Treatment began with the establishment of isolated programs in the late 1980's. The National Association for the Development of Work with Sex Offenders was formed to offer advice and consultation, organize training events, and produce publications. A 1990 survey revealed that fewer than half of local governments in England and Wales had treatment programs for this population. Currently such programs operate in varied settings, including social services and youth justice teams, voluntary agencies, the probation service, the National Health Service, education, the prison service, and other institutions such as centers for young people. Some programs are community-based and others have an institutional setting. The style of interaction between the therapist and the youth differs significantly from that in traditional counseling. Treatment uses a cognitive-behavioral framework to focus on the adolescent's thoughts, feelings, and behaviors. The therapeutic style is one of confronting, based on support and respect for the individual. Treatment requires efforts to balance society's rights with those of the abuser. Which aspects of treatment reduce recidivism are currently unknown, and outcome measurement is difficult. Therefore, workers need to be cautious and modest about the extent of probable achievement.