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Section 15
Identification of Problem Sexual Behavior in Adolescents

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Often, adolescent offenders are evasive, manipulative, secretive and have problems in the area of sexuality. Consequently, they are among the most difficult clients to assess (Breer, 1987). However, in order to properly identify and treat sexual offenders, it is essential to determine whether the sexual behaviors for which they were referred are age-appropriate or whether they are problematic and require intervention (Gil & Johnson, 1993).

Assessing Problem Sexual Behavior
Johnson and Feldmeth (1993) categorized sexual behaviors into four groups based on the appropriateness of the sexual behaviors. Children in Group I engage in childhood exploration which is considered normal because their interest in sexual behaviors is consistent with their curiosity about other parts of life. When the child is told to discontinue these behaviors, the behaviors gradually decrease or stop. Many children in Group II have been sexually abused or overexposed to sexual stimulation and therefore struggle to meaningfully integrate their experiences. Their sexual behaviors are often indicative of confusion, anger, shame or anxiety. The sexual behaviors of the children in Group II are often easy to stop with consistent, nonjudgmental, and proactive counseling because the behaviors do not represent a long pattern of secretive and manipulative behavior. Children in Group Ill also are often victims of sexual abuse. They exhibit more focused and extensive patterns and usually engage in age-inappropriate and typical adult sexual behaviors. Group Ill children hold a matter-of-fact attitude toward their sexual behavior with other children. Finally, children in Group IV often associate sexually aggressive behaviors with feelings of anger, loneliness, or fear. They exhibit coercive and pervasive sexual behaviors which extend beyond the realm of developmentally appropriate childhood exploration or sex play. Also, these behaviors tend to escalate in intensity and frequency.

There are a number of factors that can be assessed to more fully assess the appropriateness of sexual behavior. First, it is important to assess knowledge about healthy adolescent sexuality and sexual abuse for both the perpetrator and the family. Second, the openness of family communication in general, and more specifically regarding sexuality issues, also should be assessed. Third, family factors such as cohesiveness and emotional expressiveness are important factors and should be assessed. Fourth, it is important to assess the impulse control of the perpetrator to make decisions about the treatment process and setting (i.e., whether safety needs of the community are jeopardized by outpatient treatment). Fifth, assessing the social skills of the perpetrator may provide important information about treatment needs. Finally, the presence of non-sexual antisocial behavior, substance abuse, or other psychological disorders should be assessed. Through such a comprehensive assessment, the counselor becomes more able to understand the offender and treatment needs.

A Working Typology of Adolescent Sex Offenders
Persons who are untrained in working with adolescent sex offenders tend to (a) ignore serious behavior problems as normal sexual experimentation, (b) lump all adolescent offenders together and treat all the same, or (c) use an adult offender classification system. It is important to recognize adolescent sex offenders as a population separate from adult offenders and recognize the heterogeneity of adolescent offenders. O'Brien and Bera (1986) provided a working classification of adolescent sex offenders that includes seven types of offenders. While classification is often less clear-cut in practice (i.e., many offenders may fit more than one category), the typology provides direction for assessment and intervention with offenders.

The first type of offender, the naive experimenter, is typically between the age of 11 and 14 and has had little history of acting-out behavior. The naive experimenter is sexually inexperienced and engages in a limited number of sexually exploratory acts with a younger child. There is no force or threat in the sexual activity. Naive experimenters may be treated within the community on an out-patient basis. Treatment typically ends at the end of a short-term, intensive treatment and education program. The major goals of treatment with the naive experimenter are to provide a concrete education in healthy adolescent sexuality and sexual abuse for both the perpetrator and the family, and to develop more open family communication on sexuality issues to reduce the likelihood of inappropriate sexual exploration in the future.

The second type of offender, the undersocialized child exploiter, is characterized by chronic social isolation and lack of social skills. The sexual offenses are likely to be chronic and include manipulation, rewards, or other enticements. The undersocialized child exploiter is motivated to offend by a need for greater self-importance and intimacy. Undersocialized child exploiters are typically family-centered rather than peer-centered and role reversals within the family are not uncommon. Thus, it is typical for counseling with this type of offender to include interventions with any family members who are abnormally dependent. For treatment to be effective, the family may need to change their structure and style of communication. Also, it may be important to teach communication skills to the offender, who typically has inadequate or poor peer social skills. In situations in which community safety concerns have been met, treatment may occur within the community. When safety concerns have not been met (e.g., sibling incest where the victim remains at risk), residential treatment may be required.

The third type of offender, the pseudo-socialized child exploiter, demonstrates good social skills, has little history of problem behavior, and is apt to present as self-confident. Relative to other types of offenders, the pseudo-socialized exploiter is likely to have been a victim of ongoing years of abuse. The motivation for the offense is a desire for sexual pleasure through exploitation, and the offender often rationalizes the offense with little guilt or remorse. The goal of treatment includes breaking through the mask of social grace put on for the family and society. Compared to other types of offenders, the pseudosocialized exploiter often lacks real motivation for change because of a history of effectively compartmentalizing behaviors and rationalizing offenses. There seems to be a strong possibility that pseudo-socialized offenders will be lifelong offenders. While this type of offender may be seen within the community, noncompliance often dictates referral to a residential treatment program.

The fourth type, the sexually aggressive offender, often comes from an abusive and chaotic family. This type of offender is more likely than any other type to have a history of antisocial behavior, poor impulse control, and substance abuse. The sexual offenses involve force and are motivated by a desire to experience power by domination, to express anger, and to humiliate the victims. Often, treatment includes the family's tendency to undermine the counseling goals of the adolescent. Typically, treatment is provided within a residential treatment program, is of a longer-term than for other types of offenders, and includes intensive individual, peer group, and when possible, family counseling.

The fifth type of offender, the sexual compulsive offender, is often in an emotionally repressive and rigidly enmeshed family. The sexual offenses are highly repetitive and compulsive in nature. Offenses are more likely to be "hands-off' (i.e., voyeurism or exhibitionism) than is true for other types of offenders. Often, the motivation for this type of offender is the alleviation of anxiety. Counseling issues are similar to working with other compulsive or addictive behaviors and include specification of the cognitive-emotional-behavioral sequence that leads to the offending behavior and developing interventions in that sequence that can be practiced in individual, group, and family counseling. The compulsive offender may be treated within the community unless the sexual behavior is so compulsive that the client cannot remain nonabusive in an outpatient setting.

The sixth type of offender, the disturbed impulsive offender, likely has a history of various psychological disorders, severe family dysfunction, substance abuse and significant learning problems. The offenses are most often impulsive and reflect a disturbance of reality testing. Typically, treatment includes psychological testing and compilation of a complete family history. The typical referral is to an inpatient psychiatric unity or a residential treatment program. Outpatient treatment is not appropriate unless distortions in reality are controlled through medication or, in the case of substance abuse, through abstinence while in treatment.

The seventh type of offender, the group-influenced offender, is likely to be a younger adolescent with little or no previous delinquent history who engages in the sexual offense while in the company of a peer group. The motivation for the offending behavior is likely to be peer pressure and the desire for approval.

Mental health counselors should separate the offenders if they are referred at the same time, and compare and contrast the stories with the victim's report to develop a clear picture of what really happened. This assessment approach aids in confronting each offender about inconsistencies, rationalizations, projections, and blame with the goal being for each offender to take responsibility for the abuse and impact on the victim. Typically, interventions with group-influenced offenders may occur in an outpatient treatment program. It is important to consider, however, that there may be one person in the group who initiated the group behavior and, consequently, may best fit another typology (e.g., sexual aggressive). In such a case, referring this youth to a residential treatment program would be appropriate.
- Cashwell, Craig S. and Michele E. Caruso, Adolescent Sex Offenders: Identification and Intervention Strategies, Journal of Mental Health Counseling; Oct97, Vol. 19 Issue 4

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Personal Reflection Exercise Explanation
The Goal of this Home Study Course is to create a learning experience that enhances your clinical skills. We encourage you to discuss the Personal Reflection Journaling Activities, found at the end of each Section, with your colleagues. Thus, you are provided with an opportunity for a Group Discussion experience. Case Study examples might include: family background, socio-economic status, education, occupation, social/emotional issues, legal/financial issues, death/dying/health, home management, parenting, etc. as you deem appropriate. A Case Study is to be approximately 250 words in length. However, since the content of these “Personal Reflection” Journaling Exercises is intended for your future reference, they may contain confidential information and are to be applied as a “work in progress.” You will not be required to provide us with these Journaling Activities.

Personal Reflection Exercise #1
The preceding section contained information about the identification of adolescent sexual offenders. Write three case study examples regarding how you might use the content of this section in your practice.

QUESTION 15
What are the seven types of adolescent offender identified by O'Brien and Bera? Record the letter of the correct answer the Answer Booklet.