's ten life goals? If not, you can view the webinar on  NEARI Press & Training Center's YouTube channel . In November, join us to hear from Elizabeth Griffin on a webinar entitled,  " #cyberoffense: Trending Topics in Assessment and Treatment of Cyber Offenders. Elizabeth is the co-author along with David Delmonico of the NEARI Press book,  Illegal Images: Critical Issues and Strategies for Addressing Child Pornography Use and is sure to be fascinating. 

This month here in the e-newsletter, we take a look at the article  Impact of early intervention for youth with problematic sexual behaviors and their caregivers   by Jane F. Silovsky, Michael D. Hunter, & Erin K. Taylor, that evaluates the implementation of an evidence-based early intervention program targeting youth with sexual behavior problems and their caregivers for the prevention of sexual abuse.
As always, we want to remind you to follow NEARI Press & Training Center and our Parent 2 Parent project on Twitter at  @NeariPress  and  @NeariP2P  respectively, and  on Facebook   to get updates about all that we are doing. 
And last, as always, we encourage you to contact us about the articles, authors, and topics you’d like us to cover in the NEARI e-Newsletter, our webinars, and our in-person trainings. Please contact Alisa if you have ideas and thoughts about the particular kinds of training you’d like to see NEARI Press and Training Center offer in the coming year. Thank you for your interest in NEARI, and for the vital work that you do to keep children and adults safe from sexual harm,

Craig Latham, Executive Director, NEARI 
Alisa Klein, Director, NEARI Press and Training Center, 
This month, David S. Prescott and
Alisa Klein examine the article:

Jane F. Silovsky, Michael D. Hunter, and Erin K. Taylor (Please see below for full citation and abstract.)

Can the implementation of early intervention services (after first-time offenses) for youth with problematic sexual behavior (PSB) ages 10 - 14 years, and their caregivers, affect the youths’ display of PSB and influence reports of non-sexual behavior symptoms and trauma symptoms? Can these early intervention services affect the caregivers’ knowledge, skills, supports, and stress levels? 

The authors evaluated 320 youth who were between 10 – 14 years old “when the PSB occurred with a child in the family or social network.” Youth who participated in the study were treated by a multidisciplinary team at one of three geographically disparate sites that received funding from the US federal juvenile justice agency, OJJDP, to implement community-based treatment for youth with PSB, child victims, and caregivers. In order to receive the community-based treatment, the youth could have no prior court involvement and had to have at least one caregiver available to receive treatment, as well. The youth receiving treatment had been referred to these programs from a variety of agencies, with 30 percent having been charged with a sexual offense and 42 percent court-ordered to treatment for PSB. Twenty-four percent of their caregivers were also court ordered to treatment. 

Staff at the three sites received ongoing training in Problematic Sexual Behavior – Cognitive-Behavioral Treatment (PSB- CBT), a group treatment model that conducts concurrent groups for youth and their caregivers with multi-family group sessions approximately once a month. The authors, describing the treatment model, noted that: 

"The underlying approach is strengths-based, focusing on the youth as children first with capacity to learn and implement appropriate behaviour, make safe decisions, and develop healthy relationships. Using cognitive-behavioural approaches, the youth are taught rules about sexual behaviour and specific skills of coping, self-control, and decision making. Core treatment components with caregivers address managing child behaviour, supporting healthy development, sex education, abuse prevention, and rules about sexual behaviour."
The authors used the Youth with Sexual Behavior Problems Inventory (YSBPI), an assessment tool that examines history of PSB and frequency of new PSB over a six-week period, to assess change within the programs. The youths’ behavior and trauma symptoms were also measured using other tools, as were caregiver skills, strengths and supports, and family stressors specific to the youth’s PSB. 

The results indicated that the youth made early improvements in treatment that were maintained and stabilized at all three sites. For caregivers, there was a statistically significant increase in parenting skills; that is, the parents reported using more effective parenting skills by the end of the study. The caregivers reported statistically significant improvements in their levels of knowledge about sexual development, sex crime laws, rules about sexual behavior, responding to sexual behavior in children, supervising and monitoring children, parenting, and ways to talk with children and youth about sexual topics and relationships. The youth reported statistically significant inprovements in their ability to make good choices, in learning how their behavior affects others, in following rules, and in communicating with their parents. The authors concluded that there is strong potential for the prevention of future sexual abuse  when evidence-based early intervention services are provided to youth who have sexual behavior problems and their caregivers. 

Treating PSB across the age span has been an area of considerable controversy over the years, with methodological flaws creating doubt in the minds of many academics and practitioners. This well-constructed study illustrates some over-arching trends observed elsewhere in the research on treating people who have engaged in abusive or otherwise harmful sexual behaviors: treatment can work, and people who complete treatment programs typically display reduced re-offense rates. When treatment processes involve family and other supportive adults, the effects can be more pronounced. 
This last point is worth emphasizing. Family involvement is crucial when the clients are as young as those in this study. For many years, treatment has often taken place in individual or group therapy at outpatient mental health centers where the professionals were not in extensive contact with each client’s parents. Although family involvement can be a challenge in many cases, it is vital nonetheless.
Most importantly, this study demonstrates the importance of early intervention and treatment with young people with PSB. More traditional criminal-justice approaches are not likely to work nearly as effectively as the approach undertaken in this study, which included empirically demonstrated methods within the context of family involvement in treatment. We now have sufficient knowledge in this area that policymakers have an obligation to support evidence-based practices such as this. Finally, it is noteworthy that this study took place under the auspices of pre-eminent leaders in the field of PSB treatment. 

Targeting broad implementation of early intervention services has a high potential for impact given the prevalence of child sexual abuse committed by youth and the low recidivism rate following effective interventions. This multisite quasi-experimental study examined the outcomes for 320 youth ages 10–14 years and their caregivers who participated in community-based problematic sexual behavior – cognitive behavior therapy (PSB-CBT). Significant reductions in PSB with a large effect size (e.g.  t (126) = 11.69,  p  < .001,  d  = 2.08) were found. No site differences were found, despite racial and regional diversity. Nonsexual behaviour problems, emotional problems, and trauma symptoms also significantly improved. Positive outcomes extended to caregivers. Recommended next steps include rigorous strategies for examining the impact of widespread implementation of evidence-based early intervention programmes on the prevention of sexual abuse, complemented with thoughtful efforts to develop and implement policies and procedures that improve the safety and well-being of all children in the community.

Silovsky, J.F., Hunter, M.D., & Taylor, E.K. (2018).  “Impact of early intervention for youth with problematic sexual behaviors and their caregivers ," published online: 13 Aug 2018, .       
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National Juvenile Justice Network Releases New Report:

Earlier this year, the National Juvenile Justice Network (NJJN) released an interesting report called New Zealand's Youth Justice Transformation: Lessons for the United States . Authored by Melissa Coretz Goemann, NJJN's Senior Policy Counsel, the report tells us that:

"In the 1980s, New Zealand’s youth justice system was in crisis – skyrocketing youth incarceration rates, overrepresentation of the marginalized native Māori youth population, infrequent use of diversion by the police, and a court system that intervened too often in the name of rehabilitation, using alienating court processes that youth and families found difficult to participate in or understand. The United States is currently plagued by many of the same problems."

NJJN cites New Zealand as a leader in the use of restorative justice practices in their youth justice system. Further, the country "dramatically downsized their youth justice system through groundbreaking legislation which incorporated rehabilitation as the system's fundamental focus... [and] [t]oday over 75% of youth who come in contact with the police are handled through police warnings or diversion."

The report looks critically at this process of juvenile justice transformation and translates the findings into policy recommendations for the U.S. juvenile justice system, including:

  • legislating limits around juvenile arrest and charging;
  • diverting as many youth as possible;
  • using restorative justice processes for handling youth with more serious cases; and
  • placing at the forefront of the system those who are most harmed by it, and changing the system so they are no longer harmed.
By: Toni Cavanagh Johnson, Ph.D.
Duration: 3-4 hours; CE Credits: 4

By:   Joan Tabachnick
Duration: 1-2 hours; CE Credits: 2

By: David S. Prescott, LICSW
Duration: 3-4 hours; CE Credits: 4

By: Steve Bengis, Ed.D., L.C.S.W. 
Duration: 4-5 hours; CE Credits: 5

By Reverend Debra Haffner & Joan Tabachnick 
Duration: 3-4 hours; CE Credits: 4

by Jamie Suvak, L.M.H.C. 
Duration: 1-2 hours; CE Credits: 2

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NEARI Press & Training Center provides resources and training for the prevention of sexual abuse. We are a source of practical, cutting-edge information about promising and best-practice interventions for individuals with sexual behavior problems. We believe that by addressing healthy sexual development in children and adolescents, and responding to sexual behavior problems in children, adolescents, and adults, we can prevent sexual abuse before it is perpetrated.
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