How Treatment Changes Harmful Behaviors
Maladaptive, reactive, or otherwise harmful sexual behaviors are often only symptoms of underlying struggles a youth may be facing. As we have said, the goal of treatment is to discover these route problems and address them.
“We’re going to identify different decisions or skill deficits that have led to this behavior, whether it is a trauma response, poor impulse control, communication difficulties, or anger management issues,” Ashlee says. She continues,
“For example, if impulse control is a problem, then we’re going to help the child be mindful of what they’re feeling, be mindful of what they’re desiring, do some sort of pro/con list or stop-think-go techniques to help them be able to think through decisions and take in all of the different factors that are at play when they’re making this decision. On the other hand, sometimes these behaviors are manifested because the child doesn’t have words to communicate what they’re feeling. We’re going to teach them: how can you communicate that you’re sexually aroused? How can you communicate that you’re feeling unsafe? How can you communicate you have a need that needs met, and how can you meet that need in a healthy way?”
Consider the specific problem behavior of sending sexually explicit photos to peers over the phone or social media. Because this behavior has become somewhat normalized among adults, a child or teen might believe this is an acceptable way to express their sexuality. How might treatment go about correcting this behavior?
In this particular example, one of the first things the treatment team would do is educate the consumer about the legality of this behavior. Child pornography laws often prohibit the sending or receiving of sexually explicit images of a minor, even if they are sent and received consensually. “It’s something that kids and parents can get in legal trouble for, and not many people actually realize that,” Ashlee says.
Next, the providers will work with the youth to determine why they are engaging in this behavior. “What needs are they trying to meet, or what is the goal there? And what are the healthy ways that they can now meet those needs or have that desired outcome?” Ashlee explains. “If it’s because they want to be in a relationship with someone, then we’ll talk about how we can build a healthy relationship. If their motivation for doing this is to be funny, or for shock value, then we’ll discuss how we can do this in a way that’s not going to run the risk of getting them into legal trouble.”
Once the providers understand what need the behavior is meant to fulfill, they will work with the youth to help them meet that need in a more constructive manner. Ashlee explains,
“If we’re working on, for example, building healthier relationships, that’s going to take time. We’re going to dive into: what examples of relationships have they seen that are good, or positive and healthy? What have they seen that’s not positive and healthy? What did they like about each? Then we’ll move forward and start to apply. We’re going to practice how we build those relationships. We’re going to roleplay communication. We’re going to roleplay interacting in ways that are appropriate and healthy. And we’re going to help them achieve that desired outcome in a healthy, prosocial manner.”