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Deadline for Summer
2004 issue:
June 1, 2004
Association for the
Treatment of Sexual Abusers


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Volume XVI, No. 2 • Spring 2004
Adolescent Sexual Development and Sexuality: Assessment and Interventions
 
Understanding, Assessing, and Rehabilitating: Juvenile Sexual Offenders
 
Male Victims of Same-Sex Abuse - Addressing Their Sexual Response
 
 
 
 
Adolescent Sexual Development and Sexuality: Assessment and Interventions
by
D. A. Gaffney and C. Roye, Editors
Civic Research Institute, 2003 (www.civicresearchinstitute.com)
$125.00
 
Review by
Denise Carlton, MSW
Phoenix, AZ
 
The idea for this book was born when the editors attended a conference on teen sexuality and found an overwhelming response from professionals requesting more information on teen sexuality. The list of professionals included social workers, psychologists, physicians, nurses and teachers. Clearly, there is a need for more information on this subject and, as we know, teens are often unprepared for sexual development and responsible behaviors. Sources of information for teens are (by their report) peers, the media, and teachers. Parents are at the bottom of the list. Ultimately, it is the role of the professionals and parents to help prepare and guide teens.
 
This book addresses positive, healthy sexual development and serves as a guide for helping teens develop responsible behavior. It speaks of the sexual development of teens from all spectrums including chronically ill and disabled teens who have been widely ignored. Gaffney and Roye have presented the information from the point of view of teens and included at the end a chapter of articles written by teenagers that originally appeared in SEX, ETC, a national newsletter and website written by teens and for teens. SEX, ETC. covers vital sexual issues facing all teens and is distributed to hundreds of thousands of teens across the United States.
 
The book is divided into four sections with Part I addressing The Context for Understanding Adolescent Sexuality. This section discusses sexual, cognitive and emotional development along with romantic attachments and understanding cultural influences in sexual development. Gaffney and Roye have provided valuable resources in this section that includes a guide to help communicate with teens of all cultures, a cultural self-assessment to help raise awareness of our own cultural aspects, and a list of resources for accessing cultural information.
 
Part 2, Reproductive Health Care for Adolescents, provides information on contraceptives and emergency contraception. This section is educational and gives useful advice on approaching communication with teens in an informed but nonjudgmental manner.
 
Part 3 discusses Risks and Needs Associated with Adolescent Behaviors. Gaffney and Roye discuss pregnancy and sexually transmitted infections but go beyond the traditional educational presentation to include how to talk about these issues with teens and some of the concerns teens have involving confidentiality and disclosure to partners. This section also addresses the chronically ill, physically and/or developmentally delayed, and lesbian, gay, bisexual and transgender adolescents... populations that are rarely discussed in sexual development materials.
 
Of interest to ATSA members is the chapter on nonconsensual sex. Gaffney and Roye weave together issues of concern to teens regarding cultural norms, acquaintance rape, and the contribution of drugs and alcohol to sexual assault. All are issues that are of concern to teens that need to be talked about openly and non-judgmentally.
 
The last section of the book is a collection of articles written by teens and for teens. The articles are well written and address a wide range of issues from maintaining virginity, being gay, a plea for better sex ed, how to talk to your parents about sex and how to avoid date rape. It is an interesting and informative look at how teens think and view their sexual development and more importantly the pressures and problems they have to deal with often with no information and no adults to turn to for answers.
 
The book is certainly a good addition to add to the literature. The importance of providing normative sexuality interventions in treatment of adolescents is a topic of much discussion and an important addition to treatment. I highly recommend it as a solid foundation for understanding adolescent sexuality from the point of view of the adolescents themselves. It is quite beneficial in understanding and addressing the concerns and issues that teens face while also trying to develop responsible sexual behavior. Gaffney and Roye have put together a good solid foundation that will stimulate all of us to begin building our own knowledge bases in an area that truly needs the construction.
 
 
 
 
 
Understanding, Assessing, and Rehabilitating: Juvenile Sexual Offenders
by
Phil Rich
John Wiley & Sons, Inc., 2003
482 pages, $45.00
 
Review by
Jennifer Kelly, Ph.D.
Merchantville, NJ
 
Understanding, Assessing, and Rehabilitating: Juvenile Sexual Offenders is a comprehensive guide to examining the critical issues relevant for those working with juveniles who sexually abuse. Dividing his work into three sections, Rich explores the assessment, treatment, and management of these youth, while continually reminding the reader of the appropriate developmental context. In Juvenile Sexual Offenders, Rich has created a highly detailed and informative resource for clinicians of all levels of experience.
 
In section one, Rich first considers the fundamental questions everyone working within the field should ask. He challenges the reader to think critically and explore the basis for the theoretical and practical assumptions made about this group of children. Also included in this section are Rich's detailed discussion of the nature of abuse and his theory-based belief about how this population should be characterized. In defining the population, Rich takes it a step further and asks the reader to truly understand it. In particular, he suggests that in most cases, the sexual act for the juvenile is merely a means to an end - and the end is to achieve a need. His supposition continues that in order to best assess and treat this group of children and adolescents, clinicians must understand each child's specific needs. Well written and accompanied by plentiful graphics, the first section of Juvenile Sexual Offenders is a clear example of Rich's main goals: assisting the reader in challenging the accepted standards and encouraging consideration that there may be more beneficial practices yet to be developed.
 
Finally, in the first section Rich thoughtfully examines the many potential pathways to the development of sexually abusive behavior. Exploring the larger social context and effectively weaving in the developmental issues relevant for juveniles, Rich defines numerous motivating factors and emphasizes the value of the many protective factors that may influence behavioral outcomes.
 
In section two of Juvenile Sexual Offenders, Rich examines the assessment of juveniles who sexually abuse, beginning his discussion again within the context of developmental considerations. Always reminding the reader of the fluid changes evident in the cognition, affect, and behavior of children and adolescents, Rich compares and contrasts assessments between juveniles and adults. He provides a very basic description of the assessment process and moves to a clear and concise explanation of issues relevant to test construction and recidivism. In the end, the reader should understand the underlying statistical issues that affect the assessment of risk. Also in section two is Rich's outline of the steps taken to create his assessment tool, the Juvenile Risk Assessment Tool (JRAT). The tool itself is not included.
 
Finally, in the Assessment section, Rich also includes one of the most comprehensive and step-by-step descriptions of how to conduct a complete evaluation for a juvenile in which issues relevant to sexually abusive behavior are central. This section will surely please the beginning practitioner as well as the experienced clinician interested in updating their report writing skills.
 
In part three of Juvenile Sexual Offenders, Rich examines issues pertinent to the treatment and rehabilitation of juveniles who sexually abuse. First, Rich reminds the reader that the forensic nature of these cases makes them inherently different than general clinical work. He emphasizes the need for clinicians, whether assessing or treating, to be skilled in the finer points of forensic practice in order to adequately provide services in this psycholegal context. Quite pointedly, Rich lays out an easy to follow structure to guide the treatment process within the larger legal backdrop. Following this introduction, the author provides an overview of general goals for treating youth with sexual behavior problems. He goes to great lengths to ensure the reader is exposed to the meaning behind such terms as multimodal, multitheoretical, multidisciplinary, and multifaceted as they relate to the design of a holistic treatment protocol for these adolescents. In this text, Rich offers many concrete examples of treatment goals with suggestions regarding the monitoring and assessing of treatment progress.
 
A particular strength of this text is the depth of material covered. For example, in the treatment and rehabilitation section, Rich includes individual chapters allocated to key treatment topics such as thinking errors and behavioral cycles, the relapse prevention plan, and victim clarification. Likewise, he also includes in this section specific chapters on the role of individual therapy, group therapy, and family therapy for adolescents with sexual behavior problems. In addition, Rich spends a fair amount of time explaining the value of an open mind for clinicians considering with which theoretical orientation to align and offers very compelling reasons to utilize a treatment approach which blends numerous clinical orientations.
 
Understanding, Assessing, and Rehabilitating: Juvenile Sexual Offenders is a superb resource for clinicians at all levels of expertise involved in the assessment, treatment, and management of youthful sexual offenders. In his text, Rich provides great detail regarding the themes and topics relevant to the issue of juveniles who sexually abuse. Most importantly, he seeks to challenge our complacency within the field and encourages critical thinking. Understanding, Assessing, and Rehabilitating: Juvenile Sexual Offenders should be considered an essential reference for those working in the field.
 
 
 
 
 
Male Victims of Same-Sex Abuse - Addressing Their Sexual Response
by
John M. Preble and A. Nicholas Groth
Sidran Press, 2002
128 pages, $17.95
 
Review by
Ken Singer, LCSW
Lambertville, NJ
 
Nicholas Groth is a familiar name to those who know the literature on assessment and treatment of sexual abusers. John Preble is a new name to me but, according to the book's introduction, the two authors have been in the sexual abuse field for more than 40 years, working with sexual abusers and male victims and survivors.
 
Groth, who retired from sexual abuser work sometime back and has not been seen at an ATSA conference for many years, wrote the classic Men Who Rape with H. Jean Birnbaum in 1979 as well as a number of pioneering articles over the years. He apparently came out of retirement to work on this book with Preble, adding his 23 year old, 56 page long sexual victimization questionnaire to the slim (60 page) volume.
 
This book has something to offer clinicians who have little experience working with young (primarily adolescent) male victims. However, even experienced clinicians will likely find a few concepts to incorporate in their practice with adolescent male victims. (The authors acknowledge that the content is not geared for pre-adolescent males.)
 
The book provides a sense of "how to" without looking formulaic on what the inexperienced clinician should do. There is a 3 page narrative that summarizes much of the book and will help inexperienced clinicians looking for direction or script. This represents a typical dialog the clinician might have with a young man who is in early stages of dealing with his abuse. While it might sound artificial as a script, it is useful to incorporate the concepts into a monolog a clinician might have with an adolescent who is too embarrassed or confused to reveal his experience, feelings, and thoughts.
 
As experienced clinicians, we can anticipate denial, minimization, justification and other cognitive distortions from abusers. This allows us to predict and counter, when necessary, their often typical responses. The more this occurs in our work with abusers, the more confident we become in providing treatment. In anticipating the confusion, embarrassment and sometimes ambivalent feelings male victims often experience, this kind of monolog is generally helpful in getting important concepts to reduce self-blame and guilt.
 
For clinicians less familiar in working with male victims, this book provides the framework as to why the youth experiences confusion over his sexual response in the abuse.
 
One important concept the authors note is the difference between victimization and traumatization. The former refers to the exploitation or being taken advantage of in a sexual situation, and would include the legal concept in non-consensual relationships, whereas the former would look at the impact on the victim. This is an important construct that the authors unfortunately don't spend enough time discussing.
 
Particularly for male victims, aspects of the sexual abuse may be very confusing and fraught with ambivalence. How the boy/young man processes the sometimes pleasurable aspects of the abuse and his relationship with the abuser can be a significant problem well into adulthood, as many clinicians who work with male survivors can attest.
 
The book also examines the nature of the sexual activity to help the victim explore what he experienced sexually. Although this is not written for the male survivor, it is a useful reminder to the clinician to advise the survivor, or significant other that males often experience involuntary physical reactions to stimulation and this needs to be put into perspective to help address guilt and shame for the response.
 
Perhaps my biggest disappointment of this mostly useful book is that the authors could have gone into more depth in each of the seven chapters. It scratches the surface but makes the reader wish for more content. The 56 pages of the questionnaire really seems like filler to expand a work that would have been a bit too long for a journal article, yet too short to be a stand alone "book".
 
I hope Sidran Press will get the authors to expand the content and dump the questionnaire in the next edition.
 
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