A Classification System to Guide Treatment Needs for Juveniles Who Have Engaged in Abusive Sexual Behavior

• Published date: 01 November 2023
• DOI: http://doi.org/10.1177/00938548231193414
• Author: Amanda Beltrani,Tamara Kang,Austin Lee,Robert E. Mcgrath,Robert A. Prentky
• Date: 01 November 2023
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2023, Vol. 50, No. 11, November 2023, 1679 –1698.

DOI: https://doi.org/10.1177/00938548231193414

Article reuse guidelines: sagepub.com/journals-permissions

© 2023 International Association for Correctional and Forensic Psychology

1679

A CLASSIFICATION SYSTEM TO GUIDE

TREATMENT NEEDS FOR JUVENILES WHO

HAVE ENGAGED IN ABUSIVE SEXUAL

BEHAVIOR

AMANDA BELTRANI

Fairleigh Dickinson University

Kirby Forensic Psychiatric Center

TAMARA KANG

Southern Illinois University

AUSTIN LEE

University of Massachusetts Chan Medical School

ROBERT E. MCGRATH

ROBERT A. PRENTKY

Fairleigh Dickinson University

Developing an empirically derived classification system that accounts for the heterogeneity of youth could benefit the court,

probation officers, and clinicians in making informed management and treatment decisions. This study used a latent class

analysis to examine histories and treatment needs patterns among 561 youths who engaged in problematic sexual behavior

(PSB) from five U.S. states. Three classes emerged and included: (a) low treatment need (LTN) youth without dysfunctional

histories, (b) high transgressions and treatment needs (HTTN) youth with histories of conduct problems, and (c) abuse reac-

tive (AR) youth with histories of maltreatment. Over one year, the LTN group had the lowest levels of treatment needs, the

HTTN group had the highest, and the AR group had lower sexual and socioecological but higher general behavior treatment

needs. Findings from this study can assist in allocating resources and help guide the individualization of interventions for

youth with PSB.

Keywords: Juveniles with sex offenses; classification system; heterogeneity in treatment; latent class analysis

AUTHORS’ NOTE: The authors have no conflict of interest to declare. The United States Department of

Justice funded the project described herein, Office of Justice Programs [Office of Sex Offender Monitoring,

Apprehending, Registering, and Tracking] through grant # 2016-AW-BX-K004. The opinions and recommen-

dations described in this report are entirely those of the authors and do not necessarily reflect those of the

SMART Office or the Department of Justice. We are indebted to the invaluable contributions of our Advisory

Board: Judith Becker, Anthony Beech, Barbara Bonner, Keith Kaufman, Robert J. McGrath, William Murphy,

and Jane Silovsky. We are also profoundly grateful to all of the extraordinary clinicians and administrative

staff at our sites, without whom the implementation phase of this project would not have been possible.

Correspondence concerning this article should be addressed to Amanda Beltrani, School of Psychology and

Counseling, Fairleigh Dickinson University, 276 Grand Concourse, Apt 413, Bronx NY 10451, USA; e-mail:

Amanda.Beltrani@omh.ny.gov.

1193414CJBXXX10.1177/00938548231193414Criminal Justice and BehaviorBeltrani et al. / TREATMENT NEEDS FOR JUVENILES

research-article2023

1680 CRIMINAL JUSTICE AND BEHAVIOR

About 30 years ago, Knight and Prentky (1993) pointed out the marked heterogeneity of

youth with problematic sexual behavior. Chaffin (2008) identified it as “one of the

likely culprits for some of the poor juvenile justice policies” (p. 117). Indeed, many research-

ers noted that offense-based labels, for example, “juvenile sex offender,” has virtually no

value other than an administrative classification for crimes (Chaffin, 2008; Cox, 2020;

Fanniff & Kimonis, 2012; Lowe & Willis, 2020). From a classification standpoint, the term

misleads more often than informs, with little value as a risk marker, prognostic indicator, or

prescriptively for intervention purposes (Everhart Newman et al., 2018; Hunter, 2006;

Hunter et al., 2003).

These youth differ considerably on critical dimensions, including etiological pathways,

offending patterns, delinquent histories, personality characteristics, clinical presentation,

and risk of reoffense for sexual and non-sexual recidivism (Rich, 2015). Yet, management

decisions made in juvenile court continue to rely on a nomothetic understanding of a youth’s

risk of violence, which drives intervention and managerial decisions. These decisions rarely

consider the population’s diversity. Informed management decisions are particularly critical

as incorrectly prescribing an intensive intervention for youth with relatively low treatment

needs may produce iatrogenic effects, including case-hardened attitudes and beliefs (Cécile

& Born, 2009; Walker & Herting, 2020). Over-prescription of services depletes scarce

resources and may do more harm than good. When individuals with few treatment needs,

and less problematic behaviors, are mixed with more antisocial or deviant youth, their

developmental trajectory may be negatively altered (Ryan et al., 2012).

The Risk-Need-Responsivity (RNR) rehabilitation model is commonly used to inform

management decisions and guide individualization of interventions for justice-involved

populations (e.g., Bonta & Andrews, 2017). Research findings have indicated that the RNR

model has promise in case management, recidivism reduction, and helping treatment pro-

viders align interventions with individual needs (Bonta & Andrews, 2017; Brogan et al.,

2015; Long et al., 2019). RNR is composed of three principles including the Risk Principle,

Need Principle, and Responsivity Principle. These principles provide guidance on who

would benefit most from treatment (matching treatment intensity with risk level, Risk

Principle), what factors (termed criminogenic needs) to target during interventions (Need

Principle), and how to individualize services to account for the unique characteristics of the

client (Responsivity Principle, e.g., motivation, gender-responsive, mental health, cultur-

ally tailored interventions; Bonta & Andrews, 2017). Although RNR has extensive empiri-

cal support for its utility in reducing recidivism (Bonta & Andrews, 2017; Gendreau &

Goggin, 2014; Pratt et al., 2017), provides clear guidance on developing effective interven-

tions to reduce recidivism (Bourgon & Bonta, 2014), and is cost-effective (Romani et al.,

2012), less is known on how to utilize all three principles of RNR to systematically indi-

vidualize interventions for youth with problematic sexual behavior.

Systematically individualizing interventions utilizing the RNR model is challenging as

treatment providers who work with youth having problematic sexual behavior are faced

with making decisions concerning the initial risk of offending, level of care, case conceptu-

alizations, treatment planning, refinement of therapeutic focus, aftercare planning, and

long-term risk assessment and must consider a variety of factors from multiple sources

(e.g., contextual environmental factors, life stresses, and the caregiver’s ability to supervise

the youth adequately). Thus, to provide systematic guidance for decision-making, there is a

critical need to develop a classification system that delineates subgroups of youth with