Problematic Sexual Behavior – Cognitive Behavioral Therapy (PSB-CBT)
What is PSB-CBT?
Problematic Sexual Behavior Cognitive Behavioral Therapy (PSB-CBT) is an evidence-based treatment model for children and youth ages 3-18 who have engaged in problematic sexual behavior (PSB). Typically, children participate in a treatment group based on their age (preschool, school-age, and adolescents), while parents participate in a concurrent caregiver group. Treatment consists of 12-23 sessions, depending on the age of the child. The model may be adapted for individual (family) therapy.
PSB-CBT effectively addresses a wide range of problematic and illegal behaviors, including:
- Failure to recognize socially acceptable physical boundaries
- Excessive masturbation
- Preoccupation with pornography and other sexualized content
- Generation and/or dissemination of sexualized images of self or others
- Coercive and/or aggressive sexual acts
PSB-CBT is a good fit for agencies with:
- Strong collaboration with juvenile justice, child welfare, treatment services systems, schools, child advocacy centers, and other community partners
- Clinical services teams trained in evidence-based treatment.
- Active parent and caregiver involvement
- Agency policies and practices for working with this population that are strengths-based, trauma-informed, and non-punitive
PSB-CBT is a good fit for clinicians who have:
- Cognitive-behavioral and family systems orientations
- Comfort with directive approaches in clinical treatment
- Experience with group treatment models
- Presentation and facilitation skills for group training and education sessions
- Comfort managing youth behavior in a group setting
- Comfort discussing sexual development and sexual content
- Strong family and client engagement skills
- Good organizational and communication skills
- Ability to actively collaborate with partnering agencies and community stakeholders
Return on Investment
The majority of children and youth who participate in PSB-CBT cease to engage in problematic sexual behaviors; the recidivism rate among school age children is 2% ten years following completion of treatment.
Children and youth who participate in PSB-CBT also show significant improvement in non-sexual behavior problems, emotional difficulties, and trauma symptoms.
Most children and youth benefit from outpatient PSB-CBT, avoiding the cost and disruption associated with out-of-home placement. The approximate annual costs (2018 dollars) for placement in a North Carolina psychiatric residential treatment facility or a juvenile justice facility are greater than $50K and $100K, respectively.
Service Delivery
PSB-CBT may be delivered in a variety of community, residential, and confined settings, including; outpatient clinics, schools, homes, group homes, inpatient psychiatric and juvenile justice facilities.
Additionally, PSB-CBT can be offered through a variety of service delivery models, including outpatient, enhanced outpatient, intensive in-home, day treatment, and residential psychiatric services.
Treatment Goals
Eliminate or reduce problematic sexual behaviors
Improve coping skills and self-control strategies
Enhance social competence skills
Develop appropriate psychosexual knowledge and boundaries
Improve caregiver monitoring, supervision, and behavior management skills
Reduce out-of-home placement risk