You may be reading this website because your teenager has been involved in problematic or illegal sexual behavior with another person, possibly another child you know. You are not alone. We are here to help you better understand why this happened and how to move forward.

Typical Vs Problematic Sexual Behavior

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If your teen has engaged in illegal sexual behavior with another person, you might be in crisis and wondering what to do. You may be feeling Anger. Shame. Confusion. Shock. We can help you learn more about adolescents – aged 13 to 18 – who are engaging in problematic sexual behavior or are committing illegal sexual acts as defined by state or jurisdiction laws.

Teens sexual development is a dynamic process during this time in their life. Though each family may have it’s own expectations or ideas for what is appropriate and right for their teen, it is developmentally appropriate for most teens to be interested in romantic relationships, begin to explore attraction and sexuality, and engage in consensual sexual behaviors during adolescence. In contrast, problematic sexual behavior (PSB) includes, but is not limited to, non-consensual sexual behaviors, sexual acts with someone much younger than the teen, viewing, sending, or sharing own or other minor's nude photographs, or excessive pornography use. This topic might feel difficult to discuss and even consider. We’re here for you. Others have gone through this and come out stronger. 

For more information about sexual development in teenagers see: Teaching sexual health and sexual development. You may also download the Taking Action book, designed to Support Families of Adolescents experiencing PSB.


Understanding Adolescents and Problematic Sexual Behavior: Who Engages In Problematic Sexual Behavior and Why?

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How Can This Happen?

Pinpointing a single reason is difficult. Many things could have contributed.

Curiosity / Experimentation

Many teenagers are curious about sex, and they may experiment with younger children out of curiosity. They might not fully understand the seriousness and potential consequences. Youth benefit from support throughout adolescence to understand healthy relationship skills, consent, sexual development, and decision-making.

Impulsivity / Immaturity

Some teenagers are more impulsive and immature than others. They may act before thinking through what will happen next. That may lead to poor decision-making and risky behaviors. In some cases, teens may have a diagnosis like Attention Deficit Hyperactivity Disorder- (ADHD), in other cases, a formal diagnosis may not be present. But most teens struggle with impulsivity and immaturity


A history of unresolved and addressed trauma impacts youth's social and emotional well-being, as well as perceptions of the world. Witnessing violence, experiencing violence, and/or sexual abuse of violence hinder well-being and can impact social judgment and interactions.

Delinquency / Aggression

Breaking rules and engaging in delinquent behaviors may have been part of the teen’s history. Their problematic sexual behavior may be part of a pattern of general problematic behavior.

Trauma Exposure

Experiences of trauma can impact a teens perception and understanding of the world. Their beliefs about what is appropriate behavior can be negatively impacted including understanding about consent, boundaries, control, relationships, intimacy, and friendship. Though most youth who have experienced trauma do NOT develop behavior concerns, for some teens there can be a link to problematic and harmful sexual behavior.

Other Factors:

Psychological problems, exposure to sexual materials or behaviors, sexual abuse, and problems with sexual attraction to children also are potential factors.

Each situation is unique. Determining the contributing factors can take time. Working with a treatment provider can help your teenager get back on track and move toward a safe and productive future.

Teen males are most likely to be charged or accused of illegal sexual behavior in the United States. However, females make up about 10 percent of all arrests for sexual offenses. Minimal data is available regarding transgender or non-binary teens and their engagement in problematic sexual behavior. Of note, it is far more likely for trans and nonbinary teens to be sexually harmed by others than to harm someone else sexually

There's no one type of teen who engages in problematic sexual behavior. Teens who engage in PSB have varied backgrounds, family systems, intellectual functioning, socio-emotional functioning, and mental health history.

Because teens who engage in problematic sexual behavior do so out of a combination of strong curiosity, opportunity, and lack of knowledge regarding consent, the law, and possible impacts of their behavior. there is no ‘one type of teen’ that may find themselves in this situation. Teens with PSB come from all backgrounds, socioeconomic statuses, races/ethnicities, and family types.

Though it is possible for teens to have sexual interest specifically in younger children, this is very rare. Most teens who engage in problematic sexual behavior towards young children do not report having sexual interest in the other child, but rather were experiencing sexual arousal or curiosity and acted impulsively on someone who was around them.

Click here to learn more about vulnerabilities and protective factors.

What Parents Can Do

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When you find yourself in this situation, it is important for you to know that you are not alone. This Survival Guide was developed by other caregivers in your shoes.

Other parents have experienced similar emotions and reactions to yours. With the right support systems you can move from distress to a sense of hope and to a better future.

It can help to know that problematic sexual behaviors in teens typically lessen with the right type of treatment and when families are actively involved in services. Through such treatments, future problematic sexual behaviors can be prevented.

Children with problematic sexual behaviors can learn to better respect themselves and others. They can learn to demonstrate healthy boundaries and behaviors, even when the reasons for the problematic sexual behaviors remain unclear.

Tips to Remember
  1. Try to stay calm.
  2. Reassure your child you care about them.
  3. Enlist a trusted friend and/or attorney to help you make decisions.
  4. Provide close supervision.
  5. Develop and implement a plan to keep all family members safe.
  6. Inform those who need to know.

Immediate Response to Teen

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Most parents can’t possibly be calm and helpful when they first learn about their teen’s harmful sexual behavior. As with any crisis situation with a teenager, it’s best first to separate yourself from your child, calm yourself down, and try to think clearly about what needs to be done. Once you feel more calm and collected, however, your teen needs to know

  • You still love them, despite the sexually harmful behavior;
  • You will support them during treatment.

It’s okay to let your teen know that you are upset, disappointed, and angry about what they did. It’s okay for your teen to realize that you are disappointed, that the family and others have been let down, and there is much work to be done to regain trust. And your teen needs to know that you still see who they are beyond their sexually harmful behavior and that you will stand with them and do what is necessary to get help, to heal, and to make things right.


Safety Implementation

The family, in consultation with therapists and other professions, will need to develop a safety and supervision plan to prevent any further problematic sexual behavior. The “Home Safety Plan” includes information regarding restrictions for and responsibilities of the youth with PSB, responsibilities of you and all the caregivers, and activities in which the child and/or children may engage. Commonly, the safety plan is part of an initial assessment and is developed collaboratively with you (the caregivers), other adults responsible for supervision in your home, your youth, and any involved professionals such as child welfare or probation officer. The safety plan should be a working document that allows for changes and adaptations through the course of your family’s progress in services.

Components of the Home Safety Plan

The following information provides a framework for developing a safety plan. A qualified professional should assist in individualizing the plan for your family’s circumstances. The plan should include activities the teen can and is encouraged to do. Responsibilities of the caregivers in charge of the children in the home, and the family rules regarding privacy and supervision are also listed below.

Examples of rules for the teen:

  • Will not babysit for any amount of time.
  • Will not go into other children’s bedrooms without adult supervision. If invited into one of their bedrooms, the teen will say, “No,” and go tell an adult.
  • Will not have other children come into their bedroom, unless an adult is notified and is in the room to keep an eye on things.
  • Will not be in the bathroom if other children are in there. (Only one person can go into the bathroom at a time.)
  • Will keep the bathroom door closed when in there.
  • Will not engage in any “horseplay,” wrestling, or tickling with young children.
  • Will not watch any movies, TV shows, or Internet material or listen to music that are not approved.
  • Will not talk about sexual things or make any sexual comments or sexual jokes around other children.
  • Will not be alone with other children.

Activities the teen can do:

  • Play games, crafts, or sports with family members.
  • Watch approved TV, read, listen to music, or sit next to siblings on the couch.
  • Talk and joke politely with siblings.
  • Go to community events, religious activities, the store, or on family outings
  • Ride in the car with the family.
  • Eat meals or go to restaurants with the family.
  • Show appropriate affection to siblings if they initiate it and if one of the parents is there to watch. Then hugs may be OK.

I, as the caregiver, agree to:

  • Supervise interactions between my child and all other involved children, including siblings.
  • Not ask my child to babysit.
  • Make sure that an informed, responsible adult is always in charge of the children.
  • Supervise TV shows, music, videos, texting, social media, and Internet material.
  • Monitor my child’s activities, such as school work, homework, types of friends, and whereabouts, etc., and help my child make good choices.
  • Help my child to follow the rules by reminding them about the rules as needed.
  • Make sure that all the children are clothed unless they are in their own room with the door closed, in the bathroom with the door closed, or in bed.
  • Be open and accepting when talking with my child about any sexual questions or thoughts they might have.

The family agrees to:

  • Treat each other with respect.
  • Respect the authority of the parents/caregivers and follow their house rules
  • Listen to each other.
  • Be kind to each other.
  • Keep private parts covered by clothing.
  • Have to Do fun activities with each other.
  • Provide individual time for each child to talk privately with parents about important matters, including questions about relationships.
  • Help each other to be successful and to follow the rules of the family.




For most adolescents, the safety plan will have basic common-sense rules. In most cases, it should not keep adolescents from “having a life,” nor should it impose a heavy burden on youth or family members. Although a safety plan will have clear rules against some activities (for example, babysitting or looking at pornography) and will require closer than usual parental supervision, it usually will not prohibit most normal teenage activities that parents might normally approve that are otherwise supervised (e.g., spending time with appropriate peers, having a part-time job, engaging in school activities, playing sports, etc.),

How, If, and When to Reunify



Teens may be removed from their home in order to provide for the safety of other family members or to provide more intensive treatment. The information below will provide guidelines for making decisions and managing the process of returning the adolescent to the family. These guidelines are especially designed for families in which the adolescent's harmful sexual behavior involved or impacted another child in the home, such as a sibling or step-sibling, who lives in the home. However, the principles can be applied to other situations.

Will the Adolescent be Returned to the Family?

The adolescent may have been removed from their home by the legal or child protection system or the parents may have decided that it was better for them to live outside the home for a period of time. Many adolescents who receive treatment do return home to live with their families. Factors that lead to successful reunification of the family include implementing appropriate levels of supervision, strengthening house rules, and improving communication among family members. Whether an adolescent will return to live with their family depends on many factors that include

  • The seriousness of the illegal behavior
  • How long the behavior went on
  • The safety, well-being, and wishes of the other children in the home
  • The parents’ willingness to have the adolescent return home
  • The stability of the family and how well the adolescent will be supervised by the parents
  • The family’s participation in the adolescent’s treatment program and
  • The adolescents’ progress in treatment and success with probation requirements.

How does Reunification Happen?

There are several ways to have an adolescent return to live with their family. Typically the probation officer, CPS worker, treatment provider, and parents will develop a reunification plan to fit the needs of the particular family. The goals are to provide maximum safety for children in the home and to return the adolescent to a more normal setting, including school, friends, and activities. While no set list of factors exists that will always lead to a successful reunification, certain guidelines can help in developing and implementing a plan.

Guidelines for Reunification

A set of general guidelines is described below that can be useful in developing a plan for reunifying your teen into the family, i.e., setting a time-line, developing rules for supervision during visitation, and increasing levels of contact between the adolescent and the younger child.

Plans for reunification should first consider the safety and emotional well-being of the victim, if the child is in the home. Listed below are suggestions for an assessment of the parents, the adolescent, and the child victim before the reunification process begins

Before the reunification process can begin, parents should

  • Be clear and accurate about who was responsible for the abusive behavior
  • Be supportive of all the children
  • Know the details about the illegal sexual behavior, such as, how and where it happened and risky situations
  • Recognize warning signs or behaviors associated with problematic sexual behavior and know how to respond
  • Participate in the development of a safety plan for the adolescent
  • Be able to discuss the behavior with the therapist, the adolescent, and the child and
  • Know and be able to enforce the supervision rules in the home and community.
  • Have described the sexual behavior in a similar way to what appears to have happened.

Before an adolescent can begin the reunification process, the treating therapist, treatment team and sometimes an independent evaluator will assess the progress that the adolescent has made toward meeting goals of treatment and probation. If the team determines that adequate progress is being made in these areas, the adolescent may be ready for visits. The adolescent needs to

  • Understand the harm caused to the family, the child, and themselves.
  • Be making consistent progress in treatment with no sexual or major nonsexual problems at home, at school, or in the community
  • Have admitted their behavior and taken responsibility for it and
  • Know and be ready to follow the rules for visitation in the home.
  • Have described the behavior in a similar way to what the child victim said happened.

In addition, careful consideration needs to be given to how the child victim is doing before starting reunification. Depending on his or her age and ability to understand the process, the child victim should

  • Not have been pressured to begin the process by family members who want the adolescent to return home
  • Be ready for and interested in contact with the adolescent
  • Have described the sexual behavior in a similar way to what appears to have happened and
  • Be making satisfactory progress or have completed treatment, if it was recommended.

The reunification process can begin with the adolescent writing letters of apology or clarification to the victim and their parents as part of their treatment program. If the victim was a family member who didn’t live in the home but was visiting the family, such as the parents’ grandchild, a letter could also be written to that child’s parents. The letter to the adolescent’s parents can be read and discussed in a treatment session. If and when appropriate, the letter to the child victim can be read in a family clarification session prior to or during the reunification process. Some treatment programs use a “clarification” session that is attended by the teen, the child victim and other siblings if appropriate, and the caregivers. This session clarifies the youth’s responsibility and the rules to be followed during the visits and the reunification process.

A safety plan should be developed by the therapist, the adolescent, the parents and, when involved, the probation officer or CPS worker. Parents should set limits for the adolescent’s behavior in the home, know what the adolescent is to do if problematic situations come up, and implement consequences for breaking any of the rules. Some suggestions for a safety plan are listed below. These rules can be adjusted as the adolescent shows that their behavior has improved over time

During visitation and the reunification process, the adolescent should

  • Be closely supervised (within the sight of adults who understand the need for supervision) especially when around children and in other situations with significant risk.
  • Not babysit under any circumstances
  • Not be in charge of children for any activity in such places as a school, church, or rest room
  • Not discipline or correct children in the home
  • Not go into other children’s rooms
  • Leave if a child comes into their room
  • Not share a room with younger or vulnerable children
  • Not be involved in bathing or dressing children
  • Be fully dressed when in public areas of the home
  • Not have access to highly sexualized materials, including magazines, videos, television shows, or the Internet and
  • Not engage in horseplay, wrestling, or tickling with children.

It is important to note that these rules do not mean that an adolescent cannot have ordinary or typical activities for their age with appropriate supervision. They should go to school, church, the mall, or restaurants with family members and be involved in age-appropriate activities that are supervised by adults such as sports activities, band, or other school events. Over time, the adolescent can be allowed to have activities that do not require close supervision as they shows that they can conduct themselves in an acceptable way.

The process of reunification can take place in steps such as the ones listed below. The process should be planned with the therapist, probation officer, CPS worker (if one is involved), parents, and the adolescent. While the steps below may not be necessary or appropriate in every case, they can serve as a guideline for planning the reunification process. The steps can be implemented on a weekly basis or on a schedule that is planned by the team involved in developing the safety plan. The length of time to implement the plan should be decided on a case-by-case basis and can last from a few weeks to several months, depending on the circumstances and the successful completion of each step.

Suggested steps for reunification are as follows:

  • Letters of clarification or apology written
  • Determination of readiness of the adolescent, the child, and the family
  • Development of a safety plan
  • Phone calls between the adolescent and the child, monitored by the parent or therapist
  • Family clarification session with the child present, if appropriate 
  • Supervised visits out of the home, in a park, restaurant, or another family member’s home, with the child present
  • Supervised  visits in the home for two to four hours 
  • Supervised all-day visits in the home
  • Supervised two-day visits in the home
  • Overnight visits in the home
  • Weekend visits with overnights
  • Extended visits, such as during a holiday period or spring break
  • Adolescent returns home

Based on research that shows the long term importance of sibling relationships, it is important for the teen, the child victim, and the other siblings to interact in healthy, appropriate ways. While some physical contact, such as wrestling, tickling, etc., should be omitted, appropriate contact such as brief hugs, or high fives can be encouraged, when appropriate and wanted.

It is strongly recommended that the reunification process be done while the adolescent is in treatment and, if he is on probation, before the probation period ends. This timing will provide the necessary professional involvement, assistance, and oversight to give the process the best chance of being successful.

When Should Reunification not be Considered?

The following factors are potential indicators that the adolescent, child victim, or family is not at a point where the reunification process should be implemented. These factors should not be taken as definite reasons not to discuss reunification, but they can help the family, the providers, the probation officer, and child protection staff decide the overall readiness of the family to begin the process.

Reunification should not be considered when

  • The caregivers continue to deny the abuse occurred
  • The caregivers have not provided consistent, appropriate supervision during the reunification visits
  • The abuse was extremely harmful to the child victim
  • The victim has significant discomfort when discussing the topic it is expected, however, that a child might have some uncertainty about discussing the issue
  • The child continues to have significant trauma symptoms or serious response to the abuse
  • Evidence exists that the victim has been pressured to agree to reunification and/or
  • The adolescent has a recent history of significant aggressive or violent behavior.

Not all of the above factors taken alone would automatically stop the reunification process however, each of them should be given careful consideration before starting the process or if they occur as the process is implemented. Other factors may need to be considered, but these will depend on the specifics of each individual case.

Tips to Remember
  1. Many adolescents return to live safely with their family.
  2. Safety, adjustment, and wishes of all family members should be considered.
  3. Reunification should be considered in stages in ensure the safety and comfort of all members of the family.
  4. Reunification should be conducted under the guidance of professionals while the adolescent is in treatment.

Connect to Treatment

Short-term, community-based treatment often works. It's a treatment that involves therapy and support for both adolescents and caregivers. Our Caregiver Partnership Board developed this tip sheet with their advice on what to look for in treatment (English and Spanish)

Your involvement in treatment is the key to the success of your teen. Our Youth Partnership Board developed this tip sheet for caregivers:

When you’re seeking treatment, find licensed mental health professionals or those who work under their supervision. These professionals should have experience working with adolescents, problematic sexual behavior, include caregivers in their services, and be familiar with current research.

Look for someone who participates in ongoing training and is a member of professional organizations such as the American Professional Society on the Abuse of Children (APSAC), the Association for the Prevention and Treatment of Sexual Abuse (ATSA) or National Association of Social Workers (NASW). Some states may also have additional certification requirements for those who treat adolescents with illegal sexual behaviors.

Find information about evidence-based treatments through the California Evidence-Based Clearinghouse at and OJJDP’s Evidence Based Program directory Below are some examples:

Problematic Sexual Behavior – Cognitive Behavioral Therapy. To learn more and find providers see below.


Locate sites trained in Multisystemic Therapy for Youth with Problematic Sexual Behaviors (MST-PSB) operating under a valid program license from MST Associates.

Trauma-Focused Cognitive Behavior Therapy is an effective treatment for youth whose problematic sexual behavior is driven by trauma experiences.

Safer Society Foundation maintains a database of clinicians from around North America who work with sexual abusers, children with sexual behavior problems, and survivors of abuse.

The Association for the Prevention and Treatment of Sexual Abuse (ATSA) referral database promotes sound research, effective evidence-based practice, informed public policy, and collaborative community strategies that lead to the effective assessment, treatment, and management of individuals who have sexually abused or are at risk to abuse. 

Search for a local Children's Advocacy Center located near you through the National Children's Alliance. Local Child Advocacy Centers may provide services directly or guide caregivers to treatment options in their communities.

Getting the Most Out of Treatment

Keep these key points in mind when selecting a successful treatment program for your family. Treatment should be focused on the behavior problem in a positive learning environment. 

  • Therapy should not be based on adult treatment models.
  • The qualifications of the therapist are important.
  • Caregiver involvement is crucial.
  • A group setting can be helpful when focused on building positive behavior.
  • Respect and support are key.
  • Youth should not be negatively impacted by treatment.

On-going Prevention and Education

Our Caregiver Partnership Board believes that they could have prevented their teen's problematic sexual behavior and that you can too. They developed this tip sheet to encourage you as caregivers to have important conversations with your children (English and Spanish)

  • Watch your teen's behavior including when they are on electronics.
  • Listen to their words and expressions of feelings.
  • Provide support and encouragement.
  • Share your knowledge and values.
  • Research information and teach yourself when you are also unsure

Healthy development can be fostered. See "Understanding Appropriate Treatment for Teens" section for more information.

Characteristics of Best-Practice Treatment


Treatment Providers

Treatment for illegal sexual behavior is most typically provided by professionals from mental health disciplines, such as social work, psychology, and psychiatry. It is recommended that providers

In some areas, treatment is provided by juvenile justice personnel, who are typically probation officers. These treatment providers work under the supervision of the juvenile justice system. They have received training in treating adolescents with illegal sexual behavior. The recommendations we suggest above for mental health professionals, such as specialized training and knowledge of the literature, also apply to juvenile justice personnel.

Some states have special certification requirements for individuals who treat adolescents with illegal sexual behavior.

Approaches to Treatment

Our Caregiver Partnership Board developed this tip sheet with their advice on what to look for in treatment (English and Spanish).

Several treatment approaches are currently being used to treat adolescents with illegal sexual behavior. The judge or probation officer may recommend, or order, an adolescent to be part of a specific program or the parents may have a choice of providers. The availability of treatment programs may impact the decision made. In some cases, the legal/juvenile justice system may pay for the treatment. In other cases, it will be the parents’ responsibility. These are decisions that need to be discussed with your child’s attorney or a representative of the court/juvenile justice system.

When families have a choice of treatment providers, caregivers need to have information about the various approaches of treatment to decide what would be best for their teenager and family. Questions for parents to consider, as they weigh this decision, are the following:

  • Is the provider licensed to provide mental health services in the state, or is the provider working in an agency under supervisors who are licensed?
  • Does the provider have adequate knowledge about youth with illegal sexual behavior? Does the provider know the types of information provided on this website?
  • Is the provider familiar with the research and literature about adolescents who have engaged in problematic or illegal sexual behavior?
  • Does the provider attend annual trainings for this population and have membership in professional organizations? 
  • Does the provider know which approaches to treatment are the most effective? 

A good treatment program would be one with experienced, licensed therapists, who have a productive working relationship with the court, probation staff, and CPS, and with a reputation for providing effective services to these adolescents.

A questionable program is one that utilizes therapists with limited knowledge and experience with adolescents who demonstrate illegal sexual behaviors, professionals without a license, providers who perceive all adolescents with illegal sexual behavior as high risk for reoffending, and uses treatment designed for adults and are not developmentally appropriate for adolescents. Parents should evaluate how well their program works. Ideally, a program would offer information about the percentages of teens that re-offended after completing their treatment program. Parents should be able to expect that the program provides assessments of the adolescent’s treatment needs before, during and at the end of treatment.

Several approaches have been used to treat adolescents with illegal sexual behavior. Depending on the particular case, one or more of the interventions described below will typically be used.

Multisystemic Therapy – Problematic Sexual Behavior (MST-PSB)

Multisystemic Therapy (see MSTPSB) is an approach to treatment that has the strongest research support in decreasing general delinquent behavior, substance abuse, and illegal sexual behavior by adolescents. The treatment provider is available 24 hours a day, 7 days a week and works closely with the youth and his parents. MST does not include going to a clinic for therapy for an hour a week. In this approach, the therapist has only a few clients and spends a lot of time with the teen, his parents, other family members, and peers. The therapist primarily works with the parents and youth in the home to target problematic behaviors. They often also work with the caregiver and teen in community settings to improve the teen’s behavior, school achievement, and social activities. Treatment with MST-PSB takes about six to nine months, is performed in the community, and directly involves the caregivers. It is important to note that MST-PSB is not available in all areas and that there are conditions that need to be met in order for a youth to qualify for treatment. However, if MST-PSB is available in your community, it may be very helpful for your adolescent and family. 

Cognitive Behavioral Group Therapy

Cognitive Behavioral Group Therapy is a psychoeducational approach to treatment that is conducted in groups of six to eight adolescents. This approach addresses issues such as taking responsibility for the illegal behavior learning legal, appropriate sexual behavior increasing involvement in prosocial activities and with non-delinquent peers and preventing future illegal sexual and nonsexual behavior. Adolescents attend weekly 1 to 1.5 hour group sessions in the community for 8 to 24 months, depending on the program’s requirements. Parents are encouraged or required to attend and participate in a weekly educational support group. The parent group is recommended because caregiver participation has been found to significantly improve treatment outcomes. This treatment approach is widely accepted and used for adolescents.

Family Therapy

Family therapy is used to directly address the illegal sexual behavior or to focus on problems within the family that influence the youth’s progress in treatment. Family therapy usually involves all members of the family and may be particularly useful in cases where the sexual behavior occurred within the family. When a victim is a family member, then the timing of including all members in family session must take into consideration the progress the youth with problematic sexual behaviors and child victim has made in treatment and the wishes of the victims. Family therapy may be used as the primary approach to treatment or may supplement other therapies such as when the family is involved in the reunification process.

Individual Therapy

Individual therapy may be provided if other forms of treatment, such as MST-PSB or group therapy, are not available or if the adolescent has other psychological problems that need to be addressed. In this approach, a therapist typically meets with the adolescent on a weekly basis for an hour to address issues related to their illegal sexual behavior. If the youth has other psychological problems, such as depression, these would also be addressed in the individual sessions. In these cases, it is recommended that the teen’s caregivers be included in the treatment on a regular basis. The caregiver can provide important information on the teen's behavior at home, at school, and in the community. The therapist can discuss issues of behavior management, supervision, and progress in treatment during the sessions.

Residential Treatment

There are times when an adolescent is demonstrating more severe sexual behaviors that have not responded to treatment in the community, or that compromise the safety of those in his home and possibly, the surrounding community. In these situations, the adolescent may also have mental health diagnoses such as Oppositional Defiant Disorder, Conduct Disorder, Depression, Post- Traumatic Stress Disorder and/or drug and alcohol abuse. Residential Treatment Centers are designed to treat adolescents who are in need of a secure living environment, are experiencing multiple difficulties that may include complex family problems, and likely have behaviors that have not responded well to mental health treatment that has been provided in the community. Adolescents stay at the facility, and length of stay can vary tremendously to up to two years. Approach to services also varies but is often designed to promote positive behavior change and address mental health needs. During their stay, they attend individual and/or group psychotherapy and are provided with psychiatric medication management. Some Residential Treatment Centers have their own programs to treat problematic sexual behaviors and others refer their clients to programs at outpatient settings in the community. Though often challenging to take place due to distance, family involvement is critical during the adolescent’s stay and caregivers are encouraged to participate in ongoing family therapy as well as other therapy programs that are recommended.

Inpatient Psychiatric Treatment

When teens have concerning psychiatric issues that are not responding to community based approaches, they may require psychiatric hospitalization to address their treatment needs. The hospitalization can be short or long-term, depending on whether the purpose is to stabilize the youth or to address more severe psychiatric problems. Some hospitals conduct treatment programs for adolescents with illegal sexual behavior as part of the youths’ overall treatment plan, which may include group cognitive-behavioral treatment. Youth who are hospitalized should be discharged when their mental health disorders have stabilized, they have made progress in treatment, and they are responsive to adult supervision. They may be released to continue treatment in a community-based program and have ongoing monitoring of their mental health disorder.

Length of Treatment

The length of treatment varies from program to program and depends on

  • The seriousness of the sexual behavior
  • Whether the youth has other delinquent behavior and
  • The youth’s and family’s active participation and progress in treatment

Adolescents who are in community-based treatment programs and live in the community are treated in shorter-term, less-intensive programs that usually meet once a week for one to two hours and last from 8 to 24 months. Some adolescents need long-term, intensive treatment in a restricted placement. Programs in these settings typically use a “levels system” by which the youth’s progress is measured and rewarded as he moves through the levels to discharge. As mentioned earlier, if you have questions or concerns about the program, it is recommended that you discuss these with the program director or your teen's probation officer or attorney.

To learn more about connecting to treatment go here

Tips to Remember
  1. Mental Health providers should be license and have experience in this area of practice.
  2. It is recommended that the youth's caregivers be actively involved in the treatment program.
  3. Treatment should account for the adolescent’s risks, needs, protective factors, and supports.
  4. Treatment should be developmentally appropriate and encourage pro-social behaviors and peer relationships.

Controversial Treatment Practices

Some policies and practices currently used in the treatment and supervision of adolescents with illegal sexual behavior are controversial, meaning that experts in the field disagree as to whether they are necessary, appropriate, or effective.

These controversial practices include the use of

  • The polygraph (lie detector);
  • Visual reaction time such as the Abel Assessment of Sexual Interests; and
  • Plethysmograph testing (a device placed on a penis to measure arousal).

Due to its lack of reliability, the results of a polygraph are not accepted in court proceedings. The use of the plethysmograph and polygraph were originally designed for and implemented with adult sex offenders to increase the effectiveness of treatment and reduce recidivism. Though widely used with adult sex offenders, minimal evidence exists that proves that the methods are effective in reducing future sex offenses. No research indicates that the approaches increase treatment effectiveness or reduce re-offense rates when used with adolescents.

Parents should be aware that these methods are controversial. They should discuss which treatment and supervision methods will be used with their adolescent, and their necessity, with their teen’s treatment provider and probation officer and the teen’s attorney. Although these methods are recognized as controversial, they are permitted and used in some areas and by some providers.

Getting the Most Out of Treatment

Keep these key points in mind when selecting a successful treatment program for your family. Treatment should be focused on the behavior problem in a positive learning environment.

  • Therapy should not be based on adult treatment models.
  • The qualifications of the therapists are important.
  • Caregiver involvement is crucial.
  • A group setting can be helpful when focused on building positive behavior.
  • Respect and support are key.
  • Youth should not be negatively impacted by treatment.

Our Caregiver Partnership Board developed this resource to help you navigate treatment service options and participation.

now what

Click here to access the 2019 PPB Newsletter (Spanish)

On-going Prevention and Education

Our Caregiver Partnership Board believes that better communication about sexual topics could have minimized the risk of this happening in their family They developed this tip sheet to encourage you as caregivers to have important conversations with your children(English and Spanish).

talking about elephant

Click here to access the newsletter

The highlights of this document include:

  • Watch your child’s behavior including when they are on electronics.
  • Listen to their words and expressions of feelings.
  • Provide support and encouragement.
  • Share your knowledge and values
  • Research information and teach yourself when you are also unsure.

Healthy development can be fostered.

See Understanding Appropriate Treatment for Teens section for more information.

Tips to Remember
  1. The use of methods, such as a plethysmograph and polygraph, are controversial in treatment of adolescents.
  2. Parents should obtain information about methods that will be used in their teen's treatment program.

Common Questions/Concerns

Most parents have unanswered questions about teens who engage in illegal sexual behavior. Most parents must sort through a lot of wrong information as they try to get a better understanding of their teen’s behavior. What follows are answers to questions most commonly asked by parents, based on the best and most reliable information we have now.

For more information on typical vs problematic sexual behavior in adolescents/teens, explore this page of our website:

Maybe, but many youth with problematic sexual behavior have NOT also been sexually abused. It is more common for youth with PSB to have experienced other forms of maltreatment (such as neglect and witnessing domestic violence). However, it is possible. It is helpful to ask your children about how they may have learned the sexual behavior. Further, it is healthy for families to have ongoing conversations with children about what are safe and unsafe touch, what sexual abuse is, and who/how to tell if they feel uncomfortable or are concerned about sexual behavior of others. Due to concern about possible abuse including sexual abuse, a forensic interview may be conducted. For more information about forensic interviews see Many times with teens, there is not sufficient concern about experiencing sexual abuse. Other factors appear to have contributed to the problematic behavior. See Understanding Adolescents and Problematic Sexual Behavior: Who Engages In Problematic Sexual Behavior and Why? For more information.

Current research shows that most youth with problematic or illegal sexual behavior do NOT go on to be adult sex offenders. In fact, recidivism (having additional incidents of problematic or illegal sexual behavior), is quite low in this population, even without treatment. With evidence-based treatment, recidivism rates are quite low, mostly close to 3-7% chance that youth go on to engage in future problematic sexual behavior. See Connection to Treatment for more information.

Children and teens are most often engaging in PSB opportunistically, meaning they act impulsively when an opportunity arises to try something sexual and or experience a sexual feeling. As such, who your child engaged in sexual behavior with is often less important than being able to engage in the act itself. Teens, particularly, are often in caregiver/babysitting roles or have opportunities to be alone with younger children they know (family, friends, neighbors, etc.). Teens may take advantage of these opportunities, but are often not seeking them out. This is significantly different from adults with pedophilia, who have specific attraction to pre-pubescent children and seek out opportunities to engage in sexual behavior with that age group. Few youth are exclusively sexually interested in younger children. For more information on individuals attracted to young children see

Similar to the answer above, a child or teen’s sexual orientation (who they are attracted to) cannot be determined from their problematic sexual behavior itself. Most youth engage in PSB by taking advantage of an opportunity provided to them, rather than seeking out someone they are explicitly attracted to. Many youth engage in PSB with other youth of the same-sex or same-gender but do not experience specific attraction to them.

Teenage years are a time in which youth explore identity in multiple ways - what their interests are and what is important to them. Youth may engage in same-sex sexual behavior due to specific attraction and/or to explore their own sexuality. Behavior during teenage years among consenting, developmentally appropriate peers is not a problematic sexual behavior.

Some youth who engage in problematic sexual behavior may also be gay, lesbian, transgender, bisexual, queer/questioning or pansexual (LGBTQ+). Being LGBTQ+, is NOT a risk factor for engaging in problematic sexual behavior. Youth who are LGBTQ+ are actually at higher risk of experiencing victimization than non- LGBTQ+ youth and are not any more likely to engage in PSB.

All kinds of families. The families may have biological parents, step-parents, grandparents, foster or adoptive parents, or kinship parents. The families have many different levels of income and education and they represent all ethnicities. Many of these families are functioning well and have typical family problems. Other families experience high levels of stress along with a history of problems with maltreatment, substance abuse, domestic violence, and/ or unstable employment. There is no one type of family or one type of teen that engages in PSB.

When confronted with a major behavioral incident, many youth may deny what happened or only tell part of what happened. It’s a natural response for most youth due to fear, shame, and/or concern for judgment and consequences. Some youth tell the truth right away, others deny for short periods of time, and others deny for very long periods of time. Some youth say the longer they wait to tell the truth, the harder it is to tell the truth later. A child/teen’s natural fear response of denial does NOT mean they are bad kids, lack empathy, and/or are more likely to go on to engage in more harmful sexual behavior. Many youth begin to open up about what happened once they are involved in appropriate treatment and are in a supportive therapeutic environment. It is common for youth to disclose about their PSB gradually over time, rather than all at once.

Do Teen Girls have Problematic Sexual Behavior?

At present, researchers have limited information on adolescent girls with problematic or  illegal sexual behavior toward children. This lack of information is due to a number of reasons. Girls’ have significantly fewer illegal sexual behaviors than adolescent boys. Girls’ illegal sexual behavior is considered to be underreported to law enforcement and Child Protective Services. Also, most of the research has been based on small numbers of girls. As such, the research may not accurately represent this group as a whole. Here are some of the important aspects of what we know now

  • Adolescent girls commit a range of illegal sexual behaviors, ranging from limited behaviors based on curiosity to repeated, aggressive acts
  • Some adolescent girls co-offend with adolescent males
  • The most common sexual offenses by adolescent girls are nonaggressive acts, such as fondling, that occur in an activity such as babysitting
  • Adolescent girls account for about 10 percent of all arrests for sexual offenses by youth under age 18 and 1 percent of forcible rapes
  • The most frequent victims are children who are between the ages of 4 – 6 years old and who are acquaintances or relatives of the teen
  • Most adolescent girls are well-functioning with limited behavioral problems while some have higher rates of behavioral health diagnoses such as PTSD, depression, anxiety or delinquent histories
  • Compared to boys, most adolescent girls with illegal sexual behavior have a more extensive and severe history of physical and sexual abuse. The girls were abused at younger ages than boys and were more likely to have been abused by multiple perpetrators
  • The rate of future sexual offenses by adolescent girls is not known
Tips to Remember
  1. Most adolescents do not have future illegal sexual behavior.
  2. Adolescence is a developmental period of experimentation, risk taking, excessive self-focus and evolving cognitive development.
  3. There is not one "type" or profile of adolescents who commit illegal sexual behavior.
  4. Adolescents are quite different from adults with illegal sexual behaviors.
  5. There are a variety of reasons why adolescents commit illegal sexual behavior.
  6. Adolescent girls commit significantly fewer illegal sexual acts than boys.

Resources for Parents and Caregivers