Children who abuse

Stephen’s story.    

 A social worker was concerned about where to place Stephen,* a
seven-year old boy who had been sexually abused by his older
brother.  

After the older brother, aged 14, had been removed from the
home, Stephen began in turn to behave in a sexually aggressive way
to his younger, four-year-old brother. This behaviour continued for
several months until the four year old was able to communicate his
experience to his mother. 

At this point, the social worker sought to place Stephen in the
same foster placement as his older brother (his original abuser),
taking the view that Stephen had now “crossed over the line”
between victim and perpetrator and was no longer a child in need.  
* Not his real name.

Research Findings.    

Research shows that intervention with children and young people
should be: 

• l Holistic – focusing on the children’s needs across all
  dimensions of their development. 
• l Systemic – engaging families and improving the nature of the
  child’s attachments. 
• l Goal-oriented – designed to address specific, measurable
  targets associated with the child’s sexual behaviour. 

Source:S Hackett, What Works for Children and Young People with
Harmful Sexual Behaviours?, Barnardo’s, 2004.

Michael’s Story:

Michael* was a 16-year-old who had abused two pre-adolescent
boys living in his area. He had a history of family neglect, social
isolation and not attending school. He was referred to a specialist
project where he attended a group work programme.   One of the
goals Michael identified as part of his intervention was to get
back into education. As he had a significant interest in cookery,
his group workers supported him in gaining a place in a local
further education college on a cookery course. Michael found he had
a real talent for cookery. His self-esteem grew significantly as he
made achievements on the course. He also met young people of his
own age who shared his interest and with whom he felt
comfortable.   He began to mix socially with friends of his own age
from college for the first time in his adolescence. This all had a
positive impact on the focused work he undertook in relation to his
sexually abusive behaviours. He was able to talk in detail about
his behaviours and acknowledge full responsibility for the abuse,
both within the group and, significantly, also with his parents.  *
Not his real name.   

ABSTRACT:

This article looks at the current professional response to
children and young people who have sexually abused and discusses
the latest findings from research. Evidence suggests that young
people who sexually offend can be diverted away from such
behaviour, with only a minority in need of continuous, intensive
management.   

REFERENCES:

¹ Home Office, Criminal Statistics England and Wales,
2001, HMSO, 2002 

² NCH, Report of the Committee of Enquiry into
Children and Young People who Sexually Abuse other Children, NCH,
1992 

³ H Masson, S Hackett, “A decade on from the NCH
report: adolescent sexual aggression policy, practice and service
delivery across the UK and Republic of Ireland,” Journal of Sexual
Aggression, 9:2, 109-124, 2003 

⁴ Department of Health, Working Together to Safeguard
Children, The Stationery Office, 1999 

⁵ S Hackett, What Works for Children and Young People
with Harmful Sexual Behaviours?, Barnardo’s, 2004 

⁶ J Worling, T Curwen, “Adolescent sexual offender
recidivism: success of specialised treatment and implications for
risk prediction, Child Abuse and Neglect, 24, 965-982, 2000 

⁷ S Hackett, H Masson, S Phillips, Mapping and
Exploring Services for Young People who have Sexually Abused
Others: Final Report, A two-year research project funded by Youth
Justice Board, NSPCC and NOTA, University of Durham, 2003.
Available at: www.dur.ac.uk/
simon.hackett/mapping.htm  

• Simon Hackett’s new book What Works for Children and Young
  People with Harmful Sexual Behaviours? is published by Barnardo’s,
  £12.99

Up to a third of all child sexual abuse is carried out by
children and young people.1 This fact has been recognised in the UK
for more than a decade, but the professional response to young
people with sexual behaviour problems can differ widely from region
to region.

In 1992, the NCH highlighted widespread failings in responses to
this group of children. It found a lack of professional
understanding, poor intervention services, little training and few
available placements for young people.2 Since then, professional
groups have increasingly recognised the problem but awareness is
only a first step.

In a recent two-year research programme examining policy and
practice about this issue in the UK,3 we found pockets of excellent
practice with 38 specialist services offering assessment and
treatment. Commonly, these services are located in the voluntary
sector, for example both Barnardo’s and NSPCC have a network of
projects dedicated to this user group. But there are simply not
enough specialist services to go around. In some areas of the UK it
is still impossible to find a service for a young person in need of
help because of sexual behaviour problems.

The state of policy also remains highly variable, with still only
68 per cent of the 143 area child protection committees that
responded having some sort of policy statement on this issue. We
found some examples of very helpful local ACPC protocols between
local youth offending teams and specialist services, with clear
referral routes and commonly accepted standard assessment models
being used. But in other areas, such joined-up thinking remains pie
in the sky. The lack of good national guidance does not help, and
Working Together is deficient on this issue.4

But it’s not just about the availability of services. There is an
urgent need to look at the way in which we understand and respond
to these children. We need to use the considerable body of research
evidence that is emerging to help direct our professional
responses.

Earlier responses to young people showing harmful sexual behaviour
were influenced heavily by theories about, and approaches to, adult
sex offenders. With a decade of practice experience to draw on in
the UK, specialist practitioners in the field believe such
approaches are ineffective with children and young people.

But inappropriate responses to children continue, as the case
example of Stephen demonstrates (see panel). Here, it was as if the
identification of Stephen as an “abuser” invalidated any concern
about his own vulnerability; an example of narrow thinking which
pigeonholes children into polarised categories, rather than seeing
the complexity of their situations. Such muddled and confused
responses often occur because professionals allow their anxiety
about the sexual nature of a child’s actions to obscure the needs
of the child behind the behaviour.

Evidence suggests that children such as Stephen have multiple
troubles, often with histories of chronic disadvantage, multiple
abuse experiences and problematic attachment relationships. An
approach that focuses exclusively on their abusive behaviours, but
which leaves broader environmental issues untouched, is not going
to be as effective as one which helps develop a young person’s
self-esteem and self-efficacy in an environment of positive
emotional and practical support, as in the case of Michael (see
panel page 42).

It is a supreme irony that, once sexually abusive behaviour has
been identified in young people, they can often be catapulted into
a situation of multiple moves, inadequate placements, school
exclusion and social isolation, which only add to the catalogue of
problems and experiences that have contributed to the development
of the sexually abusive behaviour in the first place.

While interventions based on a cognitive behavioural framework are
supported in the literature, it is important that intervention is
tailored to the needs of the individual child and family, rather
than applied mechanistically to all. The emphasis should be on
supportive and empathic interactions.5 Dogmatic, inflexible or
aggressive approaches are unhelpful.

In contrast to other areas of child care social work, where
obsessive attention to risk has been replaced with a more helpful
emphasis on resilience and strengths, professional responses to
this group of children are still often risk dominated. Of course,
in an area of such potential harm to victims, managing risk should
be a vital element of any programme of intervention. But the
evidence on risk demands us to challenge a few professional
stereotypes.

There is still a common assumption that all young people who show
sexually abusive behaviour -Êin contrast to other juvenile
offenders – are unlikely to “grow out” of such behaviour and are at
high risk of developing more serious patterns of sexually abusive
behaviour through adolescence and into adulthood, a notion
suggested in Working Together. But evidence from North America
suggests that this is not the case for most young people. For
example, in a recent six-year follow-up study of adolescent sex
offenders in Canada, only 18 per cent of untreated and 5 per cent
of treated adolescents went on to reoffend sexually.6 In fact, in
this study the figures for non-sexual recidivism were considerably
higher than those for sexual reoffending, which suggests that work
with these young people must be holistic and focus on broad
developmental goals. There is a need for more recidivism studies
from the UK.

Some young people do indeed present high levels of risk and need
continuing intensive management. We are beginning to be able to
classify risk factors and mechanisms that can assist in the
identification of this high risk group. But the key message appears
to be that most young people can be diverted away from sexually
abusive behaviour towards an abuse-free future. This should give us
some optimism and highlight the importance of early and supportive
interventions.

Finally, it is time to start listening to the views of children and
young people who have sexually abused and their families; views not
only about how their needs can be met, but also about their
experiences of us as professionals.

Compared with other areas of social care, user perspectives on
sexual behaviour services are almost totally lacking. This might
reflect an uncertainty on the part of professionals and academics
about the validity of the views of people traditionally seen as
manipulative and untrustworthy. However, our small study of user
perspectives7 suggests that they have much to say about their
experience of professionals and that we have much to learn about
the absolute isolation and distress that families often experience
in the wake of these problems emerging. 

Simon Hackett is senior lecturer in social work at the University
of Durham. Since the early 1990s he has been involved in clinical
practice and research in relation to children and young people who
have displayed harmful sexual behaviour. He was previously
programme director of G-Map, a leading UK community-based programme
working in this field. He is an active member of the national
executive committee of the National Association for the Treatment
of Abusers (Nota) and is editor of the Journal of Sexual
Aggression.