Although a rapidly growing field, the evaluation and treatment of juvenile sexual offenders represents an area of practice fraught with clinical, ethical, and legal complexity. This article discusses the implications of new registration and community notification legislation for clinical practice, including the ethical issues they give rise to and the challenges they present to the field. Areas of clinical practice that are controversial and increase practitioner vulnerability to ethical and legal mishap are reviewed, including: involuntary treatment, preadjudication evaluation, phallometric and polygraph assessment, and cognitive-behavioral and psycho-pharmacologic treatment of deviant sexual arousal. Recommendations are made as to the management of these issues and the establishment of ethically sound patterns of clinical practice.
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References
1.
American Hospital Formulary Services
. (1997). Paxil Monograph, 1707-1711.
2.
The American Polygraph Association
. (1997). Validity and reliability of real cases [On-line]. Available: http://www.poly-graph.org:83/apa5.htm.
3.
Bank, L.
, Marlow, J. H., Reid, J. B., Patterson, G. R., & Weinrott, M. R. (1991). A comparative evaluation of parent-training interventions for chronic delinquents. Journal of Abnormal Child Psychology, 19, 15-33.
4.
Barbaree, H. E.
, & Cortoni, F. A. (1993). Treatment of the Juvenile Sex Offender within the Criminal Justice and Mental Health Systems. In H. E. Barbaree, W. L. Marshall, & S. M. Hudson (Eds.), Thejuvenile sex offender (pp. 243-263). New York: Guilford.
5.
Becker, J. V.
, & Hunter, J. A. (1992). Evaluation of treatment outcome for adult perpetrators of child sexual abuse. Criminal Justice and Behavior, 19, 74-92.
6.
Becker, J. V.
, & Hunter, J. A. (1997). Understanding and treating child and adolescent sexual offenders. In T. H. Ollendick & R. J. Prinz (Eds.), Advances in clinical child psychology (Vol. 19). New York: Plenum.
7.
Becker, J. V.
, Kaplan, M. S., & Tenke, C. E. (1992). The relationship of abuse history, denial and erectile response: Profiles of adolescent sexual perpetrators. Behavior Therapy, 23, 87-97.
8.
Berliner, L.
(1996). Community notification: Neither a panacea nor a calamity. Sexual Abuse: A Journal of Research and Treatment, 8, 101-104.
9.
Bernstein, D. A.
, & Nietzel, M. T. (1980). Introduction to clinical psychology. New York: McGraw-Hill.
10.
Blasingame, G. D.
(1998). Suggested clinical use of polygraphy in community-based sexual offender treatment programs. Sexual Abuse: A Journal of Research and Treatment, 10, 37-45.
11.
Bohart, A. C.
, & Todd, J. (1988). Foundations of clinical and counseling psychology. New York: Harper & Row.
12.
Borum, R.
(1996). Improving the clinical practice of violence risk assessment: Technology, guidelines, and training. American Psychologist, 51, 945-956.
13.
Bradford, J.M.W.
(1990). The antiandrogen and hormonal treatment of sex offenders. In W. L. Marshall, D. R. Laws, & H. E. Barbaree (Eds.), Handbook of sexual assault: Issues theories, and treatment of the offender (pp. 297-310). New York: Plenum.
14.
Bradford, J.M.W.
(1997). Medical interventions in sexual deviance. In R.D. Laws & W.T.O'Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (pp. 449-464). New York: Guilford.
15.
Bradford, J.M.W.
, & Pawlak, A. (1993). Double-blind placebo cross-over study of cyproterone acetate in the treatment of paraphilias. Archives of Sexual Behavior, 22, 383-402.
16.
Colby, A.
, Kohlberg, L., Gibbs, J., & Lieberman, M. (1983). A longitudinal study of moral judgement. Monographys of the Society for Research in Child Development, 48, 124.
17.
Cowan, P. A.
(1978). Piaget with feeling: Cognitive, social, and emotional dimensions. New York: Holt, Rinehart & Winston.
18.
Dominguez, R. A.
, & Goodnick, P. J. (1995). Adverse events after the abrupt discontinuation of paroxetine. Annals of Pharmacotherapy, 15, 778-780.
19.
Earl-Hubbard, M. L.
(1996). The child sex offender registration laws: The punishment, liberty deprivation, and unintended results associated with the scarlet letter laws of the 1990's. Northwestern University law review (pp. 789-861). Chicago: Northwestern University School of Law.
20.
Edson, C.
(1991). Sex offender treatment. Medford, OR: Department of Corrections.
21.
Egan, J. H.
, & Vandersall, T. A. (1992). Psychoanalytic psychotherapies with children. In J. R. Lachenmeyer & M. S. Gibbs (Eds.), Psychopathology in childhood (pp. 327-340). New York: Gardner.
22.
Elliott, D. S.
(1994, November). The developmental course of sexual and non-sexual violence: Resulting from a national longitudinal study. Paper presented at the meeting of the Association for the Treatment of Sexual Abusers 13th Annual Research and Treatment Conference, San Francisco, CA.
23.
Emerick, R.
, & Dutton, W. (1993). The effect of polygraphy on the self report of adolescent sex offenders: Implications for risk assessment. Annals of Sex Research, 6, 83-103.
24.
Friedrich, W. N.
(1990). Psychotherapy of sexually abused children and their families. New York: Norton.
25.
Gray, A.
, Busconi, A., Houchens, P., & Pithers, W. D. (1997). Children with sexual behavior problems and their caregivers: Demographics, functioning, and clinical patterns. Sexual Abuse: A Journal of Research and Treatment, 9, 267-290.
26.
Greenberg, D. M.
, Bradford, J.M.W., Curry, S., & O'Rourke, A. (1996). A comparison of treatment of paraphilias with three serotonin reuptake inhibitors: A retrospective study. Bull Am Acad Psychiatric Law, 24, 525-532.
27.
Grisso, T.
(1997). The competence of adolescents as trial defendants. Psychology, Public Policy, and Law, 3, 3-32.
28.
Grisso, T.
(1998). Juvenile competency to stand trial: Questions in an era of punitive reform. American Bar Association, Criminal Justice Section, Juvenile Justice Center [On-line]. Available: info@abanet.org
29.
Halverson, A. M.
(1995). The importance of caring and attachment in direct practice with adolescents. Child and Youth Care Forum, 24, 169-173.
30.
Henry, B.
, Caspi, A., Moffitt, T. E., & Silva, P. A. (1996). Temperamental and familial predictors of violent and nonviolent criminal convictions: Age 3 to age 18. Developmental Psychology, 32, 614-623.
31.
Hunter, J. A.
, & Becker, J. V. (1994). The role of deviant sexual arousal in juvenile sexual offending: Etiology, evaluation, and treatment. Criminal Justice and Behavior, 21, 132-149.
32.
Hunter, J. A.
, & Figueredo, A. J. (in press). Factors associated with treatment compliance in a population of juvenile sexual offenders. Sexual Abuse: A Journal of Research and Treatment.
33.
Hunter, J. A.
, & Goodwin, D. W. (1992). The utility of satiation therapy in the treatment of juvenile sexual offenders: Variations and efficacy. Annals of Sex Research, 5, 71-80.
34.
Hunter, J. A.
, Goodwin, D. W., & Becker, J. V. (1994). The relationship between phallometrically measured deviant sexual arousal and clinical characteristics in juvenile sexual offenders. Behavior Research and Therapy, 32, 533-538.
35.
Hunter, J. A.
, Hazelwood, R. R., & Slesinger, D. (in press). The modus operandi of juvenile sex offenders: A comparison of child molesters and rapists. Journal of Family Violence.
36.
Ingersoll, S. L.
, & Patton, S. O. (1990). Treating perpetrators of sexual abuse (pp. 58-59). Lexington, MA: Lexington Books.
37.
Jacobs, W. L.
, Kennedy, W. A., & Meyer, J. B. (1997). Juvenile delinquents: A between-group comparison study of sexual and nonsexual offenders. Sexual Abuse: A Journal of Research and Treatment, 9, 201-217.
38.
Johnson, T. C.
(1993). Assessment of sexual behavior problems in preschool-aged and latency-aged children. In A. Yates (Ed.), Child and adolescent psychiatric clinics of North America: Sexual and gender identity disorders (pp. 431-450). Philadelphia: W. B. Saunders.
39.
Kaemingk, K. L.
, Koselka, M., Becker, J. V., & Kaplan, M. S. (1995). Age and adolescent sexual offender arousal. Sexual Abuse: A Journal of Research and Treatment, 7, 249-257.
40.
Kafka, M. P.
(1991). Successful antidepressant treatment of non-paraphilic sexual additions and paraphilias in men. Journal of Clinical Psychiatry, 62, 60-65.
41.
Kafka, M. P.
, & Prentky, R. (1992). Fluoxetine treatment of non-paraphilic sexual addictions and paraphilias in men. Journal of Clinical Psychiatry, 53, 351-358.
42.
Kuhn, D.
, Langer, J., Kohlberg, L., & Haan, N. S. (1977). The developmental of formal operations in logical and moral judgment. Genetic Psychology Monographys, 95, 97-188.
43.
Lane, R. M.
(1997). A critical review of selective serotonin reuptake inhibitor-related sexual dysfunction; incidence, possible etiology and implications for management. Journal of Psychopharmacology, 11, 72-82.
44.
Lazowick, A. L.
, & Levin, G. M. (1995). Potential withdrawal syndrome associated with SSRI discontinuation. Annals of Pharmacotherapy, 29, 1284-1285.
45.
Lerner, R. M.
(1996). Relative plasticity, integration, temporality, and diversity in human development: A developmental contextual perspective about theory, process, and method. Developmental Psychology, 32, 781-786.
46.
Levesque, R.J.R.
(1996). Is there still a place for violent youth in juvenile justice?Aggression and Violent Behavior, 1, 69-79.
47.
Levine, C.
, Kohlberg, L., & Hewer, A. (1985). The current formulation of Kohlberg's theory and a response to critics. Human Development, 28, 94-100.
48.
Lexier, L. J.
, & Hunter, J. A. (1997). [Use of Depo-Lupron and Depo-Provera in the treatment of young adult sex offenders]. Unpublished clinical data.
49.
Loeber, R.
, & Stouthamer-Loeber, M. (1998). Development of juvenile aggression and violence: Some common misconceptions and controversies. American Psychologist, 53, 242-259.
50.
Longo, R. E.
(1996). Prevention or problem. Sexual Abuse: A Journal of Research and Treatment, 8, 91-100.
51.
MacDonald, K.
(1985). Early experience, relative plasticity, and social development. Developmental Review, 5, 99-121.
52.
Marques, J. K.
, Day, D. M., Nelson, C., & West, M. A. (1994). Effects of cognitive behavioral treatment on sex offender recidivism: Preliminary results of a longitudinal study. Criminal Justice and Behavior, 21, 28-54.
53.
Mathews, R.
, Hunter, J. A., & Vuz, J. (1997). Juvenile female sexual offenders: Clinical characteristics and treatment issues. Sexual Abuse: A Journal of Research and Treatment, 9, 187-199.
54.
Meyer, W. J.
, Collier, C., & Emory, E. (1992). Depo Provera treatment for sex offending behavior: An evaluation of outcome. Bulletin of the American Academy of Psychiatry and Law, 20, 249-259.
55.
Miller, P. H.
(1983). Theories of developmental psychology. San Francisco: W. H. Freeman.
56.
Monahan, J.
, & Steadman, H. J. (1996). Violent storms and violent people: How meteorology can inform risk communication in mental health law. American Psychologist, 51, 931-938.
57.
Murphy, W. D.
, & Peters, J. M. (1992). Profilling child sexual abusers: Psychological considerations. Criminal Justice and Behavior, 19, 24-27.
58.
National Center for Juvenile Justice
. (1998). Frequent questions and answers. Pittsburgh: Author. (Available from the National Center for Juvenile Justice, 710 Fifth Avenue, Pittsburgh, PA 15219)
59.
National Criminal Justice Association
. (1995). State's management of violent offenders. Washington, DC: Author.
60.
National Task Force on Juvenile Sexual Offending
. (1993). Final report. A function of National Adolescent Perpetrator Network, C. H. Kempe National Center, University of Colorado Health Sciences Center.
61.
Nelson, C. A.
, & Bloom, F. E. (1997). Child development and neuroscience. Child Development, 68, 970-987.
62.
Office of Juvenile Justice and Delinquency Prevention
. (1997). All 50 states show progress in protecting children from abduction and exploitation [On-line]. Available:http//www.ncjrs.org/ojjhome.htm.
63.
Office of Juvenile Justice and Delinquency Prevention
. (1997). 1994 children, youth, and family issues legislation: Juvenile justice [On-line]. Available: http//www.ncsl.org/programs/cyf/juvenile.htm.
64.
Quinsey, V. L.
, Rice, M. E., & Harris, G. T. (1995). Actuarial prediction of sexual recidivism. Journal of Interpersonal Violence, 10, 85-108.
65.
Report of the Virginia State Crime Commission
. (1997). House document no. 40: “Megan's law”/community notification of sex offenders. Richmond: Commonwealth of Virginia.
66.
Richardson, G.
, Kelly, T. P., Bhate, S. R., & Graham, F. (1997). Group differences in abuser and abuse characteristics in a British sample of sexually abusive adolescents. Sexual Abuse: A Journal of Research and Treatment, 9, 239-257.
67.
Robinson, S. E.
, & Gross, D. R. (1986). Ethics in mental health counselling. In A. J. Palmo & W. J. Weikel (Eds.), Foundations of mental health counseling (pp. 309-328). Springfield, IL: Charles C Thomas.
68.
Safer Society Program and Press
. (1994). 1994 nationwide survey of treatment programs and models. Brandon, VT: Safer Society Press.
69.
Schland, A. M.
, & Shaw, T. (1996). Treating sexual offenders who deny their guilt: A pilot study. Sexual Abuse: A Journal of Research and Treatment, 8, 17-23.
70.
Schmerber v. California, 86 S. Ct. 1826 (1966).
71.
Schram, D. D.
, Milloy, C. D., & Rowe, W. E. (1991). Juvenile sex offenders: A follow-up study of reoffense behavior. Unpublished manuscript.
72.
Schwartz, I. M.
, Guo, S., & Kerbs, J. J. (1993). The impact of demographic variables on public opinion regarding juvenile justice: Implications for public policy. Crime & Delinquency, 39, 5-28.
73.
Shepherd, R. E.
(1998). Challenging change: Legal attacks on juvenile transfer reform. American Bar Association, Criminal Justice Section, Juvenile Justice Center [On-line]. Available: info@abanet.org
74.
Strupp, H. H.
(1993). The Vanderbilt psychotherapy studies: Synopsis. Journal of Consulting & Clinical Psychology, 61, 431-433.
75.
Tolbert, P.
(1997). States respond to violent juvenile crimes. National Center for Juvenile Justice in Brief, 1. Pittsburgh, PA: National Center for Juvenile Justice.
76.
Ursano, R. J.
, Silberman, E. K., & Diaz, A. (1994). The psychotherapies: Basic theoretical principles and techniques. In A. Stoudemire (Ed.), Clinical psychiatry for medical students (2nd ed.). Philadelphia: J.P. Lippincott.
77.
White, F. A.
(1996). Family processes as predictors of adolescents' preferences for ascribed sources of moral authority: A proposed model. Adolescence, 31(121), 133-144.
78.
Wills, T. A.
, & DePaulo, B. M. (1991). Interpersonal analysis of the help-seeking process. In C. R. Snyder & D. R. Forsyth (Eds.), Handbook of social and clinical psychology. New York: Pergamon.
79.
Winick, B. J.
(1997). The jurisprudence of therapeutic jurisprudence. Psychology, Public Policy, and Law, 3, 184-206.
