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Problematic Sexual Behaviors (PSB) in Adolescents - FAQ

 By Stephen C. Schultz 11 Common Parent Questions with Reassuring, Honest Answers When parents first become aware of concerning sexual behaviors in their child, fear and uncertainty often take over. The questions below reflect what families most commonly ask—and the answers are grounded in clinical understanding, compassion, and hope. “Does this mean my child is a sex offender?” No. Problematic sexual behavior describes a pattern of behavior , not a label or an identity. Adolescents’ brains are still developing, and behavior can change significantly with the right support. Most teens who receive appropriate, early treatment do not go on to commit sexual offenses as adults. “If we name this, will it follow my child forever?” Naming a concern clinically is not the same as labeling a child permanently. In fact, avoiding the issue often increases the chance that problems escalate or draw unwanted attention later. Addressing concerns early and appropriately is one of the strongest ways...

Medical Necessity and the Reinforcement of Crisis Care

By Stephen Schultz (Editor’s Note: This article was inspired by a conversation I had with a mother whose son was in crisis.) The concept of Medical Necessity sits at the center of modern behavioral health insurance coverage. At its core, it is a reasonable and well-intended standard: to ensure that individuals receive the right level of care at the right time, while avoiding unnecessary or overly intensive services. When applied thoughtfully, Medical Necessity protects both patients and systems. In practice, however—particularly when authorizing residential or inpatient care for adolescents—the application of Medical Necessity can produce outcomes that run counter to its original purpose. When Cost Containment Becomes Care Shaping Medical Necessity standards were developed, in part, to reduce excessive utilization and control escalating costs. The underlying assumption is that less restrictive, lower-cost services should be attempted first, with higher levels of care approved only whe...

Honesty is more than telling the truth—it’s what keeps families connected

  By Stephen C. Schultz  When it comes to communication in families—especially between teens and their parents —a simple question can open up a surprisingly deep conversation: Which one matters most? Being right Being kind Being honest Being understood Each of these qualities carries weight. Each shapes the tone of a relationship. But if we’re looking for the one that helps families grow, heal, and stay connected through the turbulence of adolescence, honesty rises to the top. And not just the kind of honesty where we tell the truth about what happened last Thursday. I mean a broader, more courageous form of honesty— intellectual honesty, emotional honesty, and honesty with ourselves . Dishonesty and the Trust Equation Teens sometimes hide the truth—sometimes to avoid consequences, sometimes out of fear of disappointing parents, and sometimes because they simply can’t yet articulate what they’re feeling. Parents, too, may avoid full honesty in an attempt t...

From Labels to Learning: Person-First Language in PSB Treatment

By Stephen C. Schultz The language we use to describe problematic sexual behavior (PSB) is evolving. And it’s long overdue. For years, young people have been labeled with terms that reduce them to their worst moments: “Sex offender.” “Predator.” “Perpetrator.” “Aggressor.” Words that erase their humanity, ignore their developmental stage, and reinforce stigma instead of healing.                                                Here’s what’s shifting: Person-First Language Not “a sex offender” → “a teen with problematic sexual behavior (PSB).” This identifies what he is struggling with rather than defining who he is. Not “a perpetrator” → “a youth who caused harm.” This recognizes accountability without assigning a permanent or adult-level label. Not “a predator” → “a young person who needs support and intervention.” This focuses on his capacity to lea...

Holiday Insight: Finding Grace in Imperfect Relationships

 By Stephen C. Schultz As we once again head into the Holiday Season, it is important to be aware of the impact of the holidays on those we love and care about. The holidays are often described as a time of joy, family, and celebration. But for many, they bring a quieter reality - one marked by stress, loneliness, or the resurfacing of painful memories. For some people, the holidays represent connection and renewal. For others, they stir up what has been lost, what never was, or what once hurt too much to recall. The very things that make the season feel special - music, smells, family gatherings - can also awaken deep emotional undercurrents, especially for those with a history of trauma. Why the Holidays Can Trigger Past Trauma Many people who have experienced trauma - especially early childhood or relational trauma - notice that this season brings unexpected emotional intensity. Science now confirms what survivors have long known: certain times of year can activate implicit ...

Helping Teens Navigate a World of Alcohol

By Stephen C. Schultz At The Interpreted Rock , I often write about the ways we can learn from our experiences—and from one another. Every generation faces its own set of challenges, and one of the most consistent for parents and teens alike is how to navigate a world where alcohol is ever-present. Understanding this issue thoughtfully can help families build stronger, more honest relationships rooted in trust and awareness. I recently read an article that mentioned teenage and young adult drinking was on the decline—a very encouraging trend. The article suggested that, in long-term studies, moderate alcohol consumption did not show severe or lasting harmful effects for most adults studied. However, it also acknowledged that genetics , socioeconomic status , and mental health all play significant roles in how alcohol affects each person. What stood out to me most was the author’s suggestion that there needs to be a middle ground—that the real issue isn’t simply about drinking or no...

Developing a Relationship with Honesty: Understanding the Process at Oxbow Academy

 By Stephen C. Schultz Enrollment at Oxbow Academy is always an emotional experience—for both students and their families. The transition represents a major shift in life and relationships. At Oxbow, we encourage families to remember that our work is centered on a single guiding principle: “Developing a Relationship with Honesty.” When your son expresses resistance—whether by saying things like “Oxbow isn’t a good fit for me” or “I don’t belong here” —it’s important to recognize what’s really happening. These statements are not about whether Oxbow is the right program. Instead, they reflect resistance to authenticity and honesty. Students often come with a “center of the universe” mindset: “The world needs to adapt to me.” This belief is not entirely their fault—it’s something that has developed over time, often through well-intentioned patterns within families, schools, and communities. To better understand why this matters, let’s take a step back and consider some key ideas. H...

Your Favorites Today: 6 Thoughtful Reads from The Interpreted Rock

By Stephen C. Schultz Every so often I peek at the blog stats—kind of like checking who stopped by the front porch. Today’s snapshot was a fun mix: readers from around the world, and posts from different years all getting love at the same time. Below are the six most-viewed articles in the last 24 hours, each with a quick, no-spoilers synopsis so you can jump right in. A Short History of The Interpreted Rock Launched in 2008, this blog has spent over 17 years sharing practical help, family stories, and mental-health insights that age well—because people don’t stop needing encouragement, clarity, and a little humor. As told in “Unpacking ‘The Interpreted Rock’: A Journey of Meaning and Insight,” the title points to the idea that meaning isn’t always sitting on the surface; it’s discovered by looking closer, asking better questions, and thoughtfully interpreting what’s in front of us. That lens—curiosity, humility, and care—guides every post here.  Today’s Top Reads   1) The Res...

Lessons from My Daughter’s Words

 By Stephen C. Schultz Some stories stick with you because they’re beautifully written, but others stay because they make you think differently about life. My daughter Amanda has done both in her contributions to  The Interpreted Rock . From a fresh twist on a classic fairy tale in  Perfectly Wicked , to an insightful look at why bullies shouldn’t get all the attention, to a powerful reflection on  Mental Toughness , her words are equal parts wisdom, warmth, and challenge. You’ll laugh, nod, and maybe see the world a little differently. Come read, and be inspired. As I was reading through my blog the other day, I came across a few articles connected to Amanda. She’s one of those rare souls who’s always seemed older than her years — you know the kind. Driven yet kind, understanding yet grounded, with a quiet maturity that seems to “get it,” whatever it happens to be. As a child, she was both a strong student and a dedicated athlete. She was popular, but never boastfu...

Stories That Last: Three Timeless Reads

By Stephen C. Schultz Most of the time on The Interpreted Rock , I write about mental health concerns and the kinds of situations families face when life gets complicated. But every now and then, I like to share something a little different, personal stories, fun memories, and even a few lessons I’ve learned the hard way (or the fun way). These moments aren’t just filler; they’re reminders that life is more than challenges and diagnoses, it’s also laughter, connection, and the stories we carry with us. Some of these pieces are just plain fun. Others are tender reflections. A few even come from my kids, who’ve been known to surprise me with their own insights. They’re what’s called evergreen content,  stories that never really “expire” because their meaning doesn’t depend on a certain date or trending topic. You can read them today or five years from now, and they’ll still hold value. Evergreen stories are like old friends, you can come back to them any time for comfort, perspective...

Navigating the Labyrinth of Care: Why Oxbow Academy Fights for Every Student

By Stephen C. Schultz Oxbow Academy recognizes that the students who enter its doors—whether from across the country or around the world—often represent unique and highly complex clinical cases. Because of the Academy’s specialized treatment focus, families, state agencies, school districts and managed care organizations frequently go beyond standard protocols to ensure students struggling with Problematic Sexual Behavior (PSB) can access the care they need. Many of these students fall outside traditional treatment norms, which is why a large number are supported through single-case agreements with Oxbow. The families we partner with often face overwhelming circumstances, with students at significant risk of ongoing harm—both to themselves and others. For this reason, Oxbow Academy remains unwavering in its belief that these students are worth fighting for. The Invaluable Impact of the Evaluation Process Even a short-term stay (typically 60–90 days) at Oxbow Academy for evaluation c...

Timeless Reflections on Fishing, Family, and Connection

By Stephen C. Schultz Some stories never really grow old. They don’t depend on what’s trending or new—they speak to something lasting. These stories about fishing, fathers, and shared time outdoors are just that—evergreen pieces that remind us of what really matters. Fishing... It’s Really About Relationships In this 2019 post, I reflect on what begins as a simple day—tinkering with an old boat, clearing space in the garage, and trying to decide whether the weather justifies a few casts. As the day unfolds, it becomes clear that fishing isn’t really the point. Instead, it’s about the feeling of being outside, the memories that come with every step, and the connection built when you invite someone along for the ride. It’s a reminder that time spent together doesn’t need a big plan—it just needs to be shared. The One That Got Away – A Tribute to My Father Originally published in 2010, this story takes you back to a fishing trip on Collard Lake in 1973. As a young boy, my father and ...

Hidden Costs, Missed Opportunities: The Case for Specialized PSB Treatment

By Stephen C. Schultz  Hidden Costs - Missed Opportunities The hidden costs to society from a lack of early therapeutic interventions for Problematic Sexual Behavior (PSB) in adolescents are both significant and far-reaching. While direct costs (like court expenses or hospital stays) are often easier to measure, the indirect or "hidden" costs tend to be more insidious and long-term. Here’s a breakdown of these societal burdens: 1. Increased Recidivism and Chronic Behavioral Issues Untreated PSB in youth can escalate into more serious offenses over time. As these behaviors persist or worsen, adolescents are more likely to become entangled in the juvenile and adult criminal justice systems , creating an ongoing public safety concern. This contributes to overburdened court systems, correctional facilities, and probation services . 2. Mental Health Deterioration in Youth and Families Adolescents with untreated PSB often experience worsening mental health , including depressi...