Treating an adolescent male who has engaged in intrafamilial harmful sexual behaviour: a case study

ABSTRACT

This paper provides rich detail and insight into therapeutic practice with a young person in treatment for harmful sexual behaviour (HSB). Using a single case-study design, the paper illustrates an application of the core treatment components of existing best-practice HSB frameworks when working within the context of intra-familial sexual abuse between children. The paper describes a short-term treatment comprising 10 individual sessions with a young adolescent male who engaged in intra-familial sexual abuse and attended for therapy in a private practice. Intervention targeted the HSB, healthy sexual development, and emotion regulation and included parental involvement, with observable and measurable positive outcomes. The paper emphasises the importance of adopting a holistic approach to treatment. Treatment delivery, outcomes and directions for future research are discussed in the context of the extant literature.

PRACTICE IMPACT STATEMENTUsing a single case-study design, this paper provides detail about intervention sessions that would otherwise be difficult to achieve in a larger scale study. The focus on the intricacies of intervention enhances the utility of this paper for researchers and practitioners in the field.

KEYWORDS:

• Sibling sexual abuse
• sexually abusive behaviour
• harmful sexual behaviour
• intra-familial
• treatment
• intervention

Acknowledgements

The author would like to thank her colleague for proof-reading an earlier draft of this manuscript. Also, to the author’s family for providing the time for the paper to be prepared; and to the wonderful clients and their families for inviting the author into their lives and “trusting the process”.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The term “harmful sexual behaviour” (HSB) is used in this paper to encompass all degrees of sexual offending and sexually harmful/abusive or problematic behaviour that may or may not have resulted in police involvement and subsequent charges.

2 All identifying information about this case study has been changed to protect the client’s confidentiality. This case shares similarities with many other cases the author has worked with.

3 Empirical findings about the PROFESOR are still underway but it offers a comprehensive summary of the risk factors and corresponding protective factors based on a review of the literature and are designed only for planning interventions and not predicting risk (Worling, 2017). The PROFESOR uses the protective factors of the DASH-13 which has been empirically assessed as being inversely related to the ERASOR although there is doubt as to whether the DASH-13 adds predictive utility to the ERASOR (Zeng et al., 2015).