Before I left my specialist position working with harmful sexual behaviour full time, we’d dealt with over 800 cases.
That teaches you a thing or two about how the whole thing works!
One lesson that stands out…
I’m just going to come right out and say it: most of these kids are victims first.
Yes, what they may have done to others is a problem. A real problem.
But maybe not the main problem – at least in terms of helping them to not do it again.
The source matters…
There is a tendency to over-react to harmful sexual behaviour (HSB). I guess we tend to fear what we don’t understand.
Therein lies the rub. We need to understand it better if we’re to do something about it. Something that will work.
Here are a few things worth mentioning briefly at this point:
- Most kids don’t display HSB – it’s not a developmentally normal part of growing up. When kids experience stable, caring and normally functioning backgrounds they tend not to get into HSB.
- Some kids do display HSB – having said all that, some adolescents can end up straying into the realms of HSB due to the errors they make in the process of normal sexual experimentation.
- Those who do, don’t persist – this group of kids tend to desist once they get “caught” and receive some kind of input to help them understand what went wrong (even if they don’t get help, they tend not to re-offend).
Other factors can influence the onset of HSB in these more developmentally normal children.
Things like alcohol use, being in a state of emotional crisis (due to loss, bereavement, etc.).
Essentially something has upset the normal state of mind significantly. This, in turn, affects behaviour.
Victimisation as a pre-cursor…
Now, we come to the central point. A significant proportion of kids displaying harmful sexual behaviour have been victims of abuse.
According to one authoritative study*, 46% of kids displaying HSB have been victims of child sexual abuse (see red in graph).
For non-HSB kids the figure is only 16% (see green in graph).
This study was a meta-analysis and entailed:
- 59 independent studies
- 17,248 adolescents
So these findings are pretty authoritative!
The plain truth is that kids displaying HSB are much more likely to be victims of sexual abuse themselves.
Implications for intervention…
Given this state of affairs, what are the implications for the way we treat these young people?
- Avoid the knee-jerk – whenever sex is a problem the tendency is to over-react. Given that professionals are often blamed when things go wrong in child protection, we also need to stop and think before jumping to conclusions that might not be justified. Also, we need to do the right thing and look to the interests of the child first, then ourselves. All the more so knowing that they are likely to be victims of abuse.
- Get risk in perspective – this is a toughy. There is an obsession with risk nowadays. The need to balance this against the needs of children is crucial. The best outcomes for children lie in getting this right. Don’t ignore risk but don’t let it cloud things either (Learn more here). An over-estimation or non-estimation of risk is what leads to the knee-jerk mentioned above. Stop, consider, assess and then decide what to do. In that order.
- See passed the HSB – these figures should urge us to see beyond the troublesome behaviour and focus on the causes. These may be many and complex. But the likelihood is that being a victim of sexual abuse as a child will be a part of it. Keeping this in mind will help with both the previous issues – the knee-jerk and the risk obsession. Seeing the HSB child as a victim helps us get the perspective right
- Work on relationship – the best context for helping children is relationship. This will encourage trust. This is turn will maximise the quality of information we get in assessment. Get the assessment right and we’re half way there! When children are abused it tarnishes their view of other people. Understandably. Working to establish trust and restore some faith in people, is a central need of any treatment programme. Miss this and we miss the main thing.
- Sequence the response – diving straight in to talk about the HSB is probably not the best way to start (though for some kids the relief at being able to do so is palpable!). Most take a little time to be ready for that. Keep this in mind (Learn more on sequencing here). Remember the need to build trust and start with that. Listen hard, notice responses, be led by what the child gives you and then begin – very gently – to steer things. But only when they’re ready. Sequencing in treatment is everything.
- Victim first, offender second – this takes us back to the “causes of crime” debate. But we’ve established that HSB is largely rooted in victim experiences. This should be our guiding light, our compass in navigating our way through the intervention. Offence-based interventions are NOT the focus at the outset. That comes later. We MUST remember that these kids’ behaviour is fuelled by what happened to them. That’s our primary target for input.
There’s a lot more we could say about this, but hopefully these few are enough to make the point: victim experiences fuel offending and offensive behaviour in most of these kids. Particularly harmful sexual behaviour.
A couple of caveats…
Just a couple of things worth bearing in mind when dealing with HSB. Particularly if you don’t work in a dedicated HSB service…
- Consult a specialist – whilst HSB and our responses to it are now much more mainstream, it remains a relatively new and complex issue for most professionals. Assumptions are dangerous… As with any other area of specialism, we should be quick to consult those who know their stuff.
- Don’t forget risk – old habits can die hard. This is also the case in children whose development has been skewed sexually. We rightly want to focus on needs and deal with the victimisation issues. But we mustn’t forget risk either. Baby… Bath water… :0)
The kids we work with are complex. That’s the nature of the jobs we all do. Harmful sexual behaviour is one of many things that rears it’s head from time to time and demands our attention.
But I think it helps us to know that, for a large number of these kids, their own victim experiences are central to the development of the problem behaviour.
And if it’s central to the problem, it’ll be central to the solution too.
What do you think?…
- What would you add to the above list of implications for intervention?
- Please let me know your thoughts… Leave a comment below or click here.
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© Jonny Matthew 2016
* Seto, M.C. & Lalumiere, M.L. (2010) What Is So Special About Male Adolescent Sexual Offending? A Review and Test of Explanations Through Meta-Analysis. Psychological Bulletin, 2010, Vol. 136, No. 4, 526–575