Children With Sexual Behavior Problems: Assessment and Treatment.

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Methodology - Procedure

1. Children with Sexual Behavior Problems

The children and caregivers were referred for assessment and/or treatment to the two sites (OUHSC and UW) through professional and self-referral. Various professionals referred the children, including child protection service workers, physicians, mental health professionals, and teachers. The project was discussed initially by phone with the parent/caregiver by the project director. This was to inform the adult about the research aspects of the project, to determine if the child met the criteria for inclusion in the treatment or comparison group, and answer any questions the parent might have. If the parent or caregiver was willing, an appointment was scheduled for an assessment session for the child and adult.

At the assessment session, the project was again explained to the parents/caregivers and the children, including the assessment process, the random assignment to treatment, the time limited group treatment approach, and the two-year follow-up period. Written consent (child) and consent (adult) forms were explained and signed by all participants. The children and caregivers completed the instruments and measures described above. The assessment session lasted from 3.5 to 4.5 hours, depending on the child's ability to attend and complete the measures.

If the child met criteria for treatment, the child and parent/caregiver were randomly assigned to the Dynamic Play Treatment (DPT) group or the Cognitive Behavioral Treatment (CBT) group. If there was more than one child in the same family who met criteria, they were randomly assigned together to avoid the parents/caregivers participating in both treatment approaches.

The groups were 12 sessions scheduled one hour weekly for the children followed by a one hour session for the parents. The therapists were a male and female doctoral level psychology student or post-doctoral psychologists. The same male/female pair conducted the children's and parent's groups, i.e., two therapists conducted the CBT groups and two different therapists conducted the DPT groups.

The groups met on different evenings of the week in the same rooms at Children's Hospital of Oklahoma. While the parents were in their session, the children were in two adjoining rooms for a one hour free play period. They were closely supervised by two female undergraduate psychology students. For example, they were escorted to and from the restrooms or drinking fountain; the children were directly supervised at all times to prevent any inappropriate behavior occurring at the treatment site. The two principal investigators at OUHSC (Bonner and Walker) reviewed the weekly videotapes and provided weekly supervision for the therapists. (A complete description of the CBT and DPT children's and parent's groups can be found in the attached manuals.)

At the final treatment session in both groups, the parents were asked to complete the post treatment instruments. If the children needed additional treatment, this was discussed and referral sources were given to the parents/caregivers.

At one and two years post-treatment, the parents/caregivers were contacted by phone to assess the child's current level of functioning and to obtain information on any sexual behavior problems post treatment.

2. Comparison Group Children

The assessment session for these children was conducted in the same manner as described above. Following the assessment process for these children, a session was scheduled to provide information to the caregiver about the results of the testing and to provide referral sources for any suggested follow-up for the children.

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