Children with Sexual Behavior Problems Program

Grossman & Grossman, Ltd. Treatment Goals for Children with Sexual Behavior Problems are strength based and solution focused interventions where the client is seen as competent and complex rather than a label such as victim or perpetrator. Interventions are framed in a strength based, resiliency manner where the client is encouraged to build on strengths and interests.  The master’s level therapist works with parents, caregivers and their support network to develop safe and therapeutic environments with a consistent and specific focus on the establishment of strong and appropriate boundaries which will limit the SBP child’s opportunity to act out sexually. Collaboration with all involved agencies is critical to therapeutic success. Initial therapy is focused on developing a therapeutic relationship with a child who often has marked distrust of others and problems with establishing or maintaining close relationships.  Through therapy, the SBP child and parents/caregivers are assisted in the recognition of triggers to sexually reactive behaviors by learning to recognize repetitive and dysfunctional patterns that may make them more vulnerable to sexual acting out and then to respond appropriately and disrupt these patterns to establish new healthy interactions.  


Treatment Goals:

  1. Establish a therapeutic relationship that allows the sexual problem behavior child (SBP) to build a level of trust necessary for disclosure and processing of difficult and often painful memories and behaviors related to the abuse and sexually acting out.
    • Develop self-regulation/relaxation skills for child and for support persons by actively modeling and teaching de-activation  and self-calming skills.
    • Work with adults to create an environment of safety for the client.
    • Develop the SBP child’s ability to process their emotions through use of structured sensory integration exercises.
    • Facilitate conjoint sessions to discuss the abuse and behaviors within the family system and report new information to the appropriate agencies.
  2. Develop and implement safety plans for the SBP child’s natural environments, including home, school and community.
    • Create safety.
    • Counsel the parents about appropriate boundaries and safeguards and establish self-regulation and safety plans for the parents to adhere to.
    • Counsel the parents on how to respond effectively to sexually acting out behaviors by understanding the effects of trauma on the developmental stages.
    • Constantly review and modify self-regulation and safety plans as needed due to progress of the SBP child and new information or issues as they arise in all environments.
    • Safety training with the child to address what to do, what to say and who to go to in the event they are placed in an at-risk situation in which they could be victimized again.
    • Counsel adults who are in a childcare or supervisory position with the SBP child on supervision and safety requirements to keep the child safe and prevent any further sexual victimization of others.
  3. Work successfully though the issues of sexual trauma and sexual acting out with consequent understanding and demonstration of control of thinking, feelings and behaviors.
    • Explore, encourage and support the SBP child in verbally expressing feelings associated with the abuse and sexually acting out.
    • Assist the SBP child to recognize internal and external triggers (events, feelings, memories, situations) that result in recurrent and intrusive distressing recollections or acting out behaviors and develop healthy coping skills to interrupt, replace and appropriately self-manage through self-regulation and self-calming strategies.
    • Assist the SBP child in learning to recognize repetitive and dysfunctional patterns that may make them more vulnerable to sexual acting out and disrupt these patterns to establish new healthy interactions
    • Assist the SBP child in identifying thoughts and beliefs that he or she used to justify the sexual misbehavior and replace these with socially acceptable thoughts that are respectful and not exploitive of others.  Assist the child in making connections between these thinking errors and their own sexually acting out behaviors.
    • Counsel the parents on appropriate prevention and interventions to stop and redirect sexual acting out behaviors.
    • Counsel the parents on how to develop appropriate physical nurturance (touching and affection) and relationships based on healthy boundaries with the SBP child.
    • Assist the SBP child in understanding and building healthy relationships with peers and adults due to their lack of boundaries, trust, etc.
    • Encourage the SBP child to accept and initiate appropriate forms of touching and affection with trusted individuals.
    • Stop sexualized or seductive behaviors with younger or same-aged children, adolescents, adults or objects in daily life by helping the child identify more adaptive ways to meet his or her needs other than through sexual behaviors.
    • Provide sex education and discuss consequences and risks associated with sexual acting out behaviors.
  4. 4.    Build self-esteem and self-empowerment through the learning and utilizing of healthy coping skills to manage risky thoughts or urges. 
    • Assist the SBP child to reframe feelings of guilt and shame by revisiting their age at the time of the abuse and discussing their developmental level and coping skills common in response to victimization and its impact on subsequent developmental stages and recognizing personal strengths.
    • Contrast previous SBP stages with current abilities, strengths and options, building on strengths and interests.
    • Promote healthy problem solving skills by helping the SBP child develop an understanding of the cause and effect for choices using concrete daily life situations that the child has experienced.
    • Counsel the parents to focus on positive interactions and responses to the child and develop effective behavior management and discipline practices.
    • Increase the child’s ability to effectively communicate with those in their environment through the appropriate expression of feelings, listening and consideration of the effect of the behavior on others.
    • Develop impulse and anger management strategies with the SBP and parents that can interrupt escalations and return the child to a place where they can make conscious decisions on how to react and redirect themselves and to feel safe.
    • Counsel the parents to plan and follow through with appropriate, supervised age appropriate socialization activities to develop confidence, age appropriate social skills and successes.
    • Assist the SBP child in learning how to ask for help by identifying situations, people, and resources available to provide support and direction.
    • Address significant behavioral issues that the child presents which may co-exist with the trauma and represent inappropriate coping responses (sexually acting out is frequently paired with other significant behavioral issues such as anger, stealing, aggressive behaviors, manipulative behaviors, lying) that need to be addressed along with sexual behavior problems.
  5. Prepare for discharge by working with the significant people in the child’s life to develop an understanding of the need for on-going vigilance, supervision and safety planning to continue to support the child in meeting daily life challenges and use the strategies learned in treatment.
    • Engage in “what if” planning with the child and parents/caregivers to look at possible future scenarios and have an identified plan for successful management that looks at risks, effective coping and utilization of supports available.
    • Engage in discharge planning to identify behaviors and success necessary to transition from treatment considering the  strengths of child and family to achieve treatment goals, barriers to achievement of treatment goals, and support systems available to client past treatment.