Jenny Hughes, PhD is a licensed clinical psychologist specializing in trauma and PTSD. She supports helpers and healers through the common experience of vicarious trauma as the founder of The BRAVE Trauma Therapist Collective. Jenny helps trauma therapists be human again as they learn how to manage vicarious trauma and enhance vicarious resilience together. As a clinician, she practices Brainspotting, EMDR, and Cognitive Processing Therapy. Jenny is the author of The PTSD Recovery Workbook and Triggers to Glimmers: A Vicarious Resilience Journal and Workbook.
Dr. Michael Gomez is a licensed clinical psychologist in Texas and Rhode Island who specializes in trauma across diverse contexts, including child abuse, disaster response, sexual trafficking, immigration, secondary trauma, and systemic racism. He’s served on clinical faculty at Brown University’s Warren Alpert Medical School and has directed trauma-focused clinics like the Adversity and Resilience Community Center in West Texas. Dr. Gomez is also a co-founder of the NCTSN’s Trauma and IDD Workgroup and part of the film team at the University of Connecticut’s Center for the Treatment of Complex/Developmental Trauma Disorders. He currently sees clients through PCS Counseling in Lubbock, Texas.
In This Episode
The Trauma Therapist Newsletter: celebrates the people and voices in the mental health profession. And it's free! Check it out here: https://bit.ly/4jGBeSa
The Trauma Therapist Podcast: I interview thought-leaders in the fields of trauma, mindfulness, addiction and yoga such as Peter Levine, Pat Ogden, Bessel van der Kolk and Bruce Perry. https://bit.ly/3VRNy8z
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-trauma-therapist--5739761/support.
Dr. Michael Gomez is a licensed clinical psychologist in Texas and Rhode Island who specializes in trauma across diverse contexts, including child abuse, disaster response, sexual trafficking, immigration, secondary trauma, and systemic racism. He’s served on clinical faculty at Brown University’s Warren Alpert Medical School and has directed trauma-focused clinics like the Adversity and Resilience Community Center in West Texas. Dr. Gomez is also a co-founder of the NCTSN’s Trauma and IDD Workgroup and part of the film team at the University of Connecticut’s Center for the Treatment of Complex/Developmental Trauma Disorders. He currently sees clients through PCS Counseling in Lubbock, Texas.
In This Episode
- On Instagram, @braveproviders
- On Facebook, in The Vicarious Trauma Community with Jenny Hughes
- And on TikTok, @braveproviders
The Trauma Therapist Newsletter: celebrates the people and voices in the mental health profession. And it's free! Check it out here: https://bit.ly/4jGBeSa
The Trauma Therapist Podcast: I interview thought-leaders in the fields of trauma, mindfulness, addiction and yoga such as Peter Levine, Pat Ogden, Bessel van der Kolk and Bruce Perry. https://bit.ly/3VRNy8z
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-trauma-therapist--5739761/support.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the special guest host series of The Trauma
Therapist Podcast, where I'm going to be handing over the
mic to some incredible guest hosts. In each episode, you'll
hear fresh perspectives and unique insights to inform and inspire
you in all the while keeping the heart of this
podcast alive. So sit back and enjoy.
Speaker 2 (00:21):
All Right, here we go.
Speaker 3 (00:24):
Five four three two one, Hello, and welcome to The
Trauma Therapist Podcast with Guy mcpheerson. I am your guest host,
Jenny Hughes. I am a licensed clinical psychologist and founder
of the Brave Trauma Therapist Collective, and I am here today.
I'm so honored to be joined by doctor Michael Gomez.
(00:46):
He's a child psychologist. He is affiliated with the National
Child Traumatic Stress Network. He's a trauma focused CBTTFCBT trainer,
he works with secondary traumatic stress. He does all of
the things, and you'll be able to read all of
that in his bio. And I'm purposely making him very
uncomfortable right now. Thanks for being with us, Gomez, which
(01:10):
is how I refer to him, so, Gomez, thank you
for being here with us.
Speaker 2 (01:15):
Thank you, Jeddy.
Speaker 3 (01:16):
Yeah, So we have a really cool topic to talk about,
And I'm going to kind of let you just start
going because I know that once you like get on
the track, you are like a runaway train, and I
will interrupt you and ask you questions and be nosey
as it comes up. So what are we talking about today?
Speaker 2 (01:34):
The thing we're talking about, Jenny, is a treatment of
problematic sexual behavior in youth. So that means eighteen and under,
so high schoolers down to preschoolers, you know, and anything
in between. That's our topic for today.
Speaker 3 (01:47):
Yeah, So how are you, like, how did you get
into this work?
Speaker 2 (01:53):
Yeah? So that's a very good question. So the my
I'm a trauma person, and I also I'm from the
perspective of lived experience, as you know from our interpersonal interactions.
And so the way I got involved in this if
you had told me, like when I started my graduate program,
then not only are you gonna work with and I
actually work primarily with adolescent So I in Oklahoma we
(02:16):
have a preschool protocol three four or five school age
like first grade through like six, and then a teenager
like me, trying to convince you a six year old
is not a pedophile is a very easy cell. Sixteen
is a lot harder. So I focus on the adolescence.
And so if you told me, not only would I
work with them, but I'll train people how to work
with these kids, I would have laughed at you. Honestly.
(02:36):
The way I got into this is I was on
internship at Oklahoma. I was in the middle of my internship,
and so I started this in January twenty ten. Oh
my god, it was January two. That'll give me a second.
I just realized how old I am. Give me sorry,
I'm processing. Okay, I'm back. And so I done a
(02:57):
parent Child Interaction therapy at my alma moodic CA. You
it's a huge pci T stronghold, and I love the model.
One of the experiences at OU is pc I T.
But since I had done it before, I was kind
of done in the middle and everyone else was still in,
you know, kind of in the middle of theirs. And so
the director of our program, also one of the co
creators of the Problematic Sexual Behavior Treatment model for adolescents,
(03:17):
doctor Barbara Bonner, who RANDO you at the time is
now retired, called me in her office and she said, hey, Michael,
you work with teens a lot and that's kind of
your population we have. We're down in therapist in the
adolescent boys group, the PSB group Problematic sexual Behavior. And
she said, would you like to come in for the
rest of your internship basically like the next rotation? And
I have And I cannot believe, Jenny, I said this
(03:40):
to doctor Barbara Bonner, my mentor. I said, I don't
work with PARPs. Barbara, I cannot believe I said that
to this point. But doctor Bonner, if any you know,
if you have never met her, she had a very
Doctor Bonner applies went, oh, well, give it a try.
And I still remember the first day. By the way,
I did this program for six years ago. I still
(04:00):
work a lot with this population, but it's burned into
my gray matter because I did it for so many years.
Staffing in Prep three to four, group four to five
thirty notes updates five thirty to seven. And we're done.
And so the way it's set up again, we have
a preschool, school age, and adolescent. The preschool and school
(04:20):
age are done at our Child Study Center, and adolescent
you have to walk across the street to a place
called Nicholson Towers. Everyone assumes it's a safety issue because
they're teenagers, they're sex offenders. Actually isn't a safety issue.
It's a space issue because with the preschool it maxes
out at maybe like eight families max school age, maybe ten.
For adolescent we can have up to sometimes up to
(04:44):
like twelve to fourteen boys and two separate boys groups
plus a combined part, so that can be eighty bodies.
So we just can't fit that in our child study center.
It's not safety. The way you get there, you cross
the street, you go through the garage, take the elevator
up to the fifth floor, very long, like one hundred
meters hallway, and I still remember that walk, which is
walking out of that hall. And here's what I'm thinking.
I'm gonna go be here for a rotation, make Barbera happy,
(05:07):
and then I'm gone because I don't work with purpse.
I'm a child trauma therapist. I have my own sexual
trauma abuse. I have. This is I'm just gonna make
my mentor happy at the box and we're done. And
I was adamant about that. And I still don't remember
what we talked about that first group, Jenny. It was
the youngest guy was thirteen, the oldest was seventeen and
a half. For about ninety minutes. All I could think
(05:29):
about what went through my head was oh my god,
these are kids. These are freaking kids.
Speaker 1 (05:35):
Yep.
Speaker 2 (05:36):
And now I'm anyone who's listening to this. If you
had the previous reaction that I had, you're not a
bad person. I don't think. I'm not judging you in
any way. I had that reaction, I had that for years.
But for me, on my drive home, I felt horrible.
I basically wrote off an entire demographic of children, right,
and he knows how fast I did it. I didn't
even blink. RT exactly, box and throw the box in
(06:00):
the ocean. Who had these are rapists? These are child pedophiles?
F a man? Yeah, yep. So I saw them as
like monsters, not as children. And what all of our
data showing is for thirty years, our data, the National
Center for Sexual Behavior, you shows that these kids are
as different from pedophiles as you are.
Speaker 3 (06:18):
Well, And I'm so glad that you're normalizing that reaction too,
because whether we have our own history of sexual trauma
or not, we are socialized in this way to view
anyone who commits something like that as a criminal, as
a purp as a bad person, and we remove their humanity.
(06:41):
And then when we have our own human reactions and
we judge ourselves, we take away our humanness.
Speaker 2 (06:48):
Correct. Yeah, And so I decided to dedicate a chunk
of my career to that population. I found it extremely rewarding.
I'm not saying anyone has to do that. That was
my decision. The first question usually get for this population is, well,
like these must be like you know, was it like
twenty percent recovery which you might see in the adult world.
The program we have at Oklahoma is ninety eight percent effective. Wow,
(07:11):
and people, what does.
Speaker 3 (07:12):
What does that mean? What does the recovery then look like?
Speaker 2 (07:15):
Good question? So we define recidivism so like you go
through our program, you reoffend again sexually. I'm not going
to take a six year old because that's low hanging
for let's take a sixteen year It's take a high
school who is raped somebody. That one seems to me
a little like that's not a straw man. So if
we liberally define a sexual offense, the most liberal definition
(07:35):
we have, like you sex, did you drop your pants
on the bus? The recidivism rate once you finish our
program the preschool is about a twelve week, the school
age is about a twenty and the adolescent is a
year or it's a six month protocol. We want to
give them two doses to be safe. So the recidivism
for the most liberal definition like sexteen is five percent.
Speaker 1 (07:54):
Wow.
Speaker 2 (07:54):
If we define it only as contact defenses you have
to touch somebody, it's two percent wow. And people usually say, well,
that's extremely drum Now, how does that? How do you
do that? Right?
Speaker 3 (08:04):
Exactly?
Speaker 2 (08:06):
Not being as you know, I'm a very sarcastic person, Jenny,
but this next part is not sarcasm, it's not facetiousness.
I'm going to tell you and your audience in less
than sixty seconds, how you address problematic sexual behavior in
you eighteen or younger. And I'm not joking. Ready, Okay,
I'm ready. You never treat a problematic sexual behavior. You
treat a problematic sexual behavior. All thirty years of data
(08:29):
we have shows it's not a paraphilia. If you want
to be dsm about it. What it is. It's a
behavior problem. Right, So this this probably applies to you,
but the whoever's listening, I want you to think of
the last kid you saw with this type of problem
that just wants you to think real quick, give you
a second. You got them? Was that really the only
thing going on?
Speaker 1 (08:47):
Right?
Speaker 2 (08:47):
Not at all? Not at all. They had autism, they
were like in foster care, they had a dad who
was an alcoholic.
Speaker 3 (08:54):
They were I mean you literally this is we I
just was supervising interns right before this, and we were
staffing an intake and it was a nine year old
black boy who has autism and was caught in school
watching porn on YouTube, which whatever that means, like why
can he even access anything like that on a school computer.
(09:15):
But yeah, you literally just described him and then his background.
Speaker 2 (09:19):
Yeah, that's it. So it's a behavioral problem. Yeah, and
we should treat it, not.
Speaker 3 (09:23):
A contextual environmental problem exactly.
Speaker 2 (09:26):
Yeah, And you're so so the audience who's listening, and
I know this applies to you. Jenny wants you to
tick the box. If you have ever worked with caregivers,
you take the box. If you've ever done any type
of behavior therapy, However, you don't have to be like
a PCI tach or just anything behavioral. And if you
know some CBT and if you know just basic child development,
you don't have to know like like Kohlberg or anything
(09:49):
like that, or Ericson, just like you can't treat a
ten year old different like the same as a two.
If you have all four of those, congratulations, you are
now a ps B therapist. So an on a spots
shift for the a spiritist out of that feels right
right now.
Speaker 3 (10:02):
But so what is it like with the parents?
Speaker 2 (10:06):
Good question? So when I work with the parents, this
is one of the biggest shifts. When my mentor, doctor Bonner,
would say, if you work child trauma, you're working with
child welfare and sometimes law enforcement. You work with PSB
Problematic Sexual Behavior TREAM, and you're working with law enforcement
and sometimes child welfare, So it's kind of so you're
in a more legal les kind of and the just
(10:27):
like with child trauma, working with any behavioral work, caregiver
involvement not only parent but caregiver like foster parent, school
staff is mandatory. Now you will get in child trauma world,
doctor hughes, why do I got to be here? You'll
get that, and it's navigable. But in our world, in
PSB world, Doctor's I didn't rape anyone. Why do I
(10:48):
have to be in your office? Which is kind of
a legitimate question. And to give you an illustration, we
had the group we had it for the adolescents was open,
meaning people are starting and in the different times school
and school ags you are closed. They starts the same an.
So whenever we have a new person in the I
did three years boys group, three years parents, we give introductions.
(11:08):
So like we this guy I did this in take
call him Monday Wednesday. He's in our first group ever,
and so we're going through, like, all right, start us off.
My name is Janie. My son is Sebastian. He's a
group one. He's here for Ludax. My name is Okay.
We get to the man and this is the exact
words of what he says. I say, all right, so
mister Smith, please introduce yourself. Here's what he does.
Speaker 1 (11:27):
Ready.
Speaker 2 (11:29):
My name's John. My son is Billy. He rapes somebody
moving on it. So yeah. Second, the last guy he
was in month eleven, he was about to do and
so he gets he goes, Hi, my name's Craig. My
son is Alexander. He's group leader of group two. And
(11:49):
he pauses, he looks right at this man. He goes John, Brother,
I want to say something to you. I was in
the exact same seat you were day one. I said,
literally that same seat, And I hated everyone. I hated
the state, I hated the courts. I hated doctor Gomez.
I'm sitting right here like I were cool, But I
hated you. I hated that there, He's like. But you
know who I hated most. I hated myself because I thought,
I feel my family is a man and is a
(12:10):
father and almost wrong. These people can help you. These
people just give me and to me, that's just a
well run group. But if you think it's isolating to
have a traumatized child, it's isolating to have a sexually
acting out child, especially one who's sexually acting out on
your child.
Speaker 1 (12:25):
Yep.
Speaker 2 (12:25):
And so it's not a punitive thing that we have
caregiver involvement. It's like supportive, just like it would be
in the trauma world, but it's on steroids. Yeah. A
mentor told me this many years ago when I was
a grad student, and to be honest, did not believe
it until I was an license psychologist, Jenny, But what
she said was caregivers are not the problem, They're the solution.
Speaker 3 (12:43):
Hmm.
Speaker 2 (12:44):
Absolutely, And it applies in trauma, but it applies I
think ten times more in this world when you deal
with problematic sexual behaviors.
Speaker 3 (12:50):
Yeah, I mean, healing no matter what a perch you're taking,
is happening in relationship. That's also typically where trauma happens, right, Yeah,
And so even if it is a car crash and
you're all by yourself, there's still are interpersonal things that happen,
And especially when it comes to something like sexual trauma,
even the kid who is perpetrating that it's an interpersonal
(13:14):
trauma for them likely too.
Speaker 2 (13:16):
Yeah. Yeah, And often what I get asked is like, well,
since you're do working with PSB, you must work with
sexual trauma, which I do, but that's actually not the majority. Statistically,
out of one hundred percent of kids who sexually act
out six and up, only forty percent have a trauma history.
Most of it's not sexual, by the way. At the
same time, if all you did was spend your entire
(13:36):
career working with sexual abuse kids who then sexually act out,
you would be doing an amazing service. Thank you Child
advocacy centers, by the way. But another example neglect Actually
your kid is a good example. You type in unicorn
on this phone. The third HIDS is pornography. Yep, exactly,
Mom is a drug addict, iPads, a babysitter. They're just
social modeling. One that doesn't come up normally, but it
(14:01):
makes sense in hindsight is IPv. So doctor Benjamin Siegel
over at Arkansas, one of our other PSB trainers and
TFCBT trainers, did a study where you looked at sexual
modeling and cohersive modeling is predictive of psb's and I
hope we can agree never to show kids pornography. If
we can, I have to make a call. But if
(14:22):
you put them to to toe and again, cohersion modeling
in sexual modeling, sexual modeling would be kid walks in
on you and your spouse having sex. Sexual cohersive modeling
would be kid walks in on your spouse being the
piss out of you. And so we put them toe
to toe. Cohersive modeling way better predicts problematic sexual behavior
than sexual modeling, which I would not have thought of,
but it makes sense because rape is not sex. Rape
(14:43):
is cohercion, the humanization, and so.
Speaker 3 (14:47):
I kind of have a sense of control in your
life and in an experience.
Speaker 2 (14:51):
Yeah, and when I work with like DV shelters. I say,
you know, you need to screen for this, and they're confused,
and I tell them doctor Siegal study and then they
say we're gonna do this yesterday. The other group is
IDD and we had a kid who was chronologically seventeen.
He looked thirty. I was like six', one like two
point fifty on a good. Day cognitively is about. Seven
and take one at his victim's age it was seven.
(15:15):
Ye and then my third group that we see is
my favorite, Favorites, jenny my. Favorites it's my, delinquents like your.
Favorites he popped you for THE psb you were. Dealing
you were boosting cars. Ritual another effective therapy for, this
the one who we have A u is CALLED PSB
cbt and IT'S abd like preschool school Age. Adolescent Multi
systemic therapy is another very especially for that third. Group
(15:37):
it's very effective for, this but they have the same.
Ethos it's a behavioral. Problem it's a family systems, issue
right supervision. Issue it's none none of the effective treatments
out there look at these like, paraphilias like pedophilia or
things like. That it's just not what we're. Seeing the
data's contraindicating.
Speaker 3 (15:53):
That it's hard, though because especially things like multi systemic,
therapy it's so resource, heavy and we are lack the,
resources NOT i mean not only just the actual, therapists
because therapists are burning the fuck out and they're scared
to enter the field because they're not going to be
compensated for all of their school and all of their.
Education but then there's no there's no wrap around services
(16:17):
for the, providers and that's the.
Speaker 2 (16:19):
Families, yeah and so so we that's one of the
challenges why We, oh you were kind of a cheap,
date BECAUSE MSc is really. Priced it's an amazingly good.
Model it's just, yeah it's like the price of a
like good sedan essentially per. Kid but it's very. Effective,
right we work a. Lot if if you know people
are wondering, care you're, Saying oklahoma a. Lot how do
(16:41):
you get this stuff passed In, Crimson? Oklahoma it's our fearless.
Leader Doctor bonner went to the to the courts and
the legislature and, said you can keep sending them to.
Incarceration you can sit into. Enmpatient, first do you have
any open beds in your. STATE i don't think anyone
listening to this has any open beds in their. State
so or you can send it to an out patient
program and if they crap, out you just send them
(17:02):
to jail, anyway like you were going. To but this
is gonna save you hundreds of thousands of registered voters
dollars every. Year and that's HOW i got it rolled
out in places like AND i think Like North. Carolina
that's an, initiative so this Like california has One washington
state and so they're able to roll these out because
it's just. Cheaper, yeah it really.
Speaker 3 (17:23):
Is and once people can get past that initial price
tag and are able to actually see more of the long,
view it makes such, clear perfect. Sense but people get
so just like shell shocked by the sticker price that
they'll just like dig their heels in and not even go.
Speaker 2 (17:42):
Anywhere, yeah and AGAIN i think that the ANY i
Think Scott, handler who developed, them as he has even
said The fundamental, movie you can just see it as
a behavioral, problem as a family systems, issue and not
trying to treat them like they're you, know just born
criminals or their psychopaths or their pedophile then then you
just changed the Gay just that one, move you, know
price tight or not will change the way you interact
(18:03):
and the way you're able to get these kids better
and the families.
Speaker 3 (18:06):
Reunified so what's the one thing that you want anyone
listening to this to take?
Speaker 2 (18:11):
Away so, again that it's a behavior, problem not a sexual.
Problem and the other would be that these kids are
very responsive to. Treatment these families are very responsive to,
treatment even just standard out PATIENT cbt treatment behavior. THERAPY
i usually tell people these, Kids i'm not that great a,
therapist let's be, Honest i'm, okay but these kids may
(18:31):
me look. Good they may look amazingly, good LIKE i
look like an amazing. Therapy like how'd you fix?
Speaker 1 (18:36):
It LIKE i.
Speaker 2 (18:36):
Didn't they just made sure that the parent didn't give
them unlimited internet. Access that's the only THING i. Did
and like their pornography, problem like your kid pornography bo
mun Solve, like uh, yeah because you didn't give them
on limited internet? Access like why did that kid have
it pornography? Access how the hell they get? THAT i?
Know and so, yeah just something that.
Speaker 3 (18:55):
SIMPLE i, also you are an amazing clinician because because
you are human in your. Work you are yourself and your,
work AND i don't think we get enough permission to do.
Speaker 1 (19:07):
That.
Speaker 2 (19:08):
Yeah i've been told by especially my work without the
lessons and, transitionings THAT i don't have a therapist. Voice.
Yeah my last kid because he saw. ME i THINK
i was doing something with like a, console but he
saw me in different areas and he, said you don't
have a therapist, Voice AND i, said what do you?
Mean he, Goes You're they're like, oh and SO i
still have this. Kid just to upset. Him every now and,
Then i'll, Say, billy what we're going to do? Today
(19:31):
what do you want me to shut?
Speaker 1 (19:32):
Up?
Speaker 2 (19:32):
Billy how are you? Feeling would make you? Feel? Billy and,
like just to mess with, THEM i just use that
voice because he hates it, though, like, yeah this is
just HOW i talk no matter. Where but, yeah BUT
i you, KNOW i would say that that humanity is,
necessary like they need a human being in front of. Them.
Speaker 3 (19:48):
Yep exactly where can people learn more if they have,
questions if they want to reach?
Speaker 2 (19:54):
Out SO i will send you a list of some.
Information the first one Is National center For Sexual behavior Of.
Youth the Information i'm talking, about we have FREE pdf
copies At safersociety dot. Org the books are Called Taking,
Action one is A, Preteen one is A. Team i'll
send you link. There if you want a paper, copy
you can pay like four or five, bucks but the
PDFs are free. DOWNLOADS. Atsa The socia Shore Or treatment
(20:17):
Of Sexual users is very. Good but, honestly the one
Thing i'd recommend is if you have any opportunity to
GET tfcbt, training because right now it's the only therapy
that's evidence based in the ParaView lit for working. With
we're working on the teen version right, now AND i
work with some studies specifically on, that but the pre
teen preteens who have trauma and who sexually act, out
(20:37):
it's all we got right, now at least in the.
Literature and so AND i think it gives. You the
way we TRAIN psb therapist is we like to train
them IN tfcbt first and then DO psb because there's
a lot of overlap and it's more of a software
update than the just a jarring set of information they're.
Speaker 3 (20:52):
Getting and what's the best way for people if they
want to learn about getting trained IN tfcb.
Speaker 2 (20:57):
TEAM i usually recommend to do the online training for
to see if you like. It it's LIKE i think
it's like thirty bucks to do, that but then you
have access to it forever the band through M usc or,
no that's, it, OKAY i the link to and if
people hate it then then probably don't want to do
the rest of. This i'll also send You Brian allen
over At Penn state Mom Man brian put we had
(21:17):
like literally thirty articles about this and he put them in.
One so it's like a unified article with here's our,
algorithm here's what we. Do it's a one stop. Shop
thank You brian for doing. That And i'd Say i'd
read that article, too because it's VERY psb specific for,
this but that would be my, advice and it's it's
a it's an to me an intuitive. Model it's not
not a lot of bells and. Whistles we like to
(21:39):
keep it super. Simple.
Speaker 3 (21:40):
YEP i. Agree, well thank you so much for joining,
us for sharing, yourself your humanity and about this topic
that we don't no one is really talking. About no
one is even if they're doing the, work they're not
like broadcasting it far and, wide and So i'm just
so grateful for this.
Speaker 2 (21:59):
Conversation thank you for having giving me the. Opportunity, jenny
it's always a pleasure to talk to.
Speaker 1 (22:03):
You
Welcome to the special guest host series of The Trauma
Therapist Podcast, where I'm going to be handing over the
mic to some incredible guest hosts. In each episode, you'll
hear fresh perspectives and unique insights to inform and inspire
you in all the while keeping the heart of this
podcast alive. So sit back and enjoy.
Speaker 2 (00:21):
All Right, here we go.
Speaker 3 (00:24):
Five four three two one, Hello, and welcome to The
Trauma Therapist Podcast with Guy mcpheerson. I am your guest host,
Jenny Hughes. I am a licensed clinical psychologist and founder
of the Brave Trauma Therapist Collective, and I am here today.
I'm so honored to be joined by doctor Michael Gomez.
(00:46):
He's a child psychologist. He is affiliated with the National
Child Traumatic Stress Network. He's a trauma focused CBTTFCBT trainer,
he works with secondary traumatic stress. He does all of
the things, and you'll be able to read all of
that in his bio. And I'm purposely making him very
uncomfortable right now. Thanks for being with us, Gomez, which
(01:10):
is how I refer to him, so, Gomez, thank you
for being here with us.
Speaker 2 (01:15):
Thank you, Jeddy.
Speaker 3 (01:16):
Yeah, So we have a really cool topic to talk about,
And I'm going to kind of let you just start
going because I know that once you like get on
the track, you are like a runaway train, and I
will interrupt you and ask you questions and be nosey
as it comes up. So what are we talking about today?
Speaker 2 (01:34):
The thing we're talking about, Jenny, is a treatment of
problematic sexual behavior in youth. So that means eighteen and under,
so high schoolers down to preschoolers, you know, and anything
in between. That's our topic for today.
Speaker 3 (01:47):
Yeah, So how are you, like, how did you get
into this work?
Speaker 2 (01:53):
Yeah? So that's a very good question. So the my
I'm a trauma person, and I also I'm from the
perspective of lived experience, as you know from our interpersonal interactions.
And so the way I got involved in this if
you had told me, like when I started my graduate program,
then not only are you gonna work with and I
actually work primarily with adolescent So I in Oklahoma we
(02:16):
have a preschool protocol three four or five school age
like first grade through like six, and then a teenager
like me, trying to convince you a six year old
is not a pedophile is a very easy cell. Sixteen
is a lot harder. So I focus on the adolescence.
And so if you told me, not only would I
work with them, but I'll train people how to work
with these kids, I would have laughed at you. Honestly.
(02:36):
The way I got into this is I was on
internship at Oklahoma. I was in the middle of my internship,
and so I started this in January twenty ten. Oh
my god, it was January two. That'll give me a second.
I just realized how old I am. Give me sorry,
I'm processing. Okay, I'm back. And so I done a
(02:57):
parent Child Interaction therapy at my alma moodic CA. You
it's a huge pci T stronghold, and I love the model.
One of the experiences at OU is pc I T.
But since I had done it before, I was kind
of done in the middle and everyone else was still in,
you know, kind of in the middle of theirs. And so
the director of our program, also one of the co
creators of the Problematic Sexual Behavior Treatment model for adolescents,
(03:17):
doctor Barbara Bonner, who RANDO you at the time is
now retired, called me in her office and she said, hey, Michael,
you work with teens a lot and that's kind of
your population we have. We're down in therapist in the
adolescent boys group, the PSB group Problematic sexual Behavior. And
she said, would you like to come in for the
rest of your internship basically like the next rotation? And
I have And I cannot believe, Jenny, I said this
(03:40):
to doctor Barbara Bonner, my mentor. I said, I don't
work with PARPs. Barbara, I cannot believe I said that
to this point. But doctor Bonner, if any you know,
if you have never met her, she had a very
Doctor Bonner applies went, oh, well, give it a try.
And I still remember the first day. By the way,
I did this program for six years ago. I still
(04:00):
work a lot with this population, but it's burned into
my gray matter because I did it for so many years.
Staffing in Prep three to four, group four to five
thirty notes updates five thirty to seven. And we're done.
And so the way it's set up again, we have
a preschool, school age, and adolescent. The preschool and school
(04:20):
age are done at our Child Study Center, and adolescent
you have to walk across the street to a place
called Nicholson Towers. Everyone assumes it's a safety issue because
they're teenagers, they're sex offenders. Actually isn't a safety issue.
It's a space issue because with the preschool it maxes
out at maybe like eight families max school age, maybe ten.
For adolescent we can have up to sometimes up to
(04:44):
like twelve to fourteen boys and two separate boys groups
plus a combined part, so that can be eighty bodies.
So we just can't fit that in our child study center.
It's not safety. The way you get there, you cross
the street, you go through the garage, take the elevator
up to the fifth floor, very long, like one hundred
meters hallway, and I still remember that walk, which is
walking out of that hall. And here's what I'm thinking.
I'm gonna go be here for a rotation, make Barbera happy,
(05:07):
and then I'm gone because I don't work with purpse.
I'm a child trauma therapist. I have my own sexual
trauma abuse. I have. This is I'm just gonna make
my mentor happy at the box and we're done. And
I was adamant about that. And I still don't remember
what we talked about that first group, Jenny. It was
the youngest guy was thirteen, the oldest was seventeen and
a half. For about ninety minutes. All I could think
(05:29):
about what went through my head was oh my god,
these are kids. These are freaking kids.
Speaker 1 (05:35):
Yep.
Speaker 2 (05:36):
And now I'm anyone who's listening to this. If you
had the previous reaction that I had, you're not a
bad person. I don't think. I'm not judging you in
any way. I had that reaction, I had that for years.
But for me, on my drive home, I felt horrible.
I basically wrote off an entire demographic of children, right,
and he knows how fast I did it. I didn't
even blink. RT exactly, box and throw the box in
(06:00):
the ocean. Who had these are rapists? These are child pedophiles?
F a man? Yeah, yep. So I saw them as
like monsters, not as children. And what all of our
data showing is for thirty years, our data, the National
Center for Sexual Behavior, you shows that these kids are
as different from pedophiles as you are.
Speaker 3 (06:18):
Well, And I'm so glad that you're normalizing that reaction too,
because whether we have our own history of sexual trauma
or not, we are socialized in this way to view
anyone who commits something like that as a criminal, as
a purp as a bad person, and we remove their humanity.
(06:41):
And then when we have our own human reactions and
we judge ourselves, we take away our humanness.
Speaker 2 (06:48):
Correct. Yeah, And so I decided to dedicate a chunk
of my career to that population. I found it extremely rewarding.
I'm not saying anyone has to do that. That was
my decision. The first question usually get for this population is, well,
like these must be like you know, was it like
twenty percent recovery which you might see in the adult world.
The program we have at Oklahoma is ninety eight percent effective. Wow,
(07:11):
and people, what does.
Speaker 3 (07:12):
What does that mean? What does the recovery then look like?
Speaker 2 (07:15):
Good question? So we define recidivism so like you go
through our program, you reoffend again sexually. I'm not going
to take a six year old because that's low hanging
for let's take a sixteen year It's take a high
school who is raped somebody. That one seems to me
a little like that's not a straw man. So if
we liberally define a sexual offense, the most liberal definition
(07:35):
we have, like you sex, did you drop your pants
on the bus? The recidivism rate once you finish our
program the preschool is about a twelve week, the school
age is about a twenty and the adolescent is a
year or it's a six month protocol. We want to
give them two doses to be safe. So the recidivism
for the most liberal definition like sexteen is five percent.
Speaker 1 (07:54):
Wow.
Speaker 2 (07:54):
If we define it only as contact defenses you have
to touch somebody, it's two percent wow. And people usually say, well,
that's extremely drum Now, how does that? How do you
do that? Right?
Speaker 3 (08:04):
Exactly?
Speaker 2 (08:06):
Not being as you know, I'm a very sarcastic person, Jenny,
but this next part is not sarcasm, it's not facetiousness.
I'm going to tell you and your audience in less
than sixty seconds, how you address problematic sexual behavior in
you eighteen or younger. And I'm not joking. Ready, Okay,
I'm ready. You never treat a problematic sexual behavior. You
treat a problematic sexual behavior. All thirty years of data
(08:29):
we have shows it's not a paraphilia. If you want
to be dsm about it. What it is. It's a
behavior problem. Right, So this this probably applies to you,
but the whoever's listening, I want you to think of
the last kid you saw with this type of problem
that just wants you to think real quick, give you
a second. You got them? Was that really the only
thing going on?
Speaker 1 (08:47):
Right?
Speaker 2 (08:47):
Not at all? Not at all. They had autism, they
were like in foster care, they had a dad who
was an alcoholic.
Speaker 3 (08:54):
They were I mean you literally this is we I
just was supervising interns right before this, and we were
staffing an intake and it was a nine year old
black boy who has autism and was caught in school
watching porn on YouTube, which whatever that means, like why
can he even access anything like that on a school computer.
(09:15):
But yeah, you literally just described him and then his background.
Speaker 2 (09:19):
Yeah, that's it. So it's a behavioral problem. Yeah, and
we should treat it, not.
Speaker 3 (09:23):
A contextual environmental problem exactly.
Speaker 2 (09:26):
Yeah, And you're so so the audience who's listening, and
I know this applies to you. Jenny wants you to
tick the box. If you have ever worked with caregivers,
you take the box. If you've ever done any type
of behavior therapy, However, you don't have to be like
a PCI tach or just anything behavioral. And if you
know some CBT and if you know just basic child development,
you don't have to know like like Kohlberg or anything
(09:49):
like that, or Ericson, just like you can't treat a
ten year old different like the same as a two.
If you have all four of those, congratulations, you are
now a ps B therapist. So an on a spots
shift for the a spiritist out of that feels right
right now.
Speaker 3 (10:02):
But so what is it like with the parents?
Speaker 2 (10:06):
Good question? So when I work with the parents, this
is one of the biggest shifts. When my mentor, doctor Bonner,
would say, if you work child trauma, you're working with
child welfare and sometimes law enforcement. You work with PSB
Problematic Sexual Behavior TREAM, and you're working with law enforcement
and sometimes child welfare, So it's kind of so you're
in a more legal les kind of and the just
(10:27):
like with child trauma, working with any behavioral work, caregiver
involvement not only parent but caregiver like foster parent, school
staff is mandatory. Now you will get in child trauma world,
doctor hughes, why do I got to be here? You'll
get that, and it's navigable. But in our world, in
PSB world, Doctor's I didn't rape anyone. Why do I
(10:48):
have to be in your office? Which is kind of
a legitimate question. And to give you an illustration, we
had the group we had it for the adolescents was open,
meaning people are starting and in the different times school
and school ags you are closed. They starts the same an.
So whenever we have a new person in the I
did three years boys group, three years parents, we give introductions.
(11:08):
So like we this guy I did this in take
call him Monday Wednesday. He's in our first group ever,
and so we're going through, like, all right, start us off.
My name is Janie. My son is Sebastian. He's a
group one. He's here for Ludax. My name is Okay.
We get to the man and this is the exact
words of what he says. I say, all right, so
mister Smith, please introduce yourself. Here's what he does.
Speaker 1 (11:27):
Ready.
Speaker 2 (11:29):
My name's John. My son is Billy. He rapes somebody
moving on it. So yeah. Second, the last guy he
was in month eleven, he was about to do and
so he gets he goes, Hi, my name's Craig. My
son is Alexander. He's group leader of group two. And
(11:49):
he pauses, he looks right at this man. He goes John, Brother,
I want to say something to you. I was in
the exact same seat you were day one. I said,
literally that same seat, And I hated everyone. I hated
the state, I hated the courts. I hated doctor Gomez.
I'm sitting right here like I were cool, But I
hated you. I hated that there, He's like. But you
know who I hated most. I hated myself because I thought,
I feel my family is a man and is a
(12:10):
father and almost wrong. These people can help you. These
people just give me and to me, that's just a
well run group. But if you think it's isolating to
have a traumatized child, it's isolating to have a sexually
acting out child, especially one who's sexually acting out on
your child.
Speaker 1 (12:25):
Yep.
Speaker 2 (12:25):
And so it's not a punitive thing that we have
caregiver involvement. It's like supportive, just like it would be
in the trauma world, but it's on steroids. Yeah. A
mentor told me this many years ago when I was
a grad student, and to be honest, did not believe
it until I was an license psychologist, Jenny, But what
she said was caregivers are not the problem, They're the solution.
Speaker 3 (12:43):
Hmm.
Speaker 2 (12:44):
Absolutely, And it applies in trauma, but it applies I
think ten times more in this world when you deal
with problematic sexual behaviors.
Speaker 3 (12:50):
Yeah, I mean, healing no matter what a perch you're taking,
is happening in relationship. That's also typically where trauma happens, right, Yeah,
And so even if it is a car crash and
you're all by yourself, there's still are interpersonal things that happen,
And especially when it comes to something like sexual trauma,
even the kid who is perpetrating that it's an interpersonal
(13:14):
trauma for them likely too.
Speaker 2 (13:16):
Yeah. Yeah, And often what I get asked is like, well,
since you're do working with PSB, you must work with
sexual trauma, which I do, but that's actually not the majority. Statistically,
out of one hundred percent of kids who sexually act
out six and up, only forty percent have a trauma history.
Most of it's not sexual, by the way. At the
same time, if all you did was spend your entire
(13:36):
career working with sexual abuse kids who then sexually act out,
you would be doing an amazing service. Thank you Child
advocacy centers, by the way. But another example neglect Actually
your kid is a good example. You type in unicorn
on this phone. The third HIDS is pornography. Yep, exactly,
Mom is a drug addict, iPads, a babysitter. They're just
social modeling. One that doesn't come up normally, but it
(14:01):
makes sense in hindsight is IPv. So doctor Benjamin Siegel
over at Arkansas, one of our other PSB trainers and
TFCBT trainers, did a study where you looked at sexual
modeling and cohersive modeling is predictive of psb's and I
hope we can agree never to show kids pornography. If
we can, I have to make a call. But if
(14:22):
you put them to to toe and again, cohersion modeling
in sexual modeling, sexual modeling would be kid walks in
on you and your spouse having sex. Sexual cohersive modeling
would be kid walks in on your spouse being the
piss out of you. And so we put them toe
to toe. Cohersive modeling way better predicts problematic sexual behavior
than sexual modeling, which I would not have thought of,
but it makes sense because rape is not sex. Rape
(14:43):
is cohercion, the humanization, and so.
Speaker 3 (14:47):
I kind of have a sense of control in your
life and in an experience.
Speaker 2 (14:51):
Yeah, and when I work with like DV shelters. I say,
you know, you need to screen for this, and they're confused,
and I tell them doctor Siegal study and then they
say we're gonna do this yesterday. The other group is
IDD and we had a kid who was chronologically seventeen.
He looked thirty. I was like six', one like two
point fifty on a good. Day cognitively is about. Seven
and take one at his victim's age it was seven.
(15:15):
Ye and then my third group that we see is
my favorite, Favorites, jenny my. Favorites it's my, delinquents like your.
Favorites he popped you for THE psb you were. Dealing
you were boosting cars. Ritual another effective therapy for, this
the one who we have A u is CALLED PSB
cbt and IT'S abd like preschool school Age. Adolescent Multi
systemic therapy is another very especially for that third. Group
(15:37):
it's very effective for, this but they have the same.
Ethos it's a behavioral. Problem it's a family systems, issue
right supervision. Issue it's none none of the effective treatments
out there look at these like, paraphilias like pedophilia or
things like. That it's just not what we're. Seeing the
data's contraindicating.
Speaker 3 (15:53):
That it's hard, though because especially things like multi systemic,
therapy it's so resource, heavy and we are lack the,
resources NOT i mean not only just the actual, therapists
because therapists are burning the fuck out and they're scared
to enter the field because they're not going to be
compensated for all of their school and all of their.
Education but then there's no there's no wrap around services
(16:17):
for the, providers and that's the.
Speaker 2 (16:19):
Families, yeah and so so we that's one of the
challenges why We, oh you were kind of a cheap,
date BECAUSE MSc is really. Priced it's an amazingly good.
Model it's just, yeah it's like the price of a
like good sedan essentially per. Kid but it's very. Effective,
right we work a. Lot if if you know people
are wondering, care you're, Saying oklahoma a. Lot how do
(16:41):
you get this stuff passed In, Crimson? Oklahoma it's our fearless.
Leader Doctor bonner went to the to the courts and
the legislature and, said you can keep sending them to.
Incarceration you can sit into. Enmpatient, first do you have
any open beds in your. STATE i don't think anyone
listening to this has any open beds in their. State
so or you can send it to an out patient
program and if they crap, out you just send them
(17:02):
to jail, anyway like you were going. To but this
is gonna save you hundreds of thousands of registered voters
dollars every. Year and that's HOW i got it rolled
out in places like AND i think Like North. Carolina
that's an, initiative so this Like california has One washington
state and so they're able to roll these out because
it's just. Cheaper, yeah it really.
Speaker 3 (17:23):
Is and once people can get past that initial price
tag and are able to actually see more of the long,
view it makes such, clear perfect. Sense but people get
so just like shell shocked by the sticker price that
they'll just like dig their heels in and not even go.
Speaker 2 (17:42):
Anywhere, yeah and AGAIN i think that the ANY i
Think Scott, handler who developed, them as he has even
said The fundamental, movie you can just see it as
a behavioral, problem as a family systems, issue and not
trying to treat them like they're you, know just born
criminals or their psychopaths or their pedophile then then you
just changed the Gay just that one, move you, know
price tight or not will change the way you interact
(18:03):
and the way you're able to get these kids better
and the families.
Speaker 3 (18:06):
Reunified so what's the one thing that you want anyone
listening to this to take?
Speaker 2 (18:11):
Away so, again that it's a behavior, problem not a sexual.
Problem and the other would be that these kids are
very responsive to. Treatment these families are very responsive to,
treatment even just standard out PATIENT cbt treatment behavior. THERAPY
i usually tell people these, Kids i'm not that great a,
therapist let's be, Honest i'm, okay but these kids may
(18:31):
me look. Good they may look amazingly, good LIKE i
look like an amazing. Therapy like how'd you fix?
Speaker 1 (18:36):
It LIKE i.
Speaker 2 (18:36):
Didn't they just made sure that the parent didn't give
them unlimited internet. Access that's the only THING i. Did
and like their pornography, problem like your kid pornography bo
mun Solve, like uh, yeah because you didn't give them
on limited internet? Access like why did that kid have
it pornography? Access how the hell they get? THAT i?
Know and so, yeah just something that.
Speaker 3 (18:55):
SIMPLE i, also you are an amazing clinician because because
you are human in your. Work you are yourself and your,
work AND i don't think we get enough permission to do.
Speaker 1 (19:07):
That.
Speaker 2 (19:08):
Yeah i've been told by especially my work without the
lessons and, transitionings THAT i don't have a therapist. Voice.
Yeah my last kid because he saw. ME i THINK
i was doing something with like a, console but he
saw me in different areas and he, said you don't
have a therapist, Voice AND i, said what do you?
Mean he, Goes You're they're like, oh and SO i
still have this. Kid just to upset. Him every now and,
Then i'll, Say, billy what we're going to do? Today
(19:31):
what do you want me to shut?
Speaker 1 (19:32):
Up?
Speaker 2 (19:32):
Billy how are you? Feeling would make you? Feel? Billy and,
like just to mess with, THEM i just use that
voice because he hates it, though, like, yeah this is
just HOW i talk no matter. Where but, yeah BUT
i you, KNOW i would say that that humanity is,
necessary like they need a human being in front of. Them.
Speaker 3 (19:48):
Yep exactly where can people learn more if they have,
questions if they want to reach?
Speaker 2 (19:54):
Out SO i will send you a list of some.
Information the first one Is National center For Sexual behavior Of.
Youth the Information i'm talking, about we have FREE pdf
copies At safersociety dot. Org the books are Called Taking,
Action one is A, Preteen one is A. Team i'll
send you link. There if you want a paper, copy
you can pay like four or five, bucks but the
PDFs are free. DOWNLOADS. Atsa The socia Shore Or treatment
(20:17):
Of Sexual users is very. Good but, honestly the one
Thing i'd recommend is if you have any opportunity to
GET tfcbt, training because right now it's the only therapy
that's evidence based in the ParaView lit for working. With
we're working on the teen version right, now AND i
work with some studies specifically on, that but the pre
teen preteens who have trauma and who sexually act, out
(20:37):
it's all we got right, now at least in the.
Literature and so AND i think it gives. You the
way we TRAIN psb therapist is we like to train
them IN tfcbt first and then DO psb because there's
a lot of overlap and it's more of a software
update than the just a jarring set of information they're.
Speaker 3 (20:52):
Getting and what's the best way for people if they
want to learn about getting trained IN tfcb.
Speaker 2 (20:57):
TEAM i usually recommend to do the online training for
to see if you like. It it's LIKE i think
it's like thirty bucks to do, that but then you
have access to it forever the band through M usc or,
no that's, it, OKAY i the link to and if
people hate it then then probably don't want to do
the rest of. This i'll also send You Brian allen
over At Penn state Mom Man brian put we had
(21:17):
like literally thirty articles about this and he put them in.
One so it's like a unified article with here's our,
algorithm here's what we. Do it's a one stop. Shop
thank You brian for doing. That And i'd Say i'd
read that article, too because it's VERY psb specific for,
this but that would be my, advice and it's it's
a it's an to me an intuitive. Model it's not
not a lot of bells and. Whistles we like to
(21:39):
keep it super. Simple.
Speaker 3 (21:40):
YEP i. Agree, well thank you so much for joining,
us for sharing, yourself your humanity and about this topic
that we don't no one is really talking. About no
one is even if they're doing the, work they're not
like broadcasting it far and, wide and So i'm just
so grateful for this.
Speaker 2 (21:59):
Conversation thank you for having giving me the. Opportunity, jenny
it's always a pleasure to talk to.
Speaker 1 (22:03):
You
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