Academic journal article Journal of Child and Adolescent Psychopharmacology

Review of Juvenile Sex Offenders: A Guide to Evaluation and Treatment for Mental Health Professionals, by Eileen P. Ryan, John A. Hunter, and Daniel C. Murrie

Academic journal article Journal of Child and Adolescent Psychopharmacology

Review of Juvenile Sex Offenders: A Guide to Evaluation and Treatment for Mental Health Professionals, by Eileen P. Ryan, John A. Hunter, and Daniel C. Murrie

Article excerpt

[Author Affiliation]

Alan Ravitz. Department of Forensic Psychiatry, Child Mind Institute, New York, New York.

ISBN: 978-0195393309. New York: Oxford University Press, 2012, 272 pages.

Address correspondence to: Alan Ravitz, MD, Department of Forensic Psychiatry, Child Mind Institute, 445 Park Avenue, New York, NY 10022, E-mail: alan.ravitz@childmind.org

In the preface to Juvenile Sex Offenders: A Guide To Evaluation And Treatment For Mental Health Professionals, Drs. Ryan, Hunter, and Murrie explain that their emphasis will be on practicality and utility. They "anticipate that this book will provide a much-needed sensible and functional guide to experienced mental health clinicians who are involved in evaluating and treating sexually abusive youth." They note that juvenile sexual offenders are extremely heterogeneous, having more in common with other conduct-disordered youth than with adult sex offenders. This finding, backed by a great deal of evidence, should moderate the strong emotional response that "sexual offending" evokes in even the most experienced clinicians.

Ryan, Hunter, and Murrie are all experienced experts in the field, and their expertise shows. They address a highly emotionally fraught issue with balance and objectivity. They utilize a general systems approach to the problem, with an equal emphasis on biology, psychology, and environmental influences. The authors cite Uri Bronfenbrenner at one point, and Dante Cicchetti at another, both of whom have written extensively about ecological explanations of normal development as well as psychopathology. The chapters are uniformly well written and accessible, and I found little variation in the high quality of exposition, despite the fact that there are three authors.

The book begins by placing sexual offending in a social and legal context. It notes that between one third and one half of adult sex offenders began their sexual offending as adolescents, and individuals <18 years of age may commit up to 50% of all child molestations. (As a bonus, the first chapter has a very nice discussion of the concept of consent, which is relevant in a wide variety of clinical contexts.) The authors note that although the risk of sexual recidivism for juveniles is relatively low, it is often difficult to predict risk on an individual basis. Nevertheless, transferring juvenile offenders to adult criminal court actually increases the risk of recidivism. The point here is that "getting tough on crime" often does not achieve the goal of decreasing future risk.

The second chapter of the book addresses normal sexual behavior in childhood. I found it somewhat frustrating, not because it was poorly written; rather, there simply is not a lot of good information on this topic. I came away with the idea that children of all ages are sexual, but as they get older, they tend to hide their sexual behaviors from adults.

Chapters Three and Four specifically address risk factors for juvenile offending, patterns of this behavior, and the complex interaction between psychopathology and sexuality. The authors note that the study of risk factors is in its infancy, but that there are certain "endogenous" risk factors including psychopathy, deviant sexual interests, and distorted sexual cognitions. This is one of two places in the book where the authors discuss psychopathy. These discussions are of general interest to both forensic psychiatrists and mental health practitioners in general. There are also a number of "exogenous" risk factors, including having been the victim of sexual abuse. The risk conferred by victimhood, however, is complicated. Having been a victim increases the risk for the emergence of sexually abusive behavior, but it is not a very strong predictor of sexual recidivism. …

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