This meta-analysis of 11 treatment outcome studies evaluated 18 specific treatments of sexual behavior problems (SBP) as a primary or secondary target. Specifically, it examines relations among child characteristics, treatment characteristics (including practice elements), and short-term outcome (including sexual and general behavior problems). Utilizing pre- and postintervention results, the overall degree of change over the course of treatment was estimated at a 0.46 and 0.49 standard deviation decline in SBP and general behavior problems, respectively. As hypothesized, the caregiver practice element Parenting/Behavior Management Skills (BPT) predicted the Child Sexual Behavior Inventory (and the Child Behavior Checklist when BPT was combined with caregiver Rules about Sexual Behaviors). In contrast, practice elements that evolved from Adult Sex Offender (ASO) treatments were not significant predictors. BPT and preschool age group provided the best model fit and more strongly predicted outcome than broad treatment type classifications (e.g., Play Therapy or Cognitive Behavior Therapy). Results question current treatments for children with SBP that are based on ASO models of treatment without caregiver involvement.
Achenbach, T.M., & Rescorla, L.A. (2001). Manual for the ASEBA school-age forms and profiles: An integrated system of multi-informant assessment. Burlington: University of Vermont, Research Center for Children, Youth, & Families.
2.
Akaike, H. (1973). Information theory and an extension of the maximum likelihood principle. Paper presented at the Proceedings of the Second International Symposium on Information Theory, Akademia Kiado, Budapest, Hungary.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Azen, R., & Budescu, D.V. (2003). The dominance analysis approach for comparing predictors in multiple regression. Psychological Methods, 8(2), 129-148.
6.
Becker, B.J. (1988). Synthesizing standardized mean-change measures . British Journal of Mathematical and Statistical Psychology , 41(2), 257-278.
7.
*Berliner, L. & Saunders, B.E. (1996). Treating fear and anxiety in sexually abused children: results of a controlled 2-year follow-up study , Child Maltreatment, 1(4), 294-309.
8.
*Bonner, B.L., Walker, C.E., & Berliner, L. (1999a). Children with sexual behavior problems: Assessment and treatment-final Report (Grant No. 90-CA-1469). Washington, DC: U.S. Department of Health and Human Services, National Clearinghouse on Child Abuse and Neglect.
9.
Brestan, E., & Eyberg, S. (1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180-189.
10.
Burke, J.D., Loeber, R., & Birmaher, B. (2002). Oppositional defiant disorder and conduct disorder: A review of the past 10 years: Part II. American Academy of Child and Adolescent Psychiatry, 41, 1275-1293.
11.
Burton, D.L., & Smith-Darden, J. (2001). North American survey of sexual abuser treatment and models: Summary data 2000. Brandon, VT: Safer Society Press.
12.
Carpentier, M., Silovsky, J.F., & Chaffin, M. (2006). A randomized trial of treatment for children with sexual behavior problems: Ten year follow-up. Journal of Consulting and Clinical Psychology, 74(3), 482-488.
13.
Chaffin, M., Berliner, L., Block, R., Johnson, T.C., Friedrich, W., Louis, D., et al. (2008). Report of the ATSA Task Force on Children with Sexual Behavior Problems. Child Maltreatment, XX, xx-xx.
14.
Chaffin, M., Letourneau, E., & Silovsky, J.F. (2002). Adults, adolescents and children who sexually abuse children. In J. Myers, L. Berliner, J. Briere, C. T. Hendrix , C. Jenny, & T. A. Reid (Eds.), The APSAC handbook on child maltreatment (2nd ed., pp. 205-232). Thousand Oaks, CA: Sage.
15.
Cheung, M.W.L., & Chan, W. (2005). Meta-analytic structural equation modeling: A two-stage approach. Psychological Methods, 10(1), 40-64.
16.
Chorpita, B.F., Daleiden, E.L., & Weisz, J.R. (2005). Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research, 7(1), 5-20.
17.
Cohen, J.A., Deblinger, E., Mannarino, A.P., & Steer, R.A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43(4), 393-402.
18.
*Cohen, J.A., & Mannarino, A.P. (1996a). A treatment outcome study for sexually abused preschool children: Initial findings. Journal of the American Academy of Child and Adolescent Psychiatry, 35(1), 42-50.
19.
*Cohen, J.A., & Mannarino, A.P. (1997). A treatment study for sexually abused preschool children: Outcome during a one-year follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 36(9), 1228-1235.
Cohen, J.A., Mannarino, A.P., & Deblinger, E. (2003). Child and parent trauma-focused cognitive behavioral therapy treatment manual. Pittsburgh, PA, and Newark, NJ: Allegheny General Hospital and University of Medicine and Dentistry of New Jersey.
22.
Deblinger, E., & Heflin, A.H. (1996). Treating sexually abused children and their nonoffending parents: A cognitive behavioral approach. Thousand Oaks, CA: Sage.
23.
Deblinger, E., Lippman, J., & Steer, R.A. (1996). Sexually abused children suffering from Post Traumatic Stress symptoms: Initial treatment outcome findings. Child Maltreatment, 1, 310-321.
24.
*Deblinger, E., Stauffer, L.B., & Steer, R.A. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their nonoffending mothers. Child Maltreatment, 6(4), 332-343.
25.
Deblinger, E., Steer, R.A., & Lippmann, J. (1999). Two-year follow-up study of cognitive behavioral therapy for sexually abused children suffering post-traumatic stress symptoms . Child Abuse & Neglect, 23(12), 1371-1378.
26.
Fernandez, G.C. (2007, April). Model selection in proc mixed-A user friendly SAS macro application. Paper presented at the SAS Global Forum 2007, Orlando, FL.
27.
Finkelhor, D. (1984). Child sexual abuse: New theory and research. New York: The Free Press.
28.
Friedrich, W.N. (1996). An integrated model of psychotherapy for abused children. In J. Briere, L. Berliner, J. A. Bulkley , C. Jenny, & T. Reid, (Eds.), The APSAC handbook on child maltreatment (pp. 104-118). Thousand Oaks, CA: Sage.
29.
Friedrich, W.N. (1997). Child sexual behavior inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.
30.
Friedrich, W.N., Davies, W., Fehrer, E., & Wright, J. (2003). Sexual behavior problems in preteen children: Developmental, ecological, and behavioral correlates. Annals of the New York Academy of Sciences, 989, 95-104.
31.
Friedrich, W.N., Fisher, J., Dittner, C., Acton, R., Berliner, L., Butler, J., et al. (2001). Child sexual behavior inventory: Normative, psychiatric, and sexual abuse comparisons. Child Maltreatment , 6, 37-49.
32.
Friedrich, W.N., Grambsch, P., Damon, L., Hewitt, S.K., Koverola, C., Lang, R.A., et al. (1992). Child sexual behavior inventory: normative and clinical comparisons. Psychological Assessment, 4, 303-311.
33.
Friedrich, W.N., & Lueke, W. (1988). Young school-age sexually aggressive children . Professional Psychology-Research & Practice, 19, 155-164.
34.
*Friedrich, W.N., Luecke, W.J., Beilke, R.L., & Place, V. (1992). Psychotherapy outcome of sexually abused boys . Journal of Interpersonal Violence, 7(3), 396-409.
35.
*Gagnon, M.M., Tremblay, C., & Bégin, H. (2005). Intervention de groupe auprès d'enfants présentant des comportements sexuels problématiques: évolution comportementale, affective et sociale [Group intervention for children with sexual behavior problems: Behavioral, affective and social development]. Santé mentale au Québec, 30(2), 257-279.
36.
Gray, A., Pithers, W.D., Busconi, A., & Houchens, P. (1999). Developmental and etiological characteristics of children with sexual behavior problems: Treatment implications. Child Abuse and Neglect, 23(6), 601-621.
37.
Hall-Marley, S.E., & Damon, L. (1993). Impact of structured group therapy on young victims of sexual abuse. Journal of Child and Adolescent Group Therapy , 3(1), 41-48.
38.
Hembree-Kigin, T.L., & McNeil, C. (1996). Parent-child interaction therapy. New York: Plenum.
39.
Hoeting, J.A., Davis, R.A., Merton, A.A., & Thompson, S.E. (2006). Model selection for geostatistical models. Ecological Applications, 16(1), 87-98.
40.
Johnson, T.C. (1988). Child perpetrators-children who molest other children: Preliminary findings. Child Abuse & Neglect, 12, 219-229.
41.
Johnson, T.C. (1989). Female child perpetrators: Children who molest other children. Child Abuse & Neglect, 13, 571-585.
42.
Kass, R.E., & Raftery, A.E. (1995). Bayes factors. Journal of the American Statistical Association, 90(430), 773-795.
43.
Kenward, M.G., & Roger, J.H. (1997). Small sample inference for fixed effects from restricted maximum likelihood. Biometrics, 53(3), 983-997.
44.
Little, R., & Yau, L. (1996). Intent-to-treat analysis for longitudinal studies with drop-outs. Biometrics, 52(4), 1324-1333.
45.
Manor, O., & Zucker, D.M. (2004). Small sample inference for the fixed effects in the mixed linear model. Computational Statistics & Data Analysis, 46(4), 801-817.
46.
McCart, M.R., Priester, P.E., Davies, W.H., & Azen, R. (2006). Differential effectiveness of behavioral parent-training and cognitive-behavioral therapy for antisocial youth: A meta-analysis. Journal of Abnormal Child Psychology, 34(4), 527-543.
47.
McGrath, J., Cumming, G.F., & Burchard, B. (2003). Current practices and trends in sexual abuser management: The Safer Society 2002 Nationwide Survey. Brandon, VT: Safer Society Press.
48.
Morris, S.B. (2000). Distribution of the standardized mean change effect size for meta-analysis on repeated measures. British Journal of Mathematical and Statistical Psychology, 53(1), 17-29.
49.
Niec, L.N., Hemme, J.M., Yopp, J.M., & Brestan, E.V. (2005). Parent-child interaction therapy: The rewards and challenges of a group format. Cognitive and Behavioral Practice, 12, 113-125.
50.
Nixon, R. (2002). Treatment of behavior problems in preschoolers: A review of parent training programs. Clinical Psychology Review, 22, 525-546.
51.
Paul, G.L. (1967). Outcome research in psychotherapy. Journal of Consulting Psychology, 31, 109-118.
52.
*Pithers, W.D., Gray, A., Busconi, A., & Houchens, P. (1998). Children with sexual behavior problems: Identification of five distinct child types and related treatment considerations. Child Maltreatment, 3(4), 384-406.
53.
Reeker, J., Ensing, D., & Elliott, R. (1997). A meta-analytic investigation of group treatment outcomes for sexually abused children. Child Abuse and Neglect , 21, 669-680.
54.
Schafer, J.L., & Graham, J.W. (2002). Missing data: Our view of the state of the art . Psychological Methods, 7(2), 147-177.
55.
Schwarz, G. (1978). Estimating dimension of a model. Annals of Statistics, 6(2), 461-464.
56.
Silovsky, J.F. (2005). Group therapy with children who have experienced maltreatment. In P. Forrest Talley (Ed.), Handbook for the treatment of abused and neglected children (pp. 231-233). New York: Haworth.
57.
Silovsky, J.F., & Niec, L. (2002). Characteristics of young children with sexual behavior problems: A pilot study. Child Maltreatment, 7, 187-197.
58.
*Silovsky, J.F., Niec, L., Bard, D., & Hecht, D. (2007). Treatment for preschool children with interpersonal sexual behavior problems: A pilot study. Journal of Clinical Child and Adolescent Psychology, 36(3), 378-391.
59.
Stark, K.D., Swearer, S., Kurowski, C., Sommer, D., & Bowen, B. (1996). Targeting the child and the family: A holistic approach to treating child and adolescent depressive disorders. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice (pp. 207-238). Washington, DC: American Psychological Association .
60.
*Stauffer, L.B., & Deblinger, E. (1996). Cognitive behavioral groups for nonoffending mothers and their young sexually abused children: A preliminary treatment outcome study. Child Maltreatment, 1(1), 65-76.
61.
Steward, M.S., Farguhar, L.C., Dicharry, D.C., & Glick, D.R. (1986). Group therapy: A treatment of choice for young victims of child abuse. International Journal of Group Psychotherapy , 36(2), 261-277.
62.
Webster-Stratton, C. (2005) The Incredible Years: A training series for the prevention and treatment of conduct problems in young children. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice (2nd ed., pp. 507-555). Washington, DC: American Psychological Association.
63.
Berliner, L., & Saunders, B.E. (1994a). Group therapy protocol: Index. Unpublished treatment manual.
64.
Berliner, L., & Saunders, B.E. (1994b). Group therapy protocol: Standard. Unpublished treatment manual.
65.
Bonner, B.L., Walker, C.E., & Berliner, L. (1999b). Treatment manual for cognitive behavioral group therapy for children with sexual behavior problems (Grant No. 90-CA-1469) . Washington, DC: Administration of Children, Youth, and Families, DHHS.
66.
Bonner, B.L., Walker, C.E., & Berliner, L. (1999c). Treatment manual for cognitive behavioral group treatment for parents/caregivers of children with sexual behavior problems (Grant No. 90-CA-1469). Washington, DC: Administration of Children, Youth, and Families, DHHS.
67.
Bonner, B.L., Walker, C.E., & Berliner, L. (1999d). Treatment manual for dynamic group play therapy for children with sexual behavior problems and their parent/caregivers (Grant No. 90-CA-1469). Washington, DC: Administration of Children, Youth, and Families, DHHS.
68.
Cohen, J.A., & Mannarino, A.P. (1992). Structured Parent Counselling-Child Psychotherapy (SPC-CP) manual. A treatment outcome study for sexually abused preschool children (Grant #90-CA-1545). Washington, DC : U.S. Department of Health and Human Services, Administration of Children, Youth, and Families, National Center on Child Abuse and Neglect .
69.
Cohen, J.A., & Mannarino, A.P. (1994). Non-directive Supportive Therapy (NST) manual. Sexual Abuse-Specific Cognitive Behavioral Therapy (SAS-CBT): A treatment outcome study (Grant #90-CA-1545). Washington, DC: U.S. Department of Health and Human Services, Administration of Children, Youth, and Families, National Center on Child Abuse and Neglect .
70.
Cohen, J.A., & Mannarino, A.P. (1996b). Treatment of traumatized children. Client Centered Therapy (CCT) treatment manual. MCP-Hahnemann UniversitySchool of Medicine.
71.
Cohen, J.A., Mannarino, A.P., & Deblinger, E. (2003). Child and Parent Trauma-Focused Cognitive Behavioral Therapy treatment manual. Allegheny General Hospital Center for Traumatic Stress in Children and Adolescents and University of Medicine-Dentistry of New Jersey Center for Children's Support.
72.
Deblinger, E., & Heflin, A.H. (1996). Treating sexually abused children and their nonoffending parents: A cognitive behavioral approach. Thousand Oaks, CA: Sage.
73.
Deblinger, E., & Stauffer, L. (2004). NIMH Cognitive Behavioral Young Children's Group Therapy, session by session manual. Newark: New Jersey CARES Institute.
74.
Friedrich, W.N. (1995). Psychotherapy with sexually abused boys: An integrated approach. Thousand Oaks, CA: Sage .
75.
Gray, A., & Pithers, W.D. (1992). Promoting a prevention team lifestyle: A group treatment manual for children with sexual behavior problems and their caregivers (STEP) (National Center of Child Abuse and Neglect, Grant No. 90CA1470; Relapse Prevention). Unpublished manuscript.
76.
Gray, A., & Pithers, W.D. (1991). Abuse prevention treatment manual (APT) (Center for Prevention Services, National Center of Child Abuse and Neglect, Grant No. 90CA1470; Expressive therapy). Unpublished manuscript.
77.
Silovsky, J.F., & Niec, L. (1998). Group treatment for preschool children with problematic sexual behavior. Program manual. Unpublished manuscript.
78.
Stauffer, L., & Deblinger, E. (1994). NIMH Alternative Treatment Condition: Professionally facilitated support group manual. Newark: New Jersey CARES Institute.
79.
Tremblay, C., & Gagnon, M.M. (2005). À la croisée des chemins. Programme d'intervention auprès des enfants présentant des comportements sexuels problématiques. Beauport, Canada: Les Centres jeunesse de Lanaudière .
