This document describes a pilot program that uses Dialectical Behavior Therapy (DBT) to treat juvenile sexual offenders (JSOs). The program will serve 12-18 year old males who present a low risk to the community and have mental health issues. DBT focuses on emotional regulation and relationships skills, which studies show improve factors related to reoffending in JSOs. The program includes weekly group and individual therapy, phone coaching, and follow ups for 5 years. The evaluation will measure the program's effectiveness by tracking the recidivism rates of graduates through interviews over 5 years. Ethical standards for treating sex offenders will be followed to protect clients and ensure proper evaluation.

1. Juvenile Sexual Offenders
DBT as Treatment Intervention:
Pilot Program Description & Evaluation Methods
To Protect Future Generations of
Children
By: Michelle L. Farist
UGA School of Social Work

2. Broad Population Facts
• population not seen as public safety threat
• viewed with "boys will be boys" attitude
• 70 % of acknowledging sexual offenders reported
onset of offending <18
• average sexual recidivism rate for JSOs - 5 percent <1
• 22 % < 3 years
• 7 % =5< years
• (Alexander, 1999)

3. Specific Population for Evaluation
• Lives locally or within one of the surrounding
counties
• 12-18 years of age, mostly males
• Involved with the JJD or with CPS
• Judged by authorities to present minimum risk to
community’s safety
• All mental health issues within the scope of the
program
• Willing to participate

4. Similar Presenting Problems as BPD
• Emotional / Affect dysregulation
• Poor frustration tolerance
• Poor social competence
• Depression
• Anxiety
• Immaturity
• Need for validation
• Engenders frustration/hopelessness in clinicians
(Longo, 2011)(Longo & Prescott, 2006)(Ronis & Borduin, 2007)

5. Best Practice JSO
• Responsibility
• Building relationship skills/ social skills
• Empathy towards others
• Building support systems
• Prevention
• Monitoring
• (Longo, 2011)

6. DBT as Treatment with JSO
(Linehan, 1993; Sakdalan & Gupta, 2014)
DBT balances therapeutic validation and acceptance
Focus on self-regulatory & affective domains
– Make shifts in core orientation of self in response to outside world
– Learn to choose effective strategies to manage painful affect states
Wise mind- risky mind dialectical construct utilizes
common language
Assist JSO in effectively managing dysregulation in
various domains
Integrated treatment framework

7. DBT fit Best Practice Standards JSO
4 Components
• Group Interventions
(includes family)
• Individual interventions
• Telephone Coaching
(Clinician is always available
• Consultation Groups
4 Domains
• Mindfulness
• Distress tolerance
• Emotional regulation
• Interpersonal effectiveness

8. Effectiveness
• Study showed that participants demonstrated
a marked improvement (Sakdalan, 2012)
• sexual knowledge ,victim empathy, marked reduction in cognitive distortions and
attitudes condoning sex offences after completing DBT training
• CBT currently most effective
• Studies however show that change in cognition does not
equip clients with core self-regulatory base to manage risks
and create a life worth living (Sakdalan & Gupta, 2014)
• DBT best of both worlds

9. Program Outline
• Weekly Group interventions
• Weekly Individual interventions
• Weekly Caregiver/JSO interventions
• Phone Availability
• Community Liaison assists JSO in Community
• Graduation requirements
• Follow up every 6 mts for 5 years after
Graduation

10. Research Question
• The goal of this program research is to
evaluate the effectiveness of DBT as a
therapeutic intervention with JSO. At the end
of the evaluation we expect to be able to
answer the question; Will active participation
in a program utilizing the full protocol of DBT,
reduce the recidivism rate among JSO?

11. Variables
• IV- Full DBT Program for JSO
• DV- Recidivism Rate of JSO

12. Evaluation
• This evaluation will be based on reports from
JSO, that have graduated from the DBT
program, and significant others that may have
information concerning the JSO and possible
reoffending.
• The Community Liaison will conduct face to
face when possible interviews every 6 months
for 5 years following graduation.

13. Ethical Considerations
The Association for the Treatment of Sexual Abusers (ATSA,2011)
• Standard 2 Professional Conduct- Members will not allow personal
feelings to interfere with professional judgment (ATSA, 2011)
• Standard 5 Personal Problems and Conflicts- Members are obligated to be
alert to signs that a personal difficulty will or may adversely impact their
professional behavior (ATSA, 2011)
• Standard 6 Supervisory DBT has build in consultation groups.
• Must protect Clients confidentiality at all times, careful consideration
when with community members must be taken
• Evaluations coded with no identifying information
• Reporting reoffending

14. Conclusion
• It is imperative that JSO receive effective treatment :30-
50% of all sexual assaults are perpetrated by <18 year olds
• JSO continue to reoffend – 70% of Child Molesters started
before they were 18 ,number of victims per offender has
the potential to be staggering
• Therapy that is specific to the offender has shown to lessen
the recidivism rate.
• Studies of DBT with JSO show marked improvement in
reoffending factors
• Program evaluations as well as research to broaden the
collective information available
• Upholding the ethical standards of ATSA as well as other
professional associations’ ethical standards.

15. References
• Abuse, P. C. (2005). Do Children Sexually Abuse Other Children. In CDC (Ed.), Rogers &
Tremain, 1984 (2005 ed., pp. 1-9).
• Linehan, M. M. (1993). Skills Training Manual for Professionals of DBT. New York: Guilford
Press.
• Longo, R. E. (2011). Risk in Treatment: From Relapse Prevention to Wellness. Retrieved from
• Longo, R. E., & Prescott, D. S. (Eds.). (2006). Review of Current Perspectives: Working with
sexually aggressive youth and youth with sexual behavior problems (Vol. 34). US: NEARI.
• Ronis, S. T., & Borduin, C. M. (2007). Individual, family, peer, and academic characteristics of
male juvenile sexual offenders. Journal of Abnormal Child Psychology, 35, 153-163.
• Sakdalan, J. A. C., Vicki. (2012). Piloting an Evidence-Based Group Treatment Programme for
High Risk Sex Offenders with Intellectual Disablility in the New Zealand Setting. New Zealand
Journal of Psychology, 41(3), 6-12.
• Sakdalan, J. A., & Gupta, R. (2014). Wise mind—risky mind: A reconceptualisation of
dialectical behaviour therapy concepts and its application to sexual offender treatment.
Journal of Sexual Aggression, 20(1), 110-120. doi:10.1080/13552600.2012.724457