In 2007, when he was 15, Edgar Coker pleaded guilty to raping a friend. Though Coker maintained his innocence and said he had only consensual sex with the accuser, a 14-year-old girl with a mental disability, Coker’s court appointed attorney advised him to enter the guilty plea in order to avoid being charged as an adult and he was sentenced to serve over a year in the Hanover Juvenile Correctional Facility in Virginia.
With an IQ of 78, Coker himself was deemed borderline intellectually disabled and, two months after he was sentenced, the girl recanted. She said she told the police she was raped when her mother caught her “pulling up her pants” at the family home after having sex with him.
Coker was eventually released and a circuit court in Stafford County vacated his charges. But despite his innocence, Coker underwent therapy at Hanover to prevent him from sexually reoffending, which included admitting guilt in the rape case, according to Jeree Thomas, who performed legal research for Coker’s habeas petition that led to his exoneration in 2014.
“Treatment is helpful, but for [kids] who are in sex offender treatment, they have to show remorse,” Thomas, now a policy director at the Campaign for Youth Justice, told The Appeal. “There’s a whole process. In Coker’s case, where he and the young woman were about the same age and intellectual capacity, they told him he needed to say he raped her.”
That kind of treatment, experts say, is ineffective.
Since 2006, when a federal law was enacted that required children convicted (not just charged) of aggravated sexual offenses who are 14 and older to be included on the national sex offender public registry, nearly 200,000 young people have been placed on the registry. African-Americans like Coker are disproportionately represented on the registry; the sex offender registration rate for black people is twice that of whites.
Many young people on the registry have had to undergo psychotherapy, which includes sessions of “relapse prevention”—a type of treatment used for people with substance use disorder—while attending inpatient or detention centers. But relapse prevention has never been proved effective in treating young people who commit sexual offenses. Moreover, studies show that only 5 to 14 percent of juveniles who commit sexual offenses are likely reoffend.
The low recidivism rate has more to do with the way children’s brains develop throughout their teens, according to juvenile justice experts.
“Kids grow up, they enter puberty and they become very sexually curious,” said David Prescott, clinical services development director for the Becket Family of Services, an alliance of nonprofit agencies that studies youth sexual behaviors. “Also, adolescents challenge authority and break rules. So, when you get all of those things in that stage of life, especially with kids less supervised, we shouldn’t be surprised when they do stupid stuff.”
Relapse prevention treatment is under the umbrella of cognitive behavioral therapy, or CBT, and focuses on self-regulating behavior if individuals find themselves in a situation where they might reoffend.
The therapy works from a substance use disorder treatment model where, for example, drug users who feel compelled to use are taught to evaluate their situation and walk away. But substance use disorder is far different than a sexual impulse, said Pamela Yates, a Canadian forensic psychology researcher for Cabot Consulting and Research Services.
“The addiction model never fit well,” Yates said. “Sexual behavior is biologically ingrained in individuals. Having a goal of abstaining for individuals is unrealistic and unlikely to be achieved.”
In Virginia, where Coker was sentenced, a state report recommended relapse prevention along with empathy development as options for treatment of youth sex offenders, citing a 2008 study that found that over over 80 percent of mental health professionals supported the treatment. But the report also acknowledged, “given the lack of studies, these components are not designated as evidence based.”
A spokesperson for the Virginia Department of Juvenile Justice said the state uses relapse prevention as one treatment option, adding that its program “utilizes an individualized, holistic, cognitive behavioral and strengths-based approach, which encompasses individual, group and family therapies.”
The number of juvenile detention or correctional facilities that use relapse prevention methods is unclear, but a 2009 study—the most recent year available—found that more than 50 percent of jurisdictions in the U.S. and Canada continue to use it for juvenile sex offenders. In some jurisdictions, even more archaic methods are used.
“Some [kids] go into older-school models, where they have kids masturbate to images to the point of pain,” said Paul Shawler with the National Center on the Sexual Behavior of Youth. Indeed, one treatment model instructed kids to masturbate to an illicit image and then sniff ammonia until their “state of sexual arousal is completely removed.”
There is no federal oversight of treatment for young people who commit sex offenses, so states set the standards. This means that treatment varies from the progressive (multisystemic therapy, or MST, in which young people are encouraged to engage with their communities and families) to non-evidence based (using drugs that reduce arousal).
“People are trying the best with the tools they have,” Shawler said. “But what we do know is the more restrictive [of sexual behavior] we are in our treatments, the more it becomes highly problematic.”
Prescott of Becket Family of Service advocates the Good Lives Model, which uses a combination of MST and CBT that addresses underlying problems—such as feeling emotionally disconnected from peers—that might have turned into an inappropriate touch.
But Yates, the forensic psychologist, says that the Good Lives Model and other progressive treatment models are not widely used. As a result, non-evidence based science that hasn’t been proved effective in reducing recidivism is informing treatment for sex offenders in prisons and detention centers. “Many of these interventions in place just aren’t research-based,” Yates said. “Those are resources that could be redirected into other places” such as MST treatment. “As a result, now, there are practices that actually work against public safety.”
Correction: In a previous version of this story, Pamela Yates was identified as a forensic psychologist and researcher. Because Yates is a non-practicing psychologist, her correct title is forensic psychology researcher.