NOJOS Levels Continuum

(Click this link for the NOJOS Adolescent Treatment/Placement Protocol and Standards Manual, which provides a detailed description of each level.)

Sexually abusive youth are best rehabilitated with a continuum of care and services (Bengis 1986, 2002a).  The NOJOS Continuum consists of the following eight levels, beginning with the least restrictive “Level One” to most restrictive “Level Eight” as follows:



National Standards (Bengis, 2002) indicate “that use of a continuum requires special attention to the following criteria as a guideline for placement of clients:

1.  The placement should correspond to the level of risk posed by the patient.

2.  The level of client risk should be determined by examining both:

a.   the client’s level of self-control (the bottom-line acting-out which the placement has been designed to contain), and

b.  the staff-client ratios present on-line to contain these behaviors.

3.  Whenever legally possible, movement along the continuum should be based on the competency level achieved by the patient.

4.  Required competency levels should correspond to the level of internal-control required for safe placement at each level of the continuum.

5.  Initially, clients can be referred to any level of the continuum that corresponds to their diagnosed level of risk.  However, decisions regarding movement to less restrictive placements should be competency-based.

6.  The entire continuum of care should use the same sex abuser-specific assessment and treatment criteria.  While specific placements may emphasize different aspects of sex abuser-specific treatment, all placements should adhere to the guidelines established by the National Task Force on Juvenile Sexual Offending (1993). Sex abuser-specific treatment that takes place in other than outpatient settings, i.e., residential or day programs, should incorporate sexual abuser- specific milieu treatment. As such all staff in those placements should be trained:

a.   to provide abuser-specific interventions as part of their work on-line with youth;

b.  to integrate the basics of abuser specific treatment into interventions that do not involve sexually abusive behaviors; and

c.   to integrate abuser-specific issues into vocational and educational curricula.

d.  Programs (non-outpatient settings, i.e., residential or day programs) offering specialized assessment and specialized groups, but do not provide specialized milieu treatment, should not be considered sex abuser-specific programs.

7.  Whenever possible, caregivers should remain consistent as a youth moves from one level of the continuum to another (i.e., probation officer, case worker, therapists).

8.  Placements along the continuum should be evaluated:

a. by professionals trained in both evaluation methodology and abuser specific assessment and treatment; and

b.  according to sex abuser specific criteria agreed to in advance by evaluators and those being evaluated.

9. The continuum should include long-term self-help and require community relapse prevention components.

10. Day programs and educational placements should be thoroughly integrated into the continuum of care and be required to provide sex abuser specific treatment.

11. All youth placed in programs anywhere along the continuum should receive pre and post abuser specific evaluations. These evaluations should be the basis for initial placement and for discharge to less restrictive settings. These evaluations should also screen the patient according to more traditional clinical criteria (i.e., thought disorders, clinical depression, ADHD, and other neurological criteria).

(See Assessment Protocols and Standards section above.) (Prescott, David S., and Longo, Robert E., Current Perspectives: Working with Young People Who Sexually Abuse, Current Perspectives: Working with Sexually Aggressive Youth & Youth With Sexual Behavior Problems, Longo, Robert E and Prescott, David S., Editors, NEARI Press, 2006, page 53-54.)


Another professional author outlines guidelines for when it is appropriate to remove a youth from his/her home and when it should not be considered:

In Home Placement should be considered when:

  • It is in everyone’s best interests;
  • The juvenile is a relatively low risk offender;
  • The juvenile is likely to comply with supervision;
  • Treatment services are in place;
  • Risk-management strategies are in place; and/or

  • It is not considered detrimental to the victim

In Home Placement should not be considered when:

  • A history of severe abuse in the home by offender or others;
  • The family is unwilling or unable to monitor risk;
  • A history of repetitive assaults in the home despite prior interventions; and/or
  • A high risk of reoffending and access to potential victims in the home or neighborhood

In Home Placement should not be considered when:

  • Signs of sexual deviance and access to victim or victim-type in the home;
  • It would be detrimental to the victim in the home;
  • Substance abuse by offender or others; and/or
  • Other factors that clearly indicate that risk cannot be managed in the home environment


(Coffey, Patricia, Ph.D., Forensic  Issues In Evaluating Juvenile Sex Offenders, Risk Assessment of Youth Who Have Sexually Abused, Prescott, David S., LICSW, Wood & Barnes Publishing, 2006, page 80-81).

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