Identifying & Treating Youth Who Sexually Offend

Book review…

By Jonny Matthew
This review was originally published in the Journal of Sexual Aggression – the journal of The National Organisation for the Treatment of Abusers (NOTA)
Identifying and Treating Youth Who Sexually Offend: Current Approaches, Techniques and Research Edited by Robert Geffner, Kristina Crumpton Franey, Teri Geffner Arnold, Robert Falconer. 2204. pp. xxi + 317. ISBN 0 7890 2787 9.
Those searching for a reference source which addresses the principal area of ‘adolescents who sexually offend’, from both a clinical and research perspective, need look no further.

The book is divided into sections which consider the theoretical issues, assessment, treatment, and post-treatment aspects of working with youth’s who sexually offend.  This structure makes chronological sense and lends itself to ease of use.  However, I doubt many readers will use the book in this way. In my opinion this text will best serve as a good reference guide for most rather than a text that will be read from cover to cover.  Indeed, there are significant differences in the type, length and depth of the articles that leaves one with a sense of incongruity when sections are read together.  For instance, the etiological model for male juvenile sexual offending against females, posited by Knight and Sims-Knight, whilst clear and useful in its structure was also complex, detailed and not easily accessible to the non-statistically minded.  In contrast, Walker and McCormick’s survey of current practices in residential treatment facilities was an extremely succinct and relatively cursory view of the subject which was both informative and sobering.  However, this should not deflect those working with adolescents from utilizing this book and giving it shelf room.  It is an excellent collection of relevant and timely articles that offer a mix of empirical, reflective and practice-oriented material that has much to offer.
To illustrate the content, I will comment on selected articles from each section.  In addressing theoretical issues, Sue Righthand and Carlann Welch provide a good summary of the characteristics of young people who sexually abuse, offering a balanced view of the evidence without arguing for any particular etiological stand point.  The research cited is usefully spilt into categories for easy reference (maltreatment histories, family factors, social skills and relationships, mental health issues, etc.) and acts as a series of mini-synopses of each area of concern.
Lucinda Rasmussen considers existing typologies, both clinically and empirically derived, of children and adolescents (a useful separation), before comparing typologies and positing her Trauma Outcome Process (TOP) model.  The model’s name clearly locates the problem of sexually abusive behaviour in dysfunctional nurturing and/or victimisation experiences.  Whilst useful in that it acknowledges subtypes and the need to adjust treatment planning and interventions to suit, the model remains clinically derived and therefore untested in any empirically meaningful way.
In the section addressing assessment, Ian Lambie and John McCarthy summarise the factors that need to be taken into account when approaching direct work with clients as well as a précis of the Stages of Change and Motivational Interviewing models.  There follows a series of techniques that can be adopted or adapted when interviewing young people; these are simple and practical and are supplemented by some helpful pointers for working with offenders’ families.
The introductory article in the treatment section is a review, by Jill Efta-Breitbach and Kurt Freeman, of the fundamental types and modalities of intervention currently in use with juvenile sex offenders.  It serves well as an awareness raising document for the uninitiated, or for clinicians specialising in other client groups, whose knowledge and/or experience of young people who sexually abuse is scant.  I found the candid summary of the current state of empirical research on this topic extremely refreshing.
Scott Zankman and Josephine Bonomo state the standard reasons for including parents in juvenile sex offender treatment, as well as the commonly raised objections.  The argument for parental inclusion is necessarily more inductive than empirical, but is nonetheless persuasive.  The fact that the article is finished off with a reference to a recidivism study using a very small sample (p.154), is unfortunate and, in my view, diminishes what went before.
Robert Longo offers a gentle challenge to the pervasive influence of the talk-based, CBT-orientated programmes and convincingly argues for such methods to incorporate experiential treatment approaches.  Examples of these are provided.
Finally, Walker et al’s meta-analysis of treatment outcome studies offers a succinct summary of the problems besetting the study of treatment effectiveness, as well as those of meta-analysis with this population.  Whilst the paucity of comparable data means the results of the study must be treated with some caution, there are clear grounds for encouragement at the levels of treatment effectiveness shown in dealing with adolescent sexual offenders.
The journey from theoretical issues, through assessment, treatment and post-treatment issues is fairly thorough in this book, though the differences in style, length and complexity of the chapters felt clumsy at times. The articles are, for the most part, well contextualised, cogently argued, clearly structured and practically helpful.  The range of intellectual depth and practical utility is vast, but refreshing.  The clear sectioning of the book and its internal cross-referencing are particular strengths, especially when it is consulted for a specific topic rather than read as a whole.
The purely North American-centricity of the book highlights, sadly in my view, the lack of UK equivalence, and throws down the gauntlet to those of us working with this population in Europe, urging us to look again at what we can do to further our understanding of young people with sexually harmful behaviour.
By Jonny Matthew
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