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 can be profoundly impactful for families and referral sources. Students are placed in an emotionally safe, residential environment where they are able to participate in intensive therapeutic interventions and gradually disclose information related to PSB and underlying trauma. This disclosure process is clinically validated and becomes the foundation for meaningful treatment planning and relational repair.
Oxbow’s evaluation process includes a thorough psychosexual evaluation and a functional assessment, both of which are data-informed. The Academy utilizes tools such as the Youth Outcome Questionnaire (YOQ) and the Residential, Emotional, Social, Behavioral Assessment (RESBA). The final report includes comprehensive clinical data, a full psychological and behavioral profile, and a clearly articulated treatment plan—whether the student continues at Oxbow, returns home, or transitions to a different level of care, such as outpatient therapy or a Partial Hospitalization Program (PHP).
Why Outpatient Care Often Falls Short
While many outpatient providers offer psychosexual evaluations, the question is not about clinical credentials, knowledge or testing competence—it’s about process. Can an outpatient setting, where a student spends only a few hours with a clinician, truly establish the level of trust and emotional safety necessary for honest and vulnerable disclosure? Oxbow’s experience suggests otherwise.
Time and again, students arrive at Oxbow having previously participated in outpatient evaluations, only to reveal significantly more—and more accurate—information over time within the safety of a therapeutic residential setting. In many cases, prior disclosures only scratched the surface or included inaccuracies that could have misdirected treatment.
The Unveiling of Truth: A Case Study
One such case involved a 15-year-old student on the autism spectrum who had a history of technology misuse and pornography-related behaviors at school. He started the evaluation process at Oxbow. During his initial disclosures, he described a chaotic lifestyle that included frequent sexual activity, substance use, and attending raves. This narrative unfolded over eight weeks of consistent therapy and disclosure assignments.
When it came time for his clinical polygraph—a tool used at Oxbow to validate disclosures in a safe, biofeedback-based format—the student failed. This outcome is not uncommon and often indicates the need for deeper therapeutic work. After additional sessions, he failed two more polygraphs. Eventually, in a subsequent therapy session, he admitted the truth: his previous stories had been fabricated. The actual concern was far more serious—he had been inappropriately touching his non-verbal, wheelchair-bound sister.
It is important to note that this student was diagnosed with Level 1 Autism Spectrum Disorder and came from a loving, supportive family. Over time, however, he had accessed troubling content online that his parents were unaware of.
Had this student been evaluated in a traditional outpatient setting, it is likely that the false narrative of raves, drugs, and sexual exploits would have been accepted at face value, forming the basis for an inaccurate clinical report and an irrelevant treatment plan. Meanwhile, the real harm would have gone undetected, and the student would have remained at home, continuing to pose a risk to his sister.
At Oxbow Academy, the evaluation process ultimately created the conditions necessary for honesty, accountability, and healing. Due to this newly validated information, the student did continue with treatment at Oxbow after the completed the evaluation. This allowed the student to begin the hard work of relational repair while enabling the family to access necessary resources and support for their daughter. Reunification and healing became possible.
Oxbow Academy understands the immense challenges families and referring entities face when trying to secure specialized, evidence-based care. The Academy welcomes the opportunity to discuss how single-case agreements can support effective evaluations and treatment planning.
As a parent, clinician or educational professional, do you feel in your gut there is more going on, but the teen you are concerned about won't engage in conversation about what is troubling them?
Please reach out to schedule a conversation and learn how Oxbow Academy can assist.
Comments