Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program
About This Program
Target Population: Children (boys and girls ages 6 to 12 years of age) with sexual behavior problems and their caregivers
For children/adolescents ages: 6 – 12
For parents/caregivers of children ages: 6 – 12
Program Overview
Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: School-Age Group is a family-oriented, cognitive-behavioral, psychoeducational, and supportive treatment group designed to reduce or eliminate incidents of sexual behavior problems:
- The program is an outpatient group treatment program for children ages 6 to 12 years and their parents or other caregivers.
- Program can be provided to individual families when group is not an option.
- The treatment is provided as an open-ended group, with children able to graduate in 4-5 months.
- Collaboration with child protective services, juvenile court personnel, school personnel, and others involved is highly recommended.
The children acknowledge the previous breaking of sexual behavior rules, learn coping and self-control strategies, and develop a plan of how they were going to keep these rules in the future. Caregivers were taught how to supervise the children, teach and implement rules in the home, communicate about sex education, and reduce behavior problems utilizing behavior parent training strategies.
Program Goals
The goals of Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: School-Age Group are:
- Eliminate or reduce problematic sexual behavior
- Improve child behavior via better parental monitoring, supervision, and behavior management skills
- Improve parent-child interaction and communication
- Improve coping, self-control, and social skills
Logic Model
The program representative did not provide information about a Logic Model for Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program.
Essential Components
The essential components of Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: School-Age Group include:
- Modeling, observing, and providing constructive and corrective feedback on skills
- Structured program and providers who use a directive approach
- Addressing components with Children and Caregivers
- Rules about sexual behavior
- Boundaries
- Abuse prevention skills
- Emotional regulation and coping skills
- Impulse control and problem solving skills
- Sex education
- Social skills and peer relationships
- Acknowledge, apology, and amends
- Addressing additional components for caregivers
- Behavior parent training to prevent and respond to sexual behavior problems as well as other behavior problems
- Sexual development and child development including moral development
- Dispelling misconceptions regarding the behavior and implications to the child
- Support
- Separating out the groups by age:
- 6-9 year olds with 5 to 8 children per group
- 10-12 year olds with 5 to 8 children in each group.
- One caregiver group for children of the combined age ranges can be used – or separate caregiver group depending on program decisions.
Program Delivery
Child/Adolescent Services
Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program directly provides services to children/adolescents and addresses the following:
- Sexual behavior problems, general behavior problems, and internalizing symptoms
Services Involve Family/Support Structures:
This program involves the family or other support systems in the individual's treatment: Program requires weekly parent/caretaker attendance and active participation, monitoring and supporting child application of skills between sessions, and ongoing assessment of child progress in treatment.
Parent/Caregiver Services
Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program directly provides services to parents/caregivers and addresses the following:
- Parent/caregiver of a child with sexual behavior problems; parent may have limited understanding of sexual development, sexual behavior problems, and parenting strategies that improve boundaries and reduce sexual behavior problems
Recommended Intensity:
60-90 minute weekly session
Recommended Duration:
4 to 5 months depending on meeting graduation criteria
Delivery Setting
This program is typically conducted in a(n):
- Outpatient Clinic
Homework
Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program includes a homework component:
Each week the child and caregiver have activities that have them apply or practice the skills/ information taught.
Resources Needed to Run Program
The typical resources for implementing the program are:
- Group rooms including one room large enough to hold all the families for the parent-child group component
- Chalk or dry erase board
- Co-therapists for each child group (recommended). One therapist for the caretaker/parents group
- Personnel to conduct the intake assessments
- Supervisor/director of the program
- Therapeutic materials, such as books
Manuals and Training
Prerequisite/Minimum Provider Qualifications
Supervisor and lead therapists are recommended to be licensed mental health practitioners with previous experience in treatment for children and their caregivers for children with behavior problems and children who have been maltreated.
Manual Information
There is a manual that describes how to deliver this program.
Training Information
There is training available for this program.
Training Contact:
- Jane F. Silovsky, PhD
OU-YPSB@ouhsc.edu
phone: (405) 271-8858
Training Type/Location:
Onsite or at The University of Oklahoma Health Sciences Center
Number of days/hours:
Depends in part on training and experience of staff to be trained. Typically, there are 4 days of initial training, ongoing consultation (preferred live observation of program via polocom), and at least one booster training visit.
Implementation Information
Pre-Implementation Materials
There are pre-implementation materials to measure organizational or provider readiness for Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program as listed below:
The Sexual Behavior Problems of Youth Program Assessment assesses organizational and provider readiness and capacity for EBP for youth with SBP. The assessment asks about current referral, intake, and treatment program and capacities as well as staff, agency, and program skills, resources, and abilities. It is available via Dr. Silovsky contact info above and at the end.
Formal Support for Implementation
The program representative did not provide information about formal support for implementation of Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program.
Fidelity Measures
There are no fidelity measures for Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program.
Implementation Guides or Manuals
There are implementation guides or manuals for Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program as listed below:
There is background manual that provides information to assist agencies with their program development.
Research on How to Implement the Program
The program representative did not provide information about research conducted on how to implement Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program.
Relevant Published, Peer-Reviewed Research
Child Welfare Outcomes: Safety and Child/Family Well-Being
Carpentier, M., Silovsky, J. F., & Chaffin, M. (2006). Randomized trial of treatment for children with sexual behavior problems: Ten year follow-up. Journal of Consulting and Clinical Psychology, 74(3), 482–488. https://psycnet.apa.org/doi/10.1037/0022-006X.74.3.482
Type of Study:
Randomized controlled trial
Number of Participants:
291
Population:
- Age — 5–12 years
- Race/Ethnicity — 85% Caucasian, 9% African American, 4% American Indian, and 2% Other
- Gender — 67% Male and 33% Female
- Status — Participants in the treatment group were children with sexual behavior problems recruited from child welfare, law enforcement and juvenile court, physicians, school personnel and mental health centers.
Location/Institution: Oklahoma State University and University of Oklahoma
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to provide long-term follow-up data for children with sexual behavior problems. Participants were randomized into one of two treatment groups: the 12-session Children with Sexual Behavior Problems Cognitive-Behavioral Treatment Program: School-Age Program, or group play therapy, and compared to a sample of 156 children with nonsexual behavior problems treated at the same mental health clinic. Measures utilized include the Child Behavior Checklist-Parent Form (CBCL), Child Sexual Behavior Inventory, Version 2 (CSBI-2), and the Kaufman Brief Intelligence Test (KBIT). Results indicate that the CBT group had significantly fewer future sex offenses than the play therapy group (2% vs.10%) and did not differ from the general clinic comparison (3%), supporting the use of short-term CBT. There were no group differences in nonsexual offenses (21%). Limitations include that offense data was only obtained from Oklahoma and children may not have lived in the state for the entire 10-year follow-up period, and thus offenses may be under-reported, with any offenses committed in other states not included in the analyses. Additional limitations include children with unusually severe SBP or unusually severe comorbidities may have been underrepresented in the sample, and it was not possible to confirm how many children in the sample were still living in the state during the entire follow-up period.
Length of controlled postintervention follow-up: 10 years.
Silovsky, J. F., Hunter, M. D., & Taylor, E. K. (2019). Impact of early intervention for youth with problematic sexual behaviors and their caregivers. Journal of Sexual Aggression, 25(1), 4–15. https://doi.org/10.1080/13552600.2018.1507487
Type of Study:
Other quasi-experimental
Number of Participants:
320
Population:
- Age — 10–14 years
- Race/Ethnicity — Not specified
- Gender — Not specified
- Status — Participants were youth and their caregivers who participated in community-based problematic sexual behavior – cognitive behavior therapy.
Location/Institution: Three agencies serving communities across the United States with sites located on the West Coast, Midwest, and the Northeast
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the outcomes of the initial three community-based programs for youth with problematic sexual behaviors (PSB) enrolled in the Problematic Sexual Behavior – Cognitive Behavioral Therapy for Adolescents (PSB-CBT-A) [also called Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program] program. Measures utilized include the Achenbach Child Behavior Checklist (CBCL), the Achenbach Youth Self-Report (YSR), the University of California-Los Angeles Posttraumatic Stress Disorder Index for DSM-IV, the Achenbach System of Empirically Based Assessment (ASEBA, the Family Skills, Supports, and Stressors Scale (FSSS), the Alabama Parenting Questionnaire (APQ), the Multidimensional Social Support Measure – Child, and the Youth Sexual Behavior Problems Inventory (YSBPI). Results indicate that significant reductions in PSB with a large effect size were found. No site differences were found, despite racial and regional diversity. Nonsexual behavior problems, emotional problems, and trauma symptoms also significantly improved. Positive outcomes extended to caregivers. Limitations include lack of randomization, lack of comparison condition, and lack of follow-up.
Length of controlled postintervention follow-up: None.
Jenkins, C. S., Grimm, J. R., Shier, E. K., van Dooren, S., Ciesar, E. R., & Reid-Quiñones, K. (2020). Preliminary findings of problematic sexual behavior-cognitive-behavioral therapy for adolescents in an outpatient treatment setting. Child Abuse & Neglect, 105, Article 104428. https://doi.org/10.1016/j.chiabu.2020.104428
Type of Study:
One-group pretest–posttest study
Number of Participants:
31
Population:
- Age — 11–18 years
- Race/Ethnicity — Not specified
- Gender — Not specified
- Status — Participants were adolescents who completed Problematic Sexual Behavior – Cognitive Behavioral Therapy for Adolescents (PSB-CBT-A) at a Children’s Advocacy Center between 2013 and 2016.
Location/Institution: Children’s Advocacy Center (CAC) in the Southeastern United States
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate a low-intensity outpatient treatment regarding the reduction of internalizing symptoms and externalizing behaviors to include, problematic sexual behavior (PSB) for adolescents who completed Problematic Sexual Behavior – Cognitive Behavioral Therapy for Adolescents (PSB-CBT-A) [Also called Children with Problematic Sexual Behavior Cognitive-Behavioral Treatment Program: School-age Program]. Measures utilized include the Achenbach System of Empirically Based Assessment (ASEBA) and the Youth Sexual Behavior Problems Inventory (YSBPI). Results indicate that adolescent PSB-CBT-A treatment completers demonstrated a trend towards statistical significance in reduction of PSB on the YSBPI from 5.33 (SD = 6.86) at pre-treatment to 0.17 (SD = 0.41) at completion. Additionally, significant reductions in caregiver-reported youth internalizing and externalizing problems were associated outcomes of completing PSB-CBT-A. Limitations include lack of randomization, small sample size, lack of control group and lack of follow-up.
Length of controlled postintervention follow-up: None.
Additional References
Bonner, B. L., Walker, C. E., & Berliner, L. (1999b). Treatment manual for cognitive behavioral group therapy for children with sexual behavior problems. Grant No. 90-CA-1469. Administration of Children, Youth, and Families, DHHS.
Bonner, B. L., Walker, C. E., & Berliner, L. (1999c). Treatment manual for cognitive behavioral group treatment for parents/caregivers of children with sexual behavior problems. Grant No. 90-CA-1469. Administration of Children, Youth, and Families, DHHS.
Silovsky, J. F., Swisher, L., & Widdifield, J. (2010). Treatment for school-age children with sexual behavior problems and their families: 3rd Edition. Adapted from Bonner, Walker, & Berliner (1999).
Contact Information
- Jane F. Silovsky, PhD
- Agency/Affiliation: University of Oklahoma Health Sciences Center
- Website: psbcbt.ouhsc.edu
- Email: OU-YPSB@ouhsc.edu
- Phone: (405) 271-8858
- Fax: (405) 271-2931
Date Research Evidence Last Reviewed by CEBC: July 2023
Date Program Content Last Reviewed by Program Staff: October 2018
Date Program Originally Loaded onto CEBC: April 2011
