Treatment for Teen Perpetrators of Child Sexual Abuse

Adolescents sometimes perpetrate child sexual abuse. Boys more than girls perpetrate, but it is important to recognize that some girls perpetrate as well. Otherwise, girl perpetrators will not get the interventions they require and the experiences of the children they victimize may be minimized. Girls perpetrate against other girls as well as against boys. Boy perpetrate against other boys and against girls. As in other types of child sexual abuse, For the purposes of this discussion, adolescents are young people between the ages of thirteen and seventeen years old.

In the United States, children ten and older are legally accountable for sex acts that are against the law in almost all jurisdictions. When these children are convicted of sexual abuse, they are sentenced to a correctional facility or to community-based treatment. Young people whom the courts judge to be at low risk are sentenced to community-based treatment while higher risk young people go into juvenile facilities. Young people in community-base programs have probation officers who may recommend to the courts that the young people be remanded to a correctional facility if they resist treatment.

Young people commit a wide variety of sexual offenses against children that come to the attention of the law. Underwear stealing, flashing, peeping, one-time sexual touches, repeated episodes of sexual abuse, date rape, sexually aggressive behaviors in groups, and instances of lone sexual assaults that involve penetration and often personal injury. Many programs tailor their programs to fit the seriousness of the offenses and the young peoples’ degree of risk.

Community-based programs often include individual, group, family, and couples therapy for parents in combination with psychoeducation for the young people and their parents. Programs may require low-risk offenders, such as naïve experimenters, to attend the program for a relatively short period of time. Psychoeducation and discussion of what they did and why their behaviors were inappropriate and abusive are main topics of their treatment. They successfully complete treatment when they appear to understand that what they did was wrong and that they now know what is appropriate or not. Often these children have high resource, low risk families.

Young people who commit more serious offenses stay in community-based treatment for up to a year. They receive prolonged psychoeducation and long-term therapy. To the extent possible, parents are involved in the treatment program. Some parents are unwilling or unable to participate because of their own trauma histories and histories of mental illness and chemical dependency. Children with a limited degree of family support are at higher risk to reoffend. When families are willing to deal with issues that might contribute to young people’s acting out, the young people are ar lower risk to reoffend.

Sex offender treatment also takes place in juvenile correctional facilities. Some of these programs appear to work well while the young people are in the programs. Once the young people return home, many of the gains of treatment can be lost. While there is little hard evidence, programs that are effective in preventing future sex offenses work with young people and their families and help families change their ways so that they can be of help to the young people when they return home.

Most young people who have perpetrated child sexual abuse return to the family home. In order to ensure the safety of other children in the family and in the community, some programs have several different strategies for rehabilitating perpetrators, for repairing family relationships, and for ensuring child safety. These strategies include apology letters, impact sessions, and apology and reconciliation sessions.

Apology Letters

Apology letters are routine in many treatment programs for children, teenagers, and adults. Those in treatment for sexual abusive behaviors may work for weeks and months before they can produce a statement that shows they understand and accept full responsibility for the sexual abuse. Therapists and members of their therapy groups help these their clients figure out what to say and then decide whether the letter is adequate.

The letter is not sent unless the therapists know for sure that survivors and families are ready to receive it. Therefore, the family and the child survivors may be in therapy themselves when these letters are sent.

Impact Sessions

Some program have impact sessions, where survivors and other family members meet with perpetrators to tell perpetrators what the abuse has meant to them. Such sessions are best done with a great deal of preparation, when treatment professionals believe that abusers are ready to hear what people they victimized have to say.

Survivors and family members also require preparation and support so that these sessions do not have unintended consequences of leading to more hurt, guilt and shame. If perpetrators hear directly from survivors about the impact of their sexually abusive behaviors, this could be a strong motivation for perpetrators to change.

Survivors and other family members have an opportunity to tell perpetrators directly what the abuse has meant. This can be empowering as providing a boost in confidence and self-worth.

Apologies and Reconciliation

If impact sessions go well, programs may then move on to apology and reconciliation sessions. This takes a great deal of preparation and cannot be done unless the child survivors are completely prepared to deal directly with the abusers and the abusers are completely prepared to take total responsibility for their behaviors. In addition, family members must be prepared to support and encourage children throughout the process.

Apology and reconciliation sessions are rare and require highly skilled and competent professionals. At least two professionals plan and coordinate these sessions: professionals who work with perpetrators and those who work with survivors and families.

There are a couple of reasons why such sessions are rare. First, the discovery of child sexual abuse often results in families ending relationships with perpetrators, as already discussed. Second, relatively few professionals are competent to do these sessions, and some believe that cut-off from perpetrators is the best course. However, when children want relationships with the persons who abused them, then this should be taken into consideration.

As strongly as adults may feel about no contact, children often are deeply attached to perpetrators, want the perpetrators to get help, and certainly do not sexual contact with them. Ideally, apologies and reconciliation sessions would be available to all persons who would want them.