SAFE–T (OJJDP Model Program Guide)

Office of Justice Programs, Innovation - Partnerships – Safer Neighborhoods

Office of Juvenile Justice and Delinquency Prevention (OJJDP) Serving Children, Families and Communities

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SAFE–T

Intervention:

The Sexual Abuse: Family Education and Treatment (SAFE–T) Program is a specialized, community-based program that provides sexual abuse–specific assessment, treatment, consultation, and long-term support to 1) child victims of incest and their families (including adult incest offenders), 2) children with sexual behavior problems and their families, and 3) adolescent sexual offenders and their families.

The SAFE–T Program is initiated with a comprehensive clinical and psychometric assessment that assists in the development of individualized treatment plans for adolescent offenders and their families; treatment goals are usually reviewed every 6 months. The course of treatment depends on the clinical needs of the offender, as well as the availability and willingness of family members. Offenders are typically involved in group, individual, and family therapy. SAFE–T is a family-oriented program; thus, treatment providers work collaboratively with adolescents and their family members to address the risk of sexual reoffense and other important clinical needs that may be present (e.g., antisocial attitudes, depression, and social problems) while building on individual and family strengths at the same time.

The program uses a variety of cognitive–behavioral and relapse-prevention strategies and addresses issues related to denial and accountability, deviant sexual arousal, sexual attitudes, and victim empathy. Though the program is individualized, there are common topics that are addressed during treatment, including developing offense-prevention plans, enhancing awareness of victim impact, reducing the impact of traumatic past events, and enhancing family communication and relationships. Related treatment goals include the enhancement of social skills, self-esteem, body image, appropriate anger expression, trust, and intimacy.

Over the past two decades, the program has undergone some changes. For instance, the average length of treatment is now about 16 months (down from 24 months) because the intensity of individualized treatment is more closely matched to the estimated level of an adolescent’s risk of reoffending. In addition, discussions about the details of an adolescent’s past sexual offending and sexual interests are now primarily kept to individual treatment sessions. Group sessions concentrate more on the development of the skills and attitudes necessary for healthy interpersonal and sexual relationships

Evaluation Methodology:

Study 1
Worling, Litteljohn, and Bookalam (2010) conducted a 20-year prospective follow-up study of the SAFE–T Program in Toronto, Ontario. The study was a 10-year extension of a previous 10-year follow-up study (Worling and Curwen 2000). Study participants included 148 adolescents (139 males and 9 females) who were convicted of or acknowledged a sexual offense, as defined by the Criminal Code of Canada. The adolescents had been assessed by the SAFE–T Program between October 1987 and October 1995. At the time of the initial assessment, adolescents were between 12 and 19 years old (with an average age of 15). The average age of participants at the time of this follow-up study was 31½ years. The victims they had sexually assaulted were

Intrafamilial (28 percent), extrafamilial (55 percent), or both (17 percent)
Female (61 percent), male (16 percent), or both (23 percent)
Children (55 percent), peers/adults (35 percent), or both (10 percent)

The SAFE–T treatment group consisted of 58 adolescents (53 males and 5 females) who participated in at least 10 months of specialized treatment. All adolescents in the treatment group received individual therapy, and most of them also participated in group and family therapy. The average length of treatment overall was 24.42 months. Adolescents who dropped out of treatment after 12 months were classified as members of the treatment group. Slightly fewer than one third (18 out of 58) of the treatment group dropped out after 12 months of treatment, but before completing the entire program. The comparison group consisted of 90 adolescents (86 males and 4 females). About half of the comparison group received only an assessment from staff at the SAFE–T Program, but they received treatment elsewhere. The group also included 17 adolescents who refused treatment (treatment refusers) and 28 adolescents who dropped out of treatment before a 12-month period (treatment dropouts). Overall, 67 percent of the comparison group received treatment from outside the SAFE–T Program, but information regarding the nature of the treatment was unavailable. There were no statistically significant differences between the groups with respect to personal characteristics, offense characteristics, or any of the scores that came from numerous psychological tests given to adolescents during the initial assessment.

Data on recidivism (measured as criminal charges) for the 20-year follow-up period (October 1987 to October 2007) was collected from the Canadian Police Information Centre. The follow-up period for this study ranged from a minimum of 12 years to a maximum of 20 years. Recidivism data was classified into three categories: 1) sexual offenses (any Canadian Criminal Code offense of a sexual nature); 2) violent nonsexual offenses (any criminal charges involving actual or threatened violence toward a person such as assault, assault with a weapon, robbery, or uttering death threats); and 3) nonviolent offenses (offenses such as theft, break and enter, weapon possession, trafficking in narcotics, or breach of probation).

The study looked at the number of different charges that recidivists accumulated over the 20-year period and at the number of different reoffense episodes (i.e., discrete days on which a recidivist reoffended). It also examined the number of recidivists who accrued new sexual offense charges as adults (age 18 and older). Kaplan–Meier survival functions were used to compare the 20-year recidivism rates between the treatment and comparison groups. Tests for differences between survival functions are reported as chi-square values based on the log rank statistic.

Evaluation Outcome:

Study 1
Recidivism
At the 20-year follow-up, Worling, Litteljohn, and Bookalam (2010) found that adolescents who received treatment through the Sexual Abuse: Family Education and Treatment (SAFE–T) Program were significantly less likely to be charged for a sexual reoffense, a nonsexual violent offense, a nonviolent offense, or any criminal reoffense. For example, only 9 percent of the treatment group was charged with a sexual reoffense, compared with 21 percent of the control group.

The recidivism data was examined from a harm-reduction standpoint (i.e., the number of new criminal charges and the number of discrete episodes (days) involving new charges). There was a general trend for recidivists from the comparison group to accumulate a higher average number of charges and to have reoffended on a higher average number of different occasions. However, the difference between the treatment and comparison groups was not significant.

Other Information:

References:

Worling, James R. 1998. “Adolescent Sexual Offender Treatment at the SAFE–T Program.” In William L. Marshall, Yolanda M Fernandez, Stephen M. Hudson, and Tony Ward (eds.). Sourcebook of Treatment Programs for Sexual Offenders. New York, N.Y.: Plenum.

Worling, James R., and Tracey Curwen. 2000. “Adolescent Sexual Abuse Offender Recidivism: Success of Specialized Treatment and Implications for Risk Prediction.” Child Abuse and Neglect 24(7): 965–82.

Worling, James R., Ariel Litteljohn, and David Bookalam. 2010. “20-Year Prospective Follow-Up Study of Specialized Treatment for Adolescents Who Offended Sexually.” Behavioral Sciences and the Law 28:46–57.

Program Specification:

New Rating:

Promising

Re-reviewed Date:

October 2011

Program Type:

Cognitive Behavioral Treatment

Family Therapy

Wraparound / Case Management

Ethnicity:

Asian

African American

Hispanic or Latino (of any race)

White

Gender:

Both

Age:

12 - 19

Special Populations:

Sex Offenders

Target Settings:

Suburban

Urban

Problem Behaviors:

Delinquency

Sexual Activity/Exploitation

Risk & Protective Factors:

Risk

Protective

Additional Information:

Status:

Program is in operation at this time.

Performance Measures:

Suggested OJJDP Performance Measures for the Program Types(s):

Mental Health Services
Cognitive Behavioral Treatment
Logic Model: PDF
Performance Matrix:PDF
Delinquency Prevention
Family Therapy
Logic Model: PDF
Performance Matrix:PDF
Mental Health Services
Family Therapy
Logic Model: PDF
Performance Matrix:PDF

Contact Information:

Program Developer:
Barbara Rodgers, Director
SAFE–T Program
51 Panorama Court
Toronto, On M9V 4L8
Phone: 4163260647
Fax: 4163266581
Email: Click Here

Program Locations:
Staff
SAFE–T Program
15 Warrendale Court
Toronto, On M9V 1P9