Use of sex offender treatment on youth³⁹

The American Academy of Child and Adolescent Psychiatry (AACAP) and the Center for Sex Offender Management (CSOM) recommend sex offender therapy for youth and children who engage in sexual activity with others sufficiently younger or smaller than themselves. CSOM writes that some of them may represent cases of early onset pedophilia.

The organizations recommend

• extensive assessment of these children and youth’s sexual interests and behavior, developmental and psychiatric history, and in some cases, sexual attraction through use of the plethysmograph
• the use of behavioral and cognitive methods, including covert sensitization, aversion therapy with noxious odors, masturbatory satiation (possibly assisted with ammonia), and sexual arousal reconditioning
• family and group therapy
• sex-drive reducing drugs in some cases

CSOM recommends suspending the youth’s sentence contingent upon successful completion of treatment. It also notes that controversial areas pose special ethical and legal risks for practitioners:

• informed consent issues related to mandatory treatment
• the use of assessment information against youths in court
• the lack of proven validity of the plethysmograph and polygraph with juveniles
• the effectiveness of aversion therapy and arousal conditioning
• exposure of juveniles to physically or emotionally painful stimuli
• the use of masturbation in treatment
• the lack of information about the safety and effectiveness of sex-drive reducing drugs

CSOM writes that clinicians should consider developing additional consent forms to cover the use of the plethysmograph, aversive conditioning, and unapproved drugs, and that clients should understand these procedures are voluntary and that they are free to decline them.