Seven
years ago, as a third year graduate student, I began a clinical practicum at a
university based treatment program that provides services to youth at a high
security, residential juvenile justice facility. During this placement, I was
to provide individual and group therapy to adjudicated juveniles, many of whom
had committed sexual offenses. Although this was a new area for me, I already
had limited but successful experience treating individuals with serious
psychological disorders, such as depression, bulimia, and personality
disorders. I expected that, once I adjusted to the anticipation of a new job and
the idea of working with incarcerated and potentially dangerous adolescents, my
approach to treating these youth would be no different from my approach with
previous clients. Essentially, I’d familiarize myself with the latest research,
read about the empirically supported treatments, and with some expert guidance
from my supervisors and a treatment manual, I’d be ready to forge ahead.
The
good news, my supervisor shared, was that research was generally showing a
positive effect of treatment on reducing sexual recidivism for adult offenders.
The bad news was that whether treatment worked for juveniles was far less
conclusive. Then the news became worse: it was not clear exactly what type of
treatment worked, how it worked, for whom it worked, or what specifically was
the target of treatment. My readiness to forge ahead was considerably lessened,
but I was also curious given that treatment for sexual offenders was already
ongoing in the facility. I wondered: if there was not a well-established
treatment for juvenile sexual offenders, what were they doing here?
It was clear at this facility, as it is in treatment programs across the
country, that treatment providers cannot sit and wait for a “gold standard” of
treatment to be available. Children and families are in dire need of our
assistance and victims need protection. Judges are mandating youth to complete
sexual offender specific treatment and legislation previously reserved for
adult sexual offenders, such as community notification, sexual offender
registration, residency restrictions, and civil commitment, is being widely
applied to juveniles. As a result, critical decisions about a youth’s release
from incarceration, placement with family, or need for further supervision are
being made based on judgment of treatment outcomes and assessment of recidivism
risk, which are imperfect at best for juveniles.
As
a relative newcomer to the treatment and research of juvenile sexual offenders,
these realizations about the high stakes of working with these youth are both
distressing and exciting. The distress surfaces when I cannot provide families,
youth, or judges with more definitive information about the role of treatment
or future risk. On the other hand, because research and treatment of juvenile
sexual offenders is relatively new compared to many other areas of psychological
research, we have the unique opportunity to build knowledge about these youth
from the ground up. Though it is a tedious task, the work currently being done
will provide the foundation for the development of empirically validated and
cost effective treatment and risk prediction for juvenile sexual offenders and,
in fact, we are well on our way. Treatment, such as multisystemic therapy
(Borduin, Henggeler, Blaske, & Stein, 1990; Letourneau, Schoenwald, &
Sheidow, 2004), and risk assessment measures such as the Juvenile Sex Offender
Assessment Protocol (J-SOAP; Righthand, Prentky, et al., 2005) and Estimate of
Risk of Adolescent Sexual Offense Recidivism (ERASOR; Worling, 2004), are
showing promise and should leave us optimistic about what lies ahead. However,
the fact remains that neither specific types of treatment nor risk assessment
measures have empirical support to the level expected by scientifically minded
practitioners.
In the meantime, when treatment
demands are high and the legal and social consequences for juvenile sexual
offenders are serious, we as treatment providers have to pull ourselves up by
our bootstraps and do the best we can with the resources and knowledge
currently available. One bootstrapping strategy used with juvenile sexual
offenders has been the application of what is known about and practiced with
adult sexual offenders. This has both practical and clinical utility and is
certainly a reasonable launching point for work with juveniles. However, while
this approach may be used as a temporary guide, it is critical that the
assumptions about juveniles and their similarity to adult sexual offenders be
examined. One of these assumptions—that there are juvenile equivalents of child
molesters and rapists—is one focus of research being conducted by many in the
field, including at our facility. This is a particularly important assumption
to examine because, with it may come several other assumptions: that juveniles
will exhibit stability in victim choice if they continue to sexually offend;
that the groups will show different patterns and levels of sexual deviance and
criminal behavior; and that recidivism rates of the groups will differ. If
these assumptions regarding juvenile sex offenders are erroneous, treatment
effectiveness and risk prediction will be greatly diminished and application of
legal and social policies to juveniles will be greatly misguided.
The
issue of whether there are juvenile equivalents of child molesters and rapists
is also important to examine because of the value a valid classification system
will have in informing treatment, risk prediction, and possibly prevention.
Specifically, a valid classification system for juvenile sexual offenders will
identify different developmental correlates, specific offending patterns or
symptomatic presentation, treatment needs, and outcomes for each specific
subgroup. If these factors are identified for particular subgroups of juvenile
sexual offenders, children at risk may be identified early and provided with
preventative measures. Treatment may also be more cost effective because
criminogenic needs unique to the individuals in each subgroup could be targeted
and risk prediction and public policies could be improved so that the level of
intervention and supervision matches the juvenile’s level of risk and
dangerousness.
Whether victim age is as valid classification method for juvenile sexual
offenders as it appears to be for adults remains an empirical question. The
research thus far has been inconclusive as to whether juveniles who offend
younger children (child offenders) or those who offend peers or adults (peer
offenders) are truly distinct groups. Aside from differences in rates of sexual
abuse (more common in child offenders) and victim characteristics (child
offenders tend to victimize male and female relatives, whereas peer offenders
tend to victimize female acquaintances; Worling, 1995), consistent differences
between these subgroups have not been found, even on treatment outcomes or
recidivism rates (Kahn & Chambers, 1991; Nisbet, Wilson, & Smallbone,
2004; Parks & Bard, 2006; Vandiver, 2006). Part of our research is focused
on comparing subgroups of child and peer offenders on sexual and nonsexual
offense history, abuse history, social skills, impulsivity, treatment outcomes,
and recidivism. In addition, we include a group of mixed offenders—those who
have a history of adjudicated sexual offenses against both children and peers.
This group is of particular interest because, with few exceptions (see Parks
& Bard, 2006), they are often combined with child offenders, are classified
as either child or peer offenders based on their most recent offense, or are
excluded from research samples. It is possible that this is a distinct group
and that combining them with either child or peer offenders clouds true
differences between those subgroups.
Our Research
Our sample consisted of 198 child offenders (victims were age 12 or younger and
4 or more years younger than the offender), 77 peer offenders (victims did not
meet child victim criteria), and 21 mixed offenders (at least one child and one
peer victim) who were adjudicated for sexual offenses and court ordered to
complete residential sex offender treatment. Some differences between child and
peer offenders were found, as expected, on measures of sexual abuse and victim
characteristics. However, the most noteworthy findings were for the mixed
group. Admittedly, the mixed group is quite small and this likely constrains
the interpretation of the results, but the mixed group is possibly a severe
group and at the very least, worthy of further study.
Mixed Offenders
Generally, the mixed offenders had a more extensive sexual offense history than
other juvenile sexual offenders. Two sexual offense adjudications (against a
child and peer) were necessary for classification as a mixed offender; however,
many exceeded this criterion—48% of mixed offenders had three or more
adjudicated offenses, compared to 9% of child and 4% of peer offenders.
Compared to other sexual offenders with two or more sexual offense
adjudications, the mixed offenders had more victims than both groups and more
sexual offense adjudications than peer offenders. The mixed offenders were also
characterized by high rates of abuse, with nearly two-thirds having been abused
in some manner and half of them abused sexually.
The mixed offenders were also noteworthy in terms of the details of their
offending history, in that they had a varied and intrusive pattern of
offending. Specifically, the mixed offenders were more varied in victim gender
and relationship, and appeared to exhibit less discretion in their victim
choice than other subgroups. They were the group most likely to victimize both boys
and girls and the group most likely to victimize both inside and outside the
family. They were also the most likely to abuse multiple victims at the same
time, with one-third of the mixed offenders doing so, compared to 10% of child
and 5% of peer offenders. Mixed offenders engaged in penile penetration of the
victims more often than child offenders and engaged in oral sex more often than
peer offenders. Finally, the mixed offenders had the greatest variety of sexual
acts in their offense history, suggesting that they engaged in different types
of sexual acts (e.g., fondling, penetration, oral sex) with different victims.
The mixed offenders did not differ from the other sexual offenders on criminal
history variables, including age at first arrest or number of nonsexual
charges. It therefore appears that their versatility in offending sets them
apart from other sexual offenders only in terms of sexual, and not nonsexual,
crime.
Child Offenders
The child offenders were the largest subgroup, accounting for two-thirds of the
sample. Half of the child offenders were victims of abuse and, along with the
mixed offenders, experienced higher rates of sexual abuse than did the peer
offenders. Over 25% had multiple sexual offense adjudications and they were
charged with offenses against an average 1.5 victims. These youth tended to
victimize females and relatives; however, nearly one-third had an adjudicated
offense against a male. Child offenders were the least likely to engage in penile
penetration of the victims, but engaged in oral sex more often than the peer
offenders. As a group the child offenders were just over 13 years old at first
arrest and were among those with the fewest nonsexual charges in their history.
Peer Offenders
Peer offenders represented the second largest subgroup, comprising one-quarter
of the sample. Over one-third of peer offenders were victims of abuse and,
although the rate of sexual abuse was higher than what is typical in the general
population, it was lower than the rate of the other sexual offenders. Similar
to child offenders, they averaged fewer than two victims but nearly 30% had
multiple sexual offense adjudications. The overwhelming majority victimized
females and they were the group most likely to victimize non-family members and
to offend in a public place. Peer offenders were more likely than child
offenders to engage in penile penetration of victims, but were least likely to
engage in oral sex. Finally, this group was notable in terms of their nonsexual
offense history. As a group, peer offenders were likely to have been first
arrested before age 13 and had an average of over seven nonsexual charges,
which was nearly one and a half times the nonsexual charges of the other
subgroups and significantly more than the child offenders.
Involvement in Treatment
The vast majority (88%) of the sexual offenders in this study successfully
completed the one year group treatment program at the facility. The mixed
offenders had the highest proportion of treatment failures (29%), due to
serious conduct problems within the facility or unsatisfactory progress in
treatment after multiple attempts in the treatment program. Interestingly,
treatment performance was not related to either sexual or nonsexual recidivism
after a follow up period of approximately five years. Prior residents of the
facility were tracked using a legal research database, Westlaw, which allowed
for a nationwide search of adult criminal records. Rates of nonsexual
convictions were high (40%) and rates of sexual convictions were relatively low
(6%). Both of these rates are consistent with other published data on juveniles
(Reitzel & Carbonell, 2006) and with research showing higher nonsexual than
sexual recidivism rates in youthful sexual offenders (Freeman, 2007; Reitzel
& Carbonell, 2006).
Groups in this study did not differ in their rates of nonsexual recidivism, which was somewhat surprising given that peer offenders had more extensive nonsexual criminal histories than child offenders and adult rapists generally show higher nonsexual (violent, general) recidivism than child molesters (Freeman, 2007; Hanson & Bussière, 1998). Also somewhat unexpectedly, groups did not differ on rates of sexual recidivism. Despite the mixed offenders’ extensive sexual offense history, they did not have unusually high rates of sexual recidivism. In fact, the child offenders accounted for 16 of the 18 sexual recidivists, with one sexual recidivist coming from each of the other groups. Though this difference was not statistically significant, it is clinically interesting. Child offenders were clearly overrepresented in the group of sexual recidivists, as they accounted for 89% of the sexual recidivists despite accounting for only 67% of the sample.
Interpretations
Overall,
this research offers some support for the validity and clinical utility of
classifying juvenile sexual offenders on the basis of victim age. The mixed
offenders appeared somewhat more severe in their sexual offense history and did
more poorly in treatment than other groups. The child and peer offenders showed
differences in sexual abuse history, victim choice, and nonsexual crime,
similar to differences found between adult child molesters and rapists. The
results are moderately consistent with the adult and juvenile literature and
hint at further avenues for research. For example, mixed offenders may be more
sexually deviant than other groups, which could result in extensive future
sexual offending and resistance to treatment. Interventions aimed specifically
at reducing sexual deviance may be indicated for this group. This research
suggests that peer offenders may be similar to adult rapists in their
propensity for nonsexual crime and, therefore, treatment targeting general
criminal behavior may be most beneficial for them. Finally, child offenders may
be at a higher risk for sexual recidivism and future research might focus on
whether these offenders are more likely than others to continue victimizing
others as they enter adulthood.
In contrast to, and despite these important differences, some similarities
between the groups make these subgroups appear somewhat arbitrary and suggest that
victim age-based subgroups of juveniles may not be as distinct as are adult
rapists and child molesters. No differences were found on measures of physical
abuse, social skills, or impulsivity, and subgroups exhibited some
commonalities in their patterns of sexual offending and recidivism. We
therefore must closely examine, in future research, variables that are thought
to be related to the etiology and maintenance of sexual offending in juveniles
and determine whether there are differences between subgroups on those
important variables. Furthermore, there are inherent difficulties in
determining who constitutes a juvenile version of a child molester when, in
reality, the offenders themselves are children. As a result, we must be
cautious when making downward extensions of adult treatment methods and
policies to juveniles. Our research findings also make it clear that detailed
examination of a wide range of developmental factors, sexual deviance, criminal
history, and long-term offending patterns will be necessary before we can
validate juvenile sexual offender subgroups and identify their specific
treatment needs.
Closing Thoughts
Seven years ago, I began searching for answers about who to treat, what to
treat, and how to treat juvenile sexual offenders. Although I was surprised to
find that starting up in this area would not be as straightforward as
familiarizing myself with the latest treatment manual, I have been rewarded
with the opportunity to observe the rapid increase in knowledge about juvenile
sexual offenders. Recently, I have been fortunate to have the opportunity to
integrate research and clinical work in my dealings with youth. The combination
of research and practice in a clinical setting maximizes our potential to
improve the services we provide, while protecting victims and making a
meaningful contribution to the knowledge of juvenile sexual offenders. It is my
hope and expectation that our efforts in this line of work will result in fair
and effective practices for juveniles who sexually offend.
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