Damaged beyond repair?

If
the level of sex offending in the UK is to be reduced it would seem obvious
that the treatment of child sex offenders should be a priority, as they could
turn into the dangerous predatory adults of tomorrow. But, reports Natalie
Valios, treatment facilities are few and far between.

More
than 450 children are convicted of sexual offences against other children in
England and Wales each year. The most extreme of these offences can result in
the death of a child, yet there is a widely recognised lack of specialist
services for such offenders.

The
case of Dominic McKilligan brought the issue of young sex offenders sharply
into focus at the end of last year (News, page 8, 22 November 2001). McKilligan
was convicted of murdering 11-year-old Wesley Neailey in 1999, just seven
months after his care order came to an end. Three years previously he had been
placed at a specialist residential treatment unit after being convicted on 12
specimen charges of sexual abuse against a number of children.

McKilligan
is an extreme example as most young sex offenders do not kill. The review panel
that looked into the case, set up under part 8 of the Working Together guidance,
made a number of recommendations, the most crucial one being that the
government should develop a national strategy for dealing with young sex
offenders. Sexual crimes can range from a touching offence at one end, to that
committed by McKilligan. Child care consultant John Fitzgerald, who chaired the
review panel, says: "Trying to develop treatment services to deal with all
of this is a tall order, which is why we recommended a national strategy."

Some
specialist facilities have been set up within wider health service provision,
such as psychiatric units, while some are in the voluntary or private sector.
But, because there is currently no national strategy for treatment, there are
no consistent standards for care arrangements, treatment methods, clinical
oversight, accountability or staff training. There is no single regulatory or
inspection system; no ongoing evaluation of effectiveness; and no geographical
consistency ensuring equity of provision.

Treatment
does not provide a cure, nor does it guarantee that an offender will not
reoffend. "We can only try and persuade, help, and assist someone to
control and manage their behaviour," says Fitzgerald. "But not
everyone is able to do that and they can go through treatment, as Dominic
McKilligan did, but not change."

But
he insists that this is no justification for doing nothing. "There’s a
national strategy for adult sex offenders, a sex offenders’ register,
monitoring, and treatment programmes in and out of prison. There is none of
that for young people. It is difficult to treat, but the more we do it and the
better we do it the more chance we have of increasing the success rates."

And
there lies the nub of the problem – the lack of specialist placements
available. Which is why, when asked whether he thought a similar case could
happen again, Fitzgerald says: "The short answer is yes."

Professionals
working with young sex offenders can name just a handful of specialist
residential and non-residential treatment facilities around the country.
"You are going to struggle to get a service," says Alan Griffin,
project leader of Barnardo’s Chilston project in Tunbridge Wells, Kent (see
panel).

This
does not mean that there are not other services working with these young
people, but these are not specialist. Most child and adolescent mental health
teams do not feel confident to work with them, says Griffin, who is both a
practitioner and manager. "Professionals tend to under or over
react," he says. "They either don’t see sexual offending –
particularly by girls or ethnic minority children – or they see children only
in terms of their sexually exploitative behaviour and not their needs."

He
would like to see multi-agency panels assessing the treatment needs of young
people who sexually exploit set up by all local authorities. And social
services departments must take this work seriously, Griffin says. He knows of
many case studies where children’s offending is much more serious than it was
several years ago, because it went untreated.

A
recent Canadian study confirms that therapy can substantially reduce
re-offending rates.¹ It found that with at least 12 months’
intensive treatment, recidivism rates might be reduced to 5 per cent for sexual
offences, 18 per cent for violent offences, and 20 per cent for non-violent
offences. This compares with a 17 per cent recidivism rate for sexual offences,
32 per cent for violent offences, and 50 per cent for non-violent offences for
those who did not receive treatment.

Renuka
Jeyarajah-Dent is chief executive of the Bridge Child Care Development Service,
an independent organisation that was commissioned by Bournemouth, Durham and
Newcastle Councils to carry out the part 8 overview report into McKilligan’s
care.² She describes research that indicates that young people who
commit violent crimes are likely to be located at the extreme end of a
continuum of having experienced neglect, violence and abuse. She argues that
the end result may be the imprisonment of neglected, abused and damaged young
people.

"Our
worry is that once the publicity over the McKilligan case dies down it will all
be forgotten once again."

¹
James Worling and Tracey Curwen, "Adolescent Sexual Offender
Recidivism", Child Abuse and Neglect, vol 24, no 7, 2000

²
The Bridge Child Care Development Service, Childhood Lost, The Bridge
Publishing House, 2001

Treating young sex offenders

By
the time young sex offenders are referred to Barnardo’s Chilston project they
are often deeply unhappy about their behaviour, says project leader Alan
Griffin. They have been a victim of some form of abuse, although it is not
always sexual.

The
project is one of seven run by the children’s charity to treat young sex
offenders. It accepts children aged between seven and 18 and has a capacity for
15 referrals at any one time. Over 90 per cent of referrals are white teenage
males, and at a guess Griffin thinks about 60 per cent of referrals are looked
after. A child who has a long history of abusive incidents can be involved with
the project for up to two years.

"We
don’t talk about a cure because that suggests something that is done to or
given to someone," says Griffin. "We use the word ‘control’ because
ideally that comes from within. It’s a process of learning about themselves,
about how to behave differently and more respectfully. That is the key to
changing behaviour."

There
are several stages in the treatment programme and Barnardo’s subsidises the
cost. The first 10 sessions are used to see if the young person can be
successfully engaged in meaningful therapy about their abusive behaviour. The
project is only likely to withdraw at this stage if a young person completely
denies any sexually motivated offending.

As
well as individual work, a substantial proportion of the therapy usually
involves a 28-week programme of group work. They will work through several
issues, including acceptance of responsibility, and victim empathy. Every
session undertaken by a young person is mirrored by a parallel session for the
parents or carers.

Reparative
work is also carried out to restore relationships with family members where
this is appropriate.

By
the end of the treatment, the project expects young people to be:

–
Aware of their potential to offend sexually.

–
Aware of the impact this has on victims, potential victims and themselves.

–
Able to recognise situations, thoughts, feelings and behaviours which are high
risk for re-offending.

–
Able to implement an action plan to avoid re-offending.