Treatment Distinctions for Adolescent Males and Females

• Repetitive patterning of offending do not always exist
  While repetitive patterns of sexually offending behavior is well established through research chronicles, in one of the few studies regarding female adolescent offenders, no subject exhibited a repetitive pattern of sexual offending behavior (Fahrenbach & Monastersky, 1988).
• Personal histories of sexual abuse do seem to exist
  Knight and Prentky (1993), in their studies of male adolescent offenders showed a broad range of those who sexually abuse having had a personal history of sexual abuse.  Johnson (1988) suggested that 49% of adolescents, who are treated for sexual acting out, have personal histories of sexual abuse.  If almost all young females who sexually act-out have been sexually abused, it is possible that effective treatment for this population should focus not only on the sexual misbehaving behavior, but on the sexual abuse survivor issues as well.
• Relationships with their victim do seem to exist
  Studies of females who have misbehaved sexually demonstrate that these young females tend to know the victim with whom they have acted out.  In Johnson's (1989) sample (n=13) of latency aged females, all of the subjects knew their victims.  For 10 girls, their victim was a family member.  For 8 of the subjects all sexual misbehavior was within the family.

If future studies continue to support these as well as other distinctions, it is incumbent upon those who provide treatment strategies for this population to not only address these distinctions, but to also look for, and address other unique characteristics as well.

At Cottonwood we are cognizant of the very important fact that since females are different from their male counterparts, treatment methodologies and protocols must fit those unique differences.  Our treatment protocol, while framed somewhat within the treatment models and utilizing workbooks previously designed for males, diverge from utilizing the standard treatment processes which have framed treatment strategizing derived from our clinical understanding of adolescent offending from a male perspective.  Rather, our programming and specific focus on the three aforementioned areas of potentially significant differences between male and female adolescent sexual offenders, creates the scaffold of which individual treatment plans are fashioned.

Treatment Programming

Why "Making the Grade"?  As females, we have been socialized to examine our worth and "grade" our acceptance by others according to our perception of our personal worth.  Without proper support and mentoring, females grade their patterns, their past, and their potential in direct relation to the mirroring they receive from those with whom they are in close contact.  At Cottonwood, we believe that excellence is inherent in everyone who walks through our doors.  We work toward an awakening of an internal awareness of personal value and worth, and that along with that awakening appears the ability to "grade" oneself honestly, with hope and future anticipation without recapitulation.

Treatment Phases and Objectives

Each of the five treatment phases begin with an "A".  Pre as well as post grading of meeting the objectives for each level is done by each individual working on that level.  The five phases closely mirror traditional treatment modalities in terms of scope and sequence:  Treatment Objectives need not be completed in any particular order and are purposefully designated by a compass versus a number in order to provide the individual an opportunity to begin making progress in the direction that she chooses.  Providing choice is a salient component of good treatment programming for individuals with personal abuse histories as leaning to make choices facilitates a sense of personal empowerment as it falls in line with tenets of personal accountability.

Phase I:  Acknowledgement

Acknowledging not only the wrongfulness of behavior, but the need for assistance with that behavior comprises the first phase of treatment.  Many young females who act-out often verbalize empathy early on in treatment.  This phase of treatment suggests that the girl is willing to not only accept that her behaviors are illegal as well as wrong, but that she is willing to acknowledge that she has a problem that she is not able to negotiate on her own.

Treatment Objectives

• Making sense of court orders and charges
• Making sense of evaluations and assessments
• Demonstration of understanding of healthy and unhealthy behaviors
• Owning the reality of initial reactions of others

Phase II:  Accountability

Accountability is the first step one takes out of typically operating in one's life from a victim perspective.  Doing so does not minimize the impact of wrongful behaviors that have happened in one's life, but rather provides a needed opportunity to now step out of victimization and thus eliminates the potential of justification of current problematic, dysfunctional behavior.

Treatment Objectives

• Investment in treatment planning
• Becoming an effective community member
• Disclosure
• Identification of personal thinking errors

Phase III:  Awareness

One of the most important objectives of treatment is gaining an awareness of how one's acts have affected the lives of others.  During this phase of treatment myths are shattered.  These myths not only include the behaviors for which one is in treatment, but the myths which may have been created about one's own personal history.

Treatment Objectives

• Victim awareness
• Making sense of why the sexual acting out occurred
• Disclosure of personal history
• Demonstration of an understanding of boundaries and learning to set new ones

Phase IV:  Ability

During this phase of treatment there is a demonstration of the integration of new skills that have been learned that set the stage for the maintenance of newly acquired, healthy cycles and patterns.  Restorative actions are demonstrated.  Reunification with family is begun during this phase.

Treatment Objectives

• Clarification: making things clear to self and others
• Moving from victim to survivor
• Demonstration of remorse and restitution
• Demonstration of healthy, non-victimizing relationships

Phase V:  Achievement

Achieving a personal metamorphoses is just the first step toward moving in one's world with new found personal power and purpose.  Putting this part of life behind oneself is not the only outcome of this phase of treatment.  Using the skills taught in this phase of treatment concerning values and character building can greatly enhance walking into life's future with increased esteem and empowerment.

Treatment Objectives

• Putting it all together
• A new attitude
• Dismantling denial of the behavior continuing in the future
• Now what?