Meta-analysis of treatment for child sexual behavior problems: Practice elements and outcomes

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Child Maltreatment, Volume 13, Issue 2, pp. 145-166

This study, conducted by researchers at Laval University in Quebec and the University of Oklahoma Health Sciences Centre in Oklahoma, looked at the outcomes of treatments given to Canadian and American children between the ages of 3 and 12 with sexual behaviour problems (SBP). This study represents the only known attempt to examine the impact of sexual behaviour problems at the level of practice elements.1 The researchers used a mixed linear model meta-analysis to review 11 treatment outcome studies exploring the relationship among child characteristics, treatment characteristics and short-term outcomes (i.e. change in sexual behaviour problems and general behaviour problems).

Results showed that both SBP-focused and trauma-focused interventions reduced SBP. The caregiver practice element 'Parenting/Behaviour Management Skills' was by far the practice element most strongly associated with reduced sexual behaviour problems. Other significant practice elements were:

  • three other parent elements (Rules about Sexual Behaviour, Sex Education, and Abuse Prevention Skills),
  • one child element (Self-Control Skills),
  • family involvement, and
  • preschool-age group.

The results call into question the validity of the current clinical approach of using practice elements originally designed for adolescent or adult sexual offenders (child components of relapse prevention, assault cycle, and arousal reconditioning) to treat SBP in children. Only two of the tested treatments included these practice elements, and the elements were not significant predictors of the effect size for SBP.

Limitations of the meta-analysis included the limited number of treatment outcome studies that met the criteria for inclusion, and the quality of these studies: few randomized clinical trials have been conducted in SBP treatment. In addition, because of the small number of treatment groups identified, the analysis collapsed or aggregated some covariates. The scope of the search strategy
and the rigour of the screening methods were less than optimal, possibly
introducing bias into the review. Generalizing these results to all future SBP trials should be done with caution.

1. A practice element can be defined as a discrete clinical technique or strategy used as part of a larger intervention.

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Canadian CW research
Journal article