Juvenile Sexual OffendersDBT as Treatment Intervention:

Pilot Program Description & Evaluation Methods

To Protect Future Generations of Children

By: Michelle L. FaristUGA School of Social Work

Broad Population Facts

• population not seen as public safety threat • viewed with "boys will be boys" attitude• 70 % of acknowledging sexual offenders reported

onset of offending <18• average sexual recidivism rate for JSOs - 5 percent <1 • 22 % < 3 years • 7 % =5< years • (Alexander, 1999)

Specific Population for Evaluation

• Lives locally or within one of the surrounding counties

• 12-18 years of age, mostly males • Involved with the JJD or with CPS• Judged by authorities to present minimum risk to

community’s safety• All mental health issues within the scope of the

program • Willing to participate

Similar Presenting Problems as BPD • Emotional / Affect dysregulation• Poor frustration tolerance• Poor social competence

• Depression• Anxiety• Immaturity

• Need for validation

• Engenders frustration/hopelessness in clinicians

(Longo, 2011)(Longo & Prescott, 2006)(Ronis & Borduin, 2007)

Best Practice JSO

• Responsibility• Building relationship skills/ social skills• Empathy towards others• Building support systems• Prevention• Monitoring• (Longo, 2011)

DBT as Treatment with JSO(Linehan, 1993; Sakdalan & Gupta, 2014)

DBT balances therapeutic validation and acceptance Focus on self-regulatory & affective domains

– Make shifts in core orientation of self in response to outside world– Learn to choose effective strategies to manage painful affect states

Wise mind- risky mind dialectical construct utilizes common languageAssist JSO in effectively managing dysregulation in various domainsIntegrated treatment framework

DBT fit Best Practice Standards JSO

4 Components • Group Interventions

(includes family)

• Individual interventions

• Telephone Coaching (Clinician is always available

• Consultation Groups

4 Domains• Mindfulness

• Distress tolerance

• Emotional regulation

• Interpersonal effectiveness

Effectiveness

• Study showed that participants demonstrated a marked improvement (Sakdalan, 2012)

• sexual knowledge ,victim empathy, marked reduction in cognitive distortions and attitudes condoning sex offences after completing DBT training

• CBT currently most effective• Studies however show that change in cognition does not

equip clients with core self-regulatory base to manage risks and create a life worth living (Sakdalan & Gupta, 2014)

• DBT best of both worlds

Program Outline

• Weekly Group interventions• Weekly Individual interventions• Weekly Caregiver/JSO interventions• Phone Availability• Community Liaison assists JSO in Community• Graduation requirements• Follow up every 6 mts for 5 years after

Graduation

Research Question

• The goal of this program research is to evaluate the effectiveness of DBT as a therapeutic intervention with JSO. At the end of the evaluation we expect to be able to answer the question; Will active participation in a program utilizing the full protocol of DBT, reduce the recidivism rate among JSO?

Variables

• IV- Full DBT Program for JSO

• DV- Recidivism Rate of JSO

Evaluation

• This evaluation will be based on reports from JSO, that have graduated from the DBT program, and significant others that may have information concerning the JSO and possible reoffending.

• The Community Liaison will conduct face to face when possible interviews every 6 months for 5 years following graduation.

Ethical Considerations The Association for the Treatment of Sexual Abusers (ATSA,2011)

• Standard 2 Professional Conduct- Members will not allow personal feelings to interfere with professional judgment (ATSA, 2011)

• Standard 5 Personal Problems and Conflicts- Members are obligated to be alert to signs that a personal difficulty will or may adversely impact their professional behavior (ATSA, 2011)

• Standard 6 Supervisory DBT has build in consultation groups.

• Must protect Clients confidentiality at all times, careful consideration when with community members must be taken

• Evaluations coded with no identifying information• Reporting reoffending

Conclusion• It is imperative that JSO receive effective treatment :30-50% of

all sexual assaults are perpetrated by <18 year olds • JSO continue to reoffend – 70% of Child Molesters started

before they were 18 ,number of victims per offender has the potential to be staggering

• Therapy that is specific to the offender has shown to lessen the recidivism rate.

• Studies of DBT with JSO show marked improvement in reoffending factors

• Program evaluations as well as research to broaden the collective information available

• Upholding the ethical standards of ATSA as well as other professional associations’ ethical standards.

References• Abuse, P. C. (2005). Do Children Sexually Abuse Other Children. In CDC (Ed.), Rogers &

Tremain, 1984 (2005 ed., pp. 1-9).• Linehan, M. M. (1993). Skills Training Manual for Professionals of DBT. New York: Guilford

Press.• Longo, R. E. (2011). Risk in Treatment: From Relapse Prevention to Wellness. Retrieved from • Longo, R. E., & Prescott, D. S. (Eds.). (2006). Review of Current Perspectives: Working with

sexually aggressive youth and youth with sexual behavior problems (Vol. 34). US: NEARI.• Ronis, S. T., & Borduin, C. M. (2007). Individual, family, peer, and academic characteristics of

male juvenile sexual offenders. Journal of Abnormal Child Psychology, 35, 153-163. • Sakdalan, J. A. C., Vicki. (2012). Piloting an Evidence-Based Group Treatment Programme for

High Risk Sex Offenders with Intellectual Disablility in the New Zealand Setting. New Zealand Journal of Psychology, 41(3), 6-12.

• Sakdalan, J. A., & Gupta, R. (2014). Wise mind—risky mind: A reconceptualisation of dialectical behaviour therapy concepts and its application to sexual offender treatment. Journal of Sexual Aggression, 20(1), 110-120. doi:10.1080/13552600.2012.724457