Catalyzing Transformation in Youth Services: Engaging Families in Problematic Sexual Behavior Interventions

Background and Purpose:
Many children and adolescents with Problematic Sexual Behaviors (PSB) do not receive effective, evidence-based treatment—despite its proven success, with recidivism rates as low as 2% (Carpentier et al., 2006; Silovsky et al., 2019). Ensuring access to these services is critical for reducing child sexual abuse incidents involving youth and supporting the well-being of those with PSBs. This convergent mixed methods study, conducted in partnership with a statewide service provider, explored the strengths and barriers to engaging families in PSB treatment to inform policy and practice changes.

Methods:
The study combined quantitative analysis of clinical case records (2011–2021) with qualitative interviews to identify patterns in family engagement. Quantitative data included pre- and post-treatment behavior assessments using the Youth Sexual Behavior Problems Inventory and satisfaction surveys. Qualitative data came from interviews with 10 professionals and 3 caregivers. The majority of the 317 youth served were non-Hispanic Black (73%), male (85%), and averaged 11.69 years old. Nearly half of all cases (48%) were referred through the child welfare system. Descriptive and inferential statistics were used alongside framework analysis of the interviews.

Results:
Treatment engagement was high, with over 64% completing the program. On average, families attended 14.56 individual/family sessions and 3.69 group sessions. Youth showed a significant reduction in problematic sexual behaviors, with average behavior scores decreasing by 5 points (p < .001), resulting in fewer than one problematic behavior at discharge. Barriers to engagement were emotional (e.g., shame, stigma, trauma) and logistical (e.g., transportation, childcare, scheduling). Key facilitators included logistical support, virtual therapy options, emotional validation, and social support. Integrating findings showed that when these barriers were addressed, engagement improved and behavior problems significantly declined.

Conclusions and Implications:
Effective PSB treatment can lead to substantial behavior improvements when youth and families are fully engaged. Raising awareness of PSBs and the availability of effective treatments, along with addressing common barriers, can enhance engagement and improve outcomes. These findings support the need for targeted outreach and systemic changes to better support youth with PSBs and their families.