Children with PSB should be viewed first as children.6 Sexual development in children is a normal part of the development process. Sexual behaviors in children range from normative to cautionary, to problematic and harmful. PSB of children is often misunderstood. The process of growing up and forming healthy, intimate relationships starts in early childhood, continuing throughout adolescence into adulthood.

A good foundation in understanding typical sexual development is essential for accurately deciding where a sexual behavior falls on the continuum from typical to concerning to problematic or harmful.

Typical sexual behavior occurs among children who are around the same age, size, and development. It is curiosity-driven, spontaneous, and infrequent. Problematic sexual behavior is a set of behaviors that are developmentally inappropriate, potentially harmful to self or others, and potentially illegal.

For more information on typical and problematic sexual behaviors, see page 28 in the Restoring the Sacred Circle Toolkit. 

Much of what is known about PSB in the general population comes from published research and clinical practice. There is no specific body of research on PSB in American Indian or Alaska Native communities. Below are a few examples of general population facts: 

• - PSB is not related to race or ethnicity.  

• - There is no research to indicate that American Indian youth have higher rates of PSB than non-American Indian youth.  

• - Youth in the general population commit more than 26% of all sex offenses and more than 36% of sex offenses are against youth victims.  

• - Youth who exhibit inappropriate sexual behavior and receive early intervention services are less likely to have future incidents.  

• - Treatment services for youth with PSB should also directly involve parents and/or guardians. A child’s ability to recover is influenced by the support he or she receives from caregivers. Caregiver support is critical for recovery. 

For more information on what we know about youth and PSB, see page 31 in the Restoring the Sacred Circle Toolkit. 

Community Challenges & Solutions  

• Challenge:  Youth with PSB is a concern of community members, yet agencies often have no clear guidelines for response.  

• Solution:  Frequent community outreach to educate community members and dispel misunderstandings about sexual development and PSB of youth. Strengthen partnerships with local schools and engage parents. Advocate for quality screening, assessment and interventions for PSB in community. 

Capacity Challenges & Solutions  

• Challenge:  Tribes may not be equipped to handle PSB cases due to jurisdictional issues, lack of expertise and other necessary resources. Mental health services, children’s advocacy centers, or forensic interviews are not available in many tribal communities.  

• Solution:  Utilize existing training models, map processes for referral and treatment, collaborate with programs, and connect families to healers and traditional rites of passage that support healing. Consider building on the systems of care model or other strengths, resources and leaders in the community. For examples of systems of care, click this link. 

Gaps and Protocol Challenges & Solutions  

• Challenge:  Gaps in protocols exist across the country, recognizing that in tribal communities these gaps are often magnified because of unclear jurisdictional issues. Determining jurisdiction can be difficult, especially in cases of concurrent jurisdiction involving tribal, state and federal law enforcement.  

• Solution:  Consider changing laws and agency/interagency policies, protocols and procedures to be developmentally appropriate and support prevention, identification, and response and treatment strategies for families of youth with PSB and child victims. Develop a taskforce or workgroup focused on community change to address PSB of youth with agency/system leadership representatives to outline protocols.  

Access to Evidence-Based Treatment Challenges & Solutions: 

• Challenge:  Treatment that honors, respects, and integrates Tribal and community practices is needed for youth with PSB, child victims, caregivers, and other family members affected. Many tribal communities do not have access to treatment due to funding, limited number of qualified clinicians and rural locations 

• Solution:  Increase the number of providers trained to recognize and treat youth with PSB, child victims and families. Utilize existing treatment resources, CACs and traditional healers. The impact of trauma needs to be integrated into the treatment approach and should include family members 

For more information regarding overcoming challenges in tribal communities, see page 50 in the Restoring the Sacred Circle Toolkit. 

Problematic Sexual Behavior-Cognitive Behavior Therapy (PSBCBT) has demonstrated long-term positive results for youth with PSB. Trauma-focused CBT (TF-CBT) is also effective when youth with PSB have significant trauma history and symptoms. Other options to consider are: 

Honoring Children, Mending the Circle

• A cultural adaptation/enhancement of Trauma Focused Cognitive Behavioral Therapy (TF-CBT). This clinical training is offered to licensed clinicians and trainees under supervision who are employed by tribes, IHS, BIE, local tribal/public schools on or near reservations or tribal jurisdictions, or non-profit organizations working in Indian Country and serving tribal children and their families with trauma exposure. For more information, see the Indian Country Child Trauma Center's webpage.

Good Lives Model Teaching from Indian Country 

• The Good Lives Model (GLM) is a strength based appropriate and responsive model used in Indian Country and beyond with the treatment of youth with PSB. It is based on the concept of Human Goods and has been used for more than 20 years with youth who have engaged in sexually abusive behaviors and is based on the underlying assumption that all individuals have similar basic needs and aspirations that they strive for in their lives. The GLM involves combining ways to live more fulfilling lives with understanding and managing individual risks.  

For more information on how treatment services and practices for the sacred circle, view the Implementation Guide for Mental Health Providers. Additionally, see page 40 in the Restoring the Sacred Circle Toolkit. 

The National Symposium on the Sexual Behavior of Youth hosted a Youth Partnership Board Youth Panel question and answer panel session. In this session, tribal experts discussed the traditional teachings and perspectives to prevent PSB and restore the Sacred Circle.

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

*Trigger Warning: The following stories include information about sexual abuse and may be triggering

To access, "Principles for Working with Tribal Communities & PSB," see page 73 or click here.

These principles support the growth and development of healthy Lakota children. Every tribe and nation has principles and teachings that can be used to prevent PSB and promote the restoration of the Sacred Circle. Principles are grounded in respect, humility, and wisdom.

To access the, "7 Guiding Principles From Our Lakota Relatives," resource, see pages 74 or click here.

We want to keep things sacred in the lives of our children and families. It is important to know what to say and when to say it.

For the full "Talking Points by Developmental Stage," resource, see pages 75 - 76 in the Restoring the Sacred Circle Toolkit or click here.

For more information on "Following Sexual Behavior Rules for Parents and Caregivers," see page 77 in the Restoring the Sacred Circle Toolkit or click here.

"You can create change. You can make a difference. You may be the only one to empower this person."

 

Who may benefit from this information:

• Medical workers, therapists, child welfare workers, law enforcement, juvenile court personnel, school personnel, Child Advocacy Centers, and any other person who engages with children and families may benefit from this information.

Tips for engaging families: Insights from caregivers

• Open the door and give us space to hear our story. Caregivers will be more likely to trust and open up when they know you truly care about them and take the time to hear their stories.
• Create a calm, safe place, with few people around, to reinforce that comforting space to talk.
• Strive to give the overall message that you are here to help.
• Assume the best about our child, not the worst. Above all, remember that we are people, and this is a child.

We acknowledge the NCSBY Caregiver Partnership Board for their words and wisdom.

Review the following responses and consider how you might use the helpful responses in your work.

To access the full tip sheet for professionals on, "Engaging Caregivers when Addressing Sexual Behaviors in American Indian/Alaska Native Children," see pages 79 - 82 or click here.

This section includes a list of resources and links to restore the the Sacred Circle and prevent PSB.

• Indian Country Child Trauma Center
• Healthy Native Youth
• National Child Traumatic Stress Network
  • Main page
  • Sexual Abuse
  • Child Sexual Abuse Fact Sheet: For Parents, Teachers, and Other Caregivers
• National Children's Alliance
• Keep Kids Safe
• National Congress of American Indians
• Native Youth Sexual Health Network 
• National Indian Child Welfare Association

For more resources, check out pages 115 - 120 in the Restoring the Sacred Circle Toolkit.