Clinical Training

Description of Clinical Program

Sexual behavior of children and youth can become harmful to themselves and to other children as well as illegal. Problematic sexual behaviors (PSB) do not represent a medical/psychological syndrome or a specific diagnosable disorder, but rather a set of behaviors that fall well outside acceptable societal limits (Chaffin et al., 2006). We have defined children with PSB as children who initiate behaviors involving sexual body parts (i.e., genitals, anus, buttocks, or breasts) that are developmentally inappropriate or potentially harmful to themselves or others (Silovsky & Bonner, 2003). Problematic sexual behaviors of adolescents are more often also considered illegal. As a result juvenile justice is often involved with the family.

PSB-CBT™ is a group treatment model originally designed to treat youth ages 7 to 12 who present with PSB. The PSB-CBT™ treatment approach uses concurrent groups for youth and their caregivers with combined multi-family group sessions about once a month. Active participation of a caregiver is required, with the caregiver defined as the person who provides primary care of the child in the home (e.g., mother, father, step-parent, grandparent, foster parent). PSB-CBT™ shares the common theory base and core components of evidence-based programs (EBP) for PSB. The underlying approach is strengths-based, focusing on the youth as children first with capacity to learn and implement appropriate behavior, make safe decisions, and develop healthy relationships. Using cognitive-behavioral approaches, the youth are taught rules about sexual behavior and specific skills of coping, self-control, and decision making. Core treatment components with caregivers address managing child behavior, supporting healthy development, sex education, abuse prevention, and rules about sexual behavior. The PSB-CBT™ treatment manual provides structure and guidelines to the sessions, but it is not a “cookbook” that is rigidly implemented. Rather, the therapists implement the core component with adaptations to fit the families being served. The group modality includes sessions with the children and caregivers together concurrently. These sessions are about once a month. For the family modality, sessions vary in terms of setup: Caregiver alone, child alone, and the family together.

Based on the research on PSB-CBT™, the program was given a “strong” rating by the Collaborative Outcome Data Committee (CODC; Hanson, Bourgon, Helmus, & Hodgson, 2009) and is ranked as “Effective” in the OJJDP Program Model Guide. A ten-year follow-up with preteen youth randomized to PSB-CBT™ found recidivism rates comparable to youth with behavior problems but no previous history of PSB (2-3%), and significantly lower than youth randomized to the play therapy treatment group condition (10%; Carpentier et al., 2006).

Model Training and Fidelity Requirements

Individuals seeking to meet full fidelity to implement PSB-CBT™ must meet the following training and consultation requirements for the school-age model. Through this process, providers implementing the group modality will need to complete requirements for both youth and caregiver groups. Completion of these requirements and fidelity in the school-age group or family modality is determined by the PSB-CBT™ Master Trainers, or Approved Trainer.

All criteria must be met to achieve completion of full fidelity in the PSB-CBT™ school-age modality:

Individuals must have a graduate degree in behavioral health fields (i.e., psychology, social work, etc.) and have a professional license to independently provide clinical services in their home/state and/or jurisdiction.
1. Individuals enrolled in graduate degree programs in behavioral health fields (i.e., psychology, social work, etc.) who have been approved to attend the PSB-CBT™ Learning Collaborative, but who are not yet licensed ARE able to participate in all aspects of the PSB-CBT™ training (i.e., live learning sessions, consultation calls, submitting fidelity recordings to be part of gaining fidelity review, etc.), and complete all requirements of training. However, non-licensed individuals will not be provided with their final PSB-CBT™ training and fidelity completion certificate until they have provided documentation of obtaining professional licensure. Also, this requirement is needed for PSB-CBT™ Roster.
Completion of the PSB-CBT™ Provider Application in its entirety.
Completion of all pre-work assignments (i.e., pre-test of knowledge and required readings) through the Learning Center, resulting from review of the exploration phase materials.
Attendance and active participation in a PSB-CBT™ intensive clinical training approved by the OU PSB-CBT™ T/TA Program.
Demonstrate competence in assessing PSB families' progress in treatment using clinical judgement and the Assessment of Sexual Behavior - Child (ASB-C), and other standardized measures, to make appropriate decisions about completion of PSB-CBT™ treatment services.
Active participation in consultation calls in the context of an active Learning Collaborative, at minimum 80% attendance, facilitated by an OU PSB-CBT™ Approved Trainer, until fidelity to the model has been met.
1. "Active participation" is defined as, at a minimum, directly involved in consultation discussion, regularly sending recorded sessions to a Master Trainer for fidelity monitoring, and evidence of application of feedback from consultation by a PSB-CBT™ Approved Trainer.
Submit recordings of required PSB-CBT™ sessions for fidelity monitoring by a Master Trainer or Approved Trainer.
1. Individuals are encouraged to review own recordings using the OU PSB-CBT™ fidelity monitoring forms to evaluate their own performance.
Completion of at least one-year (12-months) of experience conducting PSB-CBT™ treatment with a minimum of four families (e.g., caregiver and youth) in group modality, or six-months with a minimum of two families in the family modality through completion.
Implementation of the PSB-CBT™ model per the treatment curriculum and with appropriate conceptualization of youth with PSB.
Upon successful completion, individual must agree to continue to implement the OU-PSB-CBT™ model(s) with fidelity and adhere to administrative decisions from OU PSB-CBT™ T/TA Program regarding the OU PSB-CBT™ model. Meeting the above requirements is the first step to becoming a PSB-CBT™ Within-Agency Trainer.

Characteristics of Providers Successfully Trained in PSB-CBT

Successful and sustainable implementation of the model requires attention to particular factors, or "drivers" that support model fidelity and improved client outcomes. Agencies that have successfully implemented PSB-CBT™ with fidelity note selection of clinicians to participate in training and implementation of PSB-CBT™ as a key driver to success.

Through the selection process, agencies have determined that the following characteristics are representative of
clinicians effective in their uptake and delivering of PSB-CBT™:

Cognitive-behavioral and family systems orientations.
Comfortable discussing sexual development and sexual content with children and caregivers.
Able to effectively engage caregivers, family members, and youth.
Comfortable with directive approaches in clinical treatment.
New providers who have a mature approach to families or seasoned provider who have an approach and conceptual understanding similar to PSB-CBT™.
Strong organizational skills (e.g., ability to coordinate, community outreach, and managing referrals).

Good communication skills with families and referral sources.
Prepared to actively and directly collaborate with partnering agencies and community stakeholders, such as probation and child welfare.
Able to apply and teach parents behavioral management and relationship building skills.
Experienced with group treatment modality (caregiver and child).
Comfortable managing child/youth behavior in a group or family therapy setting.
Strong presentation and facilitation skills for group training and education sessions.
Invested in sustaining the PSB-CBT™ program within agency.