4 - (SYM 34) Practice-based Outcomes of CBT for Juvenile Sexual Offenders with ADHD in Japan

Background: While Cognitive-Behavioral Therapy (CBT) effectively reduces sexual recidivism, the impact of ADHD traits on treatment in Japanese juvenile correctional settings remains under-researched. This study examines how ADHD traits influence therapeutic processes and behavioral changes.

Methods: Participants were 40 male juvenile inmates (15% with ADHD traits) who completed a structured CBT program (2022–2025) at Saga Juvenile Prison. The intervention targeted cognitive distortions and interpersonal schemas, utilizing the Interaction Model Diary for metacognitive reflection. Qualitative analysis was conducted via observation logs and staff evaluations.

Results: Participants with ADHD initially struggled with impulsivity and emotional regulation. However, significant progress was achieved through ADHD-sensitive adaptations, including visual aids and task segmentation. The Interaction Model Diary proved essential for enhancing cognitive flexibility, enabling participants to replace impulsive reactions with calmer, adaptive responses. Improvements were observed in self-understanding of offending processes and prosocial communication.

Conclusion: CBT is effective for this population when integrated with ADHD-specific strategies. A flexible framework addressing neurodevelopmental needs is crucial for enhancing treatment efficacy and successful rehabilitation in juvenile justice.