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Deposited in DRO: 23 February 2017 Version of attached le: Published Version Peer-review status of attached le: Unknown Citation for published item: Hackett, S. and Holmes, D. and Branigan, P. (2016) 'Harmful sexual behaviour framework : an evidence-informed operational framework for children and young people displaying harmful sexual behaviours.', Project Report. National Society for the Prevention of Cruelty to Children (NSPCC), London. Further information on publisher's website: https://www.nspcc.org.uk/services-and-resources/research-and-resources/2016/harmful-sexual-behaviour- framework/
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Durham University Library, Stockton Road, Durham DH1 3LY, United Kingdom Tel : +44 (0)191 334 3042 | Fax : +44 (0)191 334 2971 https://dro.dur.ac.uk Harmful sexual behaviour framework An evidence-informed operational framework for children and young people displaying harmful sexual behaviours
In partnership with 2 Welcome
This framework provides an evidence-informed tool for developing coordinated, multi-agency local responses to children and young people’s harmful sexual behaviour. We would like to thank everyone involved in the development and piloting of the framework.
Anyone using this material in other publications or contexts should acknowledge its source¹ as: Hackett, S, Holmes, D and Branigan, P (2016) Operational framework for children and young people displaying harmful sexual behaviours, London, NSPCC.
The project has been led and coordinated by the NSPCC and Research in Practice (RIP), though its production has involved a large number of national organisations and subject experts.
The framework was developed by a practice development subgroup, chaired by Professor Simon Hackett, Durham University, and draws significantly on the publication Hackett, S (2014) Children and young people with harmful sexual behaviours, published by Research in Practice.
1 We would also like to thank RIP for the opportunity to reproduce and repurpose appropriate sections of their publication; Hackett S (2014) Children and young people with harmful sexual behaviours: Research Review. Dartington: Research in Practice 4
With thanks to Working practice group We wish to thank, and acknowledge the input of, A Adcock (Walsall), C Harrison (Lambeth), Charlie members of the development groups (chaired by Beaumont (Kent), Deborah Maddocks (Suffolk), Jane Jon Brown) and the 14 local authority members of Lloyd Griffiths (Gwynedd), Katie Hewitt (Sheffield), the practice working group (chaired by Julie Henniker) Laura Davies (Camarthenshire), Lesley Ingleson who also helped shape and develop the framework. (North Yorkshire), Louise Kemp (Merton), S Evans (Vale of Glamorgan), Sarah Reeves (Cambridgeshire) National development group and Tess King (Newcastle NSPCC). Andy Newson (YJB), Carlene Firmin (MsUnderstood Pilot testing Partnership), Cassandra Harrison (Barnardo’s), Dez Holmes (Research in Practice), Susannah Bowyer We would also like to thank the eight local authorities (Research in Practice), Pam Badger (CAPE), Duncan who volunteered to further test and develop the Shepard (Police National lead for MAPPA), Eileen framework in 2015: Trudy Potter (Cambridgeshire), Vizard (Honorary Senior Lecturer, Institute of Denise Jackson and Christine Walker-Booth Child Health, UCL), Elly Farmer (CEOP), Jon Brown (Cornwall), Nathalie Fontenay (Leeds), Sarah Impey (NSPCC), Julie Henniker (AIM Project), Juliet Hillier and Stef Fox (North East Lincolnshire), Amanda (Brook), Martin Quinn (Health and Social Care Board Carpenter and Kathryn Brooks (Surrey), Tracey Northern Ireland), Pat Branigan (NSPCC), Peter Clarke Goddard and Krishna Ridley (Waltham Forest), (Glebe House), Sheila Brotherston (Lucy Faithfull Rachael Osbourne (Nottingham City), and Sarah Foundation), Alice Scott (National Child Protection Constable (Telford & Wrekin). Abuse Investigation Working Group), Simon Hackett (Durham University), Graham Ritchie (Office of the Children’s Commissioner), Susan Haacke (NCATS), A Kitchener (Siarad Da), David Derbyshire (Action for Children) and Stuart Allardyce (Barnardo’s). Contents
Introduction 6
1 Responses 11 1.1 Summary of evidence and issues 12 1.2 Audit tool – domain 1 18 1.3 Key principles and practice example 21
2 Prevention 23 2.1 Summary of evidence and issues 24 2.2 Audit tool – domain 2 28 2.3 Key principles and practice examples 31
3 Assessments 33 3.1 Summary of evidence and issues 34 3.2 Audit tool – domain 3 42 3.3 Key principles and practice examples 45
4 Interventions 47 4.1 Summary of evidence and issues 48 4.2 Audit tool – domain 4 60 4.3 Key principles and practice examples 63
5 Development 67 5.1 Summary of evidence and issues 68 5.2 Audit tool – domain 5 72 5.3 Key principles and practice examples 75
References 76 Introduction 6
It is over 20 years since a national In recent years, professionals The time is right to progress this those with a wider safeguarding have learned a lot about the work, giving it impetus, shape and remit and audit responsibility, strategy to address the challenge nature and extent of the focus within the UK child welfare, such as chairs and members of children and young people with problem, what constitutes good criminal justice and health and of Local Safeguarding Children assessment practice, and effective education systems. Boards (LSCBs). harmful sexual behaviour (HSB) interventions for children, young people and families affected by Aim of the framework was first proposed for the UK this issue. The guidelines aim This integrated framework aims to (NCH, 1992). Despite repeated support local work with children Despite increasing evidence on to provide a framework and young people who have calls – and some indications that the scale, nature and complexity to help local areas displayed HSB, and their families, of the problem, service provision a cross-government framework by delivering and developing clear across the UK remains patchy develop and improve policies and procedures, and by was about to be published (Home and relatively uncoordinated, with responses to this refreshing local practice guidelines some beacons of good practice. Office, 2010) – a strategy has and assessment tools. Levels of professional confidence important child not been forthcoming. and competence to address the protection challenge It seeks to provide a more coherent challenge are, at best, varied and evidence-informed approach (CJJI, 2013). There is an obvious for work with these children and need for a more coordinated and Who are these young people, and to better consistent approach to the issue, guidelines for? understand how to improve that recognises both the risks These guidelines have been outcomes for them. and needs of children displaying developed by a group of service harmful sexual behaviours. delivery organisations and experts Though the framework is intended in the field of HSB. They aim to contribute to the development The establishment of the Home to provide a framework to help of a national HSB strategy, it has Office National Group on Sexual local areas develop and improve been developed in the first instance Violence Against Children and responses to this important child for England, as similar work is being Vulnerable Adults in the wake of protection challenge. developed in Scotland, Wales and the Savile case, the developing Northern Ireland. work by NICE’s public health To effectively engage with the centre on the issue of HSB, and framework, the audit tool will Colleagues from all four high profile cases of child sexual require a joint local response. We nations have contributed to the exploitation and online abuse encourage input from local staff development of this framework, present an opportunity to forge with a strategic role in coordinating and we hope it will inform the a better approach to the issue of child protection and local HSB development of work to address HSB displayed by children and responses, those responsible for HSB across the UK. young people. commissioning such services, and 7
The framework seeks to:
• support an integrated • promote the advantage of understanding of, and involving frontline agencies response to, HSB and workers (especially education services) in earlier • identify a continuum of recognition, assessment responses to children and and intervention, thus young people displaying increasing the chances of HSB, ranging from early engaging earlier community-based identification and support • encourage inter-agency with low-risk cases, to work designed to reduce the assessment, intervention and isolation and anxieties that intensive work with the highest are commonly felt in decision- risk and needs making for this group, and which may result in under and • promote effective assessment over-estimation of risk as key to preventing unnecessary use of specialist • promote the use of a shared time and intensive resources language, skills and training with lower risk cases, and to exchange, and development support earlier interventions, of appropriate local peer where appropriate support systems
• ensure children and families • promote the importance of are offered the right level of evaluation and monitoring support by suitably trained of outcomes for children and skilled workers and young people who demonstrate HSB. 8
Framework structure and how to use it The framework promotes five domains (areas of focus) that cover the essential elements of developing and delivering an integrated and effective HSB service for children, young people and their families. These five key domains are closely interrelated: 1 2 3 4 5 Responses Prevention Assessment Interventions Development A continuum Prevention, Effective Multi-modal Workforce of responses identification and assessment and approach to development to children and early intervention referral pathways intervention young people displaying HSB 9
How to use the audit tool The statements are directly linked We suggest you carry out the audit exercise to establish a Each domain Each domain includes an audit to research messages, and are baseline, from which scores can be is structured exercise to enable local areas to deliberately challenging – requiring combined to provide an overview in the same way assess their practice, processes evidence to underpin each score, of local practice. An HSB framework and leadership against the five key for example – and designed and includes: scoring tool is available at areas. These exercises provide 10 to stimulate debate. The audit • a summary of the latest to help collate the statements, in no particular order, exercise should be a catalyst for nspcc.org.uk evidence to back up findings and generate a radar against which a score between 0 learning and improvement. practice and local decision graph (see the example overleaf and 4 should be given, as follows: making and the key issues If differences across agencies in figure 1). being faced Not at all/never/ (the quality of data recorded; This should enable local areas to 0 no evidence for this the approaches to assessment, • an audit tool to help you etc.) make it difficult to reach focus their efforts on the areas assess the current state in which improvement is needed Very little/very infrequently/ an agreed score, we strongly of your HSB offer and most. You can then use the very little evidence for this suggest using the lower score. service responses 1 Similarly, statements that employ examples and resources provided to draft an action plan that reflects To some extent sometimes/ subjective terms such as ‘high • the key principles to consider local needs and priorities. 2 some evidence for this quality’ or ‘confident’ may highlight when focusing on delivery, differences of opinion between with practical examples. To a fair extent/frequently/ professional groups. Again, we
3 good evidence of this recommend applying the lower A list of available tools score and considering what action and resources can also Always/to a great extent/a would be necessary for all groups be found for each wealth of extremely strong to feel confident, or be assured domain online at 4 evidence for this of quality. nspcc.org.uk To enable accurate scoring, multi-agency partners will need to work together to reflect and respond to the statements. It may be helpful for the chair of the Local Safeguarding Children Board (LSCB) to coordinate completion of the audit tool. 10
Figure 1: Example of ‘pre-and post’ self-evaluation scores (T1 and T2) A continuum of responses to children The audit exercise should be repeated after five and young people with HSB to six months, and again at ten to 12 months, to demonstrate progress and to inform any changes or developments required.
National Institute of Clinical Excellence (NICE) HSB guidelines The framework should be used alongside the NICE Workforce Prevention, guidelines (2016) on harmful sexual behaviour among development identification and young people. The guidelines make recommendations early assessment about the roles of universal services, early help assessment and risk assessment, linking with families pre and post intervention and the key principles and approaches for intervention. The guidelines aim to ensure that children and young people who display HSB, are assessed as soon as possible.
Interventions Effective assessment and referral pathways
Key
T1 T2 A continuum of responses 11 1Responses to children and young people 2Prevention displaying HSB
3Assessment
4Interventions
Developments5 1.1 Summary of evidence and issues
12
The scale of the problem minority groups, and all areas the number of cases in which HSB Sexual abuse perpetrated by identified young people with was suspected or alleged.² children and young people is not learning disabilities as service a rare phenomenon. At least one users. Many local authorities in Defining harmful sexual third of all sexual offences against England, Scotland and Northern behaviour by children and children and young people in the Ireland reported the same number of cases at the time of survey young people UK are committed by other children A wide range of terms have and young people, and the extent compared to the previous five years. However, some areas been used to describe children of sexual abuse may be much and young people who present higher. In a UK random population displayed an increase in cases of HSB: in England, just over a quarter with problems with their sexual sample (2011), Radford and behaviour. Terms include ‘juvenile colleagues found that two thirds of areas surveyed demonstrated an increase in cases, of which sex offender’, ‘young abuser’ and of individuals who had experienced ‘adolescent perpetrator’. Misuse of contact sexual abuse as children over half were males, younger people with a learning disability imprecise and vague terminology had been abused by someone can lead to misclassifying under the age of 18. and younger children; in Wales an increase in cases of females children and young people, or and young people with a learning labelling them inappropriately. The scope of referrals of disability was recorded. A shared and meaningful range children and young people of terms is important to enable displaying HSB clear communication between The lack of comparable services In the UK over a third professionals, and to allow accurate assessment of children, and accessible recording systems of sex offences against makes it impossible to capture an young people and their behaviours. accurate picture of referrals to HSB children and young services across the UK. However, a For the purpose of this framework, review of service provision across people are committed ‘Harmful sexual behaviours’ are 20 per cent of local authorities in by under 18s therefore defined as: the UK (Smith, Bradbury-Jones, “Sexual behaviours expressed by Lazenbatt and Taylor, 2013) Schools currently provide their local children and young people under indicated that males and older authority with termly information the age of 18 years old that are children formed the majority of about some circumstances in developmentally inappropriate, may those being offered a service as which HSB may occur, such as be harmful towards self or others, a consequence of HSB. sexting, bullying and gang-related or be abusive towards another activity. While this information child, young person or adult.” English and Scottish local is basic, it could contribute to (derived from Hackett, 2014). authorities had the most cases the overall picture if additional of young males from ethnic information was requested about 2 Sexting is a problem for many schools, and risk management is vital for education 13
1Responses It is helpful to distinguish between problematic and abusive sexual behaviour:
Problematic • When this type of behaviour Such behaviours are more • Problematic behaviours don’t appears to be trauma- commonly associated with include overt victimisation of related – when symptoms young people over the age of others but are developmentally originate from sexual abuse criminal responsibility or those disruptive and can cause the child has experienced in puberty. 2Prevention distress, rejection or increase – the behaviour may be victimisation of the child termed sexually reactive. As both problematic and displaying the behaviour. Sexually reactive and sexually abusive sexual behaviours are Sexual behaviour problems problematic behaviours are developmentally inappropriate are defined as behaviours more commonly associated and may cause developmental involving sexual body parts with children in the damage, a useful umbrella that are developmentally pre-adolescent age range. term is harmful sexual inappropriate or potentially behaviours or HSB. This term has been adopted widely in the harmful to the child or Abusive 3Assessment field, and is used throughout others. They range from • Abusive behaviours involve this framework. problematic self-stimulation an element of coercion or and nonintrusive behaviours, manipulation and a power to sexual interactions with imbalance that means the other children that include victim cannot give informed more explicit behaviours consent, and where the than sex play, and aggressive behaviour has potential to sexual behaviours. cause physical or emotional harm. Power imbalance may 4Interventions be due to age, intellectual ability, race or physical strength. Abusive sexual behaviour may or may not have resulted in a criminal conviction or prosecution.
Developments5 14
A continuum Hackett (2010) has proposed a continuum of behaviours model to demonstrate the range of sexual It is vital for professionals to behaviours presented by children and distinguish normal from abnormal young people, from those that are normal, sexual behaviours. Chaffin et al to those that are highly deviant: (2002, p208) suggest a child’s sexual behaviour should be considered abnormal if it: Normal Inappropriate Problematic Abusive Violent • Developmentally • Single instances of • Problematic and • Victimising intent • Physically violent • occurs at a frequency expected inappropriate sexual concerning or outcome sexual abuse greater than would be behaviour behaviours developmentally expected • Socially acceptable • Includes misuse • Highly intrusive • Socially acceptable • Developmentally of power • interferes with the • Consensual, mutual, behaviour within unusual and socially • Instrumental child’s development reciprocal peer group unexpected • Coercion and force violence which is to ensure victim physiologically and/ • occurs with coercion, • Shared decision • Context for • No overt elements compliance or sexually arousing intimidation, or force making behaviour may be of victimisation to the perpetrator inappropriate • Intrusive • is associated with • Consent issues • Sadism emotional distress • Generally may be unclear • Informed consent consensual lacking, or not able • occurs between children and reciprocal • May lack reciprocity to be freely given of divergent ages or or equal power by victim developmental abilities • May include levels • May include • repeatedly recurs in secrecy of compulsivity elements of after intervention by caregivers. expressive violence 15
Assessing children and young 1Responses A continuum of responses Figure 2: Continuum of service intensity, As identified in Hackett’s model, people and meeting their needs Morrison and colleagues (2001) adapted above, children and young people in the context of the notion of a from Ryan (1999) with harmful sexual behaviours continuum of responses is the are a varied and complex group subject of the third domain of this with diverse needs that cannot be framework: effective assessment Many addressed by a ‘one size fits all’ and referral pathways. model of service provision. Assessment In addition to the initial response The diverse needs of these children and support offered to low level 2Prevention and young people include the fact cases in frontline settings, several Parent education to help child that many of them have hitherto levels of service response and unrecognised learning difficulties, intensity are required in order to specific educational needs, a range address various levels of need Extra educational input of psychosocial risk factors and and concern, as highlighted in co-occurring psychiatric disorders the following model developed by (Bladon et al, 2005). Morrison and colleagues (2001). Local therapeutic help
The wide range of harmful sexual Hence a small network of regional, 3Assessment behaviours shown by children highly specialised assessment and Specialist and young people means their treatment services are required to provision needs should be met in a variety meet some of the more specialised of different placement contexts. needs shown by a smaller number These range from their own homes of more complex cases. Few (most children and young people), looked-after or care settings (the more disadvantaged and hard to manage young people 4Interventions with moderate risk profiles), and supervised or secure provision (young people who pose a high risk of serious, significant harm to others).
Developments5 16
In addition, imaginative and The relationship between The following model is suggested as a framework for evidence-based treatments such ‘harmful sexual behaviours’, as MST (Multi Systemic Therapy) ‘child sexual exploitation’ understanding the range of service provision required for (Borduin et al, 2004) and forensic children and young people displaying HSB: foster care (Chamberlain and Reid, and other terms 1998; Yokely and Boettner, 2002) Given the above definitional A. Support, case management and C. Network of specialist regional should be provided for young discussion, it is important to coordination in frontline settings services that provide case people who can’t be contained at locate the term ‘harmful sexual supported by specialised services consultation, teaching and training home without professional support, behaviours’ in the broader context as needed. programmes to facilitate local nor contained in an ordinary of other terms used to describe and services and to provide direct care facility, but who don’t need classify types of sexual abuse and B. Community-based teams, including interventions in complex cases the close supervision or secure sexual violence. CAHMS and the voluntary sector where young people present with provision necessary for young (such as the NSPCC or Barnardo’s) complex needs and risk profiles, people who pose a more In the UK currently, a range of at local level, who can assess and including serious mental health significant risk to others. terminology has been proposed to offer interventions to children and concerns and learning describe harmful sexual behaviours young people (and their parents, difficulties/disabilities. In the case of young people who both perpetrated and experienced carers and families) presenting with are expected to make the transition by both adults and children. It is problematic and abusive sexual D. Small number of therapeutic to adult prison, sentence planning important to recognize that each behaviours, supported where residential facilities for children and and risk management processes of the terms proposed describes necessary with input from a regional young people displaying HSB based should take into account the a range of behaviours and specialist service with consultation around the UK to allow for intensive, young person’s age and stage experiences. They are not simple and training. Community-based supervised treatment of children of development when the or fixed categories as such and teams would be well-placed to whose needs cannot be met safely offending occurred. many children and young people’s provide consultation and advice in the community. experiences are relevant to a to schools on children presenting number of terms. However, in order with sexual behaviour problems in E. Provision in secure settings, for to avoid confusion, it is important educational settings. comprehensive assessments and to point out some of the ways in interventions that address the which the terms coalesce and young person’s risks and needs, differ. In particular, the relationship linked to sentence planning and between the terms ‘HSB’ and ‘CSE’ transitions within the secure estate warrants some clarification. and to the community. 17
Although at the time of writing 1Responses Figure 3: The fit of HSB and CSE in a national consultation on a the context of wider child sexual abuse new national definition of CSE is in process, CSE is generally defined as “a type of sexual abuse in which children are sexually exploited for money, power or status” (NSPCC). CSE is broadly accepted as a form of abuse Coercion Misuse of power where a child receives something 2Prevention (material goods, psychological or relational benefits) as a result of sexual activity. Currently, one key conceptualisation of CSE is therefore as relational based sexual violence of teenagers, not only, but frequently of young women by either individual or groups of men. HSB CSE Teenage victim, Young child 3Assessment It is clear that some young people victim, mixed female relationship who display HSB are committing gender, family, based, individual acts which would fit with the above individual context and group context definition of CSE. In particular, those young people who sexually abuse other young people within Peer on peer abuse the context of relationships, often described as ‘peer on peer’ abuse, Violence No consent or choice fit both the definition of HSB as Interventions sexual behaviour which victimises 4 others and CSE as exploitative, exchange-based abuse. As Exploitative depicted in figure 3, it is perhaps most appropriate therefore to view both HSB and CSE as distinct but overlapping forms of sexual abuse. Both share the elements of coercion, misuse of power, violence and lack of consent and choice. Developments5 Scoring key: Not at all/never/no evidence To a fair extent/frequently/ 1.2 Audit tool – Domain 1 0 for this 3 good evidence of this always/ to a great extent/a wealth A continuum of responses to children Very little/very infrequently/ 1 very little evidence for this Always/to a great extent/a 4 wealth of extremely strong and young people displaying HSB To some extent/sometimes/ evidence for this 18 2 some evidence for this
Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 1.1 We capture accurate data about the number of children and young people requiring support due to their HSB, and the number who are identified through referral processes but may not be receiving support.
1.2 Our data gives us an accurate picture of children and young people displaying HSB in our area in terms of age, gender, ethnicity, and proportion with learning difficulties or disability. We use this to help us plan service responses and workforce development. 1.3 Local community-based teams, including CAHMS and the voluntary sector (for example, the NSPCC or Barnardo’s) provide consultation and advice to schools on HSB.
1.4 Parents or carers of children and young people displaying HSB receive support that is sensitive, non-stigmatising and accessible.
1.5 There is a shared understanding, across all partner agencies, of what constitutes problematic sexual behaviour and what constitutes abusive sexual behaviour.
This is a draft copy – when using the tool please download the online PDF
Comments: Date completed:
19
1Responses Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement
1.6 We are confident that children and young people displaying HSB are well-supported in terms of their HSB and its underlying causes: 1.6a Living at home (including support to families) 2Prevention
1.6b Children and young people in care settings (including links to transitions and permanency planning)
1.6c Children and young people in secure/supervised settings (including links to transitions and permanency planning) 3Assessment
1.7 We have effective arrangements in place with neighbouring areas, allowing shared commissioning of highly specialised assessment and treatment services to meet the specialised needs of the most complex cases. 1.8 The practice and service response to children and young 4Interventions people displaying HSB is proportionate to the level of risk and need they present, and interventions can be stepped up swiftly to respond to increased risk.
Comments:
Developments5 20
Children and young people are very different from adults. And those who display HSB are a complex group with different needs. 1.3 Key principles
21
• Children and young people are • Local service provision should • Children from disadvantaged 1Responses developmentally different to be arranged to address these families who suffer a number of adults and should be responded needs in different contexts and different disadvantages or risk to as such. at different levels of supervision factors are disproportionately and security. likely to suffer poor outcomes in • Children and young people’s the long term. The patterns of sexual behaviours exist on a wide • Responses to children and young these problems or disadvantages continuum, from normal and people’s HSB should reflect vary a great deal, so services developmentally expected to the level of risk and need they should be flexible enough to highly abnormal and abusive. present, and should be at the support families whatever their 2Prevention least intrusive level required circumstances, without passing • Any child’s sexual behaviour to effectively address the them from agency to agency. must be viewed within a behaviours presented. developmental context to • Primary, secondary and tertiary recognise the key differences • Children and young people prevention approaches are between the motivations and displaying HSB are a complex needed. A tiered approach is meanings of such behaviours group with diverse needs which necessary: one that distinguishes at varying stages. cannot be addressed by a children and young people ‘one size fits all’ model of whose needs can be met through 3Assessment • Descriptions of harmful service provision. parental monitoring, through sexual behaviour should those who need limited include chronological age and psycho-educative support, to developmental status, and those who would benefit from what constitutes healthy sexual more specialist intervention behaviour among children and services and placements. young people. This is particularly true when discussing children and young people with a learning Interventions difficulty or developmental 4 disorder.
Developments5 22
Practice example
In Scotland, the Risk Planning for Children and Yong The CARM group will have Management Authority and People who Present a Risk of responsibility for ongoing risk Scottish government have Serious Harm) which outlines management which should developed guidance for local a framework for multi-agency cover arrangements in relation authorities and partners decision making when young to monitoring, supervision, called FRAME for under people display harmful sexual information sharing, victim 18s (Framework for Risk behaviour or behaviour involving safety planning and risk Assessment, Management serious violence. reduction. CARM outlines a and Evaluation). rights based model of direct The CARM appendix suggests work with children and young FRAME aims to establish a that where there are concerns people who display harmful consistent, shared framework around risk of harm to others, sexual behaviours, a model that that promotes defensible and a meeting bringing together promotes public protection, ethical risk assessment and police, health social work and is systemic and child centred management practice with education as core members in orientation. young people who offend. A should be convened. Other gov.scot/ framework that is proportionate stakeholders should be involved Publications/2014/12/6560 to risk, legitimate to role, as necessary; the principle of appropriate for the task in CARM is to promote young hand, and is communicated people’s participation in risk meaningfully. assessment and management alongside partnership working The most recent version of with parents and carers. the guidance also includes an extensive appendix titled CARM (Care and Risk Management Prevention, identification 23 1Responses and early intervention 2Prevention
1Responses 3Assessment
4Interventions
Developments5 2.1 Summary of the evidence and issues
24
Prevention and Most children and young people questions, and to be able to easily public education The need to who demonstrate HSB don’t go access help and support when on to become adult offenders, they need it. In order to reduce cases of child prevent sexual particularly with the right sexual abuse and exploitation abuse and preventative interventions and Education and health are the there needs to be a coordinated, exploitation spans: support. Research suggests universal services accessed by consistent and multi-agency • primary prevention: that non-sexual re-offence almost all children and young approach to deterrence, community or population- is more common than sexual people. Schools have a key role treatment of victims and wide initiatives recidivism, again stressing the to play in the primary prevention offenders, and prevention. need for intervention to focus of HSB via a range of initiatives; • secondary prevention: on broad-based behaviour and provision of quality advice and work There are preventative elements interventions, prior to abuse developmental goals, and not with children, young people and to both deterrence and treatment, with higher risk, and/or need, just on preventing further sexual their families; and sensitive risk and and the role of primary prevention individuals and communities abuse (Hackett and Masson, casework management. Personal, – particularly for children and 2011; Boswell et al, 2014). social, health and economic young people with harmful sexual • tertiary prevention: education (PSHE) and sex and behaviour (HSB) – is particularly post-abuse interventions If sexual abuse and violence, relationships education (SRE)3 important. to help victims and including HSB, is understood and should aim to provide information perpetrators recover and to approached as a public health and facilitate discussion about sex reduce their risk of repeating problem – in that it affects all and consent, and how children, the harmful behaviour. communities, its impacts can be young people, and their parents multiple, long lasting and costly, can get further support and advice. and it can be prevented from Peer mentoring and advice, both occurring in the first place – this in and out of school, can be a can provide a helpful framework useful contribution to the primary on which prevention activity can prevention of HSB. be planned and delivered.
Primary and secondary prevention should include providing non- stigmatising, non-judgemental information and advice for children, young people, and their parents and carers. This must be easily accessible. Children and young people need the ability to find reliable information, 3 In some areas now referred to as RSE – putting to anonymously ask difficult ‘relationships’ first to emphasise the importance of teaching about healthy and respectful relationships 25
Traffic light systems (Brook, be viewed within a child protection In some cases, children and young 1Responses Identification of behaviours, recognition, 2012) can help professionals in context, and Children’s Services people displaying HSB will have referral and response identifying levels of concern and should be contacted to provide their own histories of abuse that provide a prompt for responding. assessment and recommendations need to be addressed. It is hard to consistently identify Harmful sexual behaviour should if more specialist help is needed. and recognise harmful sexual behaviour in children and young people due to issues including Brook traffic light tool (example below for children aged 9-13) differing professional training, experience, cultural backgrounds 2Prevention and values. Professionals and 9 to 13 families may also be reluctant to discuss sexual behaviour in Green behaviours Amber behaviours Red behaviours children – which remains a solitary masturbation uncharacteristic and risk-related exposing genitals or masturbating taboo area – and this can lead behaviour, eg sudden and/or in public to the behaviours being ‘hidden’ use of sexual language including provocative changes in dress, or unspoken. swear and slang words distributing naked or sexually withdrawal from friends, mixing having girl/boyfriends who are of provocative images of self or others with new or older people, having The rise in internet-related harmful the same, opposite or any gender sexually explicit talk younger children more or less money than usual, 3Assessment or inappropriate sexual behaviour interest in popular culture, eg going missing sexual harassment by children and young people also fashion, music, media, online verbal, physical or cyber/virtual sexual arranging to meeting with an online presents a challenge to parents, games, chatting online carers and agencies working with bullying involving sexual aggression acquaintance in secret need for privacy children and young people. LGBT (lesbian, gay, bisexual, genital injury to self to others consensual kissing, hugging, transgender) targeted bullying forcing other children of same age, holding hands with peers It should be standard professional exhibitionism, eg flashing or mooning younger or less able to take part in practice to view the sexual sexual activities giving out contact details online behaviours of children and What is a green behaviour? sexual activity eg oral sex young people along a continuum, viewing pornographic material 4Interventions or intercourse ranging from normal to abusive What can you do? worrying about being pregnant presence of sexually transmitted (Hackett, 2010). Levels of concern or having STIs should be considered, as opposed infection (STI) to risk, and strength-based evidence of pregnancy What is an amber behaviour? approaches should be used to deliver interventions. It is vital What can you do? What is a red behaviour? that professionals consider the continuum in line with young What can you do? people’s development, which Developments5 is dynamic. 26
Guidance to frontline Education services LSCB training for education staff for whom it is not considered identification for education, Schools, colleges and early years does not include the identification appropriate to continue to live residential and foster care establishments play a vital role in of developmentally appropriate at home. sexual behaviour, or how to respond related agencies the development and education of children and young people; and to inappropriate sexual behaviour, The AIM Project provides guidelines Getting a sense of HSB thresholds they may witness early instances and detailed information is missing for residential placements and the across frontline agencies, and of sexually problematic behaviour from government guidance. implementation of these should be among those caring for – and or be the initial point of contact Educational establishments supported by partnership working. educating – children and young when it is reported. are often fundamental in the Residential placements provide an people on a daily basis, is one management of risk and continued opportunity to shape the young of the key challenges of an The Inspectorate of Probation facilitation of a meaningful daily person’s environment, and to effective response. (2013) concluded that there is routine for children and young introduce them to appropriate ‘ongoing evidence of reluctant people who have displayed HSB, ways of behaving, alongside an Thresholds vary geographically relationships between managing been accused of HSB or who are intensive therapeutic programme and in response to decreasing agencies and schools working under investigation. They are to reduce HSB by improving capacity to deliver services. with children and young people an integral part of partnership pro-social skills. Existing thresholds are often displaying HSB’, but this finding working and need to be included dynamic, depending upon 4 is equally applicable to other in information sharing and Secure placements for children local service development sectors of education. coordination of safety plans and and young people can provide time and, ultimately, on a strategic supervision to maintain appropriate to undertake a comprehensive understanding of HSB issues. educational placements. assessment of young people whose A recent survey behaviour cannot be effectively The situation is compounded by (Kitchener, 2014) Pastoral work undertaken by managed in the community, limited inter-agency guidance on of service management educational establishments is but ultimately it is necessary to this issue, unclear information professionals suggested rarely seen or quantified, but can transition these young people sharing procedures, and siloed have a significant positive impact, back into the community. In working practices. At a national these poor relationships for example, by encouraging these instances, a stepped down level the removal of several are based on: and supporting those who have approach to transition – perhaps sections of Working Together • reluctance to share experienced HSB; by promoting via a therapeutic residential or (2012) that covered HSB hasn’t information with standards of behaviour; or by foster placement (more specialist helped local commissioning education, citing issues of signposting sources of support. and flexible than usual leaving bodies to prioritise this work confidentiality care programmes) – may be most when funds are tight. Residential and foster care effective before any return to a family setting. • perceptions about education Residential and foster placements professionals’ lack of are sometimes necessary, understanding of this area particularly for children and young people who are rejected by families • concerns about overreaction. following disclosure of HSB or 4 Either through ‘welfare placements’ or the criminal justice process 27
Foster carers are often averse to In addition to a clear and extensive and instead consider the sexual 1Responses providing placements for children case formulation of the child behaviour within a wider context Problematic sexual and young people displaying HSB, being shared with the foster (Gil and Shaw, 2013). Assessment behaviour in under due to anxiety about managing the carers (Farmer and Pollock, 1999), should consider wider welfare 12s can be defined needs and concerns, including potential blame associated with any education about normal sexual as behaviours that: further sexual offending behaviour. behavioural development – and family issues, and social, It can be hard for local authorities how to address problematic sexual economic, and developmental • are rare for the developmental to find appropriate placements, behaviour – would help to alleviate factors (Hackett, 2014) and stage and culture of the child particularly when there hasn’t yet this anxiety. There is scope for the should be dealt with differently been a comprehensive assessment development of more specialist to adolescents, who are likely to • are frequent 2Prevention of a young person’s HSB. therapeutic foster placements, have different motivations for their where foster carers receive behaviour (Chaffin et al, 2002). • include elements of Sexualised behaviour was identified specialist training about providing Professionals should notice any preoccupation as one of the problems carers placements for this client group. spike in the sexual behaviour of found harder to deal with, especially children between the ages of 5 to • fail to respond to normal when it affected other children Consideration needs to be given, 12 which is not in line with western correction from adults or in their care (Head and Elgar, matching the child or young culture (Friedrich, 1997) and may continue to occur after 1999). Ultimately, problematic or person to the placement, and risk have developed out of sexual corrective efforts harmful sexual behaviour is seen management – for example, the victimisation, physical abuse, family 3Assessment as a significant factor in placement need to safeguard other children violence, neglect, poor parenting or • involve significant age and breakdown (Head and Elgar, 1999). in the placement is fundamental. exposure to sexually inappropriate developmental differences However, Farmer and Pollock material (ATSA, 2006). between the children involved (1999) indicated that attempts to There is scope for the match the placement to the needs Sibling sexual abuse often goes • involve any use of force, of the child had been made in just unidentified, but is the most intimidation or coercion or the development of more 30 per cent of HSB cases. common form of intra-familial presence of any emotional specialist therapeutic sexual abuse (Monahan, 2010). distress in the child or children It is estimated that half of all involved Guidelines for early Interventions foster placements, adolescent-perpetrated offences 4 recognition • cause physical injury. where foster carers Younger children (under 12) involve a sibling (Shaw, 1999), yet just 19.5 per cent of sibling receive more specialist exhibiting harmful or problematic sexual behaviours should be sexual abuse victims disclose at training about identified early to prevent the the time (Carlson et al, 2006). However, it is important that people possible establishment of Schools often play an important with the opportunity to respond providing placements persistent patterns later (Vizard, role in early identification. In early have the skills to identify for this client group 2007). Guidance indicates that summary, early recognition normal, problematic and harmful professionals should avoid provides the opportunity for behaviours, and know how to early intervention and response. respond appropriately. Developments5 analysing single behaviours, Scoring key: Not at all/never/no evidence To a fair extent/frequently/ 2.2 Audit tool – Domain 2 0 for this 3 good evidence of this always/ to a great extent/a wealth Prevention, identification Very little/very infrequently/ 1 very little evidence for this Always/to a great extent/a 4 wealth of extremely strong and early intervention To some extent/sometimes/ evidence for this 28 2 some evidence for this
Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 2.1 We have prevention initiatives in place and we are confident that these are effective and appropriately targeted: 2.1a Primary prevention (community or population wide)
2.1b Secondary prevention (prior to abuse with higher risk or higher need individuals and communities, and offers of risk assessment post HSB incident)
2.1c Tertiary prevention (post abuse interventions with victims and perpetrators)
2.2 We offer non-judgemental, non-stigmatising information and advice to children, young people and their parents and carers, which is accessible by a range of cultures and literacy levels.
2.3 Children and young people in our local area can find reliable information, ask difficult questions anonymously, and access help and support when they need it.
This is a draft copy – when using the tool please download the online PDF
Comments: Date completed:
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1Responses Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 2.4 Schools across our area provide high quality PSHE or sex and relationships education which includes discussion around sexual consent.
2Prevention 2.5 Clear and consistent thresholds for HSB, considering the context of child and adolescent development, are applied across education, health and other agencies.
2.6 Foster carers, residential staff and adopters are provided with high quality training and advice about normal sexual behavioural development and how to respond to problematic sexual behaviour, and this has a positive impact on carer/ practitioner anxiety and placement stability. 3Assessment 2.7 Early recognition assessments of children displaying HSB consider wider welfare needs and concerns, including family issues, social, economic, and developmental factors.
2.8 All prevention initiatives and early intervention in our local area are clearly connected to child protection systems and draw on the specialist support of children’s social care in order to ensure effective responses to risk and vulnerability. 4Interventions
Comments:
Developments5 30
To reduce cases of child sexual abuse and exploitation there needs to be a coordinated approach. 2.3 Key principles
31
• Primary, secondary and tertiary • It is vital that young people are 1Responses prevention approaches are not labelled or stigmatised as a needed. A tiered approach to result of the identification of HSB. intervention is most appropriate, which distinguishes children • It is important that staff and and young people whose needs professionals who have the can be met through parental opportunity to respond early are monitoring, through those educated in the identification of who need limited psycho- normal, problematic and harmful educative support, to those behaviours, and know how to 2Prevention who would benefit from more respond appropriately. specialist intervention services and placements. • We need to recognise and better develop professional • A consequence of alliances that make best use of misunderstanding the path of differing professional expertise young people displaying HSB (for example, education skills in is the increased likelihood of dealing with communication and either under or overreaction language difficulties and learning 3Assessment by agencies. difficulties/disabilities).
• The connection between contributory risk factors suggests that support should not target merely the problematic sexual behaviour but also the broader concerns within the child’s family and potentially unresolved Interventions experiences as a victim of abuse. 4
Developments5 32
Practice example Prevention example
There are some areas of NSPCC PANTS Identification example good practice where primary By talking PANTS, parents and Brook sexual behaviours traffic prevention projects to target carers have a simple way to talk light tool this gap have been implemented. to children about staying safe brook.org.uk/old/index.php/ For example, educational staff from sexual abuse. It sets out traffic-lights within the borough of Waltham some simple rules to remember. Forest have been provided with For example, they should tell a Brook, the young people’s sexual the opportunity to attend AIM trusted adult about their worries. health charity, has produced an Education training. This enables nspcc.org.uk/pants online sexual behaviours traffic them to undertake an initial light tool to help professionals screening of any harmful sexual Stop It Now! working with young people behaviour that my take place distinguish between three levels within the school environment Stop it Now! UK and Ireland is of sexual behaviour: (early help assessment). a child sexual abuse prevention campaign helping adults play - Green behaviours reflect their part in prevention by This helps them to contextualise safe and healthy sexual providing sound information, the behaviour and the response development. required. Currently 100 per cent educating members of the of primary schools within the public, training those who - Amber behaviours have the borough have an AIM trained work with children and potential to be outside of safe member of staff and 80 per families, and running a free, and healthy behaviour. cent of secondary schools. confidential helpline. This is a valuable resource to stopitnow.org.uk - Red behaviours are outside of ensuring that the reaction to safe and healthy behaviour. harmful sexual behaviour is Parents protect Brook have distinguished a timely and proportionate. An information and resources range of sexual behaviours to website that aims to raise help professionals and families awareness about child sexual identify concerns when dealing abuse, answer questions, and with children and young people. give adults the information, advice, support and facts they need to help protect children. parentsprotect.co.uk Effective assessment 33 1Responses and referral pathways 2Prevention
3Assessment
4Interventions
Developments5 3.1 Summary of the evidence and issues
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Interagency working and the role of the ACT service The root of HSB is multi- The development of an interagency in Surrey are good examples. Core determined – it involves individual, framework documenting the The success of the Greater considerations family, peer, school, and community process of referral, assessment, Manchester AIM project in the assessment variables, as well as biology, intervention and case management assessment model (Print, Morrison temperament, and socioeconomics and Henniker, 2001) in ensuring of all children and young (Rich, 2011). Children and young has been identified as integral to people displaying the effective management of local agencies work together people who display harmful sexual HSB cases in children and young in a coordinated manner can HSB include: behaviours are a heterogeneous people (Hackett, Masson and encourage the development of a • working within a multi- group that require a flexible and Phillips, 2003). common referral and assessment agency, multi-disciplinary developmentally appropriate protocol for children with sexually context approach to assessment. Interagency policies demonstrate abusive behaviour. agencies’ commitment to a • close attention to child UK Best Practice in Managing Risk partnership approach and a Current approaches to protection concerns (Department of Health, 2007) common philosophy that outlines HSB assessment documentation states: “Where what is expected of workers and • use of evidence-based suitable tools are available, risk A wide range of approaches to HSB assessment should be based on other professionals. They guide assessment exist across different assessment models actions, clarify individual roles the structured clinical judgement agencies around the UK. These approach (combining actuarial and and responsibilities, and provide a approaches have been reviewed • effective inter-professional benchmark for good practice. This communication clinical methods).” However, more (Calder, 1997 and 1999; Lovell, recently, professionals are advised shared ownership is crucial for this 2002; Vizard, 2002) and several group of children, young people • analysis of the behaviour to use risk assessment tools individual assessment models alongside structured professional and their families: they often have been outlined (O’Callaghan in quality written reports. have complex needs that can’t judgement to avoid over-estimating and Print, 1994; Morrison and risk (Craig, 2003; Hackett, 2014). be addressed by a single agency Print, 1995; Vizard et al, 1995; and, as such, require a consistent, Calder, 1998; Print, Morrison and combined response. The development of risk Henniker, 2001). assessment tools has benefited practice in recent years, but they Appointing an HSB service This variety stems, in part, from are a limited resource focused coordinator the need to provide assessment mainly on assessing intellectually Engaging an HSB lead service or services for diverse subgroups average 12 to 18-year-old males coordinator to address gaps, and to of children, including those with and none are fully validated5. maintain, motivate and support the learning disabilities (O’Callaghan workforce has enabled some areas and Print, 1994) and those at to become more successful in their high risk (Vizard et al, 1995) approach to HSB work. The HSB who attend a range of services in the community or live in service coordinator role in Leeds 5 Harmful sexual behaviour among children and young residential settings. people NICE draft for consultation February 2016 35
The NSPCC review of service develop a continuum of responses those under the age of criminal 1Responses provision for young people (Brook Traffic Light Tool, AIM, responsibility, and those from displaying HSB found that the Hackett, 2014) ranging from early different ethnic backgrounds AIM2 was the most commonly community-based assessment and should be subject to the same used assessment tool by UK intervention with low level cases to referral and assessment strategies services (Smith, Bradbury-Jones, intensive work with more serious as adolescent males (who form Lazenbatt and Taylor, 2013) but it and complex cases. Effective the bulk of HSB cases) but the tool is useful to be aware of other tools: early assessment ensures cases and model used should reflect the Juvenile Sex Offender Assessment enter the system in the right place, individual being assessed. Protocol (J-SOAP)-II (Prentley and preventing unnecessary use 2Prevention Righthand, 2003); Estimate of Risk of specialist time and intensive Criminal justice system of Adolescent Sexual Offender resources with lower risk cases, assessment Recidivism (ERASOR; Worling and and ensuring earlier intervention Curwen, 2001); It is important in high concern cases. All children and young people to use the tool that best fits the entering the youth justice system young person and the needs of Preventative work and tiers of should receive a structured needs the system working with them input could lead to a reduction in assessment using the relevant (see section 3.3). escalated cases and criminalisation Youth Justice Board-approved 7 of children, and ultimately a assessment tool (Asset ), designed to identify the young person’s 3Assessment Effective assessment practice reduction in costly agency should include holistic, child- resources and external placements strengths, the risks and protective focussed, multi-agency for young people. Avoiding drift factors associated with the assessments that examine the should increase the likelihood of offending behaviour and harm to needs met by the behaviour, any prompt engagement, reduce others, and to select an effective underlying reasons or triggers, and denial and increase the possibility intervention programme. protective factors and strengths of good outcomes. that can be used to manage or While Asset doesn’t provide for reduce HSB. Risk management It can be hard to talk about HSB specialist assessment, it contains Interventions and child protection are key when language and terms mean elements that enable practitioners 4 considerations, and, where needed, different things to different to identify cross-linked issues. the use of multiple tools for risk professionals, but this could be AssetPlus is the new assessment assessment should be considered6. addressed by the use of common and planning interventions assessment and intervention framework used by local authority models using language that youth offending teams (YOTs) and Thresholds, assessments, secure establishments. timescales and drift accurately describes behaviours without stigmatising or labelling. There are few specific assessment Females who sexually harm, young 6 Criminal Justice Joint Inspection ‘Examining tools for children (under 12 years) Multi-Agency Responses to Children and Young people with learning disabilities, People who sexually offend’. February 2013 Developments5 who display HSB, hence the need to 7 To be replaced by AssetPlus 36
AssetPlus also requires the Recommendations were also made When using AssetPlus to assess harmful sexual behaviour, practitioner to make a professional in relation to improving information judgement on the impact, likelihood sharing, communication and youth justice practitioners are asked to consider: and imminence of all future harmful management oversight and behaviours (including harmful supervision of staff working with • whether the young person is on the sex • whether the young person displays sexual behaviour), including likely young people with harmful or offender register sexually inappropriate behaviour victims and circumstances. The inappropriate sexual behaviour. intervention plan links targets to The report noted that responses • whether a ‘sexual element’ was a • whether the young person is a identified outcomes (such as ‘not to the behaviour were better where characteristic of their offence/s perpetrator of domestic abuse hurting others’) and prompts to those responding had specialist summarise key conclusions from knowledge or training in this area • whether the behaviour is more serious • whether they have any concerns other relevant assessments. of work. than the charge implies about the young person’s significant relationships In 20138, a report was published Agency responses to the disclosure • what is encouraging/concerning about following the joint inspection by of harmful sexual behaviour by offence trends over time • MAPPA details HM Inspectorate of Probation young people vary considerably, into the effectiveness of multi- and professionals are unsure • whether they have information or agency work with children and how to effectively respond to evidence about any other behaviour young people in England and young people’s risks and needs. by the young person that gives cause Wales who had committed sexual There is clearly a need for a more for concern offences and were supervised coordinated strategic approach at in the community. The report local level, including assessment makes several observations and protocols and evidence-based recommendations in relation to interventions to identify and work with this group of young address the behaviour. people. The inspection found that many opportunities for early intervention were missed, and the report recommends that early intervention is included in the early help strategies of LSCBs.
8 Criminal Justice Joint Inspection Examining multi-agency responses to children and young people who sexually offend, February 2013 justice.gov.uk/downloads/publications/inspectorate- reports/hmiprobation/joint-thematic/children-yp-who- sexually-offend-report.pdf 37
MAPPA SMBs have incorporated 1Responses Multi-agency public protection arrangements recommendations from the 2013 (MAPPA) and risk Criminal Justice Joint Inspection in the development of an action management plan that begins to address Some key recommendations shortfalls in training, resource from the joint inspection by HM development, service delivery, etc. Inspectorate of Probation (2013) MAPPA SMB meetings have been were concerned with the lack of used to promote good practice and multi-agency ownership of the raise partner awareness in relation 2Prevention issue and the lack of training to harmful sexual behaviour by and expertise that influenced young people. professional responses, and MAPPA partners – coordinated MAPPA is currently focusing on by their strategic management harmful sexual behaviour and board (SMB) – are now working complex youth offending. This together to learn from good is crucial in promoting service practice both nationally and locally. provision and developments to generate an equitable response, 3Assessment The aim is to develop robust and especially in the problematic timely responses that use effective transition from young person to risk management plans and risk registered adult sex offender. This level identification to protect process could be helped by the victims of HSB, and an industry- development of an evidence-based standard risk assessment tool is risk assessment tool to support currently in development. the decision making process.
This will complement the provision These complex cases not only Interventions of a Good Lives-based model impose a huge pressure on 4 of intervention and support for resources such as staff time young people who have offended and multi-agency management sexually, and who often have – they can also, where local the most complex needs. It provision is lacking, be costly and will also work closely with the prohibitive in the context of agency Four Pillars model – a holistic placements and the commissioning risk management approach of of expert assessments. supervision, monitoring and control, interventions, treatment Developments5 and victim safety. 38
Assessment in However, there are, as yet, no residential settings agreed assessment or treatment Key roles of education establishments: protocols for children and young The HSB assessment of children people who display HSB within and young people who are a residential setting, whether Prevention Multi-agency work accommodated in a residential privately run, local authority- • helping young people to make • identification, referral, contribution to setting is little described in UK owned, within a secure estate or positive lifestyle choices and assessment and ongoing support via literature. This may be because the charity sector. The result is show respect for others, achieved multi-agency processes there are very few residential that fragments of assessment through anti-bullying work, extended provisions, but a growing number and treatment approaches from school activities, and promotion • work with other agencies to empower of private sector providers. the literature – or gleaned from of positive lifestyles and increase the resilience of young managers or staff who have people Many specialised residential attended training conferences • the formal (particularly PSHE) provisions are run by the private – are often implemented by and informal curriculum • work with other agencies in the sector, and experience shows that residential care staff with very community they rarely stay open for more than little training in this work and, four or five years, often because Single agency response usually, with no supervision of staff are not trained to deal with • early identification of vulnerable the therapy provided. the distressing nature of the work. children and young people
In practice, most children and The role of education • informed and measured responses young people with HSB are establishments to low-risk indicators of abuse or HSB accommodated in local authority Referrals from education provisions – such as children’s establishments form a significant • work with, and support of, parents homes and foster care – where proportion of referrals into multi- they are unlikely to be provided agency processes. Schools and with specialist treatment services. colleges may be involved at A long-standing UK residential many stages to manage cases of service, Glebe House has an HSB – from prevention to early excellent track record in the response – through referral into the assessment and treatment of multi-agency process and on to young adolescents, and can be support for young people and their considered a model service, with a families. Without clear guidance multi-disciplinary team operating and multi-agency support, schools within a full child protection struggle to establish thresholds to context (Boswell et al, (2014). identify cases of HSB, and to refer these to key agencies, as well as how to manage and support the individuals involved. 39
All establishments should have • In some, but significantly not communication between education 1Responses Coordination of a designated safeguarding education response all, authorities, the lead officer and other agencies, and overcome lead (DSL) who coordinates for safeguarding in education the concerns outlined in the report. When dealing with displaying and develops safeguarding meets with the school within HSB, education establishments arrangements and ensures staff 24 hours of a case coming to The report recommended may have to consider a number are fully trained. All staff need to their attention, to offer support LSCBs take action to monitor of factors that rarely arise in be aware of the circumstances and advice and take responsibility ‘the effectiveness of the multi- other circumstances: of abuse, including HSB, and to for coordinating or resolving agency response to such children be confident to take appropriate these matters. and young people in their • The young person and victim may action when needed. area, particularly including the 2Prevention attend the same school, so risk However, the Joint Inspectors identification of such cases, joint assessments may be required and Although arrangements for joint report, (CJJI, 2013) found that assessments and the interventions arrangements to accommodate working on safeguarding matters …‘some workers were reluctant to to them and their families and, both pupils agreed. are well established, there is no share information with education where appropriate, their victims’. current guidance on HSB for establishments, fearing that this • There may be several young education as there is, for example, might be detrimental to the child Although other groups have not people involved. on forced marriage (FCO and HO, or young person’. This cautionary been included, the principles 2013) and youth violence and approach not only prevents described above will apply in a • School placement(s) may be gangs (HO, 2013). Educational information that is held by the similar way to non-statutory groups at risk, so a managed move or 3Assessment establishments would welcome education establishment about such as sports groups, church exclusion may be considered. improved advice and policy to the child or young person being organisations, and youth clubs. The inform their work relating to shared with other agencies, it may roles and responsibilities, and the • The risk that some or all of the HSB. While training is useful to also put other children and young need for clear guidance, are most young people involved may be raise awareness among DSLs, people at risk if schools haven’t likely to be transferable in these bullied on their return to school. all staff should have access to undertaken a risk assessment, or situations, with attention to any current information to increase made arrangements to manage the confidentiality issues raised. • Inter-establishment or cross- their confidence to respond movements or behaviour of a child boundary issues may result in appropriately and consistently or young person. unequal treatment of young Interventions to concerns. 4 people involved. The arrangements described above to coordinate action in response • The community may be aware to initial concerns could help to of aspects of the case. encourage and facilitate improved
Developments5 40
Transition issues: older ongoing supervision is assigned; young people and that a clear care plan is in place that allows sufficient Children and young people time for implementation displaying HSB will often have (Grimshaw, 2008). to make a number of transitions, including educational and Particular attention should be placement changes, as well as paid to the needs of young people age-related service changes. making age- related transitions Transition between custodial between services in both the placement and the young person’s community and in custody. Care original community will always should be taken to ensure that need to be considered, although transitions involving young people not always completed. It is with learning difficulties take their important that effective multi- developmental and learning needs agency partnerships continue into account. across all transitions; that relevant sensitive information is shared; that clear responsibility for any 41
In the case of young people education colleagues are included 1Responses Common referral protocols aged 18 to 21, assessments and The Greater Manchester AIM in the assessment and process interventions should consider the Project assessment model in relation to a child or young age and developmental stage at demonstrates how 10 local person who displays HSB, and get which the harmful sexual behaviour authorities and key agencies support and clear information to occurred, any recurrence of the across a conurbation of some understand the referral system behaviour, the actions taken to 4 million people can follow a and how it needs to be aligned address the HSB, the success of common framework of response with the usual Child Protection those actions, current concerns, and work together in a coordinated referral routes. protective factors and strengths. 2Prevention manner (Print, Morrison and These factors have particular Henniker, 2001). This work Several assessment frameworks relevance for young people who encourages the development and protocols exist for use in have entered relationships or of a common referral and the assessment of children and become parents in early adulthood, assessment protocol for children young people. If a common and those who remain under and young people with harmful referral and assessment protocol consideration through the sexual behaviour. is to be developed it will need MAPPA/young-MAPPA process to dovetail closely with the into early adulthood. It is notable that education services existing frameworks, so as not often feel excluded from inter- to create additional burdens for 3Assessment Across the UK it is acknowledged professional communication and practitioners, or fragment children’s that there is a gap in services for discussion of the management information. Any new assessment 18 to 21 year olds. In cases where of these difficult cases. This is framework or local protocol needs the young person meets criteria for particularly unfortunate since the to be developmentally sound and adult services (learning disabilities) worrying behaviour of the child or rooted in research evidence so or leaving care teams, efforts young person is often first noted in that the full diversity of problems should be made to involve the new the school context. Any common experienced by this complex group teams in care planning early on. referral and assessment protocol of children and young people is adequately addressed. must, therefore, ensure that 4Interventions
Developments5 Scoring key: Not at all/never/no evidence To a fair extent/frequently/ 3.2 Audit tool – Domain 3 0 for this 3 good evidence of this always/ to a great extent/a wealth Effective assessment and Very little/very infrequently/ 1 very little evidence for this Always/to a great extent/a 4 wealth of extremely strong referral pathways To some extent/sometimes/ evidence for this 42 2 some evidence for this
Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 3.1 The assessment tools used by practitioners are evidence-based and suitable for an appropriate population of children and young people (age, cognitive ability, etc).
3.2 Assessments include a holistic view of the child or young person, including consideration of harmful behaviours, development, family, and environment.
3.3 Our assessment frameworks and protocols around HSB dovetail closely with related existing frameworks, and practitioners can navigate these effectively (for example, the designated safeguarding lead in school is clear on their role regarding HSB; LSCBs work on abuse and exploitation reflects HSB). 3.4 Assessment of children and young people displaying HSB in our area is multi-disciplinary and supported by effective multi- agency cooperation, but also retains close attention to child protection issues. 3.5 Our initial assessment processes identify need, effectively ensuring cases enter the right part of the system, they receive the correct level of resources, and are supported swiftly to engage at the appropriate level. This includes cases relating to the police and CPS.
This is a draft copy – when using the tool please download the online PDF
Comments: Date completed:
43
1Responses Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 3.6 Educational settings in our area are supported to effectively play a range of roles, including:
- helping young people to make positive lifestyle choices and show respect for others 2Prevention - identification
- referral
- contribution to assessment
- ongoing support via multi-agency processes. 3.7 Our referral processes and multi-agency pathways for children and young people displaying HSB are understood by all relevant 3Assessment agencies, employ a shared language and terminology, are used appropriately, and align with other relevant processes across our area. 3.8 Our assessment and referral processes are reviewed to ensure they are operating to best effect, are responsive to local needs and are accessible; this review includes the views of children, young people and families.
4Interventions
Comments:
Developments5 44
Children and young people who display harmful sexual behaviours require a flexible and appropriate approach to assessment. 3.3 Key principles
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• In all cases it is important to • Good multi-agency information 1Responses undertake a holistic assessment sharing – including disclosure which gives as clear a view as of information to other agencies possible about the child or young or placements regarding young person’s sexual behaviours people’s HSB – is essential to and the degree to which, for a building an effective and timely child of that age, they should local response. The outcome of be considered appropriate, any HSB assessments should be concerning or harmful. shared with agencies responsible for formulating care/treatment 2Prevention • There are few specific planning, or establishing assessment tools designed for safeguarding procedures (in line pre-adolescents displaying HSB, with local information sharing but approaches that address policies and procedures). the child’s developmental and abuse histories – and their social • An agreed approach to the background – are important. assessment and treatment of children with sexually abusive • Assessment approaches and behaviour within the residential 3Assessment models designed for adolescent sector is urgently needed. sexual offenders should not be Staff training and supervision used with pre-adolescents. of those working with sexually abusive children and young • Specialist assessment tools such people in residential settings as J-SOAP-II, AIM2, and ERASOR is also a priority. should be used alongside more generic models of assessment to inform a view about risk and need. 4Interventions rated.rmascotland.gov.uk/ risk-tools/youth-assessment- sexuviolence-risk/
• Local areas should consider creating a multi-agency steering group and identifying a shared vision, shared ownership and clear strategic objectives, including information sharing. Developments5 46
Practice example
Glebe House – a therapeutic The research drew on semi- involving young people aged community structured interviews with 10 and over. It also consists of Glebe House is an independent 43 young men (known as the a panel of senior managers from children’s home, run by a ongoing cohort, or OC) at a range of organisations, and Quaker charitable trust. intervals during and after their a practitioner group of HSB- Founded in 1965, it operates residency, with a further 15 who trained professionals. The panel as a therapeutic community left the community prematurely coordinates the approach from for damaged and challenging (the early leaver group, or ELG) identification to review, while young men, typically aged 16 and with staff and external practitioners work together to to 19, who are also perpetrators professionals. It also drew on undertake AIM assessments and of sexually harmful behaviour. case records, and Ministry interventions based upon the of Justice re/conviction data Good Lives Model. Fast-track Following a successful pilot for the OC and a comparison assessments are delivered in study in 1999 to 2000, the group (CG). Its key findings are tandem with statutory plans trustees commissioned a summarised in the link below. focusing on the young person substantive longitudinal study to ftctrust.org.uk/imgstore/gh_ primarily as a child in need. run from 2002 to 2014 (Boswell report_oct_2014.pdf Training on Local Safeguarding et al 2014). The advantage of Children Boards (LSCBs) this rarely employed method North Lincolnshire’s is shared with key partner was its ability to evaluate Glebe multi-agency harmful sexual agencies. House’s long-term effectiveness behaviour project won the in terms of: reduction in the Community Sentences: Young type and extent of problems People award at The Howard identified on the young men’s League for Penal Reform arrival; any key lifestyle changes Community Programme Awards after leaving; and any reduction 2014. The HSB project consists or cessation of their sexually of a multi-agency team that harmful behaviour thereafter. manages all cases of HSB Multi-model approach to 47 1Responses intervention
2Prevention
3Assessment
4Interventions
Developments5 4.1 Summary of the evidence and issues
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Intervention approaches Interventions should be child- Treatment options include: focused and based on rigorous assessment. Recommendations • Multisystemic Therapy for Problem • Increasingly, strengths-based should be made based on the Sexual Behaviour (MST-PSB) is a approaches that seek to build the needs of the child and family and particularly promising development competencies of children and the availability of appropriate local with a growing evidence base, which young people and their families are services. Effective support should provides a framework for a multi- supported. Models such as the Good target presenting problems as modal approach. Lives Model (2007) are particularly well as broad issues in the child promising. This recommends that or young person’s early experience • Education-based programmes. psychological wellbeing is central to (unresolved trauma, experiences interventions with sexual offenders, of abuse, family issues). • Cognitive behavioural therapy determining the form and content Engagement with the family or (CBT) interventions include those of rehabilitation, alongside risk carers is vital in supporting based on strengths-based models. management. change and welfare for children Interventions of a cognitive and young people in treatment. behavioural nature – which target • Group treatment programmes. offence-specific factors to help a young person to develop relapse prevention strategies – frequently underpin the work offered to young people. 49
A multi-modal approach is now 1Responses Figure 3: Resilience-based versus deficit favoured, addressing issues models (adapted from Hackett, 2006) within the young person’s broader social existence, including family relationships and context, as well as Traditional Resilience-based working individually with the young person (Ryan, 1999; Hackett, Focus To prevent further abuse To prevent further abuse 2001; Masson and Hackett, 2003). The table below shows a framework for resilience-based interventions Orientation Offence focused. Emphasis on Competence focused. 2Prevention for young people displaying HSB. diagnosis and classification Emphasis on the identification Resilience-based and traditional of factors to enchance deficit-orientated models share the strengths and functioning same primary goal of preventing further victimisation, but their Approach Expert led. Individual young Collaborative. Focus on social approaches and methods differ. person seen as the problem and environmental influences or in pathological terms underpinning and supporting abusive behaviours 3Assessment Methods Standardised protocols, Conversation, emphasis on risk assessment tools, young person’s understanding psychometric testing of behaviours and their meaning, including social and environmental influences
Result Identifies key risks and deficits. Mobilises/identifies key Interventions emphasise strengths and competences. containment and management Young person and family of risk are central to the process 4Interventions of intervention and actively drive change.
Developments5 50
Interventions with children and young people with harmful sexual Normal sexual behaviours in infancy and early childhood behaviours should respond holistically and be sensitive to are largely exploratory and are part of children’s normal the child’s developmental status. curiosity about their own and other people’s bodies. As the intervention needs to be However, pre-adolescent children may display a wide child-focused it is useful to review range of problematic sexual behaviours that are beyond evidence on what we know about what is considered developmentally normal. Johnson and working displaying HSB when presented by different types of Doonan (2005) suggest that all of the following criteria children and young people and the should be met for any child aged 11 or under to be defined links to their families and peers. as ‘sexually abusive’:
Pre-adolescent 1. The child has intentionally touched the person with whom he or she children with problematic the sexual organs or other intimate engages in the sexual behaviour, sexual behaviour parts of another person, or to upset a third person (such as orchestrates other children into a parent or sibling), or to act out Reports from service providers sexual behaviours. generalised negative emotions suggest that the average age using sex. of children being referred for 2. The child’s problematic sexual therapeutic interventions as a behaviours have occurred across 5. The child uses force, fear, physical result of their sexual behaviour is time and in different situations. or emotional intimidation, dropping, and that a significant manipulation, bribery, and/or proportion of referrals concern 3. The child has demonstrated a trickery to coerce another person children in their pre-adolescent continuing unwillingness to accept into sexual behaviour. years (Hackett, 2014). Younger ‘no’ when pressing another person children with problematic sexual to engage in sexual activity. 6. The child’s problematic sexual behaviour differ in important behaviour is unresponsive to ways from adolescents displaying 4. The child’s motivation for engaging consistent adult intervention HSB, including the nature and in the sexual behaviour is to act and supervision. meaning of their behaviour, their out negative emotions toward developmental history and their legal status. 51
Gray and colleagues (1999) Most of the behaviours took place 1Responses report data on the demographics, in the child’s own home, with the psychological adjustment, second most common location victimisation and perpetration being school (19 per cent). histories of 127 children aged 6 to 12 who had engaged in what Little empirical work has yet they termed ‘developmentally been done on children identified unexpected’ sexual behaviours. very early in their childhood with The average age of the children problematic sexual behaviours. concerned was 8.8 years and just However, Silovsky and Niec 2Prevention over two thirds of the children (65 (2002) investigated the history, per cent) were boys. Most of the sexual behaviours and social children had engaged in sexual environment of 37 three to seven- behaviour involving some element year-olds who had been referred of implicit or explicit coercion. The to an assessment and treatment vast majority of these (84 per cent programme for children with sexual overall) had extensive sexual abuse behaviour problems. Their average histories, with more girls having age was just under five. been sexually abused (93 per cent) 3Assessment than boys (78 per cent). In contrast to other research on children with sexual behaviour Gray and colleagues also found problems, more of these children that physical abuse had been were girls (65 per cent) than experienced by just under half (48 boys (35 per cent). All but one per cent) of children displaying the had prior involvement from the problematic sexual behaviours, child protection system, with over and that over half (56 per cent) three quarters (76 per cent) having had experienced multiple forms of been investigated as victims of 4Interventions abuse. Many of the children had sexual abuse. Only four of the 37 a conduct disorder (76 per cent children had no known history of overall), with boys more frequently sexual abuse, physical abuse or diagnosed (83 per cent) than girls domestic violence. (62 per cent). Attention Deficit Hyperactivity Disorder (ADHD) was also common. Most frequently these children’s sexual behaviours were directed at siblings (35 per cent) and friends (34 per cent). Developments5 52
Adolescents with harmful The vast majority of adolescents sexual behaviours engaging in HSB are male, even taking into account under- As with children with sexual reporting of young women and behaviour problems, young people the lack of available specialist presenting with harmful sexual treatment programmes for young behaviours in adolescence are women. For example, in Ryan et al’s a very diverse group, in terms of (1996) study of 1,600 adolescent background, motivation, types of sexual abusers, 97.4 per cent of behaviour exhibited, age of onset, the total sample were males. and victims targeted (Righthand and Welch, 2001). Most victims of HSB appear to be children known to the young Although it is sometimes assumed person. In Taylor’s (2003) study, that young people’s problematic just three per cent of a total of sexual behaviours are experimental 402 alleged incidents involved or of a minor nature, this is not strangers. The average age of borne out in literature. In Taylor’s victims was just over eight years (2003) UK study of 227 young old, with two peak ages: five people referred for sexually and 12. While research typically abusive behaviours in one city suggests that twice as many over a six-year period, 93 per females are abused as males, cent were referred for behaviours most young people displaying involving physical contact with the HSB appear to select either male victim’s genitals, with only seven or female victims. For example, per cent referred for non-contact Dolan and colleagues (1996) found behaviours. 31 per cent of the that only seven per cent of young sample had actually penetrated people had abused victims of both their victims, and a further 15 per sexes, and Manocha and Mezey cent had attempted penetration. (1998) found only six per cent. 53
Almond et al’s (2006) UK study others as part of an overall pattern a learning disability. In Hackett offences against more vulnerable 1Responses investigated differences in the of delinquency. The authors and colleagues’ (2013) study of victims; and demonstrating more background characteristics of suggest these young people have a sample of 700 young people impulsive and more opportunistic 300 young people displaying a higher likelihood of violating the displaying HSB, 38 per cent had behaviours (Fyson, 2007). HSB. It found the majority (71 per rights of others, engage in other a learning disability. Hickey et al cent) could be categorised in one antisocial behaviour, and are at (2006) state that one third to a Young people displaying HSB with of three dominant background high risk of reoffending (Butler half of all young people displaying learning disabilities are also likely themes: ‘abused’, ‘delinquent’ or and Seto, 2002). HSB have a statement of special to use fewer grooming techniques ‘impaired’. ‘Impaired youth’ was the educational needs. and have less awareness of social most common (88 cases: 29 per • Young people in the ‘impaired’ norms and pro-social behaviour 2Prevention cent), closely followed by ‘abused group represent a wide Although young people with a (Timms & Goreczny, 2002). youth’ (85 cases: 28 per cent) continuum that includes learning disability who display Harmful sexual behaviour in and finally ‘delinquent youth’ (42 emotional, psychological and HSB share many characteristics children and young people with a cases: 14 per cent). The authors physical impairment (including of young people without a learning disability appears to be suggest their findings support speech or hearing impediments), learning disability, there are significantly influenced by a lack the proposition of three distinct behavioural problems, some differences. These include of appropriate peer relationship ‘syndromes’ underlying harmful educational difficulties, ADHD being more likely to harm and sex education; consequently sexual behaviours in young people. and learning disabilities. However, opportunistically and impulsively; these young people may not They suggest: practitioners need to be aware being less specific in their choice of understand the harmful nature 3Assessment of the enormous variation in victim; being more likely to commit of their behaviours. • ‘Abused’ young people have socio-emotional, cognitive and experienced frequent physical physical development between and sexual abuse. They should youths of the same age. Specialist be classified as young people in assessment frameworks may be need, and are harming others as required for these young people, part of a response to their own such that can identify problems abusive experiences. with general literacy, speech and communication deficits, Interventions • ‘Delinquent’ young people do not conceptual understanding 4 ‘specialise’ in sexual offending, and suggestibility. but their harmful sexual behaviours occur in conjunction Young people with learning with a range of other deviant disabilities with harmful behaviours, such as property offences, previous offences sexual behaviours against a person, antisocial There is increasing awareness of behaviour and fire-setting. the prevalence of harmful sexual These young people are harming behaviours in young people with Developments5 54
Young women with harmful or harmful in case it led to In working with young women sexual behaviours perceived negative outcomes. it is important to consider the In reviewing differences between male and Information regarding the the research, Young females are becoming female adolescent development incidence of harmful behaviour Robinson (2009) more clearly recognised as being and the impact that socialisation for adolescent females is limited capable of HSB. However, research and the development of identifies the following and underpinned by discussions is limited and reported prevalence socio-cultural scripts have potential pathways for regarding factors that may lead to varies from 2.6 per cent to 8–12 upon the young woman’s adolescent females underreporting. The fact remains per cent (Ryan et al, 1996; Kubik, offending pathway. that female adolescents can be who engage in harmful Hecker and Righthand, 2002; sexually aggressive towards their sexual behaviour: Taylor, 2003; Johansson-Love and Research about the personal peers and younger children Fremouw, 2006; Hickey et al, 2008; histories of young women • early maturation – sexualised (Ford, 2006). McCartan et al, 2011). British who have engaged in harmful behaviours for which they studies indicate that young females sexual behaviour reveals many are not developmentally Professional inexperience and are less likely to have convictions commonalities with young men. prepared, through contact perceptions that an adolescent when referred for HSB, and tend Chaotic and abusive home with older males girl is ‘acting out’ her own to be younger (Kubik, Hecker and environments, including exposure experiences of abuse rather than Righthand, 2002). to domestic violence, are common • depression and victimisation abusing other children can make it problems for both adolescent males hard to identify adolescent females Clear sub-types of young females and females who engage in harmful • family criminality who may present a risk towards who sexually harm have been sexual behaviour. However, studies others. Macartan et al (2011) identified: one group displays suggest that females with sexual • poor relationships with suggest that young females with exploratory behaviour, driven by behaviour problems have a higher parents, particularly mother harmful sexual behaviours are likely curiosity, resulting in what tends rate of victimisation in their histories, to be referred to a range of services to be an isolated incident; another suffering abuse at a lower age, • lack of continuity of care – including mental health services group displays HSB that emerges abuse by more than one perpetrator, – not just those offering specialist from their own sexual victimisation; abuse which is more longstanding • poor peer networks provision in relation to sexual harm. a third group comprises individuals and severe, and an increased These findings support earlier who have been exposed to a likelihood of developing mental • impact of pornography LFF/AIM (2003) unpublished high level of abuse, neglect and health disturbance as a result of related to their own abusive research which identified how intrafamilial sexual abuse. They the trauma (Ford, 2006). experiences. lack of training and appropriate have higher levels of mental health supervision left professionals problems and seem to cope with – including those working in their own abuse by demonstrating residential care settings – confused HSB (Matthews et al, 1997; Hunter over what constitutes sexually et al, 2006; Kubik, Hecker and harmful behaviour. Professionals Righthand, 2002). also identified a reluctance to label behaviour as inappropriate 55
Such behaviours are consistent antisocial and offending behaviour 1Responses Harmful sexual behaviour and gang association with those found in broader – may be different to those who research into multiple perpetrator harm younger children. Over the past five years, research rape (Franklin, 2013; Lambine, into serious youth violence has 2013). Studies have found that, Presently, response to gang- increasingly identified harmful during group-based sexual associated young people, and sexual behaviour within street assaults, those who are being those involved in offending gangs in the UK (Beckett et al, harmed can take the place of a behaviour is largely rooted in 2013; Firmin, 2011, 2010; ‘dramatic prop’ (Franklin, 2013) to local community safety, policing, Khan, 2013). In this context, facilitate the bonding of the group and youth justice provision. As a 2Prevention sexually violent and abusive and enable group members to result it is important to consider behaviours manifest in a range demonstrate loyalty to one another. the relationship between these of ways including: services and local responses to Research evidence suggests harmful sexual behaviour. • intra-gang exploitation where that young people who sexually sex is exchanged for status, harm their peers, as opposed to Responses to gang-associated belonging, drugs and protection younger children, are more likely young people rely on “multi- to be involved in other forms of agency gangs meetings” and • intra-gang violence where rape antisocial behaviour, to sexually gang-specific risk assessments and sexual assault are used to 3Assessment harm outdoors (as opposed to (Beckett et al, 2014; Firmin, control and humiliate, ensuring in private dwellings), and less 2013). Ensuring young people gang members adhere to the likely to be socially isolated identified through these channels codes of the group, and that individuals (Beckett and Gerhold, are referred into processes disloyalty is punished. Examples 2003; Finkelhor et al, 2009; or services for young people have also been found where Hackett, 2014). As a result, MST displaying HSB is critical. Without predominantly boys and young interventions for young people who this collaborative approach, local men are required to sexually exhibit other forms of antisocial or services risk developing criminal assault a young woman as part of violent behaviour have also been justice responses to young people an initiation process – as a means Interventions found to be of benefit to young 4 who harm in gangs, as opposed to of demonstrating group loyalty people who sexually harm their therapeutic responses for those peers (Letourneau et al, 2009). who need them. • inter-gang violence where rape and sexual assault are used to While this area of research remains punish rivals, sometimes through in need of development, it implies attacks on the female siblings that the pathway to abuse for some and girlfriends of gang members young people who sexually harm (for a full list of models see their peers – particularly those Beckett et al, 2013). involved in other group-based Developments5 56
As is the case with young people Some of this is unsurprising, given Therefore, the harmful sexual Thornton and colleagues (2008) who sexually harm in peer groups what we know about young people behaviour of young people who examined the families of intra- – as opposed to those who harm and group behaviour in general. spend their time with antisocial, familial adolescent sex offenders alone – the influence of friends violent or abusive peers, may be attending a community-based or associates on their behaviour consistent with the social rules programme. Families were should be considered (see below). In his study into or codes of their peer group. As a uncommunicative, adversarial group behaviour, result, the following is all critical: and conflict ridden. Hackett and Addressing peer group Warr (2002) found colleagues (2014) investigated association • The nature of young people’s peer the nature and impact of parental that particular factors groups (and online peer groups), responses to their child’s harmful Studies have increasingly identified bond young people and their weight of influence, sexual behaviours in 117 cases. an association between the nature together, including: forms part of the assessment Parental responses ranged from of young people’s peer groups and • working within a multi- process. This includes being entirely supportive of the their involvement in harmful sexual ascertaining whether a young child, through ambivalence and behaviour (Henggeler et al, 2009; agency, multi-disciplinary context person plays a leadership role uncertainty to outright rejection. Letourneau and Borduin, 2008). within an abusive peer group, or Parents were more likely to be whether they are a follower. Have supportive when their child’s Such findings are consistent • close attention to child protection concerns they sexually harmed alone as victims were extra-familial, and with wider research into multiple well as alongside their peers? condemnatory when the victims perpetrator rape (Franklin, 2013; were intra-familial. Lambine, 2013), serious youth and • use of evidence-based assessment models • Interventions to address gang-related violence (Beckett et individual young people’s The distress caused to families al, 2013), and teenage relationship harmful sexual behaviour may when a child acts in a sexually abuse (Chung, 2005; Connolly et al, • effective inter-professional communication require tandem interventions abusive manner is compounded 2000), all of which have found that with their wider peer groups. further if the victim of the child is young people who sexually harm In such instances working the also a member of the immediate their peers and partners are more • analysis of the behaviour in quality written reports. youth service, schools or other family. When sexual abuse involves likely to have experienced violence universal services may play a key siblings, parents can feel that they within their peer groups than in These characteristics can partnership role. are in an impossible situation, familial settings (Barter et al, 2009; caught between trying to meet Catch 22, 2013; Firmin, 2013). As result in peer groups having a greater influence over young Working with families of the needs of both perpetrator a result Firmin (2013) suggested and victim. that responses to abuse between people’s behaviours than their children and young people young people should consider the families (Catch 22, 2013; displaying HSB Chung, 2005). Between a third to a half of sexual social environments in which young Families of children and young abuse perpetrated by children and people form their own identities people with harmful sexual young people involves close family and relationships, in a similar way behaviours are often described members as victims (Beckett, to MST interventions proposed by as multiply troubled and 2006; Worling, 1995). Although Letourneau et al (2009). dysfunctional. 57
non-abusive sexual interactions can be an isolating and profoundly Findings and Recommendations, to communicate with friends, while 1Responses between siblings and other children difficult experience for parents, 2012). This includes viewing 62 per cent use the internet for within families can occur, research and may lead to secondary post- inappropriate adult pornography doing homework. has suggested that sibling sexual traumatic responses. or illegal indecent images, and abuse often occurs over more includes sending or requesting It is a crime to take, make, permit extended periods of time, and that Duane et al’s (2002) research into images, known colloquially to take, distribute, show, possess, sexual behaviour is more likely to parents’ responses to the discovery as ‘sexting’. possess with intent to distribute, be penetrative when compared of their son’s sexually abusive or advertise indecent photographs to extra-familial harmful sexual behaviour uncovered a process As a consequence, specialist or pseudo-photographs of any behaviour (O’Brien, 1991). that included shock, confusion, assessment and treatment person below the age of 18. The 2Prevention self-blame, guilt, anger and providers are increasingly Association of Chief Police Officers Despite the seriousness of the sadness. They suggest that shock, concerned about a growing (2011) is aware of consequences behaviour, sibling sexual abuse is disbelief and confusion are all population of children and young for young people arrested. They often minimised by professionals common reactions. Indeed, parents people coming to their attention state: ‘ACPO does not support as ‘experimental’ in nature. Careful are likely to experience a range of because of sexually problematic the prosecution or criminalisation assessment of family strengths, emotional responses that further internet-based behaviours. These of children for taking indecent needs and dynamics is required to undermine their usual parenting behaviours pose difficult and images of themselves and sharing establish what has to be in place competence and resources. unique challenges. For example, them. Being prosecuted through if siblings are to live together safely to what extent is this normal the criminal justice system is likely 3Assessment after disclosure. In some situations exploratory sexual behaviour, to be distressing and upsetting siblings will need to be separated Between a third to a especially if peer related? What role for children, especially if they are for further assessment and does the behaviour play in contact convicted and punished. The label possibly intervention. In situations half of sexual abuse HSB? What factors increase the of ‘sex offender’ that would be where the need for family work perpetrated by children likelihood of internet offending? applied to a child or young person is identified, reunification may These questions may be further convicted of such offences is be a goal, though the welfare and young people exacerbated if the practitioner is regrettable, unjust and clearly and safety of the victim must involves close family less technologically savvy than the detrimental to their future health remain paramount. young person they are assessing. and wellbeing.’ members as victims 4Interventions The need to engage with the The internet has become a major parents of children and young The internet and new media part of children’s lives. The National people displaying HSB is clear. Increasingly children are harmed Audit Office (2010) reported that, Hackett (2004) suggests attention through their use of the internet, on average, 11 to 16 year olds should be given to identifying and and there is widespread concern spend 2.5 hours a day online, and building upon family strengths about what children and young younger children are becoming and competencies – not just risks people may come across while regular and confident internet and deficits. Discovering that a online (Independent Parliamentary users. Three quarters of 11 to 16 child is perpetrating sexual abuse Inquiry into Online Child Protection, year olds use instant messaging Developments5 58
Data regarding the prevalence of be a pattern of progression from In essence, the nature, extent and adolescent internet offending in accessing chat rooms and adult characteristics of adolescents the UK – including those cautioned pornography, conversations displaying sexually problematic or convicted for accessing with people online became or abusive behaviours using new child abuse images – is hard to increasingly sexual, and turning technologies is largely uncertain determine as official statistics don’t to younger adolescents and and unclear. While this remains the differentiate between adult and children (Moultrie, 2006). case, professionals’ capacity to adolescent offenders (Gillespie, recognise, respond to, assess and 2008). Their relative invisibility is manage any perceived risk is likely compounded by a lack of empirical The internet has to be inconsistent. research studies and an absence become a major part of validated and developmentally Tools and support for HSB sensitive internet offending of children’s lives. The in relation to the internet assessment models. National Audit Office and new media There is little research on (2010) reported that, In working with young people who technology-facilitated HSB in have engaged in harmful sexual children and young people. The on average, 11 to 16 behaviour online it is important Ministry of Justice (2013; cited in year olds spend 2.5 to consider the needs met by the Hackett, 2014) report that, in 2010 behaviour for the young person, to 2011, 51 males and one female hours a day online, and to ensure that they are able aged 10 to 17 received reprimands and younger children to use the internet safely in the or warnings due to possessing future. The AIM Project in Greater indecent photos or pseudo photos are becoming regular Manchester has developed a or prohibited images of children. manual (iAIM) to provide social Eleven were found guilty of and confident internet workers and youth justice technology- facilitated HSB, and users. Three quarters practitioners with a framework two received custodial sentences. for guiding their assessments of 11 to 16 year olds and interventions with adolescent Small scale research has use instant messaging males aged 12 to 18 in mainstream demonstrated that, in comparison education who have engaged to young people who commit to communicate with in harmful sexual behaviours contact HSB, this group tend friends, while 62 per online using new technologies. not to have abuse and trauma Referral behaviour may include backgrounds, coming instead cent use the internet downloading, distributing and from stable and advantaged for doing homework. producing child abuse images families and achieving in education using new technologies. (Moultrie, 2006). There appears to 59
The guidance has been designed parents or carers. Outcomes The Centre for Innovative Justice, England and Wales is now enabling 1Responses to help practitioners working with should inform other child welfare, based at RMIT University in an increased focus upon cases young people whose internet safeguarding and public protection Melbourne, Australia has published deemed to be ‘sensitive and behaviour forms part of an overall decisions and sit alongside any Innovative justice responses complex’ (Restorative Justice Best concern regarding their harmful holistic assessment of HSB risk. to sexual offending: pathways Practice Guidance, Ministry of behaviours, as well as those young to better outcomes for victims, Justice, 2011). people where this is the sole or Restorative approaches offenders and the community main cause for concern. The iAIM is to address HSB (RMIT, 2014), which outlines a All these developments offer the intended to provide a broad frame systemic restorative approach opportunity to connect victim, Restorative justice can offer a of reference to supplement clinical to both adult and youth HSB. offender and family perspectives in 2Prevention judgement, and can be used in significant additional dimension to establishing the harm caused and conjunction with the AIM2 initial work with offenders, victims and In England the AIM Project has planning for a safer future. assessment model. communities harmed by sexual over 10 years of experience and violence. There is a growing body knowledge in the use of restorative There is some evidence to caution In addition, the Lucy Faithfull of evidence in support of the work with youth HSB. It has the use of restorative justice with Foundation has developed a short, victim benefits of ‘complex and developed a restorative justice some groups of children and young education- based programme for sensitive restorative justice’ and and HSB assessment framework people displaying HSB, including young people with problematic the recognition that restorative that works on top of its AIM2 those with certain learning online behaviour –InformYP – approaches complement the offender assessment, as well as disabilities (especially speech and movement to address HSB that 3Assessment and also provides internet safety best practice guidance for Youth language, and particularly receptive seminars for parents and schools. focuses upon strengthening Offending Teams working in and expressive issues). The NSPCC and AIM are working desistance and enabling a wider restorative justice and HSB. together to develop practice engagement with the social guidance for professionals to ecology of the offender. In England and Wales, the recently support them in dealing with revised Victim Code of Practice children and young people who Internationally, a number of allows for the consideration of display internet-based sexual jurisdictions have made progress safe and appropriate restorative offending. This guidance will on the inclusion of restorative work open to all victims of crime. Interventions help in the development of case approaches towards sexual Moreover, the considerable 4 formulation to manage the risk of harm. New Zealand’s pioneering restorative expertise and repeat behaviours or reoffence, in Project Restore offers a limited experience accumulated in the identification of likely causal but safe and appropriate factors, and to inform future restorative approach towards therapeutic or treatment needs adult survivors of HSB. of the young person and their
Developments5 Scoring key: Not at all/never/no evidence To a fair extent/frequently/ 4.2 Audit tool – Domain 4 0 for this 3 good evidence of this always/ to a great extent/a wealth Multi-modal approach Very little/very infrequently/ 1 very little evidence for this Always/to a great extent/a 4 wealth of extremely strong to intervention To some extent/sometimes/ evidence for this 60 2 some evidence for this
Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 4.1 Intervention and support provided to children and young people displaying HSB in our area: 4.1a effectively target presenting problems and broad issues in the child or young person’s early experience (unresolved trauma, experiences of abuse, family issues) and is multi-modal in its approach 4.1b are evidence-based and implemented according to what is known to be effective; and include evaluation
4.1c are resilience-based (support is strengths-based, child and family centred, focuses on the child’s understanding of their behaviours, etc) rather than adopting a deficit model.
4.2 The support provided to younger children (pre-adolescence) with problematic sexual behaviour is tailored to meet their developmental needs, and takes into account their specific vulnerabilities (for example, experiencing abuse themselves); we can evidence the effectiveness of this support. 4.3 The support provided to adolescents displaying HSB in our area recognises the diverse needs that are frequently identified in these young people, including emotional, psychological and physical impairments; speech and hearing impediments; behavioural problems; educational difficulties and ADHD.
This is a draft copy – when using the tool please download the online PDF
Comments: Date completed:
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1Responses Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 4.4 We have specific support in place for learning disabled and SEN children and young people displaying HSB, which reflects their need for support around peer relations as well as developmentally appropriate sex education. 2Prevention 4.5 We can demonstrate recognition of the higher rate of victimisation and trauma in the histories of young women displaying HSB. We offer them effective services which include responses to the likely impact of this abuse (for example, the increased likelihood of developing mental health difficulties). 4.6 Where young people displaying HSB are facing criminal charges (such as gang-associated young people who display HSB) their needs and risks are addressed in a joined-up way through links across community safety and youth justice agencies (rather than adopting a criminal justice response for these young 3Assessment people, while others receive a therapeutic response). 4.7 The families of children and young people displaying HSB are provided with services and strengths-based support in our area. Our practitioners have a good understanding of the distress and shame experienced by parents, and the underlying family dysfunction that often accompanies HSB. 4.8 Our local area can demonstrate that children and young people receive effective support and education in relation to HSB using new media and technology; local schools settings 4Interventions are confident and skilled in online safety, with other agencies (including criminal justice agencies and specialist online safety organisations) effectively linked into this work.
Comments:
Developments5 62
Effective support should target the child or young person’s history, and their current presenting problems. 4.3 Key principles
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• Interventions are required to deal • Interventions should be tailored • Rehabilitative approaches,such 1Responses with a highly diverse group of to the specific needs of the child as the Good Lives Model, should children and young people and and family, rather than applied be used to enhance protective their families: routinely to all. factors, promote stable and supportive relationships and – Most adolescents with sexually • In summary, interventions need help young people develop abusive behaviours are male. to be: personal competence and healthy lifestyles. – Girls with abusive sexual – evidence-based behaviours come from • In reducing risk and building 2Prevention particularly dysfunctional family – holistic resilience, it is crucial that children backgrounds, with higher levels and young people are not labelled of sexual victimisation and – multi-modal and stigmatised unnecessarily. other abuse. – strengths-based – Young learning disabled people and supportive • Increasingly, the divide between are a particularly vulnerable and the physical and the digital worlds – proportionate over-represented group. no longer exists. Education is therefore key. Parents, carers and – tiered • Adolescents who display HSB teachers should not be afraid to 3Assessment talk to young people about their share many characteristics with – resilience-focused other young people who have activities online. a wide range of difficulties, and – multi-agency. it is important to address their • It is vital to assess parental broader problems as well as • Primary, secondary and tertiary capacity to protect their children, dealing with HSB concerns; and to prevention approaches are the ability to manage a safety remember they are young people needed. A tiered approach to plan, and their capability to meet first and ‘sex offenders’ second. intervention is most appropriate, the needs of their children while considering the wider demands which distinguishes children Interventions on the family. 4 • Responses must take into and young people whose needs account children and young can be met through parental people’s stages of development, monitoring and pro-social and should be proportionate intervention from those who to their risks and needs. It is need limited psycho-educative important not to lose sight of support, and from those who the status of the whole child would benefit from more amid concerns about the specialist intervention services sexualised nature of some and placements. Developments5 aspects of their functioning. 64
Practice example
Working with sibling assessment will involve family work will almost always sexual abuse interviewing the parents be appropriate in addressing Barnardo’s Skylight/Lighthouse about the siblings, as well this issue. works with children who have as interviewing the sibling been sexually abused, as well perpetrator. If possible and • Restorative justice appears as children and young people appropriate, the sibling victim particularly well suited to who display harmful sexual and non-targeted siblings supporting the complex behaviour. The service has over should also be interviewed. and multiple roles that exist ten years of experience in families where sibling of working with cases involving • An ecological formulation abuse occurs. Similar to sibling sexual abuse, and of – grounded in the relevant family therapy, it gives family working therapeutically to research and specific to each members the chance to help the whole family move on family, can help to outline how articulate, often for the first from the associated trauma the sibling sexual behaviour time, their conflict of roles and and distress. emerged, what supported its avoid having to reject one child continuation, and what could and protect the other. Building on the growing reduce the risk of the behaviour literature on this subject (Caffaro (or other parallel behaviours) • It provides a process for and Conn-Caffaro, 2005; reoccuring. This forms the repairing relationships and Thomas and Viar, 2005), the basis of the intervention with healing emotional hurt. As service has found the following: the family. Daly (2000) states, not only do victims want vindication • Assessment must consider • Engaging the family is and validation, some wish to family and sibling relationships essential in all work with continue relationships or help in detail. Current risk children who display harmful the family heal and move on assessment tools are relatively sexual behaviour, but the family from trauma. weak at looking at family roots of sibling sexual abuse dynamics, and a thorough suggest that more intense 65
in 2010/11 to 29 per cent in 1Responses Barnardo’s Taith Service – girls who display harmful 2013/14. In the experience of sexual behaviour the professionals working in the service, girls displaying harmful There are relatively few studies sexual behaviour tend to be in relation to girls with sexually managed within welfare services, harmful behaviour. Current with 98 per cent of referrals being literature reflects a consensus that made by Children’s Services rather there is a tendency to minimise or than Youth Offending Services. under respond to sexually harmful This coincides with the average 2Prevention behaviour by girls. Assessment age of referral being younger for frameworks and intervention girls than boys. approaches for young people are based largely on professional There is a tendency to view girls understanding of boys. who display harmful sexual behaviour as ‘victims’ and boys The Barnardo’s Taith Service as ‘perpetrators’. At the point provides assessment, intervention of referral to the service, own and training services for children victimisation experiences of girls 3Assessment and young people with harmful and young women tend to be sexual behaviour, their families and more widely known and prioritised professionals. Its girls project is an by the referring agencies when ongoing three-year project funded compared to boys. by The Big Lottery. The project aims to develop standardised Research and practice in relation assessment tools and intervention to girls who display harmful sexual resources for girls who engage behaviour within the Taith Service in sexually harmful behaviour, has highlighted the need for Interventions to identify need, reduce risk and difference in the assessment and 4 enable them to move toward intervention approaches depending healthy adult relationships. on gender. It has also highlighted the variations from professionals in Since the project started the the systems and support offered referral rate for girls increased depending on gender. significantly, from eight per cent
Developments5 66
Barnardo’s Pathways Project – supporting The process aims to: parents and carers • increase resilience: through group work helping participants to manage under difficult Barnardo’s Family Service Dundee circumstances and pressure provides extensive help and support to parents of children • improve carer capacity to who display harmful sexual prevent harmful behaviours, behaviour on a one-to-one basis, thereby allowing carers to addressing unique and individual feel confident in parenting cases. It established the Pathways their child in the future Project in response to research by Hackett and Masson (2006) into • reduce isolation by what children who have sexually highlighting that there harmed and their parents want are others in similar from professionals. circumstances.
The Pathways Project is an eight- week practitioner-led programme and peer support forum that allows people to meet with, and learn from, other parents and carers in a safe and supportive way. It provides an opportunity to gain further understanding into behaviours and needs, and allows people to share skills and learn new strategies for managing behaviours. All individuals who participate in the group sessions receive one-to-one support from the service, and only participate in the group when the practitioner or individual feel that they are ready, or would benefit. Workplace development 67 1Responses
2Prevention
3Assessment
4Interventions
Developments5 5.1 Summary of the evidence and issues
68
The consequences of a lack Without a statutory framework The current lack of clarity about Multi-disciplinary training is of overarching strategy the work relies on individual roles and responsibilities means core to promoting multi-agency professionals’ goodwill and agency agencies are responding with working; thus creating a common Over the past decade our commitment, both of which are varied commitment. There is a language of understanding and knowledge in relation to young variable. Improving outcomes clear need to integrate policies mutual appreciation of each other’s people who display HSB has requires a clear departmental lead, within existing bodies of values, roles. Training should involve all significantly increased, though a written commitment that other knowledge and good practice. key disciplines, including social there remains no overarching departments will work together, Providing such a framework will workers, health workers (GPs, strategy or guidance to progress and a mechanism for reviewing help to demystify the work, and health visitors and school nurses), the field in a coordinated way. This progress. This then needs to be to reduce barriers of fear and youth offending team workers, can result in ‘territorial’ practice, replicated at regional and local anxiety. Practitioners will child and adolescent mental health, where some authorities have level, with a model multi-agency understand the issues more education, residential staff, and developed policies and procedures agreements policy and procedure. clearly, have a solid understanding foster carers, and must be tailored while others have a more ad hoc This group of young people of process, and be more open to to the individual’s environment. approach. The latter approach often have multiple and complex address the ‘problem’. prevents skills, knowledge and needs. Changing their behaviour A research project across two ideas being shared in a fair and requires the services of more Currently, agencies working Welsh authorities (Warr, 2012) consistent manner, and thereby than one agency, while effective in isolation are likely to be identified that more specialist reduces the chances of appropriate risk management and support duplicating work, missing out training was one of the most responses for the young person requires involvement from all the vital communication (sharing of important factors to practitioners and their family. professionals involved with the information) and not recognising (between 80 and 82 per cent of young person and their family. the value of other agencies’ practitioner feedback). These systems need clarity around contribution – this can result in a risk, responsibility and their blame culture. Professionals must respective roles and tasks. It’s acknowledge that this work is not vital that representatives from the exclusive province of any one the different systems regularly agency, and that they are not meet to review the ongoing being asked to address additional manageability of the work. tasks, but to more effectively address this issue in a way that fits and enhances their existing roles and duties. 69
Training and equipping managers generic statements such as: 1Responses Interagency training across agencies is crucial. Frontline There is little literature about ‘interventions are to be delivered by managers are the cornerstone of practitioner training for work specialists’ (Youth Justice Board, good service delivery, and policy with HSB (Dadds, Smallbone 2008) and managers ‘should be and service innovation can’t and Nisbet, 2003) though there fully trained and have adequate happen without their buy in. is general concern about the experience of working with young LSCBs are in a good position to lack of training opportunities for people who sexually abuse’ (Youth lead the training process, and practitioners working with this Justice Board, 2008). The Youth the establishment of a national client group (Hackett, Masson Justice Board (2008) guidance on coordinators group – sponsored and Phillips, 2003). Knowledge of training suggests a focus on: basic 2Prevention by central governmental – HSB assessment and intervention awareness raising, followed by would enable many positive approaches is necessary within more in depth training; intervention developments in the field. all agencies. All practitioner and assessment; and increasing training should correspond to the understanding of working with four-tiered approach to service those with mental health problems It is crucial to create provision, to ensure the range and minority ethnic young people. of people working with children These recommendations echo a common language and young people displaying HSB those made by Hackett, Masson of understanding and have appropriate knowledge. For and Phillips (2003). 3Assessment example, at tier one, teachers, mutual appreciation volunteers and mentors need In the NSPCC review of service of each other’s roles access to appropriate education provision for young people about normal, problematic and displaying HSB across the UK harmful sexual behaviour. At tiers (Smith, Bradbury-Jones, three and four, practitioners need Lazenbatt and Taylor, 2013) all specialist training in therapies with local authorities questioned a developing evidence base for use reported that appropriate staff with young people displaying HSB. training was available, but that Interventions specific training for different 4 National guidance provides subgroups of young people minimal indication of the training displaying HSB was not. The need needs of people working with to ensure a well-trained workforce children and young people who was a key recommendation of display HSB. It tends to make the survey.
Developments5 70
In a research study of the people with harmful sexual requested by respondents in the effectiveness of LSCB interagency behaviours. Similarly, there was survey undertaken by Hackett It is crucial to review training on HSB, Hackett, a reported significant increase et al (2005). In undertaking their of how local areas: Carpenter, Patsios and Szaillasy in participants’ confidence in study, the authors developed their • use any Common (2013) examined the impact of distinguishing between appropriate own scale to measure the impact Assessment Frameworks short courses on 197 professionals and inappropriate forms of sexual of such training on professional in the UK. These courses – behaviour in young people, and attitudes, awareness and self- • develop the role of the lead common across LSCBs – were their knowledge of local area efficacy and which can be used professional generally one day in duration and policy and procedures. by other training providers as typically aimed to raise awareness a resource (Carpenter, Patsios, • promote the latest of HSB among practitioners, Some areas of knowledge were Szillasy and Hackett, 2011). information sharing guidance informing them of key areas of not improved as a consequence (from central government research into HSB and the types of these courses. Recognition of Integrated working departments as well as local policies) of practice responses required. the different nature and responses practices required to young women • operate ‘team around the Hackett and colleagues found displaying HSB, the needs of young With the demise of the Children’s child’ style practice that such courses were effective people with learning disabilities Development Workforce Council, in improving professionals’ who sexually abuse, and the need Children’s Trust arrangements, and any clear or obvious champion for • deploy and resource early confidence in working with young to offer tiered levels of intervention identification procedures people presenting with harmful according to assessed levels of risk integrated working, local workforce development tends to focus on sexual behaviours, particularly and need remained limited. This will give an delivering ‘more for less’. Strong in relation to their own efficacy. The authors conclude that these understanding of how joined integrated working practices Courses also helped to raise areas of knowledge may be more up the local cross-children’s continue to be key in ensuring awareness among participants suitable for more advanced training workforce response is to children and young people are kept about the relatively low base rate that builds on introductory or issues of HSB. of sexual recidivism in young awareness-raising courses, as safe when dealing with HSB issues. 71
1Responses Impact upon practitioners working in this area and the importance of supervision Supervision is a major factor in staff retention (Webb and Carpenter, 2011; Carpenter et al, 2012). The perception of supervisor support – as well as support from peers at work – predicts intention to remain 2Prevention employed, while low supervisor and co-worker support are significantly related to the intention to leave (Dickson and Perry, 2002).
There is a real need for robust staff support, particularly through external consultancy or clinical supervision rather than just case 3Assessment management supervision. Staff must be given the chance to reflect on the impact of this work on themselves and their relationships.
4Interventions
Developments5 Scoring key: Not at all/never/no evidence To a fair extent/frequently/ 5.2 Audit tool – Domain 5 0 for this 3 good evidence of this always/ to a great extent/a wealth Workforce development Very little/very infrequently/ 1 very little evidence for this Always/to a great extent/a 4 wealth of extremely strong To some extent/sometimes/ evidence for this 72 2 some evidence for this
Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 5.1 We can demonstrate effective multi-agency arrangements and approaches to HSB in our area; practitioners and managers across agencies report clarity about thresholds, risk, responsibility and their respective roles and tasks, meaning work is not duplicated, information is shared effectively, and the value of each agency’s contribution is recognised. 5.2 We ensure that strong integrated working practices are at the heart of working with HSB, and routinely review our HSB work in relation to:
– the use of the Common Assessment Frameworks (or equivalent EHA)
– the role of the lead professional
– the latest information sharing guidance (both national and local policies)
– the ‘team around the child’ or equivalent local models. 5.3 We have in place systems to enable those working in universal and non-specialist services to ‘draw down’ expertise and consultation advice (including supervision where appropriate) from colleagues with specialist knowledge. This is building capacity in the wider early help workforce and reducing demand on higher tier services.
This is a draft copy – when using the tool please download the online PDF
Comments: Date completed:
73
1Responses Statements Score Evidence supporting this score Assurance systems in place locally for QA/evidencing this statement 5.4 Multi-disciplinary training is provided to those working with HSB, and is inclusive of all key disciplines and groups (teachers, volunteers, mentors, residential care practitioners, youth justice colleagues, youth workers, social workers, clinical practitioners, youth offending team workers, child and 2Prevention adolescent mental health workers, police); this training embeds a common language of understanding and mutual appreciation of each other’s roles; we routinely and robustly evaluate the impact of this training on professional attitudes, awareness and self-efficacy. 5.5 We offer bespoke training and support for foster carers and adopters that recognises the specific needs of this group; we can evidence the impact of this training and support. 5.6 Frontline and team managers across our local area are well 3Assessment supported, and their critical influence on service delivery, culture and morale is recognised; we can evidence the impact of this support. 5.7 We routinely and robustly review our workforce development activity including supervision, with a focus on practitioners’ experience of working with HSB, which contributes to a learning culture. 5.8 We are confident that those working with HSB (not just those in roles where clinical supervision is established practice) are 4Interventions provided with high-quality, reflective supervision that supports them to manage the impact of this work; supervision is audited and we can evidence its positive impact on the workforce.
Comments:
Developments5 74
Practitioners will understand the issues more clearly, have a solid understanding of process, and be more open to address the ‘problem’. 5.3 Key principles
75
• Among professionals in the field • Effective multi-agency working • Bespoke training should be 1Responses there is now a general consensus and coordination are needed provided for individuals caring that children who engage in in both universal and targeted for children and young people ‘abnormal’ sexual behaviours services. Each member of the displaying HSB in home or should not be labelled as ‘sex workforce should understand residential settings (including offenders’ or ‘sex abusers’. their role and take responsibility foster carers and adopters). to identify issues and either • There has been significant debate refer or provide help. • All those working with HSB need about how to describe children support to manage the impact of and young people who display • Workforce development is this work. Reflective supervision 2Prevention harmful sexual behaviour without not only about formal training should be made available to labelling them. Difficulties in – it includes supervision and everyone working with HSB, not defining such behaviour are providing opportunities for just staff in clinical roles. compounded by a general lack of peer support and knowledge knowledge of childhood sexuality, exchange. • Supervision should be audited, and what constitutes normal and its impact on practitioner sexual development. • All training should be evidence- wellbeing – as well as on practice based and evaluated in terms – should be reviewed. • The children’s workforce needs of its impact on practice and on 3Assessment a shared understanding of how professional attitudes, awareness the local HSB response operates and self-efficacy, rather than just in practice; HSB frameworks and participant experience of any protocols must work alongside given course. existing processes, to avoid practitioners becoming confused • A tiered approach to workforce or frustrated, and to avoid development must be aligned duplicating work and missing to the creation of a tiered issues for concern. intervention response, so that Interventions it spans the full spectrum of 4 agencies and individuals involved in identifying and addressing HSB.
Developments5 References 76
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Illustrations by Jamie Nash. © NSPCC 2016. Registered charity England and Wales J20161055. 216401. staff. NSPCC Hull. The adult and children pictured are models volunteers. Photography features Photography by Tom Scotland SC037717.