|
Article Excerpt
Adolescent sexual acting out behaviors frequently occur in the context of comorbid issues, such as depression, trauma, behavioral disorders, and developmental deficits, thus rendering any single treatment modality less effective. Augmenting traditional treatment with an existential-humanistic perspective enables counselors to more effectively address a host of common co-occurring conditions.
**********
Adolescents who exhibit inappropriate sexual behavior frequently have coexisting mental health problems that compound the decisions regarding selection of treatment approaches. The full extent of the client's emotional problems must be assessed. It is important to consider not only the sexually offending behaviors of the adolescent but also any associated mental health or emotional problems that may be present. Depression, trauma, behavioral disorders, and developmental deficits occur on a fairly consistent basis in sexually acting out adolescents (Baker & White, 2002; Gerardin & Thibaud, 2004; Gray et al., 2003; Lambie & Seymour, 2006; Metz & Sawyer, 2004; Rich, 2003). A cognitive-behavioral approach has traditionally been used to treat inappropriate sexual behaviors, but the use of this approach alone may not adequately address common coexisting conditions (Rich, 2003). The addition of existential-humanistic (E-H) interventions may be helpful in treating the conditions that often accompany sexual acting out behaviors. Counselors should consider adopting a combination of therapeutic approaches to more effectively treat adolescents presenting with these problems.
The purpose of this study is to review the literature and, using an E-H framework, to present adjuncts to existing treatment protocols for adolescents with inappropriate sexual behaviors. Consideration is given to those components of the adolescent's development and environment that contribute to her or his acting out behaviors and existential anxieties (e.g., death, freedom, isolation, meaninglessness; Yalom, 1980).
COMMON CHARACTERISTICS OF ADOLESCENT SEX OFFENDERS
The literature focuses on two distinct types of adolescent sex offenders: (a) those who offend against peers or adults and (b) those who assault children. The first type of offender predominantly assaults females and strangers and frequently operates in public areas (e.g., 15% of these cases in the United States occur in a school environment; Hunter, 2000). The latter group tends to be male offenders who prefer male victims (Rogers & Tremain, 1984). Most of these child-related offenses occur in the victim's home, particularly during child care activities, and in 90% of cases, the victim is known by the perpetrator (Ryan, 1991). The average age of the victim is 7 to 8 years old, and the majority of the victims are related to the offender (Ryan, 1991). Becker, Kaplan, and Cunningham-Rathner (1986) reported that almost half of sibling offenders demonstrate nonsibling paraphilic behavior. Adolescent sex offenders also generally have a history of nonsexual criminal offenses and a high incidence of antisocial behaviors and conduct disorders (Hunter, 2000).
Ninety percent of adolescent sex offenders are male and approximate the general population in terms of ethnicity, religious preference, and geographic location. The median age of reported offenders is between 14 and 15 years old (Utah Task Force of the Utah Network on Juveniles Offending Sexually, 1996).
The number of female sex offenders is increasing, and females who have experienced more severe victimization histories for all types of abuse report that the age of onset of their sexual offending behavior is often even earlier than that of males (Gray et al., 2003; Mathews, Hunter, & Vuz, 1997). There is evidence of sexual aggression in children as young as 3 and 4 years old, with the usual age of onset being between 6 and 9 years old for adolescent offenders in general (Araji, 1997).
There are a number of characteristics that are common to the adolescent sex offender population. The Appendix lists the common characteristics that appear regularly in the clinical records of adolescents who are in treatment for sexually inappropriate behaviors. These characteristics are considered from three distinct, although interrelated, perspectives: (a) characteristic symptoms, (b) sociocultural characteristics, and (c) environmental characteristics.
Characteristic Symptoms
Becker et al. (1986) studied the incidence of depressive symptoms in adolescent sex offenders with a history of abuse (sexual, physical, or emotional). They found that 42% of adolescent sex offenders experienced major depressive symptoms, as measured by the Beck Depression Inventory. The respondents' mean score was 2 times higher than that of a random sample of nonoffending adolescents.
Along the same lines, Millard and Hagan (1996) and Apsche, Evile, and Murphy (2004) found recurring themes of emotional disturbance in their study of adolescents in two sex offender treatment programs. These included diagnoses of posttraumatic stress disorder and personality disorders, including borderline personality disorder, narcissistic personality disorder, antisocial personality disorder, and histrionic personality disorder. These studies revealed that treatment participants consistently shared specific personality traits, life experiences, and perceptions. Treatment participants reported their engagement in aggressive and self-destructive behaviors and additionally reported childhood experiences marked by physical and emotional abuse and neglect, which were often related to substance abuse in the family. Few of these participants reported exposure to positive male role models (Apsche et al., 2004). The victims of their aggression encompassed a broad spectrum, including family members, acquaintances, and strangers, and accounted for both genders and all ages (Millard & Hagan, 1996).
Many adolescent sex offenders are also victims of sexual abuse, ranging from introduction to pornography and explicit sex acts at an early age to rape and sodomy (Gerardin & Thibaud, 2004; Gray et al., 2003; Rich, 2003). In these cases, counselors must help offenders work through their issues of victimization (Muster, 1992). Apsche et al. (2004) noted that 98% of the residents in one treatment program reported a prior history of victimization including sexual, physical, and/or emotional abuse(s). The authors also reported that there was a history of nonsexual delinquency and generalized antisocial tendencies found in the backgrounds of adolescents who engaged in aggressive sexual offending behaviors.
Sociocultural Characteristics
Thus far, more similarities among adolescent sex offenders have been documented than culturally derived differences. According to van Deurzen (1998), "All cultures are built around rules for sex, aggression, and affiliation" (p. 136). One factor that adolescent sex offenders of all racial and ethnic backgrounds have in common is that they have broken these rules. Further commonalities include a lack of assertiveness, poor social skills, and inadequate impulse control (Smith, Monastersky, & Deisher, 1987), all of which contribute to...
|
