Children With Problematic Sexual Behavior

Clear, practical guidance for clinicians facing the challenges of assessing and treating children with problematic sexual behaviors.

Problematic sexual behavior (PSB) among children is rarely addressed in mental health training or in continuing education programs. Although research on PSB and effective interventions has advanced significantly over the past two decades, much of this knowledge remains buried in academic journals without practical demonstrations for real-world clinical work.

This book provides a clear introduction to the topic of PSB, discusses how this research-based understanding can translate into effective clinical assessment, and provides a treatment protocol that can be used by any mental health provider. Rich case examples illustrate how providers can handle difficult interactions with children and caregivers with both compassion and scientific rigor.

 

Preface

Acknowledgments

Introduction: Improving the Care of Children With Problematic Sexual Behavior

Part I: Understanding Children With Problematic Sexual Behavior

• 1. Children With Problematic Sexual Behavior: A Practical Overview
• 2. Assessment of Children With Problematic Sexual Behavior

Part II: Phase-Based Treatment for Problematic Sexual Behavior

• 3. Phase-Based Treatment for Problematic Sexual Behavior: An Overview
• 4. Phase 1: Family Sexuality and Response
• 5. Phase 2: Healthy Sexuality
• 6. Phase 3: Skill Development
• 7. Alyssa P.: A Preschool-Aged Child with Self-Focused Problematic Sexual Behavior
• 8. Alvi L.: A School-Aged Child Watching Internet Pornography
• 9. Jamar W.: A Preteen Child Interested in Sexual Relationships
• 10. Special Applications of Treatment Phases
• 11. Pitfalls and Frequently Asked Questions

Appendix A: Resources

Appendix B: The Assessment of Sexual Behavior-Child Version (ASB-C)

Appendix C: The Exposure to Sexuality Scale (ESS)

Appendix D: Sample Sexual Behavior Rules

Appendix E: Sample Scenarios

References

Index

About the Author

Brian Allen, PsyD, is professor of pediatrics and psychiatry in the Penn State College of Medicine and core faculty in the Penn State Child Maltreatment Solutions Network. He is the founder of Transforming the Lives of Children (TLC) Research and Treatment Center at Penn State Children’s Hospital. Dr. Allen is one of the foremost authorities on preteen problematic sexual behavior (PSB). He is currently leading a multi‐site team developing an updated measure to assess PSB. His research has been funded continuously over the past eight years by NIH. He has published numerous journal articles and two clinically focused books: Treating Traumatized Children (Guilford, 2014) and The Science and Clinical Practice of Attachment Theory (APA, 2023).

In this book, Dr. Allen provides a thoughtful and nuanced empirical discussion of children with problematic sexual behavior, PSB, a very poorly understood phenomenon. Dr. Allen is a leader in this area, and this work clearly summarizes our current theory and research. Moreover, Dr. Allen also puts forth a flexible phase-based individual treatment for PSB, a significant innovative contribution to this field, which is sure to help effectively mitigate children’s PSB.
—Rachel A. Wamser, PhD, University of Missouri, St. Louis, MO, United States

This volume is an indispensable resource for clinicians who encounter children with problematic sexual behavior. Dr. Allen’s approach is based on standard child psychotherapy principles and expands existing expertise so that referral to a specialist is not required. It can be flexibly delivered as a standalone intervention or embedded within a broader course of therapy. The extremely informative case scenarios walk clinicians through assessment and the phases of treatment.
—Lucy Berliner, LICSW, University of Washington, Seattle, WA, United States

This book represents a substantial contribution to the field, successfully bridging research and practice while correcting long-standing misconceptions about childhood problematic sexual behavior. It offers an empirically grounded, developmentally sensitive, and clinically practical approach to assessment and treatment that is feasible for real-world settings. Its clear structure, strong assessment framework, and thoughtfully integrated case material make it an invaluable resource for clinicians, trainees, and advanced students in psychology and related disciplines.
—Kelly M. Babchishin, PhD, Assistant Professor and Director, Sexually Harmful Behaviours Research Lab, Carleton University, Ottawa, ON, Canada