oxbow-academy-postcast

The Importance of Therapy and Treatment in Dealing with Autism and Hypersexuality in Teenagers

As if dealing with autism wasn't difficult enough, hypersexuality can create additional challenges for teenagers and their families. Inappropriate behavior, unwanted advances, and poor social skills can make it difficult for these teenagers to navigate everyday situations.

That's where Oxbow Academy's treatment program for autism and hypersexuality comes in. In this podcast episode, Tiffany Herlin, LCSW, talks with Matthew Call, LMFT, about how Oxbow Academy's program provides individualized therapy to help your teenager manage their sexual behaviors. Autism experts specializing in hypersexuality treatment understand the unique needs of your teenager and will work with them to develop healthy coping strategies. Don't let autism and hypersexuality hold your family back. Start healing now.

Specialized Treatment for Autism & Hypersexuality in Teens

Navigating the complexities of autism and hypersexuality in teenagers can be overwhelming. As parents and caregivers, we face the daunting task of addressing our children's complex needs while ensuring their safety and well-being. But it is imperative for parents to recognize the need for further treatment when existing options fail, particularly if there's a concern about potential abuse. Join Tiffany Herlin, LCSW, and Matt Call, LMFT of Oxbow Academy as they discuss:

  • The importance of specialized residential treatment programs when outpatient therapy falls short.
  • The benefits and advantages of structured care tailored to teenagers with sexual behavior issues and autism.
  • The role of an evaluation period and testing to determine the best course of action for your son.
  • How programs like Oxbow Academy provide essential multidisciplinary support, helping teenagers build self-esteem and better futures.
Why-Seek-Specialized-Treatment

Concerned about your teen's escalating sexual behaviors? Don't wait. Get the support you need now. Oxbow Academy can help. We offer personalized support for families facing these challenges. Call 855-676-4272 to learn how we can guide your family toward healing.

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    Introduction

    Tiffany: Welcome back to our last episode. This has been such a great conversation. I hope parents who are listening feel like we've been able to touch on things they're struggling with and give them some guidance and resources that they can use.
    The last thing we're going to be focusing on is, say that parents have done outpatient therapy. They've set clear boundaries around technology.

    Matt: Which the kids have then subsequently railroaded right over.

    Tiffany: Yeah, and the parents are just feeling like nothing's helping their kids manage not only struggling with being autistic and the things that come with that, but also with hypersexuality and maybe even sexually acting out and pornography use that is deviant.

    Treatment for Hypersexuality and Autism

    Matt: Yeah, I mean, obviously being autistic by itself is not the challenge. The challenge is the things that go along with it. People don't need treatment for being autistic, but they might need treatment for being socially isolated. They might need treatment for depression. They might need treatment for engaging in stimming behaviors that are dangerous or unhealthy. And so that's really what we kind of have to challenge when we go in there.

    Tiffany: Specifically, when they're struggling with being hypersexual is what we're addressing.

    Matt: Exactly.

    Tiffany: Parents are feeling at their wits end and just at loss and not sure what to do. Maybe they worry that they are going to act out with someone that's younger than them or that they already have. What do parents do at that point?

    So we're here to talk about treatment options for their son. Now, as parents know, there's outpatient therapy, there's IOP (intensive outpatient therapy) as well. And once you've exhausted all those resources, the next step would be residential treatment.

    When should a parent seek out treatment for their son with autism and hypersexuality?

    Matt: The simple answer is when basically you've hit a point where the options that are available to you are just not there anymore. I think a lot of times parents will start looking at treatment when there is serious concern, that there might be abuse or if a report has already been made and CPS is saying, "You need to look into this."

    Tiffany: For our listeners, CPS is different for different states, but it strands for Child Protective Services.

    Matt: Yeah, Child Protective Services, DCFS, there's a lot of different names. But whatever that agency is in your state, the one that you have to make reports of suspected abuse to, a lot of times, those agencies will say, "You probably ought to look into treatment because there's a good chance that we're going to have to report this to the police, the police are going to investigate, charges might potentially come up."

    One of the things I often tell parents is if there's significant suspicion that this is going to be an issue and that it's going to turn into a legal issue, you might want to preemptively send a kid to a program like this.

    Tiffany: You should because it's going to be helpful.

    Matt: Yes. This is not me giving legal advice obviously, but the justice system is overworked, it's overbooked and one of the things I would tell the parents is anything you can do to make their job easier for them, they're going to appreciate it. If they don't have to hound your son down and try to get them into juvie or something like that and you are being proactive and saying we have taken steps to help with this, at the very least, it's going to reflect that you're taking this seriously and that you're wanting to do what needs to be done.

    And for some situations, especially if there has been abuse, parents do run the very real risk that if they don't do something, they could get their other kids taken away from them if there's suspicion this is happening and you're not taking appropriate steps. And so that's where those kinds of situations would often be useful.

    But also, if you have a strong suspicion and you're at your wit's end, and you haven't found anything else that has worked, then maybe that's the kind of situation you're in. For me, as a parent with autistic kids myself and as a clinician, almost everything I do is focused on attachment and about connection to family. And so there is nothing more antithetical to who I am as a person than to say, take somebody out of their family and put them somewhere else. And so I get that that is a heart wrenching, horrible experience that no parent ever wants to have to go through. But unfortunately sometimes it's necessary.

    Sometimes that is the only other option because the alternative is just far, far worse. And so, we don't make that decision lightly and I don't think any parent makes that decision lightly.

    Tiffany: Right. This shouldn't be your first step, this should be your 10th or 20th step when you've exhausted all your resources.

    And we've talked about earlier that the legal system is not always educated and understanding to kids who have autistic spectrum disorder, who have “offended” and they're going to treat them as an “offender” which will not be in your son's favor. And so that can be very scary as a parent. So finding placement for him and being preventative is important so that the legal system doesn't have to step in and guide that, and parents get to be in control.

    Finding the Right Placement

    Tiffany: One thing that I want to point out is there is support and help in this field of finding the right placement for your son. We have educational consultants, which are amazing. They do come with a cost, but I would say it's absolutely worth it because what they do is they come into this industry, they learn about all the programs, they develop relationships with all the people in the programs, and they specialize specifically in just knowing exactly what the programs offer.

    And so when you hire them and say, "Okay, my son, he's on the spectrum, he's struggling with sexual issues, what are my options? Or he's also struggling with suicide ideation." And there might be comorbidity as well with just not only being on the spectrum and acting out sexually and that educational consultant can come in and say, "Oh, here's three programs I want you to go visit and talk to and it would be a great fit for you," versus you having to go on the internet, Google something and hope that you find the right place. And there's so many of them. It's such a vast world that can be overwhelming. You're already in a crisis. So that's a great resource for parents so that they can have that support and help to find the right program.

    Let's talk about why someone might choose Oxbow versus another program that might treat their son for sexually acting out and also being on the spectrum, but they might also treat all sorts of things. Oxbow Academy is a specific program that deals with sex specific issues. And then on top of it, they offer testing within the first 90 days to see if your son really actually needs long term treatment with them. So they don't want to keep any child at Oxbow Academy that doesn't need sex specific treatment.

    Matt: Right, because potentially the kid could actually get worse if they shouldn't be in this kind of an environment and there shouldn't be this kind of a milieu (social setting).

    Tiffany: Yeah, and we can dive into that a little more of what that looks like. And then they also have a house that is specifically for kids who are on the spectrum, which is unique to other programs that may keep all the kids in the same milieu. What is the benefit to having a separate house, do you think?

    Benefits and Challenges of Separate Houses

    Matt: Well, the benefits are the exact same things as the disadvantages to it. I remember when I was in grad school, my diagnostics professor, when he was teaching us about autism, said, "The problem with autism isn't that this particular person is autistic. It’s that everybody else isn't."

    And so, in theory, you'd think that if we get all the autistic kids together, they're all going to kind of understand each other and it's going to be this wonderful environment. And for a lot of times there is some truth to that because they are going to understand each other. There's going to be a certain measure of empathy.

    But then we also run into situations like we talked about in one of the previous episodes where you got a kid who's hyper aroused and another kid who's hypo aroused. And they're clashing with each other and they're actually triggering each other and creating more problems.

    Now, having said that, the advantage for me is that when you have a program where this is the expectation, that we know this is the type of milieu we work with and we're getting our staff to understand specifically that these are the unique challenges you run into with this population, they're in a much better position to create the kind of culture that is going to be more neurodiversity affirming for them.

    And so the kids themselves may not create this ideal environment. It might end up looking a little more like Lord of the Flies for a while, but because of the environment of staff now understanding this is kind of the unique issues we work with and the kids themselves kind of starting to understand this is how things work here, they can pay that forward and help their peers understand this is kind of how things work.

    I've sat in a lot of groups where we'll have a kid that raises his hand and says, "I'm starting to clarify right now and I don't know what to do about it." And four or five other kids will raise their hands and be like, "Totally. I've been there. It was hard. This is what you need to do. Pay attention to this." And so there’s this taking that stigma out of it and putting kids in a situation where they're going to understand each other.

    Now, granted, if you've got a kid who's really good at masking or they're ambivalent about their diagnosis, they might be a little more hesitant to want to be at the East campus because they're like, "I don't think I'm ‘that autistic.’" But my experience has been a lot of times that still creates a positive experience for them because they get to see things triggered.
    It's kind of like being able to be surrounded constantly by mirrors. They can see themselves in some of their peers when they were younger or when they were less reactive or before they started doing their disclosure. And it gives them an opportunity to kind of take a look at that and say, "Oh, wow. Yeah, this is totally what it was like for me. I remember this is what I was like," that experience you talked about earlier with your daughters, where they got to see what it's like to be a mom for a minute and to not be listened to. And it's like, "Oh, wow, this really kind of sucks."

    Tiffany: Well, there's research that shows that group therapy can be more powerful and conductive than individual therapy. So when you are having your son go to a residential treatment setting that is a more controlled environment with fewer variables, and then also being with similar types of other teenagers who have similar struggles, it's going to be much more powerful for them to grow and learn from each other.

    And you and I have both seen this. I can't say how many times I've been in a session, I told one of my students like, "Hey, let's work on this or this is something you can do." And they'll blow me off. And then they sit in group therapy and their peers tell them the exact same thing. And they're like, "That's a great idea."

    And you're like, "I just told you that," but it doesn't matter. It's coming from their peers.

    Matt: I joke that you have to tell kids the same thing about a million times before it kind of sinks in. I repeat myself a lot. Any student who's ever worked with me knows that, "Yeah, Matt will repeat himself a lot," because you kind of have to. You have to repeat yourself a lot, but getting that repetition of, “my therapist is holding this boundary with me and then staff are holding this boundary with me and then I get out and my peers are prompting me on this same thing, that repetition and from multiple sources is going to get the kids to start to say, "Oh, maybe there's something to this."

    Experience and Evaluation at Oxbow Academy

    Tiffany: I've worked at Oxbow for a number of years and I actually was with Oxbow before we had different houses with different milieus and the kids separated. And when we decided to open up a house that we called the East house for kids who were autistic spectrum disorder, watching that shift and watching the boys move out of that population and being together, a miraculous thing happened. We had boys who normally wouldn't have stepped up and who had flown under the radar become leaders and gain confidence and the cool thing about Oxbow is they're able to, at times, where a student may do really well at that house and then they'll shift them back into the independent house with the other boys who are not on the spectrum to see how that they would function when they go home and they're not going to be surrounded by their same peers who are diagnosed the same.

    Matt: Or they find that sweet spot generally. I worked with a student for the entire 16 months where they never once got dropped from his independence level. And he maintained that and part of the reason he was able to do that was because he learned how to kind of take the things that were bothering him and he said, "Okay, I'm going to kind of store this up and I'm going to process it,” and then he and I would start walking across campus and sometimes he'd make it about halfway through and then he'd be like, "Okay, I just can't hold it anymore." And he would just start letting loose and just cursing and swearing. "I'm so freaking sick of these kids. They're driving me freaking crazy," or whatever, but because it gave him that chance to feel like I have a safe space that I can kind of have this vent and this outlet, he was able to find something that worked for him, which is kind of masking when I need to, I can kind of cope and regulate when I need to, but then I know there's a space here that when I finally need to just let loose and just vent all of this frustration. I have a safe space to be able to do that.

    And doing so was so good for him because he was able to find that sweet spot of, "this is my optimal functioning level," and sometimes the kids will do that.

    Tiffany: So I want to take a step back. For parents who are listening and don't know what Oxbow Academy offers, I think it's important to walk them through what to expect.

    Initially your son would go through about a 90 day period of an evaluation. It could take longer. It could take shorter, but we aim for about three months. And during that evaluation, they go to a specific house unless they're under an age, like they have specific houses that are specialized based off of age and based off of their social needs, but initially they go to an evaluation house and they go through this whole process of going through their full sexual history, creating a sexual disclosure, ultimately going and validating their story through what we call a clinical polygraph.

    If you want to know more about it, we have a lot of information on the website. It's not the way that parents or people may be aware of that we see on social media where it's used as an interrogation tool in the legal system and someone's in a basement, yelling at your son, trying to catch him in a lie. We don't believe in it being used that way.

    The way that it's used is a way to validate their story, not catch them in a lie. So it's ultimately us working with the student as a therapist saying, we want to prove that you're telling the truth.

    Matt: And that's helpful for the kids sometimes because a lot of times they'll find themselves in a spot where "I've told mom and dad the whole truth, I've told them everything and they still don't believe me."

    And it's helpful for the parents because one of two things happens. Either they're like, "Okay, well I already knew that. That's good to know that we know the full story." Or sometimes it's like, "Oh, I'm so glad it's not worse than I thought it was," because parents can run all sorts of scenarios through their heads.

    And like, “We know that it happened with this person, but did it also happen with this person?” And there are other victims that I'm not going to know about. And something about getting that and being able to be like, we have the full puzzle pieces. We know the full story. That's helpful. So it can sometimes actually alleviate that anxiety and now we have a much clearer picture of what we're dealing with.

    Tiffany: Well, it helps build trust again, which is ultimately what we're trying to do. There's been a fracture between a parent and their child and trust has been lost and it's to help create trust and rebuild that relationship back up.

    And that's ultimately what the goal is for the polygraph and then the evaluation. And a student is never sent to a polygraph without being fully prepared. It may take a month before they go, maybe even longer, depending, because we want to make sure that they are successful and pass, right? We don't want them to fail.

    And if they do fail, then they come back and they do more work and they're not punished. They're not ashamed. It's just, "Okay. It sounds like you have more work to do before we can successfully pass."

    Matt: Yeah. One of the things I will often say to kids at that point is when a kid's coming in and they've failed a polygraph, and actually even honestly, before they go to the polygraph, the way that I will usually phrase it is, "Okay, and what else?"
    Because if you ask them, "Is there anything else?" Most likely they're going to say no, right? But if you presuppose and assume that there is something else and you say, "Okay. So we know you failed the polygraph and we know you failed this particular question or were these two or three questions where it talks about, 'do you have any other victims?' So we know you failed that. So who are your other victims?"

    And you just assume that that's going to be there.

    And it's, "Okay, well, I swear there wasn't anybody else."

    "Oh, okay. So what you're telling me is you're not ready to talk about that yet. Okay. Well, let me know when you are because when you're ready, we can talk about who these other people are."

    Tiffany: Or what else is going on.

    Matt: Right. Exactly.

    Tiffany: Yeah. So once they successfully pass, the cool thing about Oxbow is it's not like if you were to go hire a psychologist to do a psychosexual evaluation and send your child for a couple hours or maybe a day or two to be evaluated by the psychologist. The cool thing is that we get to help the parents choose a psychologist of their choice. It's separate from someone at Oxbow, so it's not an in-house and biased person. They're creating an evaluation that's separate from Oxbow.

    And we get to send over a write up of how their son has done clinically for the past 90 days, how they're doing academically and residentially. And when you think of residential, it's a whole team effort. Whereas when your child's at home, it's just you and possibly a significant other.

    Matt: Which no parent can do.

    Tiffany: No one can do that.

    Matt: That's just not possible.

    Tiffany: Yeah. Especially with this issue. Whereas in a residential setting, you have staff who are coming on and off shift, so they're refreshed. You have teachers who are working with your son and then therapists and groups, and we're all working together as a team and constantly talking about each student.

    Matt: And the truth is that even with all of that, students will still act out. Students will still find ways to kind of go around those rules. And I think that's especially helpful for parents cause then it's validating to be like, "Oh, so this isn't just me. This isn't just me being a bad parent."

    We've got a whole team of people that's watching this kid 24/7 and he still managed to get so and so to do such and such.

    Tiffany: Or find pornography.

    Matt: Yeah, exactly.

    Tiffany: But it's obviously more controlled in an environment with smaller windows to do anything like that. Oxbow is also unique in that they have windows and cameras and their staff are all individually trained to create a safer environment because of the issue we're dealing with.

    But backing up real quick, going back to the testing, we send all this information to a psychologist and the past polygraph, and they then write up a psychosexual evaluation with a risk assessment of what their son's level of risk is. Do they need sex specific treatment long term or do they need something else? And what are the recommendations for treatment so that there is a specific individualized treatment plan for their son, not something that's just cookie cutter.

    Matt: And sometimes the answer is going to be no. I actually just ran into this last week and got an assessment back from a kid and the evaluator said, “This kid needs some sex specific work, but he doesn't need it at a residential level. He probably needs some psychosexual education that needs to account for these kinds of things and that's what the kid needs."
    And so, the nice thing about doing that evaluation through a third party, is as a clinician, I'd like to think that after almost seven years doing this, I have a pretty good read on kids and I'd do a pretty good job of being able to tell this is probably a kid that's going to need help. But I've been wrong before, you know?

    And so it's helpful for me personally to know I'm not just jumping at shadows and what I'm actually seeing seems to be based upon some actual empirical data, not just my own best judgment, which admittedly is flawed.

    Tiffany: Yeah. Well, we're human. And like I said, we're going to be biased in various ways. We work with other programs as well. There's different programs out there that specifically work with kids who are on the spectrum. They may not work with the sexual piece, but they work with kids who are on the spectrum.

    And we've had kids sent to us from other programs who started sexually acting out or posing some threats to their other students and we're worried about them. I have one boy that I'm thinking of in particular, who came, was tested, did not need us, really was just struggling with understanding the social skills, the boundaries, what healthy sexual relationships really look like. He only needed us for about a month or two, passed his evaluation, and then we had him go back to that program to keep working on his other issues.

    Benefit of Oxbow Academy

    Tiffany: And that's a benefit of a place like Oxbow versus another program. And, and so that's something that can really help ease parents anxiety around this issue because it's scary. It's scary to send your kid away. It's scary to be in crisis where you really don't have a choice but to send them away. Otherwise, there may be legal issues that veer your son a different direction that you're scared of.

    And so Oxbow Academy has a safe place to get them fully evaluated and tested to say what's really going on. And if there are legal ramifications or involvement with the courts, then this can be really helpful in the courts to say, “Look, we've had him tested. Here's his level of risk. He's going to get the help at Oxbow” or “He's actually a low risk and here are our options and what's recommended.” It's going to help your son in his favor in so many ways.

    Matt: Yeah. Having that document in place is important. Let's say hypothetically, you've got a kid and the issue is not necessarily sex specific. There was a sexual component to it, but you're thinking maybe that a program that's more neurodivergent specific is needed. That's what we feel like he needs, but they say, “Well, he's got some sexual stuff in his history. So we have to rule that out.” Being able to take that testing to that program helps them with their potential liability of being able to say, “He's been independently assessed. This is our opinion. He doesn't seem like he's a high enough risk that that would be a problem,” and then that gives them an opportunity to say, “Okay, we might be able to potentially take your son now.”

    Tiffany: A lot of programs won't take kids if they're sexually acting out. That puts their program at risk. If they're not specific to dealing with sexual issues, then they're not going to be able to handle that.

    There's so much more we could talk about with what Oxbow Academy can offer. You can go online to learn more about the program or even call us. Know that after the evaluation, if your son does need sex specific treatment and is on the spectrum, he then would go to a house, this East house is what it's called, that is specifically for kids on the spectrum who are dealing with sexual issues.

    Housing and Progression

    Tiffany: So he'd be in a milieu that provides safety for him with peers who are struggling with similar themes and maybe not necessarily in a milieu that has students who are neurotypical who might be more planned out and have different motives of why they sexually acted out.

    Matt: Yeah. And having said that, there is also a possibility that your student might eventually find his way over to the neurotypical campus.

    It's not uncommon for students who have kind of hit a point where they're now becoming stagnant in that environment at East campus and among that group of kids to be able to say basically I've reached the peak of what I'm able to do at this point. And then the challenge is, let's try to recreate the environment of what it's going to look like outside of Oxbow a little more realistically, where you can be in a mixed group of people and not just around kids that are neurodivergent.

    And then of course we also have the independence house, which gives kids an opportunity to start to regain some access to internet technology and things like that, and have access to cell phones. That also would potentially give them an opportunity to start to have some scaffolding to kind of get them ready to go back home. So it's not just like I've been in this program for a year and I haven't even seen an internet connected device for the last year. And now all of a sudden I'm home and how do I navigate that change?

    Tiffany: So that's a great thing about Oxbow is it offers specific houses that meet the kids where they are at and where they need to progress to. So that independent house you're talking about is, like you said, right before they get to go home. How are they going to deal with extra freedoms, especially around technology?

    Matt: And every week when we meet in the treatment team, one of the things that's on our agenda every week is, where are the students at and do we need to make any house changes? We assess that every single week. We sit down and we say, “Okay, how's this kid doing? Does he feel like he still needs to stay at the East house? Does he feel like a kid who maybe is ready to kind of move on to independence or is he ready to move on to West campus or whatever?”

    And so that's something we're constantly assessing, every week.

    Tiffany: For parents who aren't familiar with residential settings, every week, the whole team gets together. So that means the therapist, teacher or academic director, residential director, the head over all the staff, and they get together and talk about each student of how they're progressing. So again, it's a whole team effort of helping your son grow and heal in this very difficult journey.

    Schooling and Safety

    Tiffany: And that brings me to my last thing. I think parents ask, is there school? Absolutely. We provide a credentialed schooling environment with teachers and online learning as well, for those who are able to manage online, and so it's a blended learning model. And so your son wouldn't get behind in school.

    And then lastly, parents ask me, is my kid going to be safe? And that's a legitimate concern, knowing that you're sending your kid away to a place you don't know. I would ultimately say as you're in this process, if you do need to find residential treatment, go tour the program. It's one thing to look online and to see the program and to talk to the people, but you want to go there. A way that you're going to know that a program is safe, especially dealing with sexual issues, is are the staff specifically trained on what to do to keep the peers safe? Are there cameras in rooms? We actually go to the extent that there's windows on all of our office doors. So that it not only keeps the student safe, it also keeps us safe as therapists as well.

    So there's transparency on all levels that allows a culture that says, yes, we talk about this topic openly and we're also creating transparency and safety. So it's not shame based and we know all that's going on and there's a very small window of any major risks for students to act out and to get themselves in trouble or hurt other people.

    Matt: There's an old poem that talks about a situation where there was a valley where people like to go on the edge of this cliff and look over and watch it because it was so beautiful, but they kept falling off of it. So they get together and they say, what do we do? Do we put a fence around the cliff or do we put an ambulance at the base of the mountain? And initially, they put the ambulance there and it just keeps picking people up off the ground. And then finally someone comes along and says, this is stupid. Why don't we put a fence around that?

    And one of the key things to understand with staff is that a lot of the stuff that we're doing is preventative stuff, that we're monitoring kids for preventative things, stuff that may not necessarily be a problem in and of itself, but that learning how to kind of guard against those small infractions, those small moments where they're breaking boundaries, it actually helps prevent a lot of big problems down the road.

    Preventative Measures and Boundaries

    Matt: So for example, your student might talk about, “well, it's so obnoxious. Anytime I want to go behind a staff member, I have to stop and say, can I go behind? That's so dumb and I hate it.” Or I have to ask to cross a threshold. I have to go ask to open the fridge and they hate that because those are things they've been able to just kind of take for granted.

    But the thing is, if we have those kinds of rules in place, what that does is that creates an environment where we're teaching them consent on a daily basis. Every time they want to enter a room or exit a room, they're having to practice the skill of, I have to actually stop and ask for permission for something, which is going to train them to start to use consent, to start to actually ask for things instead of just taking it.

    I had the same thing in my office. I've got a bowl of candy and it's always fun, kids walk in there and they just reach for something and I say, "Hey, did you ask for that?"

    "No, I didn't."

    "Okay. Well, do you want to ask for it?"

    "Yeah. Can I have a piece of candy?"

    "Sure you can."

    It’s those little things that actually help teach that consent on a moment to moment basis, but it also creates those small boundaries so that a lot of the bigger issues are going to happen.

    And honestly, what we'll often see is when kids do engage in the bigger problems like actual sexual acts out with other peers, a lot of times it's because they've started off by disrespecting these smaller rules, the small areas of boundary crossing. And when those are not consistently held, that's when kids start to say, "Well, how far can I push this boundary?"

    Tiffany: Well, and just to clarify for parents, there's so much transparency and boundaries set at Oxbow that the window of opportunity is so small. It's just a matter of seconds, the window of opportunity versus, maybe an hour at home that they would have. So keep in mind that's why Oxbow is set up the way it is, to create safety so that kids can grow, heal, and progress and move past this issue that most kids don't want to keep, they want to have to be different. They want to move past this issue and learn how to connect and attach in a healthier way.

    Success Story of a Student

    Tiffany: Let's end on a success story you may have of, it can be a specific one or any general that you've seen working with students who are on the spectrum and acting out sexually at Oxbow.

    Matt: I do have one. I've got a lot of kids that I've loved working with over the years, but I got to tell you, there's one in particular that always sticks out for me. This particular student, when he arrived at Oxbow, his dad brought him in a truck, they borrowed a truck and he pulled into the parking lot and we sat down and we did the orientation meeting and the kid knew that it was going to be time pretty soon for dad to be leaving.

    And being a kind of a stoic autistic kid, he was bottling up a lot of his emotions and trying to be respectful. And suddenly when he saw his dad get into the truck, he just knew he couldn't do that anymore. So he ran and he hid under the truck.

    Tiffany: I remember this.

    Matt: And we sat there and we cajoled and we talked and we tried to encourage and like, "Come on, bud. Come on out." And eventually our late equine director Tony North was able to kind of come over there and say, "Hey, do you want to come see the horses?" And, eventually the kid came out and we got him out, but you know, I worked with this kid for a year and a half and he did amazing work.

    And he's graduated high school now and has just really come a long way. And I think one of the biggest things that, for me, the most rewarding experience about working with this kid was that this was a kid who just genuinely has a lot of love in his heart. And he wants to have good relationships with other people, but he just struggled partially because he just doesn't get social cues and just didn't get social cues at the time. He was constantly at this low boil where he was always getting kicked out of his window of tolerance. He didn't know how to manage that.

    When he finally found a space to be able to say, "I'm not a bad kid and I actually have good things that I contribute and there's people that care about me and that want me to be in their lives."

    I did a lot of sand tray therapy with this kid. And at one point we had a sand tray and he was sitting there and he had this nest with these three eggs in it. And it was significant because there were two white eggs and there was a brown egg. And so he saw himself as the brown egg, the outsider, and he was sitting there and he had this nest and there were the two eggs and the one on the side.

    And he sat there and he just looked at it for a while. And then picked up the egg and he put it next to it. And he said, “It belongs.” And I said, “yeah, it does. It belongs.” And for him, that was the big moment of, “I'm not this outsider. I’m still wanted. I'm still cared about.” I could have talked about this kid for hours, but you know, he did incredible work and I think moments like that just make my job just so fun. It's so fun.

    Rewarding Results and Conclusion

    Tiffany: It's just so rewarding to see the kids from the very beginning come in with just no self esteem, no idea of a future. And then to leave believing in themselves, seeing themselves as a new man and that they do have a future. There's hope and that what they did doesn't define them. They have a second chance.

    That's what makes our job worth it. It's hard work, what we do, like without a doubt and those moments are what make it all worth it

    Well, thank you so much, Matt, for joining us and talking about this really important topic. And we hope that as a parent, if you're listening, that you were able to walk away with some hope, knowing that you're not alone and that there are resources and help and support for you out there.

    Thank you again for joining us for this podcast.

    Matt: Thank you.

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