1. Section 4: Treatment
2. Key Topics for the Treatment Section
   • Part I: Program Availability and Settings
   • Part II: Rehabilitative Trends
   • Part III: Goals, Frameworks, and Modalities
   • Part IV: Common Treatment Targets
   • Part V: Challenges and Controversies
   • Part VI: Treatment Outcomes
3. Availability of Juvenile Sex Offender Treatment Programs Nationwide
4. Program Settings for Juveniles: Community vs. Residential
5. Continuum of Treatment Settings
6. Benefits of Community-Based Treatment
   • Intervene in natural environment
   • Support productive involvement
     • Family
     • Peers
     • School/employment
   • Generally cost-effective
7. Benefits of Residential Treatment
   • Increased structure and security
   • Victim and community safety
   • Immersion in treatment
8. “Getting Tough” on Juvenile Crime
   • Lowered minimum age for waiver
   • Eliminated many confidentiality restrictions
   • Harsher punishments and mandatory sentences
   • Reduced judicial discretion
9. Impact of Adult Dispositions on Youthful Offenders
   • Recidivism increases
   • More serious types of recidivism
   • Reduced access to rehabilitative services
   • Increased victimization and suicide rates within institutions
   • Lowered self-expectancies about remaining crime free
10. Examples of Evidence-Based Interventions
    • Wraparound Services
    • Functional Family Therapy
    • Multisystemic Therapy
11. Common Treatment Goals
    • Accept responsibility for behaviors
    • Identify contributing factors
    • Explore, utilize effective coping strategies
    • Develop prosocial skills and competencies
    • Establish positive peer relationships
    • Promote healthy family functioning
12. These Youth Aren’t “Specialists”
    • 55% had a prior non-sex offense
    • 61% were convicted of non-sex offenses as adults
    • Only 5% convicted of sex offenses as adults
      • Of sexual recidivists, 72% were also convicted for non-sex offenses as adults.
13. Most Common Theoretical Frameworks Reported Nationwide
14. Multiple Modes are Important
    • Group time constraints
    • Sensitive issues and dynamics
    • Responsivity factors
    • Deviancy training concerns
15. Use of Various Modalities Nationwide
16. Common Treatment Targets
    • Responsibility-taking
    • Cognitive distortions or thinking errors
    • Victim empathy
    • Intrapersonal and interpersonal skills
    • Relationship skills
    • Healthy masculinity
    • Arousal control
    • Trauma resolution
    • Values clarification
    • Family functioning
17. Treatment Targets in Programs Nationwide
18. Process-Related and Contextual Variables
    • Therapist characteristics
    • Treatment climate
    • “Approach” goals
19. Juvenile Sex Offender Programs for Females
20. Treatment Targets for Females vs. Males in Programs Nationwide
21. Future Directions for Juvenile Female Sex Offender Treatment
    • Identify unique risk and protective factors
    • Clinical characteristics, modus operandi
    • Gender-responsive programs
    • Treatment outcome research
22. Treatment Programs for Children with Sexual Behavior Problems
23. Psychiatric Disorders and Juvenile Sex Offenders
    • Common presence necessitates screening
    • Can interfere with treatment engagement and response
    • Pharmacological interventions may be warranted
24. Potential Pharmacological Interventions and Cautions
    • SSRIs may be beneficial for co-occurring disorders
      • Side effects may include reduced preoccupations and sex drive
      • FDA Warning
    • Antiandrogens not recommended as first-line intervention for youth
25. Juvenile Programs Using the Polygraph Nationwide
26. Recidivism Trends for Treated Youth Released from Facilities
27. Treated vs. Non-Treated Youth in a Community-Based Program
28. MST vs. Alternative Treatment
29. Summary of Key Points
    • New and evolving field
    • Consider “what works”
    • Holistic, integrated, and comprehensive
    • Challenges and controversies exist
    • Treatment has promise