Listen to thisThis is the third article in a three-part series on adolescent sex offenders. The previous two articles dealt with the need for workable definitions of sex offender treatment and the foundations of successful residential treatment with this population of young people. This article will examine the dynamics of working in residential care with these young men, and will outline some of the treatment modalities that can be utilized. (See Part 1 and Part 2)
Reasons for offending
Probably the most important dynamic to be aware of when working with
adolescent sex offenders is the diversity of the young people. This is
not a homogenous population. There are many manifestations of sexually
intrusive behavior. There are also many different reasons why people
offend. These have to be kept in mind when interacting in a therapeutic
milieu. Lumping the young people together as sex offenders without
acknowledging the differences is counterproductive.
The type of sexually intrusive behavior exhibited by these young men varies a great deal. The most common is fondling. However, it ranges from obscene phone calls to violent rape. Some young people will commit one or two offenses while others will offend hundreds of times. Most adolescent offenders usually have one or two victims. These victims are usually chosen from among family members or people in near proximity. Other offenders assault strangers although this is less common.
Adult offenders tend to have victims of choice. That is, they have a preference for a particular age and/or gender. Adolescent offenders are less likely to be as selective. In our experience the young men we have worked with are more likely to be opportunity offenders. They victimized the people they could access. There are exceptions to this, but the ages and gender of their victims were often not yet “fixated". However, most victimized people younger than themselves.
The majority of the young men we have worked with tended to be “seductive" rather than outrightly violent offenders. They selected vulnerable and needy children, befriended them and then assaulted them. The assaults usually progressed over time from fondling to penetration. Not all of the victims saw themselves as “victims". Some “consented", for lack of a better word, to the activity as part of the price of the so-called “friendship". This helped the offender rationalize that there was nothing wrong with what they were doing.
The reasons for offending often vary a great deal. It is a common belief in the human services that most offenders engage in sexually intrusive behavior because of a need to have power and control over other people. We believe that the reasons people offend are more complex. We do not deny that the need for a sense of power and control is the reason why some people offend. However, there are other reasons, including reasons behind the need for power and control itself.
Many of the young men we have worked with have been lonely, vulnerable and socially isolated individuals. For them sex offending was a way (however inappropriate) of trying to reach out to other people. They chose people younger than them because they lacked the skills to have appropriate relationships with people their own age. For these young people the offending was about fulfilling a need to attach to another human being.
Other kids offend as a way of gaining control over their own abuse. These young men are repeating what happened to them when they were younger. This form of “undoing" their own abuse is often very ritualized and compulsive in nature. These kids often talk about not feeling that they have any control over what they are doing.
We have worked with other kids who seemed to really believe that they were doing nothing wrong. Many of these young men often grew up in sexualized environments where they were victimized by numerous other people. Sexual victimization was a “normal" part of their lives. They were simply engaging in what they were taught to believe was appropriate behavior.
Confrontation
There are also other reasons why people offend. The point we are trying
to make is that the reasons are complex and need to be treated as such
in the residential milieu. The milieu needs to be flexible in order to
accommodate the many needs of the young people. A rigid program that
tries to fit all the young people into a “power and control" box is
doomed to failure. An example of this is how confrontation is used by
the staff. Confrontation is a key component in sex offender treatment.
It is the process of immediately challenging inappropriate behaviors
shown by a young person. If John grabs Bob the staff confront John on
his aggressive behavior. Traditionally this confrontation has been used
as a means by which staff exert their power over the young person. This
type of confrontation is often loud and aggressive (and unsuccessful).
We've called this “penis whacking" confrontation because of its “in your
face" and aggressive style that some think is needed in sex offender
treatment. This may work (we don’t think so) with “power and control"
offenders but we think it misses the point. It teaches the young people
that you get what you want by being the most powerful one, which only
reinforces their offense-type behavior.
Confrontation should be used as a means of teaching appropriate behaviors. It is a powerful “life space" intervention. In the case we mentioned the staff can help John learn other ways of dealing with anger or frustration. The moment can be used to help Bob to learn how to protect himself against victimization.
The key to all of the interventions is helping the young people to learn about respect. They need to learn how to respect themselves as well as other people. Every intervention needs to take this into account.
We believe that the most powerful and influential work with these young people occurs in the milieu. Therapy is an adjunct. It provides important education and opportunities for self-awareness but the day-to-day modeling, support and teaching moments that happen within the daily lives of the young people is often where the real change occurs.
Therapy
The following is a brief description of the more formal aspects of the
program in which we both worked. We always tried to keep in mind that
these were structures we needed to help focus our work. They weren’t in
themselves anything more than that.
When the young person came into the program an assessment phase took place. This time, which was usually about a month in length, allowed the staff to assess whether the program was the appropriate place for the young person to stay for treatment. This phase was also used to help acquaint the young person with the program, and the staff and other residents.
During the assessment, the program therapist carried out a therapeutic assessment with the young person and available family members. This assessment involved individual and family interviews as well as the young person completing some psychosexual testing material. The interviews involved the therapist obtaining, among other information, a beginning picture and understanding of the young person themselves, the family context and dynamics, offense information, and feelings and attitudes toward treatment, The purpose of the assessment was to identify the young person's and his family’s needs and strengths and to use this information to plan treatment and aftercare goals with them.
Given the effectiveness of working with adolescents in groups as well as males who have sexually offended, group therapy was a large part of the treatment program. A number of groups were held on a weekly basis. The groups were generally run by front-line staff and program therapists. The focus of the groups varied. Some focused on the offending behavior while others looked at more general relationship and emotional issues. The offending behavior groups involved inviting the young people to explore the cycle of their offenses, or what led up to, was involved in and took place after the offenses, along with ways to detour out of the offense cycle. One group was devoted to looking at specifically issues related to relapse prevention, which included not only behavioral strategies but strategies around emotional and relational health. A psycho educational focus was used in a different group to challenge views that were abuse-promoting. In this group the young people were also provided with information about the impact of abuse on victims. Healthy sexuality was also addressed in a group format. More informal groups focused on issues around the dynamics and relationships in the program and were called as needed.
Drama work was also done with the young people in the program. This group work was led by a community playwright in conjunction with front-line staff. The purpose of this group was to provide an avenue for the young people to express emotions appropriately, to explore their creativity and to deal with painful or challenging issues in a safe manner. The nature of the group also required the young people to act in cooperation and use problem-solving skills. The young people wrote their own scripts with assistance from the group leaders and then put on drama productions using their own scripts. People involved in the young people’s lives were invited to these productions. Through this group the young men achieved a sense of accomplishment, mastery and esteem.
Another aspect of treatment was individual therapy. This time allowed the young person to address issues that initially may have been too threatening to address on a group basis, such as issues around sexuality. Often young people worked on abandonment, victimization and trust issues in this context. Family relationships were often sources of pain or confusion for the young people which they chose to talk about with their individual therapist. Work around feeling expression and management were dealt with as well.
Whenever possible families were invited and encouraged to be part of the young person's treatment and this included family therapy. Families often used this time to address feelings and questions around the offense behavior. However, a number of other themes were also considered such as; family relationships, past issues of familial abuse, conflict resolution, building on family strengths, feeling expression and ways to support the young person. Time was spent focusing on what the young person and family needed in order to prevent relapse and to assist the young person in re-integrating back into their family, where possible, and into their community.
Conclusion
We have tried in this three part series to give an overview of the key
aspects of working with adolescents who have sexually offended. In many
ways these are complex kids. Yet working with them does not have to be
hard. Like all kids they need opportunities to learn, to be respected
and to grow.
