The thought change system an empirically based cognitive behavioral therapy for male juvenile sex offenders: A pilot study.

Abstract

Recent research in treatment of sexual offenders suggests that comprehensive cognitive -behavioral approaches may yield significant decreases in deviant acting-out behaviors. The current pilot study examined such a treatment called the Thought Change System, which is an empirically based cognitive -behavioral therapy, in a residential treatment center, existing in Portsmouth, Virginia. This system includes the identification of the functions of the negative thoughts, feelings, behaviors, and beliefs, and replacing them with transitional thoughts, feelings, behaviors, and beliefs, and finally alternative beliefs. The Thought Change System also implements the Case Conceptualization Method based an adaptation of the Beck (1998) suggested methodology of mode deactivation. The offenders were adolescent males, age's 11-18, who have a history of failed treatment at prior placements or outpatient treatment centers. The results of this study indicate that a cognitive -behavioral methodology that addresses the underlying personality traits may be effective for severely disturbed sexual offending adolescents; evident by reduced psychological distress, reduced sex offending risk, and reduced aggressive beliefs. KEY WORDS: cognitive/behavioral treatment; juvenile sexual offenders; cognitive distortions; case conceptualization; sexual offender treatment ********** The following description proposes the type of treatment for juvenile sex offenders as treated by the Behavioral Studies Program (BSP) at The Pines Residential Treatment Center (The Pines) in Portsmouth, Virginia. The proposed typology is based on the collected works of Richardson, Kelly, Bhante, and Graham (1997); Awad and Saunders (1991); Monto, Agourides, and Harris (1998); Becker and Kaplin (1991); Becker & Hunter (1998); and Hunter (1989). The Pines offers residential treatment for male and female sex offenders. Ninety-eight percent of residents report a prior history of victimization, including sexual, physical, emotional, and/or environmental abuse(s). In support of Hunter and Becker's (1997) review, these residents report their own victimization to have occurred during an early developmental ages (2-5 years). In addition, few residents talked about or acknowledged their abuse(s) until years after the abuse occurred. A prior history of victimization at a young age, and few disclosures appear to be consistent in the histories of those that sexually offend and victimize. Statistical support for this premise is evident in the male population at The Pines. Up to 93% of male BSP residents have been victimized in all four of the above abuse parameters. The juvenile sex offender falls primarily into two major types: those who target children and those who offend against peers or adults (Hunter, 1989). The major difference present in these two groups is based on the age difference between the victim and the offender. Child offenders have been defined as those who target children five or more years younger than themselves (Hunter & Mathews, 1997). The presence of deviant arousal is often found in juvenile male child molesters who offend against young males, and may be indicative of early onset pedophilia. Indications of non-sexual delinquency and generalized antisocial tendencies have been found most frequently in backgrounds of juveniles who have engaged in aggressive sexual offending. Specific psychological diagnoses are associated for those with a history of prior abuse. For example, a child with numerous early childhood traumas may cause a later diagnosis of Posttraumatic Stress Disorder (PTSD). Johnson, Cohen, Brown, S., and Bernstein (1999) suggest in their longitudinal study that early childhood trauma victims are considerably more likely than those who were not abused or neglected to have Personality Disorders (PD) and elevated PD symptoms, particularly those PD within the Cluster B spectrum as outlined within DSM-IV-TR (APA, 2000). …