email page print pageAll Topic Reviews
269 Amazing Sex GamesA History of MarriageA Pocket History of Sex in the Twentieth CenturyActionAll the WayAlways Forever MaybeAmerica UnzippedAmerica UnzippedAmerica's Sexual TransformationAmerican EugenicsAmerican GirlsAmerican HookupAn Interpretation of DesireAnarchism & SexualityAnatomy of a BoyfriendAnatomy of LoveAnthony GoicoleaAnticlimaxArt and HomosexualityArt/PornAssuming a BodyAutoportraitBachelors and BunniesBecoming OrgasmicBehind the Red DoorBest Sex Writing 2005Better Sex Through YogaBetter Sex Through YogaBetter Than EverBetween Mom and JoBeyond Diversity DayBeyond SexualityBeyond SpeechBeyond ToleranceBig Porn IncBill HensonBodies in DoubtBody ImagesBonkBoys Don't CryBreasts - A DocumentaryBrothelBuying SexCase Studies in Communication about SexCase Studies in Sexual DevianceCaught in the WebCelibaciesChildren and SexualityChildren and the Politics of SexualityChildren with Sexual Behavior ProblemsChildren, Sexuality and SexualizationChristy ReportClay's WayClinical Manual of Women's Mental HealthClose toYouClumsyCold HitCollege SexComing of Age in AmericaConfessions of the Other MotherCybersexCyborgasmDare... to Make Love with 2, 3, 4... or MoreDare... to Try BisexualityDating: Philosophy for EveryoneDeadly ButterflyDebating Same-Sex MarriageDeep GossipDeparting from DevianceDesire, Love, and IdentityDigital DiariesDilemmas of DesireDirty MindsDirty StoriesDisorders Of DesireDisorders of Sex Development:Doing ItDoing ItDoing It Down UnderDown and Dirty Sex SecretsDude, You're a FagEarly Embraces IIIEmerald City BluesEmotionally InvolvedEnjoying Guilty PleasuresErotic CapitalErotic InnocenceErotic PassionsEthics, Sexual Orientation, and Choices about ChildrenEveryday PornographyEvolution and Human Sexual BehaviorExploring TranssexualismFade to BlackFagbugFaking ItFamilies Like MineFast GirlsFinal JeopardyFinding H. F.Fire on the Mountain DVDFor Lesbian ParentsFor The Bible Tells Me SoForbiddenFrictionFrom Disgust to HumanityFrom Shame to SinFuckologyGay, Straight, and the Reason WhyGender in the MirrorGender OutlawsGeography ClubGetting OffGetting RealGetting the Love You WantGirls & SexGirls Gone MildGirls Gone SkankGLBTQGoddess WorshipGoing DownGood GirlsGood PornGood Sex IllustratedGreat Answers to Difficult Questions About SexGuide To Getting It OnHandbook New Sexuality StudiesHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHard to GetHardcore from the HeartHear Us Out!HeterosyncraciesHit & MissHomosexualitiesHookedHooking UpHow Sex Became a Civil LibertyHow Sex ChangedHow Sex WorksHow To Be GayHow to Do Things with Pornography How to Give Her Absolute PleasureHow to Have Magnificent SexHow to Make Great Love to a ManHow to Make Great Love to a WomanHow to Make Love Like a Porn StarHow to Think More About SexHypnography for MenHypnography for WomenHysterical MenI'd Rather Eat ChocolateI'll Be Your MirrorIf Men Could TalkImpotenceIn a Queer VoiceIn Praise of the WhipIn the Mood, AgainInsatiable WivesIntense Games DVDInvestigating Young People's Sexual CulturesIt's Perfectly NormalIt's Perfectly NormalItís Your HourJane Sexes It UpJock SturgesJust Between UsKama-Sutra--The Secrets to the Art of LoveKids Gone WildLegalizing ProstitutionLegalizing ProstitutionLet's Get This StraightLets Talk about SexLetters to Penthouse Vol. 50Likely to DieLittle ChicagoLoose GirlLosing Matt ShepardLoveLove and DesireLove and SexLove JunkieLove Lust DesireLove SickLustMad for FoucaultMagical ThinkingMaking American BoysMaking Babies the Hard WayMaking Chastity SexyMaking Peace with PornMaking ScenesMale SexualityMalefemaleMaster BreastsMating in CaptivityMedicalized MasculinitiesMelancholia and MoralismMenMental Health Issues in Lesbian, Gay, Bisexual, and Transgender Communities MiddlesexMoney ShotMoral Panics, Sex PanicsMy Girlfriend Comes to the City and Beats Me UpMy HeartbeatMy Horizontal LifeName All the AnimalsNatural BeautyNerveNerveNew Sex Now DVDNightswimmingNone of the AboveNormalNormalNot GayNot My ShameNot The Marrying KindNot Under My RoofNothing PinkOedipus WreckedOn Being RapedOne Hot SecondOne Hour in ParisOpenOrgasmOrgasm Inc.OrgasmologyOrgasmsOver 100 Truly Astonishing Sex TipsOverexposedPeekPeriod PiecesPervPhilosophizing About Sex Philosophy of Love, Sex, and MarriagePin-up GrrrlsPINSPlease Don't Kill the FreshmanPolicing SexualityPolyamory in the 21st CenturyPornPorn NationPorn StudiesPorn UniversityPornifiedPornlandPornographyPornographyPornography, Sex, and FeminismPosition Of The Day PlaybookPray the Gay AwayPredatorsPremarital Sex in AmericaPrinciples and Practice of Sex TherapyPrivate Dicks - Men ExposedPrivate Practices DVDProblem GirlsPrudePsychopathia SexualisQueer PhilosophyRapeRape Is RapeRated X - A Journey Through PornRazmatazRecruiting Young LoveRedefining GirlyRedefining RapeRegulating SexRelax, It's Just SexRethinking Gender and Sexuality in ChildhoodRethinking RapeRunning with ScissorsSatan's Sex BookScreening SexSelling Sex ShortSexSex & Single GirlsSex (Ed)Sex and SpiritSex and the American TeenagerSex and the SoulSex and the Soul, Updated EditionSex and WarSex at DawnSex by NumbersSex DetoxSex Fiends, Perverts, and PedophilesSex in CrisisSex ObjectSex OffendersSex on the BrainSex PositionsSex Q & ASex, Family, and the Culture WarsSex, or the UnbearableSex, Therapy, and KidsSex, Time and PowerSextasySexting and Young PeopleSexual ArtSexual Boundary ViolationsSexual DevianceSexual DisordersSexual EcstasySexual EthicsSexual FluiditySexual IntelligenceSexual Orientation and Psychodynamic PsychotherapySexual Orientation and School PolicySexual PleasureSexual PredatorsSexual Teens, Sexual MediaSexuality in AdolescenceSexuationSexyBookShameShamelessShy GirlSlutWalkSmall FavorsSmutSocial Control of Sex OffendersSome Assembly RequiredSplit ScreenStir-FryStraight to JesusStrange BedfellowsStripped BareSurviving Sexual ViolenceSymptoms of Being HumanTalkTalk to Me FirstTechniques of PleasureTestosterone RexThe Anthropology of SexThe BabiesThe Better Sex Guide to the Kama SutraThe Big Book of PornThe Birth of the PillThe Blue Moon Erotic Reader IIIThe BodyThe Breast BookThe Breath of Tantric LoveThe Busy Couple's Guide to Great SexThe Case of the Female OrgasmThe Chemistry Between UsThe Clitoral TruthThe Dangerous Art of Blending InThe Education of SophieThe Emergence of SexualityThe End Of AliceThe End of SexThe Erotic EdgeThe Erotic Lives of WomenThe Essential KamasutraThe Evolution of BeautyThe Fate of GenderThe First Man-Made ManThe First TimeThe Gay Baby BoomThe Good Vibrations Guide to SexThe Happy Hook-UpThe Hite ReportThe Humble Little CondomThe Illustrated Guide to Extended Massive OrgasmThe Illustrated Story of OThe Love CureThe Madness of WomenThe Men They Will BecomeThe Mirror of LoveThe Miseducation of Cameron PostThe Moral Panics of SexualityThe Naked Truth About SexThe Nature of Sexual DesireThe New Erotic PhotographyThe New Gay TeenagerThe Notebook GirlsThe Only Girl in the CarThe Order of the Poison OakThe Origins of SexThe Other HollywoodThe Other PlaceThe Other Side of DesireThe Perils of MasculinityThe Perversion of YouthThe PervertThe Philosophy of PornographyThe Philosophy of Sex: Contemporary ReadingsThe Pleasure's All MineThe Politics Of LustThe Porn TrapThe Pornographer's GriefThe Pornography IndustryThe Praeger Handbook of TranssexualityThe Psychodynamics of Gender and Gender RoleThe Purity MythThe Real Truth About Teens and SexThe Right to Be ParentsThe Secret Lives of GirlsThe Sex Addiction WorkbookThe Sex Lives of TeenagersThe Sex MythThe Shared HeartThe Sleep of ReasonThe Smart Girl's Guide to PornThe State of AffairsThe Story of SexThe SurrenderThe Ten Minute Sexual SolutionThe Tenth CircleThe Transformations of GwenThe Transformations of GwenThe Trauma MythThe Ultimate Guide to Sex and DisabilityThe Vagina MonologuesThe ValleyThe Violence of CareThe Virgin BlueThe Virginity ClubThings Tom LikesThinking KinkThinking XXXToo Hot to HandleTransTransTransgender Children and YouthUltimate JudgementUltimate SexUndoing GenderUnlikelyUntangling the WebUntrue VirginVirgin NationVirgin Sex for GirlsVirgin Sex for GuysVirginity LostWhat Does Consent Really Mean?What Women WantWhat's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhat's Happening to Tom?What's Wrong with Homosexuality?When Jeff Comes HomeWhen Sex Goes to SchoolWhen the Piano StopsWhere Do We Fall When We Fall in Love?Who Has What?Who's Been Sleeping in Your HeadWilhelm ReichWired for IntimacyWomen and Child Sexual AbuseWomen and MadnessWritten in the FleshYou Know Me WellZen Sex
If you are a clinician and work with children and families, it is almost certainly that you have encountered a child in your office or in the community that the parent/s is highly concerned about their son or daughter's sexual acting out behaviors. Many of these behaviors, in my experience, have ranged from benign and completely developmentally appropriate to behaviors that are surely symptoms needing to be targeted and raise questions about inherent "assumptions" that these behaviors must be learned from somewhere. In American society, sex and sexuality continue to be subjects that are feared, ignored, silenced, or simply brushed to the side. With these cultural and societal influences, there is no wonder why many clinicians don't feel prepared to answer such questions from parents. Many clinicians simply refer clients to "experts" in the community in order to avoid having to make a decision about how to appropriately intervene. Frankly, training around sexual behavior problems in children, adolescents and even adults are quite lacking in the mental health field. Moreover, unless you attend a specialized training program that targets these issues, it is hard to find worthy training at all around sexual behavior issues. Given the relative commonality of expressions of sex and sexuality in addition to the relative common histories of chaotic home environments, physical abuse and neglect, and sexual abuse histories, a focus in educating current and future clinicians seems obvious. Yet, as a society, we are behind in the research targeting sexual behavior problems, particularly the pathogenesis of sexual behavior problems. To date, there are very few large sample studies that target normative versus pathological sexual behavior problems. Fortunately, for the mental health and research fields, William N. Friedrich has written a book that not only addresses normative versus pathological sexual behaviors in children and adolescents, it goes the most important step further and describes a treatment approach that targets the influence and role of the family as well as the role attachment plays in these behaviors. As Friedrich writes, "sexual behavior problems are relational and should be treated as such."
Friedrich's book, from start to finish, is clearly articulated and well-focused. He takes the reader from the overview of the book, through the research and rationale for this type of an approach, to a sequenced assessment and treatment manual of sexual behavior problems. If one is a part of the therapeutic community, then one is acutely aware of the intense debates that take place regarding the role of attachment in the treatment of children who come from chaotic backgrounds and have lacked the stability and predictability that help children develop the appropriate skills to regulate their affects, understand and maintain healthy and safe relationships, develop solid sense-of-self, and help individuals develop behavioral control mechanisms. The undisputed fact is that attachment is a very real part of human development and is correlated with healthy development. What is constantly being debated is how does one utilize this knowledge to create appropriate and data supported treatments for children who have chaotic and disrupted backgrounds and develop maladaptive coping strategies to manage life's daily challenges.
There is an abundance of "theorists" touting how to approach children who have "attachment disorders" that have actually been proven to be harmful, however Friedrich takes his emphasis on "relational" and integrates a model of treatment that holds significant support for its efficacy. Parent-Child Interaction Therapy is a model of therapy that focuses on increasing a parent's ability to respond to the needs of their child, integrates behavioral approaches to parenting, and emphasizes nurturing the parent-child relationship. The idea being that improved parenting skill, improved awareness of the needs of a child by a parent, improved consistency and behavioral approaches, provides the stability and structure that helps the child to develop a closer relationship with parents and, in turn, allows the parent to begin to improve positive feelings about and see their child in more loving ways.
Friedrich has taken the view that sexual behavior problems in children and adolescents have particular risk factors making it more likely that one will develop sexual behavior problem, one being a history of chaotic homes and the lack of a child's needs being met. Furthermore, he claims that due to the histories of the "culture" around sex and sexuality a family brings to the existence and more importantly maintenance of sexual behavior problems, targeting families is a key aspect to improving targeted behaviors. Friedrich suggest that a targeted intervention promoting effective and behaviorally driven parenting skills, increasing awareness and response to a child's needs, targeting psycho-education and skill development within the child, and emphasizing nurturing environments, will lead to better and sustainable outcomes for these individuals and families. As an evidenced driven therapist, I can appreciate a Family-Based, Attachment-Oriented approach to working with families with children that express sexual behavior problems. What this approach does, is allows for the normalization of sexual behavior, provides the needed psycho-education on appropriate sexual development, provides an emphasis on families to solve their problems and increase their ability to effectively parent, and gives the child skills to manage their life without resorting to sexualized behaviors as a coping strategy.
Overall, Friedrich's book Children with Sexual Behavior Problems: Family-Based, Attachment-Focused Therapy, is a thorough overview and practical treatment guide for treating children with sexual behavior issues. Given that much of his data that was presented in this book came from his own studies, additional research and data are needed to fully test the validity of a Family-Centered, Attachment-Focused approach utilizing Parent-Child Interaction Therapy as a major means of increasing parenting skills of children with sexual behavior problems. Furthermore, aside from the anecdotal evidence presented, further investigation into understanding the mechanisms of change, and isolating the strategies that are most helpful with this type of approach would be extremely helpful for the therapeutic community. I would recommend this book for any practitioner that focuses their practice on treating children, adolescents and families.
© 2010 Ryan R. Lindsay
Ryan R. Lindsay, LCSW, St. Louis Center for Family Development, LLC, Clinical Director/Co-Founder, [email protected] Ryan Lindsay is the Clinical Director and co-founder of the St. Louis Center for Family Development, LLC, a mental health and social service agency that provides in-home, trauma-informed, evidenced-based interventions to individuals in the St. Louis, MO community. Prior to his current position, he was the co-founder of the Ann Arbor DBT Center and worked to develop and help lead an Adolescent DBT Program for Washtenaw County Community Support and Treatment Services in Ann Arbor, MI. Ryan works daily to improve the lives of those individuals who suffer from emotional pain as a result of trauma.