Abstract: This is a tale of the journey seven young men took as they progressed through sex offender treatment. It describes their challenges and triumphs as they faced their past, present and future. The author weaves the stories of the young men into an examination of the treatment process for adolescent sexual offenders.

t is evident a significant number of sexual assaults are perpetrated by adolescents (Kahn & Lafond, 1988; Perry & Orchard, 1992). The research suggests that sexually assaultive behaviours by adolescents involve force and coercion of much younger victims, pose the risk of physical injury, and are often not their first sexual experience (Fehrenbach, Smith, Monastersky, & Deisher, 1986; Kahn & Chambers, 1991; Pierce & Pierce, 1987; Smith & Monastersky, 1986). From a preventative viewpoint, early intervention with adolescent sex offenders is necessary to reduce progression toward more serious sexually aggressive behaviours evident in adulthood (Groth, Longo, & McFadin, 1982).

There are only a small number of articles that provide treatment guidelines for adolescent sex offenders (Groth, Hobson, Lucey, & St. Pierre, 1981; Kahn & Lafond, 1988; Lombardo & DiGiorgio-Miller, 1988), and even fewer studies have examined the efficacy of these treatment approaches or methods recommended (Davis & Leitenberg, 1987; Kahn & Lafond, 1988; Rowe, 1988). Of the evaluative studies available, none have examined the process of the treatment itself.

A qualitative study offers a range of information and depth of understanding about the experience of treatment that cannot be obtained through a quantitative investigation. Exploring the experience of participants in a treatment program offers a better understanding of a complex phenomenon that is affected by various individual, interpersonal, and social factors. It is also helpful to those working with sexual offenders to be more responsive to the needs, experiences, and viewpoints of the young sexual offender.

RESEARCH DESIGN

Participant Selection
Seven male adolescents, ranging in age from 15 to 18, having completed treatment in a program for adolescent sexual offenders, agreed to participate in this study. All had committed sexually aggressive offenses against victims younger than themselves. The length of time since treatment varied from one month to three years. As well, participants were chosen for their ability to reflect on and provide a full and sensitive description of their experience (Colaizzi, 1978; Polkinghorne, 1989).

Interview Process
Qualitative data were derived from three unstructured interviews with each participant. The interviews were intended to give participants an opportunity to reflect upon their own experience of participating in a treatment program and the meaning they gave this experience. The entire interview process was focused on eliciting a response to the central question: "What is it like for you to have participated in the treatment program?" Each interview focused on clarifying meaning and exploring experiences in more depth (Field & Morse, 1985; May, 1989; Smith, 1993; Swanson-Kauffman, 1986).

FINDINGS: EXPERIENCING AN UPHILL JOURNEY

Five themes stood out most vividly in participants’ accounts of their journey: (1) contending with the rough spots, (2) feeling supported by others, (3) working hard to stay on track, (4) being transformed by the journey, and (5) the aftermath — a continuing challenge.

Theme 1: Contending with the Rough Spots
The adolescents’ accounts of the treatment program portrayed a number of personal challenges that tested their strength and ability to persevere. The difficult nature of the journey was attributed to the trying times that seemed to come and go:

It is like an ocean. You are sailing across it. At times, the waters get a little rough, like a hurricane or something will come by. But sometimes it will be calm. But you never know. The difficult times are points where the waves are getting too high. They may crash down on you, but you always seem to get back up afterwards. What I mean by that is like, if you fall down or just can’t handle it anymore, like if you freak out or something like that—afterwards you just get back up to where you were before or you just start over again. — Rick

Many said that they had a hard time sticking with the journey, as they were continually being faced with challenges such as getting the lay of the land, resisting the journey, and feeling forced to stay on track.
Getting the lay of the land. The early experience of entering the treatment program was particularly difficult and was described as a time marked by anxiety and confusion. None of the adolescents knew what to expect. Greg explained what it was like for him when he first started:

It is like taking us from here and putting us in Vietnam during the war. You don’t know what is going on, you don’t know what to do, you are out of place. You don’t know anybody and you feel that you are being attacked in a lot of different ways. That was the way I was feeling. Everybody was attacking me. — Greg

As a result, the adolescents were initially resistant and questioned whether being in the program was appropriate. Rick explained that he thought to himself, "What the hell am I doing here? I don’t need to be here."
Almost all the adolescents suggested that before they went into the program, they thought it would be easier. They were surprised by the discipline and rules, and suggested they were more restricted in comparison to their life outside.

The first couple of days, you know, it is a different schedule to go on. When you weren’t in there, you know, you go to bed when you wanted to and you wouldn’t lose all these privileges. I could watch the TV when I wanted to, go to bed when I want to. In there you go to bed at a certain time, you had a certain amount of TV. It’s totally different. I still remember them saying "It’s not Club Med." You can’t expect it to be. — Elvis

Although it took the participants differing amounts of time to adjust to the structure, it seemed to get easier for the teens once they came to understand the program expectations, had a clear sense of the program boundaries, and were willing to abide by them.
Part of the experience of entering the program was feeling alone and vulnerable. Most of the adolescents would get through this difficult time by finding a connection with someone in the program, even if this connection was obscure. As the boys began to fit in, they gradually began to feel more comfortable. Elvis explained that being accepted was important because "it was hard until they got to know you. After they knew you, they accepted you, liked you, were friends with you, talked to you."
This seemed to be the first exploration of the relationships that would continue to have a significant influence over the course of the journey.
Resisting the journey. Soon after the adolescents entered the program, they were challenged to face the issues that had brought them to treatment. This was discussed as the longest and most intense part of the journey. Initially, all except one did not want to face their issues or make the changes they needed to make. They mentioned that they "didn’t want to do it at first," "didn’t want to deal with anything," and "weren’t willing to work." As a result, they talked about attempts to avoid dealing with their issues and the expectations of the program.

Some of the avoidance was obvious, as indicated in this statement:

When I first came in, I wouldn’t do any of the work. When I was confronted, I would leave the group. Like, if somebody said you need to talk about your problem, I would just get up and leave the group. — Jack

Some would often engage in acting-out behaviour, including taking off or going AWOL, to avoid focusing on core issues.
Other attempts to avoid issues were more subtle, like "putting on a front" and pretending that everything was okay. Some found more socially appropriate ways to take a break from dealing with their issues.
Some of the teens’ resistance to the program was apparently due to lingering resistance to authority and efforts to have control in their own lives. As a result, the boys seemed to struggle to be in control in a situation where there were many external sanctions in place:

It was always a power and control issue when I first started there ... because the staff, they would try to talk to me and all that. Like you know, I wouldn’t let them talk to me. I would always walk away. I would totally ignore them. I would tell them to "F— off." I didn’t want to associate with any of them at all. — Rick

Gradually, the adolescents began to understand how they were ultimately "in control" of their lives. Greg suggested that despite the external control and structure imposed by the program, he had control of his own life in a lot of other ways. He explained. "They threw it back at you and said okay, this is the situation, here’s the problem. What are you going to do with it? Are you going to run or are you going to stick around and try to face it and deal with it?"
Feeling forced to stay on track. As a result of resistance, whether it was avoiding issues, not meeting program expectations, or fighting authority figures, the young men would experience coercion from others to stay on track. All began to realize that if they did not stop fighting the program, there would be legal ramifications. It was a very real possibility that they would either go to jail or return to jail if there was not a noticeable difference in their behaviour.
At the same time, many were feeling pressure from families, who they did not want to let down:

At that point my Mom was everything to me. In a lot of ways she still is, but it was back to where I didn’t want to disappoint her. I didn’t want to hurt her more. And so I just stuck with it instead of running, because if I ran, then I knew I would upset her. — Greg

The adolescents described how, if they challenged the rules or resisted the authority of the staff, they would feel consequences in the form of restricted privileges or "losing a level" on the motivational system. Inherent in the step down to a lower level was a reduction in privileges and unsupervised activity. Elvis was very clear in his conviction that this was "punishment."
According to the boys, the program encouraged everyone to work together as a team to promote change for each individual resident. This meant they were there to support each other. As Greg explained, "If the kids in the program saw someone making the effort, then fine, we would take them in, we would help them out." However, the teens would also confront each other and hold each other accountable. Tom explained that "You kind of get hassled a bit by the other kids in the group, and it’s not for the worst, it is for helping you." The coming to grips with, working through, and eventual resolution of personal issues and interpersonal conflict was a noted experience by the participants.

Theme 2: Feeling Supported by Others
The journey as described by participants revealed a relational context in which there was increasing knowledge of self and others through sustained connection. It was a process that seemed to include mutuality and respect as participants joined others on their journey. Their journey included increased disclosure of self and the incredible experience of feeling understood, supported, and cared for by others. It was apparent that trust was an essential foundation for this process:

It was just the basic of finding trust. That is about it. Finding trust in people, because after when I started talking to them, I felt fine. I could be open and all that. But it was just, you have to trust the person before you, like, say anything. — Rick

Having trust in the people in the residential setting was a major concern for all participants. They suggested their lack of trust at the beginning of the program contributed to their hostility and resistance, their unwillingness to talk about their feelings, and their efforts to "put on a front" and "present an image to others." It seemed they were choosing to remain hidden from others out of fear that if they were to reveal themselves, they would be rejected. However, the boys were encouraged to reveal parts of themselves and learn more about each other through disclosure in the groups. Seeing others model risk-taking and self-disclosure encouraged them to be open about their concerns as well. Through this process of self-disclosure, the adolescents experienced a healing force and gained new insights about themselves and others. This willingness to reveal one’s self was a new experience to many of the young men who, in the past, had elected not to discuss their problems with others. The participants’ stories convey a process in which the adolescents come to feel understood. The reciprocal nature of the adolescents knowing and understanding each other is particularly poignant in their descriptions. Part of knowing and understanding each other came as a result of having a "shared experience" with other adolescents in the program. Many of the adolescents stated that before they came into the program, each believed -that he was the only one with this problem. Within the program, each adolescent realized he was not unique. Greg explained that coming to realize this "takes some of the pressure off you in a way," providing a sense of relief, a sense that "we’re all in the same boat."

Because of this shared experience, the adolescents had a strong conviction that they were in the best position to understand each other and to help each other. They had "been there," they knew what the other person was thinking and feeling, and they knew how they could help the person move ahead and prevent him from falling off track.
As the teens began to involve themselves in the treatment process, by offering support and disclosing feelings, they found themselves increasingly accepted by other members. Seeing their impact on others and being able to help others led to a re-examination and eventual rejection of their belief that they had little of value to offer. The discrepancy between poor self-esteem and the feedback from others widened to a point where they were able to have a more positive view of themselves.

Most felt the staff also understood them. The young men thought the staff "really listened" and knew how they were feeling. Tom suggested that his key worker "had a grip on what (he) felt and stuff." The participants implied that, through the modeling by staff, they learned to work as a team with peers, the staff, and their families. They suggested that the program resembled a family and, in many respects, they interacted with the staff and other kids as they would have interacted with parents and siblings.
The participants indicated that the primary role their families played in their treatment was providing support. For many, this support came as a surprise, as many feared their families would withdraw when they learned about their sexual offending behaviour:

When my mom did come, she would hear these good things from the counsellors in the group, so she would be proud of me. So like I figured, although I knew she would never leave me, just up and leave me abandoned or whatever, with no support, I didn’t want to take that chance. Because I was always scared that Mom would just say like a lot of other parents, no, I don’t want nothing to do with you. — Greg

Despite this fear, all but two of the boys felt that their families were there for them, and were learning and changing along with them. These adolescents indicated their parents "wanted to be a major part of their treatment" and "wanted them to go through it together." The advantage of the treatment program was that the families could practice or experiment with new behaviours without the immediate pressure of having to live together. Families were also in the ideal position to support the boys and their changes after the program. The two boys who did not have a connection to family following the program felt somewhat alone in dealing with issues in the community. For these boys, having the staff show that they cared was particularly important because of the lack of family caring and support:

You know someone cares about you, that is all; for my case anyway. Most of the other kids in there had their families involved and they obviously knew someone cared and I know that my parents do not care about me. — Rick

Theme 3: Working Hard to Stay on Track
During the "rough spots," the adolescents would resist working on treatment and struggle to stay on track. However, despite these rough spots, the adolescents also had times when they would work with the support of others in order to forge ahead on their journey. This process was not a linear one. The adolescents would fluctuate between the rough spots, where they were fighting against treatment, and "working hard," where they put a great deal of energy into staying on track and moving forward. During those times when they felt they were on track and working hard, it was evident that they (a) had made a decision to take action, (b) were working hard, and (c) were engaged in a process of new understandings. Decision to take action. The decision to take action was not easy. Many of the participants explained they finally got tired of fighting the staff and the program. They often used the term "giving in" to describe the process of moving from "fighting the program" to "accepting the help."

I think you just get accustomed, you know, to dealing with it that you just got tired of dealing with it in such a harsh manner. Instead of trying to fight it, I turned around, turned the negative into positive energy. — Greg

They began to realize that if they did not accept the help, they would be "wasting their life" and would just end up "back in here or in jail."
Many different sources provided motivation for participants in the program. The teens felt that the motivational system helped them to stay on track and allowed them to focus on specific goals. It was also inspiring to see other adolescents doing well and leaving the program. At the same time, it was helpful to see their peers struggling with issues, as they also learned "what not to do."
The desire to get out of the program, and the recognition that this depended on them, left open the possibility that they had some control over the process. They explained that it was "all on their shoulders," they "had to meet their treatment half way," and they were the ones that "had to accept the help."

Actually, it’s not really up to the staff if (the kids) want to work. It’s up to the other person if they really want to do this or not. — Scott

Some of the young men started to accept help when they realized they were capable of responding to the challenges they faced. They started to believe in themselves and the changes they could make. Scott explained that he could "feel" a difference inside when he knew he "could do it."
Working Hard. The overall sentiment from the participants was that they worked very hard throughout the course of the program. They felt that "they had to work for everything they wanted." Because of the "uphill journey," each day was a laborious struggle:

All I know is that you had to take it day to day; and whether you liked it, the next day came. You had to deal with it, everything, over and over. — Greg

Because the lower levels had many restrictions, the adolescents anticipated that the higher levels would be easier. However, each progressive level required new skills and new behaviours:

Starting out on a bottom level where you have very few responsibilities. When you get up (to the top level), there you have basically no rules. You set your own and it is a responsibility to set your own rules for yourself. You have to be more responsible. Not goofing off. You know, if there is a problem, you take control of itso that the staff don’t have to always be there and worrying about it. You know, you can handle yourself. —Elvis

Many adolescents would describe times that were "pretty hard to go through." For some it was "dealing with issues over and over," for others it was "working things out" with their families or "facing their victim." Each individual struggle was a challenge that left the participants with a sense of accomplishment and personal agency.
New understandings. It was clear from the adolescents’ accounts that the didactic component of the treatment program, which focused on the sexual offense and how to stop it, was imperative for their feelings of success. Many of the adolescents felt that having an explanation for their sexual assault was the first step toward its control:

I would always fall off track, so I wasn’t getting the proper help. [The proper help] was to understand what my problem was, like being on a cycle and rationalizing about what you did. To understand that it is important to know to get yourself off the cycle. Understand that you are doing something wrong. I never had that type of help to understand. — Elvis

The participants explained how they began to understand the connection between other problems in their lives and their sexual assaultive behaviour. For example, when they did not know how to handle things, they would "bottle it all up inside" and eventually resort to assaultive behaviour "to feel better, or to get power, or whatever we were looking for":

I had problems that built up in me. What I was doing was expressing them in the wrong way and I knew it was wrong. — Elvis

Through their interpretive accounts, the participants indicated that many things could have contributed to their assaultive behaviour. These included their own victimization, family life, low self-esteem, rationalizing problems, feeling power, and poor anger management. In many ways, they saw themselves like other teens who had problems in their lives. Elvis explained that "they have trouble in their life and we had trouble in our lives, but in a different way."
In understanding their sexual offenses, the teens seemed to respond most to the "sexual assault cycle" as described by Ryan, Lane, Davis and Issac (1987). The concept of the "cycle" provided a framework on which the adolescents could attach their individual feelings, thoughts, and behaviours so that they could understand the cognitive, behavioural, situational, and psychological events that contributed to their offenses.
By understanding the cycle, they learned specific "tools" that they could use to stop their assaultive behaviour and counteract their usual ways of responding. Casey explained that "assaulting and how to prevent it, kind of becomes one." The adolescents talked about how they are "drilled on the material every day," until it just "sticks in your head." It was a relief to finally understand why they were doing what they were doing, and how they could stop it:

When you don’t know much about it, you don’t know what things lead up to it. There are a lot of unanswered questions which makes it hard to change unless you know the answers. If you don’t know how to change, it is hard to. With a lot of my questions and stuff being answered, it made it so you had the answers and with the answers you can change a little bit easier. — Greg

For all of the adolescents, developing empathy for their victim was a challenge. The boys were asked to think about what it would be like to be in their victim’s shoes. They had to write "in detail" what the experience would be like from the victim’s perspective. They came to understand the impact of the assault on the victim, "like the flashbacks, the delayed things, where they have nightmares for months." Finally, when appropriate, they were asked to apologize to their victim.
A second type of "new understanding" for the teen was learning to express emotions and to talk about things rather than keeping everything bottled inside. Most of the boys would try to pretend everything was okay and to hide what they were really experiencing. When asked how they were feeling, they would typically minimize with such responses as "I’m fine."
The easiest emotion for most of the boys to voice was anger, but it was also the most difficult to manage. Some of the participants indicated that anger management always was and still is a problem for them. They realize the impact that their anger can have on others and feel that they must change their behaviour if they are going to make their lives different.

Theme 4: Being Transformed by the Journey

I always used to say to the new people coming in, you are this egg and as you get through this program it starts cracking and you start breaking out of it, and when you get out of the program, you break right out of your egg. Elvis

The participants’ stories portray an evolution of self as a part of their experience of the treatment program. Many felt that they were a "whole new person" entering a "new life" when they left treatment.
Each adolescent described himself as a whole different person, a "better person," than he was before. The teens attributed much of this change to no longer acting out in inappropriate ways. Elvis explained that "you are not this bad kid any more." The adolescents saw themselves as more responsible, more mature, having a better attitude, caring more about each other, and being concerned about their own lives. Tom stated, "I don’t know, they just changed me. They did more for me and my whole life than anybody else."
Many also saw themselves as contemptible because of the sexual offense. They expressed this with such statements as "I was feeling pretty crappy about myself." When the adolescents were close to graduating from the treatment program, they started to have such questions as "Who am I outside of this group?" and "What kind of person am I going to be now?" They had to think about what they wanted to do with their lives. Casey explained this quandary:

Coming in, you know what you’ve done, you know who you are, this is what they are telling you, this is who you are. You’re going out, and it is just like, I’m all by myself and it is like, okay, well, in there this is who I was, this is what I did. Out here, what am I going to do, and who am I? — Casey

Many had the hope that if they were able to stick with their goals and stay on track, their future would be better than their past.

Theme 5: After the Journey—The Real Work
Although graduating from the treatment program was a time of celebration, the end of the program did not indicate that the change process had finished. Each adolescent was discharged from the program when the staff had the confidence that he was ready and equipped to take on new challenges back in the community. However, the real work lay ahead as the task of reorganizing their lives and implementing new behaviours lay ahead. Moving back to the world outside of the program was described as entering a "whole new world" and involved considerable uncertainty. It was a world without the same restrictions or structure. Some adolescents moved into a new living arrangement, some went to new schools, and most tried to stay away from old friends and routines that were a part of their "old track":

I forgot what the world was like. Because I hadn’t been around anywhere else but the surroundings, the cottages, on my own. So everything had changed. Within six months it was like a whole different place. — Greg

The adolescents talked about the fact that they were afraid that they would reoffend again once they left the program. They worried that "when you go back home, you may go back to your old track":

I think the hardest part was actually trying to remember that now you are out of the cottage you have to use the stuff that you learned, out here. Instead of it just being all in your head, it has to be in your heart. — Scott

It was helpful for the adolescents to know that they could keep in touch with staff at the program, visit from time to time, and get help when needed. Tom explained, "If I saw myself slipping, the first thing I would do is call. I would call the program or something if I had to." In addition to attending a process group following discharge, some of the teens kept in contact with their friends from the program. Greg explains that when he needs to talk to someone, his friends from the program would "know it is urgent, they know it is serious, and they say, let’s get together." Five of the seven boys felt that they were also supported by their parents after leaving the program. They explained that their parents had learned about their abuse cycles and could help them keep on track. In contrast, Scott and Rick did not have parental support upon leaving the program:

My mom and stepdad never thought I was ready to leave the program. They thought I should have stayed there for another year before I left. They didn’t believe in the change and they never saw the change. — Scott

The participants were also concerned about what others from the community would think about them. They imagined that most people would not accept their backgrounds. As a result, all of them were very selective about who they would talk to about their history of sexual assaultive behaviour:

But you have built it up, you just don’t go off and tell someone right away. You think about it and how they might take it. If they really like you, you know, care about you or not, and they are not going to turn their back on you. — Elvis

It was kind of like "we don’t want the criminal element in our school." You know, "I don’t want a sex offender in my school." I go "well that’s not fair at all" ... The thing they are scared of is that you were this person. Once a criminal, always a criminal. But that is not the case. But that is the typical societal stereotype. — Casey

Although most of the adolescents told a friend or a teacher whom they -. knew they could trust, in two cases the adolescents elected to tell no one = other than their immediate family.
In some cases, the teens did experience some negative reactions from people in the community. For example, Casey experienced disapproving repercussions when his new school was told about his past:

However, most of the time the adolescents found that many people were more accepting than they expected. They were pleasantly surprised to see that people would recognize the work that they had done and would not judge them by their past mistakes. Greg explained that people would think, "That’s the way he was before and this is the way he is now. I like him for the way he is now, not what he did before."
Recovering from relapses. Although the participants described having experienced significant personal growth from going through the treatment program, many of the participants experienced "relapses" into earlier patterns of behaviour after they were discharged. It was easy for them to be pulled back into the lifestyle choices that had characterized their pre-treatment life. To witness this regression was a disconcerting experience for them and took effort on their part to get back on track:

By getting into the crime stuff, it is just like you are reoffending, but in a different way. I took it that way. Because when I did get into the crime stuff, I kind of looked at it like I was reoffending. So I was like, I don’t want to be like this. — Tom

Despite these slips in different aspects of their lives, many of the adolescents were pleasantly surprised to find that in relation to their sexual offending behaviour, the counteractive thoughts were "almost automatic" or they had no thoughts of reoffending. In contrast, Scott suggested that he had to face the decision about what kind of life he would live after the program. Part of this was deciding whether he would offend again or not.
It seemed that Elvis was the only adolescent in this study who felt that things had been quite smooth since his stay at the program. He had connected with a teacher from his school who continued to support him and encouraged him to try new things:

I grew and matured a lot in the program. But after I got out of there, I did a lot more growing up and maturing. Getting into the martial arts and stuff, I started hanging around with people that were more mature. So that helped. — Elvis

For all of the other adolescents, life outside the program is a daily challenge as they continue on their "uphill journey" toward building a better life for themselves.

DISCUSSION/IMPLICATIONS
The stories told by the adolescents in this study suggest that day-to-day interactions in the treatment program are of utmost significance. The adolescents recalled a number of daily events that stood out for them as noteworthy, whether it was waking up, doing chores, having fun, or attending groups. It seems that the "treatment" offered by the program could not be confined to counselling sessions or group therapy. Instead, almost everything that goes on in the daily lives of adolescents in treatment must be construed as potentially therapeutic.
This study also demonstrates the significance of the peer group to the adolescent’s development. For example, many of the adolescents stated that before entering the treatment program they were shy, lacked positive social skills, and functioned poorly in peer interactions. It seems that by being encouraged to interact in the treatment milieu, the teens became more effective in their interpersonal skills. By helping others, the young men gained added proof of their own competence and worthiness. This experience supports the research that suggests that the phenomenon of peer influence has been regarded as very powerful in the socialization of children (Schaefer, 1980).
Caring relationships, which included empathy, trust, security, and compassion, seemed to be the foundation for the experience upon which the change process occurred for these adolescents. This experience fits with Stone Center theorists who suggest that people develop through their increasing ability to build and enlarge mutually enhancing relationships (Surrey, 1985). Stated simply, as the quality of relationships grows, the individual grows. The experience of the young males in this study demonstrates that boys who lead a life of disconnection and violence can learn to participate in non-self-centered, mutual relationships and can learn to grow in connection.

Implications for Treatment
In completing this project, I am aware that institutional solutions to human problems are becoming unfashionable. The most common criticism is based on the suggestion that effects gained in residential treatment do not generalize because of the lack of similarity between institutional and community life (Brendtro & Wasmund, 1989; Garrett & Marler, 1989).
However, looking at outcome measures alone may be too unidimensional to truly assess the value of a treatment program. Brownwell, Marlatt, Lichtenstein, and Wilson (1986) explain that the risk for relapse is determined by individual factors (negative emotional states, inadequate motivation, lack of coping skills, response to treatment, and physiological factors) and social factors (social support and external contingencies). As can be seen, response to treatment is only one factor in many that should be considered in ensuring maintenance of desired behaviour.
The experience of these adolescents suggests the key to successful integration of the sexual offender into the community appears to be the establishment of linkages with community resources and support systems. Such factors include the availability of support from family and peer networks, and the presence of accepting school and community environments.
Every effort should be made to treat children in connection with their families and communities, and families should be involved in as many facets of the treatment process as possible. Including family members in the treatment process suggests to the families and the adolescent that everyone has an important role to play in the helping process. Family members can be taught new skills, can take part in solving problems, and can learn new ways of interacting with each other.
In respect to this particular treatment program, it seems to have been successful in addressing its "missions" in responsibility, healing, wellness, education, and connectedness. In interviews with the adolescents, it was found that the youth were generally enthusiastic about their experience and eager to describe the help that they received from the treatment program.

References
Brendtro, L.K., & Wasmund, W. (1989). The peer culture model. In R.D. Lyman, S. Prentice-Duim, & S. Gabel (Eds.), Residential and inpatient treatment of children and adolescents (pp. 81—96). New York: Plenum Press.

Brownwell, K.D., Marlatt, G.A., Lichtenstein, E., & Wilson, G.T. (1986). Understanding and preventing relapse. American Psychologist, 41, 765—782.

Colaizzi, P.F. (1978). Psychological research as the phenomenologist views it. In R.S. Valle & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48—71). New York: Oxford University Press.

Davis, G.E., & Leitenberg, H. (1987). Adolescent sex offenders. Psychological Bulletin, 101, 417—427.

Fehrenbach, P.A., Smith, W., Monastersky, C., & Deisher, R.W. (1986). Adolescent sex offenders: Offender and offense characteristics. American Journal of Orthopsychiatry, 56, 225—233.

Field, P.A., & Morse, J.M. (1985). Nursing research: The application of qualitative approaches. Rockville: Aspen.

Garrett, C.J., & Marler, B.K. (1989). Conduct-disordered children and adolescents. In R.D. Lyman, S. Prentice-Dunn, & S. Gabel (Eds.), Residential and inpatient treatment of children and adolescents (pp. 289—304). New York: Plenum Press.

Groth, A.N., Hobson, W.F., Lucey, K.P., & St. Pierre, J. (1981). Juvenile sex offenders: Guidelines for treatment. International Journal of Offender Therapy and Comparative Criminology, 25, 265—272.

Groth, A.N., Longo, R.E., & McFadin, J.B. (1982). Undetected recidivism among rapists and child molesters. Crime and Delinquency, 28, 450—458.

Kahn, T.J., & Chambers, H.J. (1991). Assessing reoffense risk and juvenile sexual offenders. Child Welfare, 70, 333—345.

Kahn, T.J., & Lafond, M.A. (1988). Treatment of the adolescent sexual offender. Child and Adolescent Social Work Journal, 5, 135—148.

Lombardo, R., & DiGiorgio-Miller, J. (1988). Concepts and techniques in working with juvenile sex offenders. Journal of Offender Counseling, Services and Rehabilitation, 13, 39—53.

May, K.A. (1989). Interview techniques in qualitative research: concerns and challenges. In J.M. Morse (Ed.), Qualitative nursing research: A contemporary dialogue (pp. 171—182). Rockville: Aspen.

Perry, G.P., & Orchard, J. (1992). Assessment and treatment of adolescent sex offenders. Sarasota, FL: Professional Resource Exchange.

Pierce, L.H., & Pierce, R.L. (1987). Incestuous victimization by juvenile sex offenders. Journal of Family Violence, 2, 351—364.

Polkinghorne, D.E. (1989). Phenomenological research methods. In R.S. Valle & S. King (Eds.), Existential-phenomenological perspectives in psychology (pp. 41—60). New York: Plenum Press.

Rowe, B. (1988). Practical treatment of adolescent sexual offenders. Journal of Child Care, 3(6), 51—58.

Ryan, G., Lane, S., Davis, J., & Issac, C. (1987). Juvenile sexual offenders: Development and corrections. Child Abuse and Neglect, 11, 385—389.

Schaefer, C. (1980). The impact of the peer culture in the residential treatment of youth. Adolescence, 15, 831—845.

Smith, J.K. (1993). Hermeneutics and qualitative inquiry. In D.J. Flinders & G.E. Mills (Eds.), Theory and concepts in qualitative research: Perspectives from the field (pp. 183-200). New York: Teachers’ College Press.

Smith, W.R., & Monastersky, C. (1986). Assessing juvenile sexual offenders’ risk for reoffending. Criminal Justice and Behavior, 13, 115—140.

Surrey, J.L. (1985). Self in relation: A theory of women’s development (Work in progress, No. 13). Wellesley, MA: Stone Center Working Papers Series.

Swanson-Kauffman, K.M. (1986). A combined qualitative methodology for nursing research. Advances in Nursing Science, 8(3) 58—69.

This feature: Sandra Martin (1997) Sex Offender Treatment: An Uphill Journey. Journal of Child and Youth Care, Vol. 11 No. 1 pp 27-42