By Stephen C. Schultz
There is a question that is regularly the topic of discussion whenever a parent calls me;
How do we make responsible decisions about our son's future when we may not yet understand the full story?
There are times when the most important question is also the most difficult to answer: What do we really know?
When a young person has engaged in problematic sexual behavior, the questions facing parents, clinicians, attorneys, and other professionals can be especially complicated. There may be conflicting accounts of what happened, important information that has not been disclosed, or behaviors that are difficult to understand without more context. The consequences of our decisions can be significant, both for the young person and for the people who may be affected by their behavior.
In these situations, it is tempting to look for a clear answer. We want to know what happened, why it happened, whether it is likely to happen again, and what needs to change. But what if the information available to us is incomplete?
That is where the quality of an evaluation becomes especially important.
What Do We Know, and What Are We Assuming?
An evaluation is only as informative as the information available to the person conducting it. Interviews with a young person and their parents are important, but they may not tell the entire story. Records from schools, therapists, previous placements, and other professionals can add valuable context. Observations of the young person's behavior over time may reveal patterns that are difficult to recognize during a single appointment.
Sometimes, the young person provides a detailed account of their behavior. Sometimes, they disclose only part of what occurred. There may be shame, fear, confusion, limited insight, or concerns about the legal consequences of speaking openly. Parents may also have incomplete information, particularly when behaviors have occurred outside the home or have been deliberately concealed.
None of this automatically means that a young person is being dishonest or that a parent has failed to recognize a problem. It means that we must be careful about treating the information we have as though it represents everything there is to know.
A useful evaluation should distinguish between established facts, reported information, clinical interpretation, and unanswered questions.
That distinction matters. An assumption can become accepted as fact simply because it has been repeated often enough. On the other hand, the absence of documentation does not necessarily mean that a behavior never occurred.
How, then, do we make sound decisions when the available information leaves important questions unanswered?
The Value and Limitations of Risk Assessment
Structured assessment tools can help clinicians organize information and evaluate factors associated with sexual behavior risk. Instruments such as the J-SOAP-II and ERASOR are designed to help qualified professionals assess factors relevant to sexual reoffending among adolescents. Other measures may examine broader concerns, including violence risk, emotional functioning, trauma, or behavioral difficulties.
These instruments serve different purposes. Some focus more heavily on historical factors, while others consider changeable risk factors or broader clinical needs. The evaluator must determine which tools are appropriate for the individual and the questions being addressed.
But no single instrument provides a complete picture of a young person. Assessment scores are not lie detectors, and they cannot predict future behavior with certainty. Their findings must be interpreted alongside the available history, the quality of the information, the young person's developmental level, and professional clinical judgment.
If important information is missing, that limitation needs to be acknowledged. The responsible response is not to fill the gaps with speculation, whether that speculation favors or condemns the young person. It is to identify what remains uncertain and consider what additional information may be needed.
Intuition may alert us to a concern worth exploring, but intuition is not proof. A thorough evaluation should examine the evidence, consider alternative explanations, and make its limitations clear.
When Legal Considerations and Clinical Needs Intersect
There are circumstances in which a young person's attorney may advise them not to discuss allegations or particular events while legal matters are pending. That advice may be entirely appropriate within the legal process.
At the same time, limited disclosure can affect how much a clinician is able to understand about the behavior, its context, and the factors that may contribute to it.
These realities can coexist. A young person should not automatically be labeled dishonest because they have chosen not to discuss something, particularly when they have been advised to protect their legal interests. Yet a clinician may also be unable to reach certain conclusions without adequate information.
This creates a challenge for families and professionals. How can the young person's legal rights be respected while ensuring that clinical decisions are based on the best information reasonably available?
The answer requires thoughtful coordination among the family, legal counsel, and clinical professionals. It also requires honesty about what an evaluation can and cannot establish.
The goal should not be to pressure a young person into disclosure or to reach a predetermined conclusion. It should be to understand the available information, identify what is still unknown, and determine what is needed to make responsible decisions about treatment and safety.
An Evaluation Is Not the Same as Treatment
An outpatient evaluation may be an appropriate and sufficient starting point for many young people. It can provide valuable information, identify treatment needs, and help families and professionals determine the next steps. A residential evaluation is not automatically better, nor is it necessary for every young person.
However, when the questions are complex and important information remains unclear, an extended evaluation in a residential setting may offer opportunities that are difficult to replicate through scheduled appointments alone.
At Oxbow Academy, the evaluation process is designed to gather information over an extended period in a residential setting. Rather than relying exclusively on interviews and retrospective reports, the clinical team can observe how a student responds to everyday expectations, frustration, peer interactions, staff direction, and interpersonal boundaries.
The Residential Emotional Social Behavioral Assessment, known as RESBA, provides a structured approach to documenting behavior and interactions. But RESBA is only one part of the picture.
Throughout the evaluation, information is gathered from multiple sources, including RESBA data, clinical notes, residential staff observations, academic notes, and data associated with the Relationship Board. The therapeutic disclosure process and the results of a clinical polygraph, when the student successfully completes it, provide additional information for the evaluation.
These records do not stand alone. Together, they contribute to a body of reviewable documentation that the qualified examiner can consider when conducting the psychosexual evaluation and Sexual Behavior Risk Assessment (SBRA). The examiner can consider the student's presentation across multiple settings and sources of information, rather than relying solely on what the student or parents report during interviews.
A successful polygraph should be understood as one contributing source of information, not proof that every disclosure is complete or accurate. As with any assessment method, its results must be considered alongside the broader clinical picture.
The examiner may also consider formal psychological testing and structured risk assessment instruments, selected according to the student's needs and the questions being evaluated. These measures can contribute useful information about risk factors, emotional and behavioral functioning, and other clinical concerns. Their value depends on using the appropriate tools and interpreting their results in context.
Why does this matter? Because a young person's behavior, relationships, academic functioning, and responses to expectations may reveal important information that is difficult to capture in a single appointment. When these observations are documented over time and considered alongside the student's history, disclosures, and formal assessments, they can help develop a more detailed functional understanding of the student.
The goal is not simply to assign a risk category. It is to better understand the circumstances surrounding the behavior, the factors that may contribute to it, the student's strengths and challenges, and the skills and supports needed for meaningful change.
This integrated assessment contributes to the individualized treatment plan and to detailed clinical recommendations for the family and professionals who will support the student after he returns home. Those recommendations can help guide continued treatment, family involvement, safety planning, and the transition to an appropriate level of care in the community.
No single source of information, test, or observation can tell us everything we need to know about a young person. The value lies in bringing multiple sources together, examining how they relate to one another, and acknowledging the limitations that remain.
That is the difference between collecting information and developing a comprehensive clinical understanding.
An extended residential evaluation also involves a significant commitment of time and resources. It should be considered when the clinical questions, the young person's needs, and the limitations of less intensive approaches justify it. The purpose is not to keep a young person in residential care longer than necessary, but to gather meaningful information, provide treatment, and help determine an appropriate path forward.
What Questions Should We Be Asking?
Whether we are parents, attorneys, clinicians, or other professionals supporting a family, we can help by asking thoughtful questions about the evaluation process.
For example:
What information supports the conclusions being reached?
What information is missing, and how might that affect the findings?
Which assessment tools are being used, and what are their limitations?
How are the young person's developmental needs, strengths, and circumstances being considered?
Why is a particular level of evaluation or treatment being recommended?
How will the findings translate into practical treatment recommendations and a plan for returning home?
These questions are not intended to challenge professionals for the sake of challenging them. They are intended to encourage clarity and help everyone involved understand the reasoning behind important decisions.
A good evaluation should be able to explain not only its conclusions, but also how those conclusions were reached and where uncertainty remains.
Understanding Risk Without Defining a Young Person by It
When problematic sexual behavior occurs, we have a responsibility to take it seriously. The safety and well-being of others matter. Accountability matters. Effective treatment and realistic safety planning matter.
But so does the young person.
A young person is more than the behavior that brought them to the attention of professionals. Understanding the behavior does not excuse it. Taking the behavior seriously does not require us to assume that the young person's future has already been determined.
Our responsibility is to make decisions that reflect the best information available, acknowledge what we still do not know, and provide the level of support and accountability that the circumstances require.
Sometimes, a focused outpatient evaluation will provide what is needed. In other situations, the unanswered questions may justify a more comprehensive process that includes extended observation and treatment. The appropriate choice depends on the individual, the concerns involved, and the clinical questions that need to be answered.
Perhaps the most important question is not simply, What risk does this young person present?
It is also, What do we need to understand about this young person to make responsible decisions about treatment, safety, and the future?
That question leaves room for accountability without giving up on growth. It encourages careful assessment rather than assumption, and it reminds us that good clinical decisions depend not just on gathering information, but on understanding what that information means.
When the stakes are high, that distinction matters.
Comments