By Ineke Way, Ph.D., LMSW
I appreciated the opportunity to attend the ATSA conference online. Of the several most beneficial sessions I attended, I’m writing about the presentation by Kevin Creeden, Neuroscience and adolescent sexual problems: Developments and treatment issues.
Creeden focused on several themes that are important for assessment and intervention with adolescents with sexually abusive behaviors: (1) the role of disrupted attachment, (2) brain changes following childhood trauma, and (3) the role of executive functioning in decision-making. His presentation outlined normal adolescent development, highlighting the current awareness that an adolescent’s brain is not fully developed until age 25 (especially true for males), and Creeden then outlined the relationship between trauma / adverse childhood experiences (ACEs) and sexual behavior problems.
This presentation focus echoed the theme of many presentations at this conference – an increased emphasis on the humanity of the adolescent with sexually abusive behaviors rather than a taking a punitive approach. I believe this shifting emphasis is supported in the literature, “Punitive or pathologizing correctional philosophies can be understood as defensive survival responses on the part of policy-makers, judicial officials and professionals, administrators, and staff who often have the best interest of children and families at heart but who have become dysregulated as result of a combination of vicarious trauma… direct exposure in the line of duty to traumatic stressors… and political and economic pressures, constraints, and (real or perceived) threats…” (Ford & Blaustein, 2013, p. 4).
Given these realities, Creeden recommended the following treatment considerations: (1) include caregivers in treatment, (2) strengthen skills of reading social clues (e.g., watching a movie without sound, and then with sound to identify information that was captured and missed), (3) body-based sensory-focused work to strengthen self-regulation, (4) tap into and strengthen positive experiences (e.g., music, writing, story-telling), (5) support access to pro-social peer groups (during and following treatment), and (6) practice and strengthen attunement (which he termed “serve and return”) skills. Although on the surface these are not novel treatment components, Creeden provided the theoretical, neurobiological, and developmental basis for this incorporation.