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Teen Sexual Issues - A New Treatment Approach

By Stephen C. Schultz

I recently returned from a visit to California where the clinical director of Oxbow Academy and I met with a family whose son recently graduated from Oxbow. This meeting was to "check in" with the family, see how things were going and assist in realigning any expectations that may be unmet. The one thing that is glaringly apparent is that the students come home with a maturity level and insight unmatched by their peers. As we work with these families, that are truly pioneers in their persistence and dedication to their sons, we have noticed some trends.

About sixty percent of the students have come to us from other residential placements, wilderness treatment programs or outpatient therapists. The other trend is similar in percentage, sixty percent, but represents students that are adopted. We’re not quite sure what to make of this yet, but it’s interesting none the less.

Here are some brief Oxbow Academy statistics;

100% - Students that struggle with addictive sexual concerns

60% - Students that are adopted

45% - Students with an IEP (Individual Education Plan)

65% - Students who struggle with NLDASD, ADHD, Reactive Attachment Disorder or other co-morbid issues.

Because of the shame associated with sexual issues, what therapists and families know about is usually just the tip of the ice berg. These boys are great at playing “information poker”; only laying down the cards that people already know about. The rest of the “cards” they are determined to keep close to the vest. It’s this “game” that makes adolescents so hard to work with on an outpatient basis. General residential care isn’t much different. Often, by the time we are contacted, behaviors have escalated to a crisis situation and financial resources for treatment have run thin. So we asked ourselves a question;

“How can we set up a system that encourages and supports early intervention?”

I’m pleased to share with you that our first phase of treatment provides an integrated and consolidated evaluation. This first phase is 90 days. Students integrate into academics, residential living and therapy. They work with their therapist in providing a full sexual disclosure. They then participate in a bio-feedback exam (Polygraph) to validate their honesty. Then, summaries of the students efforts in academics, residential living and therapeutic efforts are combined with the results of the bio-feedback and are sent to a psychologist to perform the Psychosexual Evaluation. This gives the parents and referring professionals an Integrated Functional Assessment, Psychological testing and Sexual Risk Assessment all within the first 90 days. At this point, parents and allied professionals will know what level of continued care is required.


  • Parents only commit to first 90 days
  • Referring treatment programs can have students return if clinically appropriate.
  • Allied professionals have a clinically sophisticated option to discuss with families.
  • Students are fully engaged in academics, residential activities and therapy prior to and during testing.
  • Clinical use of the polygraph encourages the student to “lay all the cards on the table”, thus allowing the development of a complete and accurate treatment plan.



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