FEMALE JUVENILE SEXUAL OFFENDERS:
DO GENDER DIFFERENCES REQUIRE SPECIALIZED TREATMENT?

In 1990, a major provider of residential treatment to emotionally disturbed adolescent girls began to recognize that some residents had sexually offended children before their placement at the facility. As the staff became more sophisticated in the assessment of past sexual offending, they learned that more adolescent girls had clear histories of sexual offending than had previously been imagined. In response to this fact, a specialized program was developed fo this population.

The development of this specialized program was highly dependent on literature and treatment models concerning or designed for male juvenile sexual offenders (JSOs). This was due to the paucity of literature that describes the characteristics of treatment needs for female JSOs. The reliance on treatment methodologies developed for male juveniles may be problematic, however, since it is not clear that female and male sexual offenders share the same characteristics and/or treatment needs.

Perhaps the most significant difference between male and female JSOs is their own history of sexual abuse. Studies of male JSOs show that a minority were sexually abused as children. This is significantly different from studies of female JSOs in which all, or almost all, of them have been sexually abused.

Moreover, a study of the 20 female JSOs served at the facility found that 90 percent had confirmed histories of sexual abuse, and in the other 10 percent there were allegations of sexual abuse. This gender difference suggests that programs for female JSOs may benefit from approaches to treatment which differ in some respects from programs designed for their male counterparts.

As mentioned above, the specialized treatment approach adopted by this facility was modeled after programs designed for males. The central element of this specialized program is a "stage system" protocol that defines progress in treatment, linking the achievement of critical treatment objectives to decreasing levels of staff and parental supervision. The assumption is that the risk for dangerous behavior decreases as the girl and family make progress on the goals defined in the protocol.

Each stage delineates goals for both the girl and family, the milieu monitoring plan, the visitation plan and the requirements for progressing to the next stage. Treatment in the milieu, individual and group therapy assists the girl in working on her goals at each stage of the protocol. Family therapy and a parents' group provide support for the family, helping them to understand the treatment process and achieve treatment goals.

For example, when a resident enters the program on stage one, she works on specific objectives, such as sharing the details of her sexual offending with the other participants in a structured sexual offenders group. To help the resident attain this objective, her individual therapy focuses on piecing together her offending history. While on stage one, she must also tell her parents and social worker the details of he sexual offending. Finally, before she advances to stage two, she must develop an initial prevention plan to help her avoid repeating past behaviors.

Each girl is also on a special milieu plan that reflects her progress on the stage system. The purpose of the milieu monitoring plan is to provide safety for each individual group ember. During the first two stages of the protocol, a girl must be in the same room as a staff member during all program activities and visible to staff at all times. If this level of monitoring is not successful at containing high risk behaviors, increased levels of monitoring would be required, such as being within arm's reach of a staff member, or removal from the group. Intensive monitoring also provides staff with the maximum opportunity to observe, label and redirect behaviors during the initial stages of treatment. As the girl progresses hrough the stages of the protocol, the level of staff monitoring is gradually decreased.

The clinical component of the program includes the sexual offenders treatment group, specialized individual therapy and family work, all of which are integrated with the girl's overall treatment goals. The sexual offenders treatment group is organized by modules which include:

• Thinking Errors:
  • Understanding the self-statements and misperceptions (e.g., He really wanted me to...) that support sexual offending
• Sexual Offense Cycle:
  • Defining the repetitive pattern of behavior that precedes the offending behavior
• Victim Clarification:
  • Recognizing the impact of the behavior on the victim and writing letters of apology
• Empathy:
  • Developing empathy for the victim through psychoeducation and art therapy

The individual therapy sessions focus on preparing each resident for the group and making progress on the objectives of the stage currently being worked. Family work includes full disclosure by the offender to her family, plus parent support groups and psychoeducational meetings for parents.

Although adapted from programs designed for males, the faculty has found most aspects of this treatment model very adaptable for females. Staff have identified significant similarities between male and female JSOs, including the specific nature of the behaviors, the premeditation of the offending and the violent sexual fantasies that precede the offending. These similarities suggest the need for similar treatment approaches.

An important point of divergence between programs for males and those for females is the timing of sexual abuse survivor treatment. A basic assumption of programs designed for males is that offender treatment must precede sexual abuse survivor treatment. The validity of that assumption with regard to females is being tested by staff at the facility, since virtually all female JSOs are survivors of sexual abuse. Rather than wait until residents have completed the stage system before beginning survivor treatment, sexual offenders who have made significant progress -- specifically those who have disclosed their offending behavior in group therapy and to their parents and accepted responsibility for the behavior -- may be placed in a survivors' group.

Thus far, no negative effects from this earlier introduction of survivors' work has been seen at the facility, but the practice needs to be evaluated in the future. It is possible that survivor work may undermine a girl's willingness to own her offending behavior. On the other hand, if the offending behavior is causally linked to having been sexually abused, then survivor treatment may be a critical element in the elimination of the sexual offending. Future program adaptations and evaluation will focus on the varying needs of male and female JSOs based on empirical gender differences.