Carol Carson and The AIM Project Guidelines for Understanding and Managing Sexually Problematic / Harmful Behaviours in Residential Settings Carol Carson and The AIM Project copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd AIM: To develop confidence in understanding and managing sexually problematic and harmful behaviours in residential settings Objectives: To provide information from research and practice about why children and young people may engage in these behaviours To provide a framework for initial assessments in residential settings To provide information on understanding and managing young people who are sexually exploited To consider ways of managing sexual behaviours on a unit level copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd To consider ways of managing sexual behaviours on an individual level, including pattern mapping and stages of managing risk, and suggestions for individual work To allow participants to reflect on their own practice and to share practice with others and to develop action plans. copyright 2010 carol carson associates ltd

What the Guidelines Cover Part One Section One – Information from Research and Practice on understanding sexually problematic and harmful behaviours Under 10s Adolescents Adolescents with a learning disability Section Two – Checklists to evaluate sexual behaviours Section Three – Managing Sexual Behaviours Departmental Level Unit Level Individual Level copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Section Four – Ideas for individual work PART TWO Form One – Admission Risk Assessment sheet Form Two – Internal Residential Care risk and needs assessment Form Three – Detailed intra/inter agency planning Form Four – Agreement/Contracts Form Five – Recording Form Form Six – Timeline/ Chronology Sheet copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Healthy Harmful Mutuality Exploitation Exploration Intent to cause harm Choice Force/coercion/threats Fun, Laughter Distress, anxiety, shame, No intent to cause harm Planning/ Secrecy No power differential Persistent/ frequent Periods of disinhibition Compulsive/ Hard to dissuade Out of balance copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Understanding Younger Children Lack of research and statistics Girls are also displaying these behaviours Healthy sexual development is disturbed or disrupted either through abuse or highly sexualised environments Their bodies may have become sexualised and they are overwhelmed with feelings they cannot comprehend Emotional and physical space violated leaving feelings of anxiety, distress, anger related to sex copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd If not abused, but exposed to sexual information, confusing messages and poor boundaries can also create confusion, tension and anxiety related to sex Other factors, unpredictable and unstable backgrounds; violent or chaotic environments; little warmth or empathy; sex paired with aggression or as an exchange commodity In general the sexual behaviours are a way of dealing with intense negative emotions and sexual sensations that may be overwhelming for them, and scary and they may not have any positive ways in which to manage them copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Gil and Cavanagh-Johnson Continuum Group One – Normal Sexual Exploration Group Two – Children who are Sexually Reactive Group Three – Extensive Mutual Sexual Behaviours Group Four – Children who Molest copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Understanding Adolescents Adolescents make up approx 1/3of those convicted of sexual offences. Many have distorted or stereotypical views about relationships and sexual relationships in particular Reasons they engage in the behaviours is also to meet internal needs; overwhelming anger, anxiety, fear, loneliness etc. Puberty means body changes, and hormones creating intense sensations and emotions in their bodies Media and peer pressure to be successful sexually copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Not all adolescents who display these behaviours go on to be adult sex offenders. Work now more holistic looking at all aspects of their life; viewed as young people with needs and social and developmental deficits Factors from research and practice Neglect & Emotional Abuse Conduct disorder Sexual Abuse Other behavioural problems Physical Abuse Gender and Ethnicity Social Inadequacies Healthy and Harmful as for the Young Ones copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd O’Callaghan and Print Continuum Normal Behaviours Behaviours suggesting monitoring/ limited response Behaviours suggesting assessment and intervention Behaviours requiring a legal response, assessment and treatment copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Understanding Adolescents with Learning Disabilities Over represented in surveys eg 37%. Not more harmful, more likely to be caught or admit to the offence. Autism – work ongoing about this Similar routes into the sexual behaviour as the others copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Specific Factors Klinefelters Syndrome Lack of understanding about consent or impact on others May not have mainstream concepts of social mores about sexual boundaries Lives more restricted generally; social contacts more limited Denial of appropriate sexual education copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Checklists for evaluating Behaviour Based on a continuum from Healthy to Harmful, with eight areas (questions) all based on research and practice Needs to be checked against all the areas to have a balanced picture. Any gaps should provide a prompt to seek the information. Assessment on partial information should be viewed as temporary. Behaviour is likely to fall within one part of the continuum or straddle two Where behaviour is placed depends on how many answers are in each section copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Pattern Mapping Vital importance of good detailed recording and good assessments which are shared ( Farmer and Pollock 1998) Assessment is an ongoing process: helps the child or young person see progress ensures they do not get labels for life Helps the group decide on whether the level of risk has reduced Key Questions What is the possible cause of the behaviour? What is the pattern of the behaviour? What is the meaning of the behaviour for the child/young person? How motivated is the child/young person to work on their behaviour? copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Cause of the behaviour: Understanding facilitated by good assessments Pattern of the behaviour: Frequency, increase/decrease, gaps, trigger factors, patterns leading up to incidents Meaning of the Behaviour: Linked to trigger factors such as emotions; what do they get out of the behaviour; how do they use the behaviour ie to control, intimidate Motivation to Change Behaviour: how able are they to talk about the behaviour, and how willing are they to work on their behaviour and develop internal controls ( Miller & Rollnick 1991) copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Pattern Mapping 1st Stage: SW and YOT to compile chronology from files of key events. Put into a timeline 2nd Stage: Pull all the past and current information on sexually prob/harmful behaviours to provide a visual reference. Put into a time line If other significant behavioural problems eg. violence then do a time line of these incidents as well Put the time lines together and compare: Draw up working assumptions NB: Working Assumptions are just that, assumptions and not facts copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd 3rd Stage: Take the working assumptions and decide how to check them out Recording and monitoring b) Direct work with the individual child/young person c) Decisions around issues like contact/ rehabilitation home Make a plan which has measurable outcomes (short and long term) This helps to measure progress and whether or not the risk is reducing copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Managing Sexual Behaviours Departmental Level Unit Level Individual Level copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd The role of the worker 1. Stability, Security and Consistency 2. Individual time and attention 3. Emotional Literacy 4. Self esteem and Life skills deficits 5. Celebrating Achievement 6. Desexualise the environment 7. Culture of the Unit/role modelling 8. Good Recording copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Individual Level – Managing Risks Internal risk and needs form Supervision and Monitoring Honesty and Openess Confidentiality vs Protection Being part of the assessment process Motivation to change Taking responsibility for their past, present and future behaviour Work on their sexual behaviour copyright 2010 carol carson associates ltd

copyright 2010 carol carson associates ltd Individual Work – Ideas for Sessions Getting Started – building up resources; co-working; making time; identifying needs 2. Planning the work – Focus and structuring of sessions and examples 3. Ideas for sessions a) emotional literacy; b) self esteem; c) functional coping mechanisms; d) communication skills; e) Relationship and social skills; f) problem solving and decision making skills copyright 2010 carol carson associates ltd