What is PSB-CBT?

While sexual exploration and play are a natural part of childhood sexual development, some children’s sexual behavior is more than harmless curiosity and requires specialized intervention. When sexual behaviors impacts the safety or well-being of the child and other children, it is important for families to obtain support and treatment.

Developed by the University of Oklahoma, PSB-CBT is an evidence-based therapy offered to children ages 3-14.  Weekly sessions with the child and caregiver address:

  • Supervision and safety;
  • Parenting strategies;
  • Rules about sexual behavior and boundaries;
  • Abuse prevention;
  • Age-appropriate sexual education.

How Does PSB-CBT Help?

PSB-CBT aims to eliminate problematic sexual behaviors and improve prosocial behavior and adjustment in children, while reducing stress and enhancing skills in parents and other caregivers.

PSB-CBT can help children and families work together to:*

  • Improve affective and cognitive coping skills;
  •  Develop and practice self-control strategies;
  • Develop and practice social skills;
  • Increase empathy and understanding of the impact of behavior on others.

*This information was adapted from the website for the National Center on the Sexual Behavior of Youth or www.ncsby.org. 

The Need for PSB-CBT

As CAC referrals regarding child-child touching have increased dramatically, the Mental Health Program recognized a gap in available services for children engaging in problematic sexual behaviors.  To address this gap, CAC master’s level clinicians have completed training with the University of Oklahoma to provide Problematic Sexual Behavior Cognitive Behavioral Therapy (PSB-CBT) services. 

Developmentally Typical Behaviors of Children Ages 3-12

Children 3 to 5 Years
  • Do not have a strong sense of modesty
  • Enjoy their own nudity
  • Gender differences are understood
  • Limited information about pregnancy and childbirth
  • Learning labels for sexual body parts, but use slang terms
  • Interested in toileting functions
  • Sexual and genital curiosity increased
  • Interested in body differences between girls and boys
  • Exhibit sex play with peers and siblings
  • May experience pleasure from touching their own genitals, even in public
Children 6 to 12 Years
  • Aware of genital differences between males and females
  • More knowledgeable about pregnancy and reproduction
  • Knowledge of pubertal changes
  • May engage in sex games with peers and/or siblings
  • Show modesty and embarrassment of showing body
  • Interested in viewing sexual content in media/technology
  • Use sexual language with peers
  • May continue to experience pleasure from touching their own genitals, but behavior becomes more private

Consultation for Caregivers and Professionals

The CAC Mental Health Program provides consultation and training for professionals who face challenges in understanding and responding to children’s sexual behavior or when there are concerns about a child's sexual behavior with another child. We can provide information and guidance to:

  • Distinguish between sexual behavior that is part of typical development and behavior that is concerning;
  • Use an understanding of children's sexual behavior to respond in a healthy and effective way;
  • Help children and families access services from professionals, when needed, and
  • Help determine if PSB-CBT (Problematic Sexual Behavior-Cognitive Behavioral Therapy) services would be helpful to a child and family.

If concerned about a child's behaviors, contact the CAC’s Director of Mental Health & Advocacy, Catalina Perez, LICSW at 857-334-4522 or Catalina.Perez@mass.gov for information or consultation.

Q & A


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