, Azadeh Azad
Introduction
It is natural and healthy for children of the same age and size to explore voluntarily each other’s bodies as
well as gender roles. These behaviours become unhealthy when the interest in sex is much more than the
child’s other interests, when it is no more spontaneous and carefree but a way to get rid of one’s anxiety,
and when it involves coercing or duping other children. Children who have been clinically assessed as
having unhealthy sexual behaviours (being sexualized), who did not follow the rules set by their parents to
reduce or end the behaviours, or who have molested other children, need to receive professional treatment.
In this paper, three treatment models are presented in a concrete and non-theoretical fashion: an individual
therapy, a family therapy, and a group therapy. None of these treatment models are by themselves sufficient
for helping the sexualized children. Only a treatment plan that is a combination of all of these models
would be optimal.
1. Individual Therapy
Individual therapy is generally more convenient for sexualized children who do not molest other children,
or sexually abusive children who cannot be treated within a group setting. More importantly, since the
children’s sexualized and/or molesting behaviours are usually indicators of serious psychological problems
or earlier victimization, individual therapy allows for an in-depth or long-term work on these issues while
the inappropriate behaviours decrease.
Main Objectives of Individual Therapy
Forming a Working Therapeutic Relationship with the Child
Coming to therapy is often experienced by children as frightening or some kind of punishment. The
therapist shows interest in the child and presents the therapy session as a safe and even delightful
experience that the child would like or consider worthwhile. The therapist meets the child in a room with
a niche for play therapy. He/she conveys to the child that the problem behaviour will be brought up in many
different ways. He/she identifies language that will be used in all the sessions for naming the child’s sexual
behaviour. For instance, if the parent has talked about the child having been humping other children, the
therapist asks the child how he or she calls this act.
Using Different Techniques to Gather Information From the Child
Although the therapist has got an account of the sexualized behaviours from the child’s parents, he/she asks
the child to describe “what happened” in his or her own language .In the beginning of individual therapy,
the therapist creates a safe, positive, and dependable environment where denial is permitted for a short
period of time in order to avoid power struggle. Art work is used to diagnose children and get information
about their self-image and psychological issues. The therapist may ask the children to draw a self-portrait, a
picture of themselves doing something they like or they don’t like, or the picture of the worst and the best
thing that ever happened to them. There is a discussion after each drawing.
The technique of externalizing the sexualized behaviours away from the children is also used. Children are
presented with the concept of the sexualized behaviour becoming a monster that has got control over them.
They then give the monster a name (e.g., touching monster) and try to control it by detecting when and how
the monster appears and influences them, and what they can do to get help instead of fighting the monster
by themselves. The therapist may also use therapeutic games such as Let’s Talk About Touching or Walk
the Walk which provide children with a means to deal with complex issues while playing card or board
games. Another technique would be to tell children what is already known about the sexualized behaviours
and ask them to fill in details.
Developing Appropriate Vocabulary With the Child
The therapist asks the child to help him/her choose a vocabulary for addressing the child’s sexualized
behaviours. This vocabulary needs to be clear, simple, and nonjudgmental, as it is used to correctly identify
the behaviours and to help decrease and eventually eliminate them without injuring the child’s growing self-
esteem. Harsh phrases such as “that disgusting play” are counter-productive.
Taking a baseline measure of the child’s sexual behaviours
The therapist writes down all of the child’s sexualized behaviours, from compulsive masturbation to
exposing his/her genitals in public, to peeking in the school’s washrooms.
Determining the Precipitants of the Sexualized Behaviours
The therapist thereby finds out the precipitating factors of the behaviours as well as its risk factors, which
help the creation of an individual treatment plan. But, the knowledge of the precipitating factors is also
crucial to the children themselves. As Toni C. Johnson says, “It is very helpful for the children to know
what precipitates their problematic sexual behaviour so that they can anticipate the feelings and gain control
over their behaviours. If the precipitating situations are ones which the child cannot avoid, then the child
must be aware of them and find ways to control himself/herself when these situations arise, or find ways to
alert others to help on these occasions.” (1994).
Some children get anxious and want to engage in sexualized behaviours, when they sees aggression on TV,
when they foresee aggression in their environment, and when they recall specific individuals or
relationships. Some children despise authority figures, some hate men, and some may feel anxious around
women who are mothers. There are children who can make a connection between their difficult feelings
(e.g., loneliness, sadness) and the need to act out sexually. For instance, one boy who saw his prostitute
mother being beaten up by a man and then taken to the hospital began making an association between
loneliness and sex that was very much like the classical conditioning: whenever he felt lonely he had the
desire to hurt another child sexually, or whenever he had the desire to act out sexually the same type of
sadness and loneliness he had experienced at the time of his mother’s beating would come over him.
Gathering Information About Risk Factors
Circumstances or situations that may contribute to the recurrence of the sexualized behaviour constitute risk
factors, which include:
1. Sexualized behaviours across settings.
A list of risk factors can be drawn for each child after getting the maximum information from parents,
caregivers, teachers, the child and his or her siblings. For example, one nine-year-old who molested many
children in the neighborhood was more prone to sexualized behaviour when he was unsupervised, when he
played with smaller or younger boys, when his mother and her boyfriend were nude in front of the child,
and when he walked home from the school instead of taking a bus.
Assessing a History of Victimization
The therapist assesses for the history of earlier abuse, neglect, family violence, and substance abuse. He or
she also asks the child’s earlier experience with the sexualized behaviour: “How did you learn about this
kind of touching/rubbing?” “Did you ever see anyone touch/rub this way?” “Did anyone touch/rub you this
way?” The therapist may use the child’s self-portrait to remind him or her what words were used by the
child to call different body parts, and then ask if anyone touched the child’s genitals, and if so, what were
the circumstances.
Understanding the child’s Perceptions of Family Dynamics
Another reason for individual therapy is to find out if the child’s needs are being met in the family, as
well as what the child’s perceptions of family conflicts and parental discipline are. However, the therapist
can not rely on information from the child and must make a full family assessment.
Reducing /Stopping the Sexualized Behaviours
The child should be removed from any person or thing which may be causing the child’s feelings of acting
out sexually. Based on the baseline data, the therapist decides which one of the child’s sexualized behaviours
needs to be worked on. An abusive behaviour should be attended before other behaviours. As for the other
sexualized behaviours, the therapist chooses the one that is easiest to stop so that the child gets some
encouragement for the treatment of his/her behaviours. It is important to work on one behaviour at a time, and
to check with the database to see if a behaviour has been decreasing. It is also important to allow the child
participate in the therapeutic plan and feel control over his/her life, as this will contribute to more positive
results and to a greater sense of self-esteem. The therapist teaches the child that sex does not equate love,
that he/she is responsible for his/her behaviours, that he/she has choices to make regarding his/her behaviours.
The child is provided with appropriate sex education, acceptable sexual behaviour, a system of consequences
for misconduct, and strategies to anticipate and control the desire to sexually misbehave.
Assessing the Child’s Readiness and Preparing Him/Her for Group Therapy
In order to assess if the child is ready for group therapy, the therapist should see if he/she is able to:
1. Listen and understand.
The child needs to understand the specific topic of the group in advance. The therapist may portray the
group in the following way: “You’ll be coming on Monday morning to meet with me, and four other
children your age. You and the other children have a lot in common- you’re all boys (or girls), you’re all 9
years old, and you’ve all had problem with touching other children. We’re going to talk about the touching
problem and find out ways to help you stop doing that.”
Processing Material Produced in Group
Individual therapy enables the therapist to investigate into relevant clinical material that rises within group
therapy sessions.
Secondary Objectives of Individual Therapy
These objectives are about helping children improve their self-concept and self-esteem, learn social skills,
reduce their feelings of helplessness and vulnerability, identify their needs and get their needs met, have
realistic views of family and family roles, and become future-oriented.
2. Family Treatment
Sexualized behaviour can be reduced only if it is also treated within the family system, which has essentially
caused its appearance and continuance. The therapist needs to deal with every family member’s needs and
rights and behave sensitively towards all members of the family. In order for the therapist to engage the
whole family in therapy, and to create an accompaniment for future in-depth therapy, he or she provides
psycho-educational groups as the first step in family treatment.
Psycho-educational Groups
There are both parents’ group and children’s group, which usually last about ten weeks. The main purpose
of psycho-educational groups is to give intelligible and precise information about children’s sexualized
behaviours. A secondary goal for the parents’ psycho-educational group is to give them an opportunity to
meet and support each other.
The therapists raise the same issues in both children’s group and adult group, although they use different
methods. Children are provided with games and playful assignments to learn the lessons, whereas adults
directly discuss the chosen topics. Each group lasts one hour and is divided in three parts. During the first
fifteen minutes, participants review what they did the previous week, get ready for the lesson; a snack is
served to the children. The middle part, which lasts twenty minutes, consists of a structured lesson and
discussion. During the last fifteen minutes, the two groups get together, parents and children tell each other
what they learnt and thereby clarify and reinforce the lessons. This exchange of information between
parents and children encourages open communication regarding uncomfortable sexual subjects.
The topics covered in psycho-educational groups consist of:
1. Characteristics of sexualized children: average age, types of sexualized and/or molesting behaviour,
gender of molester and victim, and most common situations (e.g., older siblings, extended family members,
neighbors, and school friends).
After completing the psycho-educational groups, parents and children participate in separate group
therapies that run parallel.
Parents’ Group Therapy
Both parents need to participate in group therapy even if they are separated. Parents’ group therapy
generally lasts two hours, half an hour longer than the children’s group. As most parents work during the
day, an evening group is more convenient. Group therapy sessions are focused on the sexualized behaviour
of children, but at the same time deal with many emotions and concerns of the parents.
Main Objectives of Parents’ Group therapy
These objectives consist of parents’:
Parents become aware of the need to eliminate all sexual stimuli from the child’s surroundings. These
include porno magazines, dirty jokes, TV shows with sexual content such as soap operas, shows and
movies that contain scenes of violence. They learn to monitor their children to dress age-appropriately, and
their daughters to wear shorts under skirts. Parents understand that they should avoid sexual interaction in
front of the child and only display greeting hugs and fast kisses. They also understand that verbally and
physically aggressive behaviours will create anxiety and the subsequent desire for sexual behaviours. Parents
realize that sexualized children may need to be supervised, their bathroom activities done separately from
other children, not be allowed to walk around nude, not be allowed to sleep in the same bed with other
members of the family or in the same room with another child. Parents learn that they should be emphatic
about which behaviours are permissible and which are not. Parents might find it funny when their child tries
to pull down the bathing suit of another child while playing under the sprinkler, and punish the child when
he/she tries to lift another child’s skirt while playing in the living-room. To a sexualized child, these
behaviours are alike. Consistency is critical. All sexualized behaviours must be forbidden.
Secondary or General Objectives of Parents Group Therapy
These objectives consist of understanding parental sense of inadequacy, and feelings of guilt or
confusion; recognizing strength and weaknesses of the family and the marital relationship; reducing
concealment and manipulation among family members; increasing open communication and the ability to
predict conflicts; and finally, identifying and improving those interactions that facilitate the sexualization of
the family milieu.
Family Therapy
All members of the family participate in the family therapy. The therapist helps everyone understand that
the child’s “touching problem” is very much like a child’s stealing problem or lying problem. As in
when a child steals, other children report to the parents if something has been stolen from them, these
children should let the parents know if the child acts out sexually. The child with sexualized behaviours
needs to be part of this plan, as this is done not to humiliate the child but to help him/her not to do the
behaviours. The therapist states that parents are the only ones who can give consequences or rewards to the
child. If the child molests other children in the family and cannot be stopped, the therapist recommends
his/her placement in a group home where treatment is provided.
In later family sessions, the therapist and the family members discuss how they now look at the sexualized
behaviours, what they will be doing to stop similar problems in the future, and what has been the
contributing role of each member regarding the sexualized behaviours. The therapist needs to identify and
reinforce positive changes and repeat the skills that have been learnt in therapy. If the abusive child and the
victim are both in the family, it is beneficial if the child who molested apologize to the child-victim either
verbally or in writing.
3. Group Therapy
Being in a group with other children is beneficial to sexualized children who have learnt to relate to other
children primarily in sexual and aggressive ways. It helps them learn new ways to interact with other
children. Also, many sexualized children feel apprehensive in being with an adult in a closed room with the
adult talking to him/her about sexual matters. They feel less anxious if there are other children and more
than one adult present.
Objectives of Group therapy
Objectives of group therapy consist of decreasing children’s sexualized/abusive behaviour; increasing
children’s understanding of their unhealthy assumptions about sex and sexuality; increasing children’s
understanding of healthy sexuality; increasing children’s cognizance of situations that precipitate, or bolster
sexually inappropriate behaviours; understanding and integrating feelings and thoughts related to earlier
victimization as well as any physical, emotional, or sexual abuse, neglect, divorce, and death; helping
children look at their own behaviours, evaluate their behaviours, become aware of situations that precipitate
their behaviour, and think of what will happen as a result of their behaviours before they act; increasing
children’s capability to detect and value other people’s feelings, wants, and rights; helping children clarify
their wants and values and develop their own goals; increasing children’s ability to satisfy their needs in
socially acceptable ways; increasing children’s relatedness to other people and developing their internal
resources that foster further growth.
Group Format and Length of Sessions
It is beneficial to have many treatment cycles. The group can meet once a week, one and a half hour each
session. Because sexualized children generally come from homes where few things are predictable, having
a ritual that the group goes through every week, helps them have clear expectations and learn to conform to them.
Group Structure
Sexualized children should be placed in a therapy group where children are of the same gender, same size,
same emotional and developmental level, same degree of pathology, and almost the same age (a maximum
of one-year age difference is recommended). This is because the therapists need to monitor and process the
dynamics of victim and victimizer during the sessions. Boys and girls under the age twelve generally do not
like to share sensitive subjects about their bodies and sexuality. Because of the impulsiveness of these
children regarding sex and aggression, it is most helpful to have only four to six of them in a group. Three
therapists for six children are the best ratio. With this ratio, therapists can control the behaviour of the group
and pay attention to the children's individual needs.
Choice of Therapists
Sexualized boys and girls need to learn to establish healthy rapport with therapists of either gender. A
male therapist can join a girls’ group after the introductory phase of the treatment. This male co-therapist
can model for the capacity of a male to talk about sexuality without acting on it. A female therapist is
crucial in a group therapy because many sexualized children come from single-parent homes where the
mother has problems with emotional and sexual boundaries. A stable female therapist provides this children
with the opportunity to define themselves outside of the mother’s projections and ambiguities.
The Setting
The best space for group therapy is a room large enough to contain a desk-height table and chairs, and
small enough so that children may not be able to use it for recreation. Children remain more focused in a
space with boundaries. For groups of younger children, a play area with small toys for the recess is needed.
Preparation of Children for Group Therapy
Children are told that the group consists of work, fun, and food. Also, in order to make children understand
that the group therapy is focused, every child should be told that in the first session other children will be
telling the group about their “touching problem”, and then he/she will be asked to tell the group about
his/her touching problem. Children should know that the “touching problem” would come up in different
ways in each session.
Group Process
Children and parents meet in a waiting room. The therapists check in with the parents and exchange
information while the children play. Then, children’s group begin with a snack and sharing time. Food
represents affective nourishment and makes children feel comfortable in a group setting. Children talk
about good and bad things that happened to them during their week. Then the structured activity begins.
Afterwards, the children begin relaxing and playing. After playtime, the group’s unstructured activity
begins. During unstructured activity time, children talk about what they have learnt and how the group
went. It is a time to learn socialization skills. After group, children join parents in the waiting room and
play together again as parents talk together. Therapists can gather helpful information about the parents’
interaction and parenting style.
Therapeutic Interventions
Plays
Children choose one of the group members to be the director. The director decides a story to be played by
all of the children. Sometimes the therapists guide the children to explore and play a story with a
meaningful topic. The director decides which role is portrayed by whom. After the first rendition of the
play, the director reallocates the roles. Usually, there are strong characters and weaker ones in the play.
Children gain an insight into the feelings of a victim or a victimizer by playing these roles. The perspective
gained from playing each role can help children understand how it feels to be victimized and how it feels to
be the victimizer. Sexual behaviours should not be performed.
“Stop the Action” Game
In the game “Stop the Action”, everyone freezes the moment the words are uttered by a therapist. Then,
everyone thinks about what he/she was doing. Children learn to slow down sometimes and ponder on their
actions and feelings. Also, the therapists may choose a theme, for example “sadness” and tell the children
that they will call “Stop the Action” if they notice sadness in the behaviour of one of the participants.
Cartoons
Drawing cartoons by children is used to explain what happens when they abuse. Children draw frames
describing what they were thinking or feeling before they abused, then how they involved a child in
sexual behaviour, and finally what happened after the abuse. Children are asked to draw the feelings
and thoughts of their victim. The more familiar children become about what triggers their behaviour, what
happens during the acting out, how they feel afterwards, and what are their victim’s feelings, the more able
they are to stop the behaviour. Subsequently, children draw cartoon frames that depict some alternative
behaviours to the molesting ones. They can cut the alternative frame and tape one end of it over the
molesting behaviour. Then, they can draw frames showing how the subsequence would look after the
alternative behaviour occurs. Children can compare the alternative behaviour sequence with the sequence of
molesting behaviour by lifting up the frames.
Progressive Stories
In this technique, the therapist begins to tell a story that is related to the objectives of the therapy and every
child adds on to it in their turn. The children sit around a table and each knows their turn. The therapists sit
at intervals between the children in order to divert the story when it gets away from the topic. This
technique provides the therapists with information about the children’s anxieties, conflicts and thought
process related to the story topic.
Making Videos
The therapists choose a topic and children decide whether to do a television talk show, mime the topic,
make a “speech” in front of the camera, or make a “commercial”. Children can decide how to make a
commercial on sexual abuse prevention.
Making Pamphlets
Children can write and illustrate a pamphlet where the topic is something like how it feels to be sexually
abused, what it is like to live in a foster home, or how many kinds of mothers exist in the universe. The
therapists can type it or assist children in other ways. An 8.5 x 11-inch piece of paper can be folded in three
and its different sides used.
Relaxation Techniques
By learning to relax at will, children gain a feeling of control over their bodies and emotions. The children
get in a relaxed posture in their chair with their arms on their sides. The therapist tells them they are
going to relax by contracting and loosening their different muscles. The children use only large muscles
and move on in some way through the body. The therapist’s voice is calm, gentle, and monotonous. After
the exercise, children discuss how they felt. By learning to separate and work on different muscles, children
learn to control how they feel and become more able to direct what takes place in their bodies and
environment. They can use relaxation technique whenever they notice the presence of a situation that
triggers their sexualized behaviour.
Guided Imagery
To do a guided imagery exercise, children get in a relaxed position in their chairs, put their arms on the
table, and stretch forth their legs, with their eyes closed. They, then, concentrate on the story being told by
the therapist. Children are asked to imagine every scene, recall or guess all the sounds, smells, touches and
motions. Stories are about something like taking a walk on the beach. Positive scenes can describe any
number of people, being affectionate and respectful to each other, or the child being popular or successful
in some endeavor. Negative scenes can depict a child being apprehended after having touched another child
and going through an ordeal. The therapist describes the child’s feelings in details. Children are asked to
memorize the scene and recall it whenever they feel like wanting to act-out.
Metaphors
Each child may have a metaphor to use when talking about their feeling about a specific touching problem.
Some children use the term “tingly” feeling, others use the term “scary” feeling. Once the feeling has a
name, it becomes more clear, stronger, and more alive. Metaphors can be chosen and used in other
situations where children find themselves. “Space invader” is an excellent term for speaking of someone
who violates the child’s physical and emotional boundaries. The term is both humorous and strong, and can
be used to warn the children themselves as well as others when they are being invasive.
Metaphorical Stories
The therapists read to the children some metaphorical stories about touching problems or having been
abused. They, then, discuss these stories together. Gardner (1971) created a technique called Mutual
Storytelling, in which the child or the children tell a story, then the therapist retells the same story with the
same characters and the same conflicts, but suggests a different ending to the events, an ending that is
healthy and socially appropriate.
Role-Plays
Children can learn to solve problems by doing role-plays. Two children perform a problem that one of them
has had in the previous week. If one of them had a negative interaction with a teacher, he/she can play the
teacher and show the group how the teacher behaved and how he/she reacted. The second child will now
play the teacher and the first child plays himself/herself. Then, the group evaluates the interaction and
recommends substitute ways for the child to behave. The child alters the way he/she behaved and tries to
see if the new behaviour changes the teacher’s behaviour. Finally, the children reverse roles in order to
understand how it feels to be in different people’s shoes.
Art Materials
Art materials are used in most types of group therapy with children. A helpful activity for sexualized
children is to do the family drawing. Children are asked to explain what people in the drawing are doing,
and how they are feeling and thinking. The family drawing is an excellent tool to assess the child’s
progress.
Music and Dance
Therapists play piano, or any other musical instrument, for children in order to compel them to think about
a topic, listen to the music, and come up with a song. After making the song, children can sing it in their
minds as a way to stop a sexual acting-out from happening. They can also get a psychic satisfaction out of
singing it to the group. Dancing is very beneficial to children who have been sexually or physically abused
and live in tense and stiff bodies. Physical activity related to music and dance releases entangled physical
and psychic energy.
Letter Writing
Some children express the desire to communicate with their abusers. Therapists can take note from children
who can not yet write. Children feel more comfortable expressing their untold feelings in a letter.
Sometimes, they want to express love and affection towards their abusers. It is important that they feel free
to do so. The letter may be mailed or not. If they decide to mail it, children should be first aware of the
impacts of sending the letter.
Conclusion
Sexualized children are not offenders. According to Lucy Berliner and Les Rawlings, “In most cases, the
behaviours are learned responses to abusive experiences and deficits in the family and community
environment rather than intentional criminal conduct.” (1991) The obvious objectives of the treatment
models is to stop the sexualized behaviours of children. Most therapists agree that in order to bring about
these changes, a combination of individual, group, and family therapy are needed. Children with sexualized
behaviours are engaged in individual therapy both at the onset of treatment in order to create a therapeutic
alliance and develop a context for group therapy, and all along the treatment process in order to discern the
underlying reasons for their behaviours. Also, individual therapy provides the best setting for reexamination
and clarification of the issues that have emerged in group therapy. Family therapy enables parents or other
caregivers to provide children with a sense of safety by mindfully addressing their inappropriate sexual
behaviours, and making sure that other children do not fall victim of these behaviours. And finally, group
therapy has a critical place in an expedient treatment plan. During group therapy, children come to
experience relationships with the therapists and other children in which they are expected to empathize with
others and take responsibility for their actions. All these treatment models eventually provide children with
the skills to cope with risky circumstances and the insight and understanding of not harming others.
Bibliography
Becker, J. V., C. D. Harris and B. D. Sales (1993). Juveniles Who Commit Sexual Offenses: A Critical Review of Research, in Sexual Aggression: Issues in Etiology, Assessment, and Treatment, G. C. N. Hall,
R. Hirschman, I. R. Graham and M. S. Zaragoza (eds). Washington: Taylor and Francis.
Berliner, L. & Rawlings, L. (1991). A Treatment Manual: Children’s Sexual Behaviour Problems. Unpublished manuscript. Seattle, WA: Harborview Sexual Assault Center.
Borduin C. M & S. W. Henggeler, D.M. Blaske, R.J. Stein (1990). Multisystemic Treatment of Adolescent Sexual Offenders. International Journal of Offender Therapy and comparative Criminology, 34, 105-113.
Bonner, Barbara & and C. Eugene Walker, Lucy Berliner, "Children with Sexual Behaviour Problems:
Assessment and Treatment", Report by National Center on Abuse and Neglect, US Department of Health
British Columbia Ministry of Education (1999). Responding to children's problem sexual behaviour in
elementary schools : a resource for educators. Victoria, B. C.
Burton, Jan Ellen & Lucinda A. Rasmussen (1998). Treating Children with Sexually Abusive Behaviour
Problems, The Haworth Maltreatment and Truma Press.
Cunningham, C., & McFarlane Kee (1991). When Children Molest Children. Safer Society Press, Vermont.
Gardner, R. A., (1971). Therapeutic communication with children: The mutual storytelling technique.
New York: Jason Aaronson.
Gil, Eliana & Toni C. Johnson (1993). Sexualized Children: Assessment & Treatment of Sexualized
Children & Children Who Molest, Foreword by William N. Friedrich , Launch Press.
Johnson, Toni C., (1994). Decreasing Problematic Sexual Behaviours in Children. Unpublished manuscript. Seattle, WA: Harborview Sexual Assault Center.
Katz R. C. (1990). Psychosocial adjustment in adolescent child molesters. Criminal consequences of childhood sexual victimization. Journal of Child Abuse and Neglect, 14: 567-575.
Kaufman, B. & Wohl, A., (1992). Casualties of Childhood: A Developmental Perspective on Sexual Abuse Using Projective Drawings. New York: Brunner Mazel.
Lundrigan, Paul Stephen (2001). Treating youth who sexually abuse: an integrated multi-component
Approach. Haworth Press, New York.
Ryan, G. D. & Lane, S. L. (Eds.) (1991). Juvenile Sexual Offending: Causes, Consequences and Correction. Lexington, MA: Lexington.
2. A history of impulsive and aggressive behaviour.
3. A history of victimization.
4. Obsessive-compulsive behaviour.
5. The use of threat or violence.
6. Propensity for multiple victims.
7. An unconcerned family in denial.
8. Being unrepentant and unwilling to stop the behaviours.
2. Conform to pointers.
3. Associate with peers.
4. Comply with group rules and adapt himself/herself to limits.
5. Manage his/her own affect (not to become overly excited by peers, and not to lose control and cool
which prevents him/her from learning and causes distraction in others).
6. Take part in group activities.
2. Psychological problems of sexualized children: poor boundaries, impulsiveness, low self-esteem,
isolation, earlier victimization, and aggression.
3. Molesting behaviours: fondling, digital penetration, penetrations with objects, vaginal and/or anal
intercourse, etc.
4. Appropriate sexual play: what sexual behaviours between children are age-appropriate.
5. Difference between normal sex play and sexual molestation: how to distinguish between age-appropriate
sexual play and sexual abuse.
6. Family dynamics: the dynamics of families in which children become sexualized (severe parental
dysfunction; children’s psychological abuse and neglect; enmeshed or disengaged family boundaries; overt
or covert sexual abuse and violence; etc.).
1. understanding of their children’s pattern of sexualized behaviours.
2. comprehension of their participation in providing external control (i.e., supervision)
3. comprehension of their participation in helping their children with internal controls (e.g., responding
when children ask for help as part of their prevention strategies).
4. collaboration in recognizing and dealing with high-risk factors for their children.
5. capacity to keep communication open with their children about sexualized behaviours.
6. understanding of specific family dynamics that fosters a climate in which sexualized behaviours may
occur.
7. collaboration with the children’s therapy.
8. clarity about their own feelings and thoughts, and responses to the child who molests, the child-victim,
and other family members.
, Azadeh Azad