Problematic Sexual Behavior - Cognitive Behavioral Therapy Training and Technical Assistance Program

Dear Colleagues,

Our Oklahoma PSB-CBT Team thanks you for the care you are taking in serving children and families during this difficult time of COVID-19. To aid in your efforts, we’ve identified a number of resources that may be helpful for families navigating social distancing and for therapists working to quickly launch telehealth services. Our Oklahoma PSB-CBT website now has a page with special links and PDFs dedicated to COVID-19 resources. You can access it via the Resources page.

Please feel free to share this link with others who may benefit from this information. We also encourage you to share with us additional resources that you are finding helpful in your efforts to care for youth and families navigating the impacts of COVID-19.

Thank you again for your commitment to the families in your care. If we can be of additional assistance, please feel free to contact us.

Take care,


The Oklahoma PSB-CBT Team

The PSB-CBT Learning Collaborative was more intense than any others we have participated in, but that shouldn’t scare you away because it is well worth all the time, effort, and vulnerability! Our team grew so much through the experience, we didn’t just expand our skills and learn the treatment…we grew as a clinical team, we learned how to help our organization and community see the need and benefits of the treatment, we built connections with other teams across the country, and we felt connected and supported by our trainers. The PSB-CBT Training Team were incredible and helped our team feel safe in an intense learning process. Most importantly, we successfully implemented a new program and have seen how impactful it is and how valuable it is to our community and state.

Nicola Herting, Ph.D.
Senior Leader and Clinician
Fargo, ND

While sexual exploration and play are a natural part of childhood sexual development, some children's sexual behavior indicates more than harmless curiosity.  In cases where sexual behaviors pose a risk to the safety or well-being of the child and other children, it is imperative for families and communities to step in and intervene through proper identification, support, and treatment.

Problematic Sexual Behavior - Cognitive-Behavioral Therapy (PSB-CBT) is a comprehensive family-based clinical treatment intervention for children with problematic sexual behaviors and adolescents with illegal sexual behavior.  The PSB-CBT models were developed and tested at the Center on Child Abuse and Neglect at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma.  Training and technical assistance regarding children with PSB and adolescents with illegal sexual behavior is offered through our PSB-CBT T/TA Program to facilitate dissemination of up-to-date information and implementation of evidence-based treatments for families with youth with problematic sexual behaviors.  To support community implementation of PSB-CBT, the T/TA team has integrated the National Child Traumatic Stress Network (NCTSN) Learning Collaborative model into T/TA services to best engage and train personnel at behavioral health agencies, children's advocacy centers (CACs) and other service agencies.

The PSB-CBT T/TA Program is led by staff at the University of Oklahoma Health Sciences Center who are experienced clinical providers and trainers in PSB-CBT.  The PSB-CBT T/TA Program has significant experience in research, evaluation, training, and services for problematic or illegal sexual behavior of youth.

Our previous evaluations and experience have demonstrated an advantage for successful community implementation and sustainability of the PSB-CBT model when partnering with CACs who have leadership invested in improving practice and policy to address problematic sexual behavior of youth.  Priority or this unique training opportunity will be given to CACs or to sites partnered with their local CAC, and who are able to start serving youth as quickly as possible after the clinical training.  This is most likely to occur when agencies already have: (1) existing referrals of youth with problematic sexual behavior (or referral sources); and (2) collaborative relationships with community agencies (e.g., child protective services, children advocacy centers, law enforcement, and juvenile justice).

Important Facts about the University of Oklahoma's Treatment Model for Problematic Sexual Behavior

  1. Cognitive-behavioral and social ecological approach.

  2. Short-term, community-based outpatient program for boys and girls and their caregivers.

  3. Treatment services provided either in family or group modality with 6-8 youth in group.

  4. Requires active involvement of parents or other caregivers in family therapy sessions or in a concurrent caregivers' group.

  5. Referrals to the program often come from a variety of community partners (e.g., child protective services, juvenile justice, schools, other mental health providers, and direct from families).

  6. Very low rates (2%) of problematic sexual behavior found in 10-year follow-up of school-age youth (Carpentier, Silovsky, Chaffin, 2006).  Program evaluation of the adolescent model suggests similar rates of 2% for future problematic or illegal sexual behavior over time, which is better than the national average (Caldwell, 2017).

  7. Programs for adolescents, school-age children ages 7 - 12 and up to age 14, and preschool ages 3 - 6.

_Tx Model - pre-teens tug-of-war