1. INAPPROPRIATE SEXUAL BEHAVIOURS IN OUT OF HOME CARE ACWA Conference 19 August 2014 David Duffy MAASW MSW (PQ) Residential Clinician © 2014 Life Without Barriers

2. Role of Life Without Barriers Life Without Barriers’ family support and out-of-home care services include: Foster care Residential care Supported accommodation Family contact Case management Education Clinical services Cultural planning Family support Transition support Respite

3. Sexual Development Sexual behaviours begin to emerge in infancy Overt behaviours peak between the ages of two and six Overt behaviours decline with age and re-emerge in adolescence Sexual development is an individualised process. (Friedrich, 1997; Friedrich, 1998; Tarren-Sweeney, 2008).

4. Inappropriate Sexual Behaviour Inappropriate sexual behaviour on the part of a child or young person includes, but is not limited to, sexual behaviour or activity that: places the person at risk places others at risk causes offence or impacts on the person’s social and community inclusion.

5. Complexity Young people in out of home care typically have complex maltreatment histories (complex trauma) Young people in Out of Home Care have a high rate of sexual behaviour problems, especially children and youth in residential care It may lead to more serious behaviour Extreme reactions from carers and others

6. Consequences Placement breakdown Sexual exploitation Re-traumatisation Carer/family/peer stress and rejection Disrupted attachment School disruption Legal system involvement

7. Challenges Lack of Australian research No single definition of inappropriate sexual behaviour Misconceptions about inappropriate sexual behaviour Secretive nature of some sexual behaviour The need for non-stigmatising responses Few specialist services in regional and remote areas

8. TRAINING PROGRAM

9. Training Overview Target population: Carers of children 12-17 years of age with inappropriate sexual behaviours Training parameters: 2 x 3 hour workshops and a participant workbook Homework (optional): Homework is used to help reinforce the practices supportive of effective use Resources required: This program is implemented into an existing therapeutic environment that will have individual offices, group rooms, and administrative assistance Recommended provider qualifications: Bachelor’s degree with 2 years appropriate clinical experience in a relevant field

10. Training Goals Provide carers a practice framework Prevent, eliminate or reduce the behaviours Enhance documentation and timely communication Build attachment relationships Reduce carer stress and reactivity Increase carer understanding and behaviour support skills Increase collaboration and consistency in response from carers, young people and needed services.

11. Theoretical Foundation Adolescent development (Rich, Steinberg & Scott; Zimring) Childhood sexuality (Fredrich, Ryan) Trauma (Briere, Herman, Perry) Attachment (Bowlby, Fredrich, Rich, Schore) Psychoeducation groups (Dixon, Marsh, Brown) Functional analysis and positive behaviour supports (Horner & Sugai, LaVigna & Willis).

12. Training Modules Adolescent development Development of sexual behaviours Inappropriate sexual behaviours Sexual behaviours and the law Young people living in OOHC Risk factors Cultural considerations Carer reactions Consequences Knowledge Information gathering Making sense of the behaviour Support strategies Skills

13. How do we decide whether the behaviour is inappropriate? Age appropriate sexual behaviours Concerning sexual behaviours Very concerning sexual behaviours (Ryan and Blum, 1994)

14. Information Gathering Sources of information Requesting further information Collecting behavioural observations

15. Making sense of the Behaviour While the behaviour may appear overtly sexual in nature, the motivation for the behaviour may not be sexual at all. Silovsky and Bonner (2003) argued that the behaviours may be related to natural curiosity, anxiety, imitation, attention-seeking, or self-calming.

16. Domains SafetyStability Wellbeing

17. How we can increase safety? Monitoring Documentation and communication Reporting risk of significant harm

18. How we can increase stability? Psychoeducation Relationship building Self Care

19. How we can increase wellbeing? Behaviour support Referral to specialist supports

20. Putting it all together

21. Training Outcomes

22. 22 Sub copy to go here Where to next Continue evaluation Training of trainers Roll out across other sites Systems to maintain skills Establish reference group Increase carer access Widen target group.

23. Contact Details David Duffy MAASW MSW (PQ) Residential Clinician Life Without Barriers Email: david.duffy@lwb.org.audavid.duffy@lwb.org.au Phone: 02 6690 3500