Dealing with Juvenile Sex Offenders with Impaired Families

1. MnATSA 6th Annual Conference March 27-29, 2002 Dealing with Juvenile Sex Offenders with Impaired Families David X. Swenson Ph.D. LP & Gerald Henkel-Johnson Psy.D. LP Specializing in Forensic Psychology dswenson@css.edu & gjohnson@css.edu D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

2. How to make and unmake a monster: the development & treatment of a sex offender D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

3. to identify the developmental influences on • the juvenile sex offender • to describe the maintenance cycle of offense • to know the essential links for establishing motivation • to understand essential role of families in treatment • to identify treatment objectives for family types • to determine amenability to treatment • to identify substitutes & neutralizers for nonparticipating families D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

4. Overview A series of models that help understand the development of and intervention points for juvenile sex offenders and their families Developmental Influences Offender Cycle Client & Family Amenability Substitutes & Neutralizers How does it develop? How is it maintained? How amenable to change? How to make the best of a worst situation? D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

5. Effective intervention with juveniles & families is essential: • Only 2-4% of adolescents are responsible for most sexually assaultive behavior • Nearly ½ million youth each year are involved in violent crime • About 63% of youthful sex offenders have committed nonsex offenses • 40% of the offenders who victimized children under age 6 were juveniles • Youths <18 account for about 10% of all sex related murders; 27% of child sex homicides • JSO’s are responsible for about 20% rapes & 60-80% of child molestation • Adolescent offenders often have a history of multiple victims prior to their first arrest. The average number of victims is 7 with some offenders having as many as 30 or more victims in their past. • Adolescents who have been physically abused are 7.6 times more likely to rape or sodomize other children compared to sexually abused adolescents • Patterns of aggression set by age 8 often continue into adulthood D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

6. …and the boy becomes the man • Of adult men who sexually assault boys, 50% recognized their interest by age 16 • About half of all adult offenders began offending as juveniles • 70-80% of adult offenders report physical/sexual abuse as youth • ½ of all adult offenders had at least one deviant sex interest before age 18 • 42% of pedophiles begin their sexual offending before the age of 12. • Nearly 70% come from violent or dysfunctional families D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

7. Development of a Juvenile Sex Offender • Infancy • FAS/FAE • ADHD • attachment • hyperreactive • “colicky” • unhealthy • pain • Peers • delinquent peers • initiation • attention/recognition • belonging • act out • revenge PROBABLE OFFENSE • Personality-- What prevents you from offending? • values (“It’s wrong”) • empathy (“it would hurt others”) • consequences (“I’d get in trouble”) • ego dystonic (“that’s not me”) • shame/embarrassment (“what would other think”) • esteem (I’d feel awful”) • identification (“wouldn’t want that to happen to me”) • personal responsibility (“I would be responsible”) • self monitoring & control (“I’d stop myself”) • coping (“other ways to deal with tension”) • Family • cohesion • flexibility • boundaries • discipline • marital relationship • handle emotions • poor role modeling • physical, emotional, sexual abuse • explicit sexuality • MI/CD • Pre-family • poverty • single • unwanted • MI/CD • immature • abused D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

8. 1. Feels OK 16. Rationalizes, “forgets” 2. Trigger event 15. Distracts self from discomfort, gets busy The Offending Cycle 3. Feels victimized, used, betrayed, helpless, powerless, tricked, abandoned, takes victim stance 14. Feels fear of getting caught, shame, guilt 4. Gets angry, depressed, anger self directed, “bad me,” “ain’t it awful” Revenge fantasy becomes boring, thrill-seeking threshold increases 13. Feels re-empowered & relief 5. Withdraws from others, becomes isolated Gets caught, feels victimized, recycles 12. Assault 6. Build’s revenge fantasies, initially reduces intensity 11. Victim grooming: seeks & arranges opportunity to assault 7. Thinking errors justify revenge fantasies 10. Self destructive 8. Acts out revenge toward others 9. Thinking errors justify acting-out D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

9. Comorbidity of Disorders • 70-87% of juvenile offenders have • psychiatric problems • 50-80% have learning problems, • special education, repeat grade • 45-80% have conduct disorder • 55% have character disorder • 65% with IQ <70 engage in inappropriate sex behavior • 35-50% mood disorder • 30-50% anxiety disorder • 20-40% attention/hyperactivity disorder • 20-30% substance abuse • The Point: • There are usually multiple problems, influences, and modifiers that must be considered & treated D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

10. Potential Progression in Personality Disorder PDD ADHD FAS/FAE Oppositional Defiant Disorder Antisocial Personality Disorder Psychopathic Personality Disorder Conduct Disorder Stimulus seeking Lack goals Parasitic Predatory Violent Criminal acts Impulsiveness Disregard safety Irresponsibility Lack remorse Aggression Destruction Deceitfulness Rule violation Hostile Defiant Negative Inattention Poor social skills Learning deficits D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

11. Irresponsible- arrestible Extreme- criminal Irresponsible- nonarrestable Responsible 1.Has a pattern of accepting responsibility at home, at work, and in society. 2.Has a lifestyle based on hard work and the fulfillment of obligations. 3.Has consideration of others. 4.Derives self-respect and the respect of others through achievement. 5.Desires to violate occur, but disappear without having to make a conscious choice. 6.Does not infringe on the rights of others. 7.Makes choices that are in the best interest of both self and others. 8.Trusts in the judgment of others. Koerner & Fawcett Continuum of Criminal Behaviors 1.Accepts responsibility only to a degree and with excuses. 2.Frequently lies, manipulates, and intimidates. 3.Generally unreliable and chronically late (performs poorly at work). 4.Fails to fulfill promises and obligations at home. 5.Shows irresponsibility in some ways yet is conscientious in others. 6.Expects to fail and makes only half-hearted attempts. 7.Lacks goal direction. 1.Accepts responsibility only after being nailed down, and then fights all the way. Has all the thinking patterns of the extreme criminal, but with less extensive crime patterns. 2.Is a minor violator who rarely gets caught. 3."I'm a loner." "I'm unique." Is secretive. 4.Feels successful since a great deal of personal involvement in criminal activity has gone undetected. 5.Has strong returning desires to violate, but is discouraged from doing so much of the time. 6.Has always seem responsible and surprises everyone. 7.Without great restraints, will implement violations previously only thought about. 8.Moves away from family or from rural to urban areas for reasons of greater freedom and being unknown (incognito) 1.Accepts no responsibility 2.Has a continuous flow of criminal thoughts from the time s/he wakes up. 3.Has only self-concern. 4.Does not view self as criminal, but as a good person. 5.Seeks to promote self at the expense of others. 6.Criticizes others, claims injustice and blames others when things don't go as planned. 7.Commits hundreds of crimes and is never found out. 8.Sees being nice as a weakness. 9.Is over-confident and grandiose. Won't stop trying to beat the system.

12. Amenability to Treatment: To what extent is a client able & willing to productively participate in treatment? High Limited: Willing but Unable Motivated: Willing & Able Motivation: willingness, enthusiasm, initiative, follow though, disclosure, effort, risk taking, etc… Incapacitated: Unwilling & Unable Resistant: Unwilling but Able Low Low High Ability: capacity, intelligence, deficits (FAS/FAE, PDD, ADHD, etc… D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

13. Estimating Amenability: engagement in treatment • Acknowledgement: acknowledges that a problem exists • Accountability: accepts personal responsibility for offense • Goal setting: defines well-formed goals/outcomes • Goal attainment: can identify benefits of previous interventions • Self disclosure: discloses relevant personal information • Attendance: regularly attends treatment; timely • Participation: contributes relevant comments, reactions, insights, • Insight: identify connection between events, motives, and behavior • Affective response: shows guilt, remorse, embarrassment, shame, etc • Limit setting: responds to directives and imposed restrictions • Planning: formulates and follows recommended behavior change • Positive role taking: provides support, encouragement, confrontation to others • Feedback: listens to, considers, and experiments with feedback • Follow through: completes behavioral assignments thoroughly and on time Note: low ratings on these does NOT mean a person is Untreatable— just that they will likely require more time, effort, skill, and staff to effectively treat. D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

14. Treatment complicating and interfering factors of families of JSO’s • parental limitations: developmental, intellectual, physical, • psychological disabilities • parental criminal lifestyle • not believe in treatment or medication • may have inappropriate stimulating material in home (e.g., porn, overt sexuality) • marital conflict, side-taking, manipulation • unstable adult/parent figures (e.g., passed around, multiple live-ins) • resistance to & mistrust of intervening agencies • inconsistent parenting style • alcohol/chemical abuse • not acknowledge child’s needs or behavior problem • not acknowledge their role in contributing to or resolving the problem • blaming the child and denying focus on their personal or marital problems • minimizing the significance of the offense • passive compliance (agreeable in meetings but not follow through) • continuing emotional, physical, sexual abuse at home • threaten or guilt child into non-disclosure about family problems • defensive stance due to pending court action Note: be careful of over/under-pathologizing families D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

15. Treatment considerations based on expectancy theory & amenability Then…you get Impulsive ACT! Motivation Expectancy Instrumentality Valence Rational + + Belief that effort expended will improve performance & get a better reward The outcome or reward is valued or desirable Belief-expectancy that s/he has the capacity to do it Low self esteem Negative self concept Low self efficacy External locus of control • Treatment Strategies • high structure • consistency • uniformity • explicitness • immediate consequences • positive reinforcement • feedback & shaping • reflective learning • positive role modeling & vicarious experiences • positive self appraisal & persistence • choices • reward effort & persistence • reasonable goal setting • identify intrinsic interests in tasks • learn resiliency • increase constructive self attribution • mastery experiences • verbal persuasion • reduced arousal (relaxation & reframing) • Reward Structure • initially immediate & continual toward variable ratio • current preferences (when possible) then shift to complete positive & prosocial • small wins • public recognition No previous experience (no opportunity, no role model, impoverished environment) Limited capacity (unable to plan, integrate learning, transfer or generalize learning, inattention, etc.) Victor Vroom, Expectancy Theory

16. Treatment complicating and interfering factors of families of JSO’s • parental limitations: developmental, intellectual, physical, psychological disabilities • parental criminal lifestyle • may have inappropriate stimulating material in home (e.g., porn, overt sexuality) • poor marital relationship, conflict, side-taking, manipulation • unstable adult/parent figures (e.g., absentee, passed around, multiple live-ins) • resistance to & mistrust of intervening agencies • inconsistent parenting style • alcohol/chemical abuse • not acknowledge child’s needs or behavior problem • not acknowledge their role in contributing to or resolving the problem • blaming the child and denying focus on their personal or marital problems • minimizing the significance of the offense • passive compliance (agreeable in meetings but not follow through) • continuing emotional, physical, sexual abuse at home • threaten or guilt child into non-disclosure about family problems • defensive stance due to pending court action D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

17. Cohesion Disengaged Separated Connected Enmeshed Chaotically Disengaged Chaotically Enmeshed Rigid Structured Flexible Chaotic Adaptability Rigidly Disengaged Rigidly Enmeshed Olson’s Circumplex Model of Family Systems Balanced Families D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

18. Cohesion Behavioral Aspects of the Circumplex Dimensions Disengaged Separated Connected Enmeshed • individual decisions • separate spaces • low interaction • little consideration • emotional detatchment • unaware of others • separate lives • low loyalty • in each others business • limited outside family • speak for each other • emotional contagion • no privacy • over dependency • subordinate to group • excessive loyalty • lack leadership • role ambiguity • role shifts • labile emotions • inconsistent decisions • erratic discipline • too much change • no accountability • autocratic leadership • strict discipline • role rigidity • too little change • unaware of development • rigid control • imposed decisions • dogmatic • limited consequences Rigid Structured Flexible Chaotic Adaptability D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

19. Cohesion Treatment Strategies for the Circumplex Dimensions Disengaged Separated Connected Enmeshed • To decrease • disengagement: • build shared goals • cooperative tasks • family meals, activities • current updates • appreciate styles • family album • To decrease enmeshment • & foster independence: • teach limits • define & enforce privacy • outside friendships • drive wedges • speak for self • individual differences • distinguish differences • conflict and controversies • To reduce chaos & • increase order: • clear & consistent roles • explicit & written rules • clear decision hierarchy • parental unity • accountable for behaviors Rigid Structured Flexible Chaotic • To reduce rigidity & • increase flexibility: • distribute power & decision making • substitutes & neutralizers • discuss & vote • discuss consequences of imposed rules • new family rules • paradoxically overcontrol Adaptability D. X. Swenson & G. Henkel-Johnson, MnATSA, 2002

20. Poor response to intervention by family Apprehension & Fear Skill Needed Psycho- pathology Personality Disorder • marriage counseling • personal counseling • medication mgt. • anger group • CD treatment • parenting • communication • conflict • stress • style • reassurance • encouragement • patience • third party • worse future • Court order parents to Tx • contact conditional on Tx • supervised contact • in-home Tx • clear, explicit, written rules & consequences • incident monitoring (“paper trail”) • revised visitation • Termination of Parental Rights (TPR) • ---------------------------------------------------------------------- • increase involvement with positive role models • outside of family (e.g., sports, church, clubs, etc.) • increase out of family activities • extra-family support system • orient toward future goal attainment • remove child (foster placement, extended family) • help child understand limitations, personality, • adjustment problems of family members Parents Making the best of a worst situation Juvenile