How is Oxbow Different from Other Programs?
Many residential programs have an unofficial “three strikes” policy. This means that the first time that there is an incident, the program will provide additional structure, hoping the behavior will subside. The treatment team will often request a Sexual Risk Assessment for the student, but in the mean time, they keep the student apart from others and they increase supervision over him. This only fosters shame and guilt while decreasing opportunities to build trust towards disclosure. This makes the accuracy of the Sexual Risk Assessment questionable. When the behaviors eventually continue, the student becomes more sneaky and sophisticated and more problems arise.
Research presented at an Association for the Treatment of Sexual Abusers (ATSA) conference a few years ago showed that the most effective way to work with students with sexual behavioral problems is in a homogeneous population. There are many programs, hospitals, and residential settings that have a “tract” or a “wing” where the students who struggle with sexual issues work on their problems. Although they have good intentions and caring staff, this is not the most effective clinical arrangement.
Because of the shame and guilt associated with sexual issues, teens are great at playing “information poker,” meaning that they only lay down the cards that people already know about. The rest of their “cards” they keep close to the vest. It’s this “game” that makes adolescents with sexual behavioral problems so hard to work with.
Many may look at the model of treating students in a homogeneous population and think of treatment that focuses on addiction. While there are some important similarities, such as emotional support, safety in discussing the issues in a group, and even some bio-chemical aspects of addiction that are relevant, these are not the main reasons. The number one benefit of a homogeneous population is that it establishes a culture that disrupts patterns and assists students in developing a relationship with honesty.
Culture of Cooperation
Todd Spaulding, the clinical director at Oxbow Academy, mentioned an experience he recently had with a student on his caseload. This student was previously at another residential program where he sexually acted out. A couple of weeks after admission to Oxbow, this student wrote the classic “pull me” letter to his parents, stating that “I hate it here. The other students don’t like me! They treat me like a monster! This isn’t where I belong! I’m not fitting in.”
Based on reports from Oxbow’s residential and academic departments, Todd discovered that this student was testing his surroundings and the willingness of other students to not “follow the rules”. Anytime he broke a physical or emotional boundary, his peers reprimanded him. For example, when he sat too close to another students, his peers asked him to give the other student space. Another example happened when he passed a note and his peers called a group to discuss it. His patterns were being disrupted, which is an uncomfortable but necessary process for students to work through. It is imperative that these patterns of manipulation are disrupted before “treatment” can begin.
Is Oxbow Academy a Good Fit for Your Son?
When deciding how serious your son’s sexual problems are, it is important to consider his specific behaviors and patterns. As you are considering this, these are some guidelines that can help you compare what are common and normal among adolescents and what are not:
Common Adolescent Sexual Behaviors
There may be emotional consequences associated with some of these behaviors. If needed, outpatient treatment should be sufficient.
- Sexually explicit conversations with peers
- Obscenities and jokes within cultural norm
- Sexual innuendos
- Flirting and courtship
- Interest in erotica
- Solitary masturbation
- Hugging, kissing, holding hands
- Foreplay (petting, making out, fondling) and mutual masturbation. There may be moral, social, religious, or familial rules that discourage this behavior, but these behaviors are not abnormal or illegal when private, consensual, equal, and non-coercive.
- Monogamist intercourse: Stable monogamy is defined as a single sexual partner throughout adolescence. Serial monogamy indicates long-term (several months or years) involvement with a single partner which ends and is then followed by another. Once again, there may be moral, social, religious, or familial rules that discourage this behavior, but these behaviors are not abnormal or illegal when private, consensual, equal, and non-coercive.
Although some of these yellow flag behaviors are not necessarily outside the range of behavior exhibited in teen peer groups, there should be a serious assessment made in order to rule out any “red flag” and/or illegal behaviors. When they are exhibited in the context of more than one issue that is listed below, or patterns develop, please seek further evaluation.
- Sexual preoccupation/anxiety (interfering in daily functioning)
- Pornographic interest (type is a factor, like bestiality, child, violent)
- Sexual intercourse/promiscuity (indiscriminate sexual contact with more than one partner during the same period of time)
- Sexually aggressive themes/obscenities
- Sexual graffiti (especially chronic and impacting individuals)
- Embarrassment of others with sexual themes
- Violation of others’ body space
- Pulling skirts up/pants down
- Single occurrence of peeping, exposing with known peers
- Mooning and obscene gestures
- Masturbation to underwear (very common)
Red flag behaviors need further specialized evaluation. Boys rarely just have one red flag problem and will usually reveal patterns involving multiple yellow and red flag behaviors upon further inspection.
- Compulsive masturbation (especially chronic or public)
- Degradation/humiliation of self or others with sexual themes
- Attempting to expose others’ genitals
- Chronic preoccupation with sexually aggressive pornography
- Sexually explicit conversation with significantly younger children
- Obscene phone calls, voyeurism, frottage, exhibitionism, sexual harassment
- Touching genitals without permission (i.e., grabbing, goosing)
- Sexually explicit threats (verbal or written)
- Sexual contact with significant age difference (sibling, neighbor, relative)
- Coerced sexual contact
- Coerced penetration
- Sexual contact with animals (bestiality)
- Sexting (the use of electronic devices to send sexually explicit photos of oneself or others)
It is important to understand your son’s behaviors in terms of “risk”. Risk is determined by the efforts your teen takes to avoid structure or rules created by you to extinguish his bad behaviors. To give an example, imagine a scenario where a teen uses his family’s computer to view pornography. In response, his parents put a block on their computer. If this teen hacks through the block to continue access, he puts a trusting relationship with his parents at risk. Continuing this scenario, imagine his parents taking away their internet service. After that, they catch their son using their neighbor’s home to access porn on their computer. This behavior is not just risking parental trust, but also neighbor relationships and potential legal action. This teen is willing to take risk associated with continuing his behavior even after it caused familial and/or social consequences.
Where to Start for Help?
The first phase of treatment is our 90-day evaluation. Your son can integrate into academics, residential living, and therapy. With a therapist, your son will give a full sexual and non-sexual disclosure. Once your son completes his disclosure and has shared everything with his therapist and family, we schedule a validation test. This validation test validates you son’s honesty. We then send summaries of his efforts in academics, residential, and therapy, along with his validation test results, to a psychologist who can give a psycho-sexual evaluation. You and referring professionals will receive an integrated functional assessment, psychological testing, and Sexual Risk Assessment. From this, you can know what kind of care you son needs.
- Parents only commit to the first 90 days
- Referring treatment programs can have students return if clinically appropriate
- Allied professionals have a clinically sophisticated option to discuss with families
- Families have a clinically sophisticated option to discuss with their home therapist
- Students are fully engaged in academics, residential activities, and therapy prior to and during testing
- Clinical use of the validation test encourages the student to “lay all the cards on the table”, which helps them complete an accurate treatment plan