Table Of ContentTreating Children
with Sexually Abusive
Behavior Problems
Guidelines for Child
and Parent Intervention
This page intentionally left blank
Treating Children
with Sexually Abusive
Behavior Problems
Guidelines for Child
and Parent Intervention
Jan Ellen Burton, PhD
Lucinda A. Rasmussen, PhD
with
Julie Bradshaw, LCSW
Barbara J. Christopherson, LCSW
Steven C. Huke, MS
David H. Justice, MS
Contributor
First published 1998 by Haworth Press, Inc.
This edition published 2013 by Routledge
711 Third Avenue, New York, NY 10017
2 Park Square, Milton Park, Abingdon, Oxon, 0X14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 1998 by The Haworth Press, Inc. All rights reserved. No part of this work may be reproduced
or utilized in any form or by any means, electronic or mechanical, including photocopying,
microfilm, and recording, or by any information storage and retrieval system, without permission
in writing from the publisher.
Cover design by Monica L. Seifert.
Library of Congress Cataloging-in-Publication Data
Treating children with sexually abusive behavior problems : guidelines for child and parent inter-
vention / Jan Ellen Burton ... [et al.] ; David H. Justice, contributor,
p. cm.
Includes bibliographical references (p. ) and index.
ISBN 0-7890-0473-9 (alk. paper). ISBN 0-7890-0472-0 (alk. paper).
1. Sexual disorders in children—Treatment. 2. behavior disorders in children—Treatment.
3. Children—Sexual behavior. 4. Child psychotherapy—Parent participation. 5. Parent-child
interaction therapy. I. Burton, Jan Ellen.
RJ505.P37T74 1998
618.92,858306—dc21 98-6095
CIP
CONTENTS
About the Authors vii
Preface xi
Acknowledgments xiii
PART I: GUIDELINES FOR PRACTICE
Chapter 1. Sexually Abusive Behavior Problems:
Definitions and Current Knowledge 3
Defining Sexually Abusive Behavior Problems 6
Current Knowledge 9
Summary 27
Chapter 2. A Treatment Approach 29
Trauma Outcome Process 31
Using the Trauma Outcome Process in Therapy 49
Summary 55
Chapter 3. Integrated Treatment Planning 57
Assessment for Integrated Treatment Planning 58
Treatment Modalities 75
Assessing Treatment Progress 83
Summary 88
Chapter 4. Parallel Group Treatment 89
Structure of Group Treatment Program 90
Treatment Topics in Children's Group 96
Group Treatment for Parents 104
Combined Groups 106
Summary 106
PART II: TREATMENT EXERCISES
Introduction 111
Chapter 5. Accountability 113
Activity: Draw the Offense 113
Activity: Taking Responsibility for Your Problems 116
Activity: Steps and Slides Abuse Cycle 119
Activity: The Hot Seat 126
Activity; Catch That Thinking Error! 131
Chapter 6. Empathy 139
Activity: "Conversation" with the Victim 139
Activity: Letter to the Victim 142
Activity: The Giving Tree 149
Activity: Draw Victim/Own Face 152
Activity: How Would You Feel If... ? 154
Activity: Why My Child Didn't Tell Me 157
Activity: Empathic Responses 160
Chapter 7. Coping with Trauma 165
Activity: Basket of Trigger Feelings 165
Activity: What Happened After You Were Abused? 168
Activity: Who Is Responsible? 174
Activity: How My Family Has Changed 177
Activity: The Fire 179
Chapter 8. Relationship Skills 187
Activity: Anger Thermometer 187
Activity: Trust Target 192
Activity: Trust Exercises 198
Activity: What Makes a Friend 201
Activity: Wheels of Intimacy 204
Activity: Flight Plan for Effective Communication 206
Activity: Blueprint for Boundaries 214
Chapter 9. Sexuality 225
Activity: Body Respect 225
Activity: The Great Big Stop Sign 230
Activity: A Touch Is a Touch 234
Activity: Relapse Prevention "Fire Safety Plan" 237
Activity: Communicating Sexual Values 245
Chapter 10. The Power of the Treatment Team 251
Activity: Collaboration 251
Epilogue 254
References 255
Index 269
ABOUT THE AUTHORS
Jan Ellen Burton, PhD, is a psychologist at Valley Mental Health and
in private practice in Salt Lake City, Utah. She currently coordinates
the sexual abuse program for children and adolescents at Valley Men-
tal Health. This program includes both victims and perpetrators. Dr.
Burton previously worked with adult sex offenders at the Center for
Family Development. In recent years she has made a number of pre-
sentations in connection with her work with sexually abused and sexu-
ally abusive children.
Over the past twenty-two years, Dr. Burton has primarily worked
with children, adolescents, and their families. She provides individual
therapy in conjunction with family treatment. Dr. Burton believes it is
critical to create an environment in which children are able to verbalize
their opinions, thoughts, and feelings. If victim issues are not
addressed, there is a risk that victimization will lead to perpetration.
Jan Ellen Burton graduated from Purdue University in 1975, and
has had individual therapy and group treatment experience with adults
as well as juveniles. She has worked in the substance abuse and
outpatient units at Valley Mental Health and has had experience within
the public school systems in Salt Lake City, Utah, and Milwaukee,
Wisconsin. In addition, Dr. Burton worked with physically and emo-
tionally handicapped children at the Curative Rehabilitation Center in
Milwaukee. The 1992 article "Precursors to Offending and the Trauma
Outcome Process in Sexually Reactive Children," published in the
Journal of Child Sexual Abuse, was an initial attempt to conceptualize
responses to victimization as they relate to perpetration. This book
developed as a continuation of that early conceptualization.
Lucinda A. Rasmussen, PhD, is an assistant professor at the School
of Social Work at San Diego State University. She received her doctor-
ate in social work in 1995 and her MSW in 1983 from the University
of Utah in Salt Lake City.
Dr. Rasmussen was a licensed clinical social worker in Utah for
over ten years. She coordinated the group treatment program for chil-
Vll
Treating Children with Sexually Abusive Behavior Problems
VIU
dren with sexually abusive behavior problems at Primary Children's
Medical Center's multidisciplinary Child Protection Team in Salt Lake
City. Her clinical experiences include treating child sexual abuse vic-
tims and their families as well as adolescent and adult sex offenders.
Her interest in understanding how victimization can lead to the devel-
opment of perpetrating behavior led to her work with sexually abusive
children.
In Utah, and now in San Diego, Dr. Rasmussen has helped create
and improve treatment resources for juvenile sexual offenders and
children with sexually abusive behavior problems. She is currently a
member of the San Diego County Network on Sexual Offending and
the California Coalition on Sexual Offending. She was previously a
founding member of the Utah Network on Juveniles Offending Sexu-
ally (NOJOS). She coordinated a nine-day training symposium for
practitioners on the assessment and treatment of juvenile sexual
offenders. She co-authored two Utah state reports about juvenile
sexual offending and helped develop state protocols for the identifica-
tion and assessment of juvenile sexual offenders for Utah's juvenile
justice system.
Dr. Rasmussen has published two articles on child sexual abuse
intervention in the Journal of Child Sexual Abuse, She also authored a
manual for the Utah Division of Family Services to train foster parents
on parenting strategies for managing children with sexual behavior
problems.
Julie Bradshaw, LCSW, is a clinical social worker currently serving
as the Director of the Child Protection Team at Primary Children's
Medical Center in Salt Lake City, Utah, where she has worked for
seven years. The Child Protection Team specializes in assessing and
treating victims of abuse and their families.
Ms. Bradshaw received her BA in 1975 and MSW in 1981 from the
University of Utah, where she graduated with honors. She majored in
psychology as an undergraduate and specialized in the treatment of
abused children while in graduate school.
Ms. Bradshaw's career, which began in 1974, has included broad
experience in the field of social services. She has worked extensively
with troubled and delinquent youth within the Youth Corrections and
Mental Health systems. She has also worked with abused and
neglected children, within the Utah Division of Family Services. Ms.
About the Authors IX
Bradshaw served as a troubleshooter for the Executive Director of the
Utah Department of Human Services, investigating child fatalities,
complaints, and consumer concerns.
Barbara J. Christopherson, LCSW, is a licensed clinical social
worker who has specialized in developing intervention programs
and providing treatment for victims of abuse and domestic violence.
She received her MSW in 1979 from the University of Utah in Salt
Lake City. She helped establish the multidisciplinary Child Protec-
tion Team at Primary Children's Medical Center in Salt Lake City
and served as the team's director for four years. She also served as
president of the Utah chapter of the American Professional Society
on the Abuse of Children (APSAC). Ms. Christopherson has act-
ively collaborated with other child abuse professionals in Utah and
Oregon to improve treatment services for victims of abuse and their
families. She has given presentations at numerous local, regional,
and national conferences. She is currently in private practice and is a
family therapist at the Morrison Center Counterpoint Program in
Portland, Oregon.
Steven C. Huke, MS, received his bachelor's degree in psychology
from Reed College and his master's degree in clinical psychology
from the University of Utah. He was a member of the Child Protec-
tion Team at Primary Children's Medical Center in Salt Lake City.
Mr. Huke has given presentations at regional and national confer-
ences on the treatment of youth with sexually abusive behavior
problems and sexually victimized children. He is currently a family
therapist at the Morrison Center Counterpoint Program and has a
private practice in Portland, Oregon.
David H. Justice, MS, is a research specialist at Salt Lake Valley
Mental Health and an instructor in sociology at Salt Lake Commu-
nity College in Salt Lake City, Utah. His research interests are in the
areas of medical sociology, the sociology of mental health, and
social problems. He has presented papers on the effects of psycho-
social stress on chronic disease. His teaching interests include the
areas of the sociology of mental health, social psychology, research
methods, and the sociology of race and ethnicity, particularly Native
American issues.
