Treatment and Practice Profiles of Youth with Sexual Misconduct Problems in Usual Care

Abstract

From a common dataset, three analyses on related samples were conducted to describe the therapeutic practices and associated treatment targets provided to youth who had sexual misconduct (SM) targeted as part of their mental health treatment. The first analysis examined the demographic and clinical differences between youth with (n=479) and without SM (n=3885) who received treatment across all levels of care. To control for demographic and placement variance across levels of care, coarsened exact matching was used to create a comparable sample of youth at the intensive in-home level of care (142 youth with SM and 479 youth without SM). The second analysis examined whether mean treatment target and practice element dosage, diversity and factor scores differed depending on group membership. To examine whether treatment patterns for youth with SM clustered into groups in a meaningful way and to account for variance in treatment patterns, a third analysis was conducted where cluster analyses were performed on a sample of male youth who received treatment for juvenile sexual offending at a single residential facility (N=49). Results showed youth with SM had more co-occurring disorders, greater functional impairment, longer treatment episodes and were more likely to be placed out of home compared to youth without SM. In the matched sample of youth at the intensive in-home level of care, youth with SM received more interventions and a greater number of total unique interventions attempted during their treatment episode. SM youth also had a greater number of total treatment targets and total number of unique treatment targets attempted during their treatment episode. Youth clustered into unique groups based practice and treatment profiles. Treatment target cluster groups bore some similarities to prior hypothesized pathways to sexual misconduct. Practice element cluster groups did not cluster in manner which would suggest therapists are consistently using a structured, manualized, evidence-based treatment approach. This study provided novel insights into treatment as usual for youth with sexual misconduct and contributed to prior research that showed youth with SM are a heterogeneous group with diverse practice and treatment needs.