Harmful Sexual Behaviour Research Articles

The all-Wales forensic adolescent consultation and treatment service (FACTS): A 5-year referral cohort study.

FACTS is a Wales-wide mental health service for 10-17-year-olds with needs beyond the remit of mainstream child and adolescent mental health services (CAMHS). As a purely consultation-liaison service, it differs from other UK services in the field. To describe a complete cohort of referrals to FACTS 2013-2017 with service exit by June 2018. Clinical, social and offending data were extracted from FACTS records. 80 young people completed a FACTS episode, averaging nearly a year (309days; range 13-859days). Mostly boys (65, 81%) of mean age 15.4years (range 9-18), two-thirds (n=53) had three or more referral reasons, one invariably being threatened/actual harm to others; only half were criminal-justice involved. Half (41, 51%) were committing sexually harmful acts. Half were self-harming (41, 51%). All but seven had had at least one adverse childhood experience (ACE), nearly half (35, 44%) four or more. Nevertheless, post-traumatic stress disorder (PTSD) was rarely diagnosed (7, 9%); just over one-quarter (23, 29%) had no diagnosis at all. Correspondence analyses endorsed two distinct Attention deficit hyperactivity disorder groups, distinguished by presence/absence of evidenced brain damage or dysfunction. Suicide-related behaviours clustered with the other diagnoses, flashbacks and psychotic symptoms with no diagnosis. Change in home circumstances during a FACTS episode was slight. The complexity of presenting problems and service involvement evidences need for FACTS. The extent of persistently harmful sexual behaviours is a novel finding, suggesting need for more expert input for this at other service levels. Rarity of PTSD diagnoses was surprising given the extent of ACEs. This raises concerns that services focus on disorder signs rather than the child's inner life. Given the extent of problems, minimal change may be a positive outcome - especially when remaining in the community. Further development of this service should include explicit case-by-case goals and indicative outcome markers.

Teachers as human rights defenders: strengthening HRE and safeguarding theory to prevent child sexual abuse

Sexual abuse is a public health issue with long-term consequences for children’s lives and education. The Convention on the Rights of the Child is a key reference point in safeguarding, increasingly incorporated into domestic law. This article aims to strengthen safeguarding theory and practice by reviewing human rights education (HRE) theory and aligning it with care-based ethics. It proposes a renewed focus on HRE in teacher education that examines the teacher’s role and professional responsibilities, strengthens rights-based knowledge, and explores the transformative power of rights. By empowering teachers with skills to recognise and act on harmful sexual behaviour (HSB), they can become powerful human rights defenders, protecting children against child-on-child and adult-on-child abuse. Drawing on empirical data on teachers’ understandings of HSB, we apply theory, cautioning against an under-theorised approach that over-relies on rights knowledge or children’s ability to claim their rights in an emotionally charged arena with asymmetrical power relations.

Does Gender Affect Judges' Perceptions of Sexual Assault Cases?

There is growing recognition that females engage in harmful sexual behaviour that is similar in severity and type to males. Existing research, however, suggests that there is a bias towards leniency in judicial systems for female sexual offenders (FSOs) in comparison to male sexual offenders (MSOs). Specifically, FSOs receive shorter sentences than do MSOs and are less likely to be sentenced to prison. The majority of research examining disparity in sentence outcomes for FSOs have been analysed through a quantitative lens. Qualitative methodology is also needed to understand any subjective differences in the way that judges perceive case-relevant factors and whether these perceptions differ as a function of the offender's gender. The present study is a qualitative study that examined judges' perceptions and descriptions of FSO compared to MSO in 10 matched cases of sexual offending. The study found that although there were many similarities in how judges perceived FSO compared to MSO, there were also unique differences that could explain more lenient sentences for FSOs (i.e. the vulnerability, poor mental health and adverse backgrounds of FSOs). Other unique differences found were that judges' perception of FSOs behaviour was described as depraved and cruel, whereas MSOs similar behaviour was not described in such an emotive way. The present study provides additional insight into the reasons for a bias towards leniency for FSOs. In particular, it points towards judicial focus on particular personal circumstances that are seen as relevant in sentencing FSOs but not for MSOs.

Vince Mercer, The AIM restorative practice and harmful sexual behaviour assessment framework and practice guidance

Vince Mercer, The AIM restorative practice and harmful sexual behaviour assessment framework and practice guidance

Sexual Fantasies and Harmful Sexual Interests: Exploring Differences in Sexual Memory Intensity and Sexual Fantasy Characteristics.

The perpetration of harmful sexual behavior is a global concern, with deviant sexual fantasies identified as a prominent etiological risk factor. However, the concepts of state sexual fantasy characteristics (e.g., vividness and emotionality) and associated trait sexual memory intensity have received minimal investigation concerning harmful sexual interests, formulating the impetus for this research. Two online surveys were conducted in community populations. Study 1 (N = 414) aimed to validate the psychometric properties of a trait sexual memory intensity scale (SMIS) through principal components analysis, confirmatory factor analysis, and evaluation of concurrent validity. Study 2 (N = 820) endeavored to explore associations between state sexual fantasy characteristics and cognitive-behavior variables (e.g., frequency of masturbation to a reported fantasy), and evaluate differences in fantasy characteristics and SMIS scores between participants with and without harmful sexual interests. Collectively, results supported the factor structure, concurrent validity, and internal consistency of the SMIS, while revealing significant associations between the SMIS, sexual fantasy characteristics, and several variables. Significant differences in sexual fantasy characteristics and SMIS scores were evident but variable among harmful sexual interests. Findings encourage the consideration and research of interventions focused on impairing mental imagery and memory in the management of harmful sexual interests.

A TALE OF ATTEMPTED MURDER AND HIV … S v Nyalungu 2005 JOL 13254 (T) “

The South African Law Commission (as it was then – hereinafter “SALC”) was commissioned to investigate various aspects of the law as it related to HIV/AIDS. In its 5th and final report (Project 85, 5th Interim Report on Aspects of the Law Relating to AIDS – The Need For A Statutory Offence Aimed At Harmful HIV-Related Behaviour, April 2001 – hereinafter “SALC 5th report”), it dealt with “harmful (ie unacceptable) sexual behaviour by a person with HIV or AIDS that could transmit HIV or expose others to HIV, current measures available to address such behaviour and whether there is a need for statutory intervention” (viii of the executive summary of the report). This note considers the SALC’s recommendations in this regard and the reality that there have been no reported cases of successful prosecution under the common-law crimes for the wilful transmission of HIV, but that the case in point shows a willingness on the part of the courts to accept that such behaviour is dire and will be punished albeit under the guise of some “lesser” offence. Whether the decision is S v Nyalungu ([2005] JOL 13254 (T) (unreported)) has/will made/make it a less daunting task to prosecutecrimes involving allegations of the wilful transmission of HIV/AIDS is yet to be seen.

From Fantasy to Reality: Self-Reported Aggression-Related Sexual Fantasies Predict Sexually Sadistic Behavior beyond Indirect and Direct Measures of Sexual Preference

ABSTRACT Aggression-related sexual fantasies (ASF) have been related to various forms of harmful sexual behavior in both sex offender and community samples. However, more research is needed to fully understand this relation, particularly whether ASF is associated with harmful sexual behavior beyond hostile sexism against women and a sexual preference for violence and sexual violence. In the present study, N = 428 participants (61.9% women) between 18 and 83 years of age (M = 28.17, SD = 9.7) reported their ASF and hostile sexism. They rated their sexual arousal by erotic, violent, and sexually violent pictures as a direct measure of sexual preference. Response latencies between stimulus presentation and arousal ratings were used as an indirect measure of sexual preference. ASF and the directly and indirectly assessed sexual preference for violent and sexually violent stimuli were positively correlated. They were unrelated to hostile sexism against women. ASF showed the strongest associations with self-reported sexually sadistic behavior and presumably non-consensual sexual sadism beyond these preferences and hostile sexism in the total group and separately among men and women. The findings indicate that ASF and sexual preference are not equivalent constructs and further underscore the potential relevance of ASF for harmful sexual behavior.

Ensuring long-term success of personalised support for a young man with intellectual disability and harmful sexual behaviour: a Swiss case study

ABSTRACT Some people with intellectual disability who have sexually offended require long-term support with risk management. This paper demonstrates how least restrictive practices within a Swiss social care setting are utilised to support a young man with intellectual disability, mental health difficulties and persistent high risks. It is underpinned by the social model of disability, which directs attention away from individual pathology onto environmental support structures. Data was generated through qualitative interviews with the patient, forensic psychologist and social care provider and an in-depth analysis of the patient file. Current approaches to community support are synthesised and applied to this exemplary case. Hence, the analysis compares empirically based patterns from the case with the aims of risk management, person-centred planning and sexual offending treatment, highlighting the mechanisms that enable this support package to work. This results in a novel conceptualisation of sexual offending treatment success that encompasses environmental support structures.

“Maybe I imagined it, maybe it really was all just childish play”: Complexity and ambiguity in survivors' perceptions of harmful preadolescent sexual behavior

BackgroundHarmful preadolescent sexual behavior (HPSB) is an understudied phenomenon in the field of child sexual abuse (CSA). ObjectiveThe purpose of the present study was to analyze and describe the experiences and perceptions of adult survivors of HPSB. Participants and setting16 survivors of HPSB were recruited as part of a purposeful sample. Their ages at the time of the study ranged from 21 to 50; they were Jewish-Israeli, secular, and Hebrew-speaking. MethodsSemi-structured interviews and qualitative thematic analysis were conducted based on a descriptive phenomenological-psychological approach. ResultsParticipants described elements of complexity in their perceptions of the “truthiness” of their memories and the mutuality of the HPSB experiences, as well as their primacy, seriousness, and life impact. They also described elements of support during disclosure, but mostly exposed the challenges and hardship involved, particularly the lack of legitimacy in exposing harmful sexual behavior perpetrated by other children. ConclusionsBoth the HPSB experiences themselves and the subsequent disclosure contributed to the development of detached, mistrustful identities among the participants.

Is Restorative Justice an Effective Approach in Responding to Children and Young People Who Sexually Harm?

In the UK, Australia, and further afield, restorative programmes have been developed as a response to the failure of the criminal justice system to give victims of sexual violence a voice in the legal process. The restorative justice literature has tended to focus on sexual offences perpetrated by adults and the importance of being victim centred. When it is a child or young person (CYP) who sexually harms, it poses a unique set of challenges for law and society and the restorative practitioner. This article explores the reasons why a different approach may be warranted given the perceived failure of conventional criminal justice in addressing the growing problem of child and adolescent harmful sexual behaviour (HSB) in Scotland. It discusses the difficulties with balancing the rights of the victim with the CYP who perpetrates the HSB and considers the challenges encountered by practitioners in the implementation and application of restorative programmes in HSB cases involving CYP. Although the evidence supports a growing need for a different approach, and restorative justice may offer just that, problems with net widening, the referral process, and resistance from other professionals and victim advocacy groups present real barriers. Consequently, restorative practitioners are likely to find practising in this area more challenging due to a lack of support and cooperation.

Comparison of children's advocacy center responses to harmful sexual behavior among siblings: An international perspective

BackgroundHarmful sexual behavior (HSB) is sexual behavior exhibited by children and adolescents that is developmentally inappropriate and/or harmful or abusive towards themselves or others. Victims of children with HSB are commonly siblings. Multiple professionals may be involved in cases of youth HSB involving siblings, which places Children's Advocacy Centers (CACs) in a key position to directly address intrafamilial HSB. Approximately 25% of all cases seen at CACs in the U.S. are youth-initiated HSB. However, no known research has examined how CAC professionals approach decision-making and response to intrafamilial and sibling HSB, particularly across regions and cultures. ObjectivesTo examine the perspectives of professionals from three separate CACs in Israel, eastern U.S., and southwestern U.S. regarding their decision-making and response process for sibling HSB. Participants and settingThirty-seven multidisciplinary team members from the three CACs, including representatives from child welfare, law enforcement, family advocacy, mental health, and the court system, among others, participated in the study. MethodsParticipants completed focus groups that asked them to discuss how their system would respond to a vignette case. Dedoose was used for thematic analysis. ResultsUsing qualitative thematic analysis, results indicate all sites perceived sibling HSB as a family crisis, and they prioritized establishing safety and providing therapeutic interventions. Differences across sites were on how to establish safety and when to use legal actions. ConclusionsThe study draws attention to the influences that formal policy and community contexts have on CAC decision-making, particularly around the availability of evidence-based treatments and caregiver engagement.

A systematic review of the United Kingdom's contact child sexual exploitation perpetrator literature: Pointing a way forward for future research and practice

AbstractUntil recently, empirical evidence exploring Child Sexual Exploitation (CSE) has been scarce, particularly in relation to contact exploitation, where the convicted perpetrator seeks direct physical (offline) contact as opposed to solely targeting the victim online. This article presents a systematic review of the UK's contact CSE perpetrator literature, searching from 2009 to the present day to ensure that studies encompass the categorisations detailed within the CSE statutory definitions. Twenty‐three research articles were appraised using a Mixed Methods Appraisal Tool (MMAT). A narrative synthesis approach was used to synthesise the findings from qualitative and mixed methods studies identifying four significant analytical themes including (a) barriers to examining a complex phenomenon, (b) recognising the contact CSE perpetrator, (c) understanding the contact CSE perpetrator and (d) responding to the contact CSE perpetrator. This review synthesises evidence in a singular study, ideal for policy‐makers and stakeholders to provide a more comprehensive safeguarding response, guide future research directions, and provide suggestions for law enforcement disruption strategies within the United Kingdom. Recommendations for policy, practice, procedure and training include improving the recording of data, re‐categorising CSE as CSA, targeting harmful sexual behaviour and group offending, and designing evidenced based perpetrator treatment programmes. Future research centring on the perpetrator's adverse experiences and the strategies used to instigate sexual contact could advance understanding of how these crimes could be prevented.

Preventing harmful sexual behavior in primary schools: Barriers and solutions

BackgroundSchools are recognized as crucial stakeholders in preventing and combating public health problems such as sexual violence and abuse. While prevention efforts have often focused on safeguarding children from adult perpetrators, less attention has been dedicated to safeguarding against harmful sexual behavior (HSB) displayed by children and young people at school. As little is known about teachers' understanding of and responses to HSB in primary school more research is needed. ObjectiveThe objective of the study is to explore and identify barriers to the prevention of HSB in primary school. Possible solutions to these identified barriers are pursued through a transformative lens. Participants and settingNineteen informants from six schools participated in focus-group interviews at their respective schools in the south-eastern region of Norway in May and June 2019. Fifteen of the informants were primary school teachers, three were school principals and one was a social worker. MethodsThe focus-group interviews were transcribed verbatim, and the transcripts and field notes were analyzed using thematic analysis. FindingsPrimary school teachers report a lack of HSB competence and limited multi-agency cooperation or coordinated practice. Under these circumstances, the teachers perceive the prevention of HSB as an overwhelming individual professional responsibility. ConclusionsThe study suggests that the following three policy initiatives need to be prioritized:1.Training in healthy, problematic, and harmful sexual behavior to be made mandatory across all schools and cooperating agencies2.Statutory interdisciplinary cooperation between schools and relevant agencies to be enhanced3.National guidelines on the prevention of sexual violence in schools, creating an overarching structure, to be developed and implemented.

Exploring teachers’ lived experiences of child-on-child harmful sexual behaviour at school: an interpretative phenomenological analysis

ABSTRACT Child-on-child harmful sexual behaviour (HSB) at school is highlighted in the literature, although very little is known about how teachers experience it. Interpretative Phenomenological Analysis was used to address this knowledge gap. Semi-structured interviews were conducted with nine teachers from two special schools and one mainstream school. The proverb of the three wise monkeys was used as an analogy to aid sense-making and to capture the essence of the teachers’ lived experiences of child-on-child HSB, revealing it was not seen, heard or spoken about. Instead, HSB was accepted and expected as part of the special school day because it was not recognised and paid little attention to, whilst in the mainstream school, it was not recognised due to a lack of knowledge and understanding. A lack of training, support and the sharing of information compounded teachers’ fears for personal safety, careers and reputation. Implications for teachers and multi-agency professionals are discussed.

An innovative multi-agency consultation model for harmful sexual behaviour displayed by children and young people: practice paper

ABSTRACT Harmful Sexual Behaviour (HSB) has been regularly documented as a demanding area of practice within the United Kingdom (UK). The aim of this paper is to share a practice model developed in an under-resourced inner London borough. The HSB forum is formed of a multi-agency group of professionals and runs monthly providing a platform for practitioners to seek consultation for young people they are working with who are displaying HSB's. Initial feedback for the forum from practitioners has been consistently positive and they have valued specifically the opportunity to formulate, have clear directions, and the multi-disciplinary perspective. In addition, most reported feeling empowered to implement the recommendations suggested. Given the shared vulnerability factors between those displaying HSB's and other at-risk young people such as those who are being sexually exploited, this model provides an innovative way that practitioners can be supported by multiple agencies where there is a lack of specialist services.

Using sexual health and safety education to protect against child sexual abuse in residential care: The LINC model

AbstractChildren and young people living in residential care are vulnerable to sexual abuse, and there is scant evidence about what sexuality education could help address this vulnerability. This paper explores the impact of the Power to Kids: Respecting Sexual Safety programme, which involved capacity‐building workers to have ‘brave conversations’ with children and young people in residential care. The aim of the study was to capture the perceptions of workers about changes in their skill and confidence levels in relation to having brave conversations with children and young people and the impact of those conversations on children and young people. A mixed‐methods study was undertaken, involving multiple sets of interviews with 27 workers associated with four residential houses. The qualitative and quantitative data analysis showed that workers perceived the impact of the capacity building and brave conversations as strengthening protective factors available to children and young people vulnerable to sexual abuse. The research revealed the ‘LINC model’ as a viable approach to capacity‐building workers to educate children and young people in residential care about sexual health and safety. Workers perceived the enhancement of the following protective factors: stronger safe relationships, greater comfort disclosing abuse and improved knowledge of normal versus harmful sexual behaviour.

Assessing Sexual Behaviours in Children and Young People: A Realistic Evaluation of the Brook Traffic Light Tool

The Brook Traffic Light Tool intends to support professionals in responding to developmentally inappropriate behaviours in children and young people. This is important as the number of reported harmful sexual behaviours in children and young people is rising. This study is a realistic evaluation of Brook Traffic Light Tool training implemented across a southern locality, using the Kirkpatrick model of evaluating training. Data were collected in a three‐phase mixed methods approach comprising 436 initial questionnaires, 60 additional detailed questionnaires and 13 interviews. The results show that confidence among professionals was raised and multiagency responses to risk were enhanced. The Traffic Light Tool training also increased awareness of sexual development. Direct impact upon the behaviour of children and young people was difficult to ascertain, and categorisation anomalies were found when behaviours were not explicitly outlined in the Traffic Light Tool. A range of professionals with little previous training had encountered both harmful and healthy sexual behaviours in children and young people. Comparison of the numbers of sexual behaviours observed to national figures proved problematic as no baseline or national strategy currently exists.‘This study is a realistic evaluation of Brook Traffic Light Tool training… using the Kirkpatrick model of evaluating training’Key Practitioner Messages The Traffic Light Tool enhances practitioner confidence in the area of sexual behaviours in children and young people and can impact positively on risk assessments but only when all agencies have been trained. The Traffic Light Tool can remove the context into which the behaviours are situated, making assessment one dimensional. Using the Traffic Light Tool when a behaviour is not explicitly listed may result in subjective judgements being made. It is difficult to assess the direct impact of the Traffic Light Tool on the behaviour of children and young people

Characteristics of adolescent boys who have displayed harmful sexual behaviour (HSB) against children of younger or equal age

BackgroundAdolescents who have displayed harmful sexual behaviour (HSB) are often described as a heterogeneous population, but different offender-, offense-, or victim-based typologies have been proposed. Two common typologies are based on the victim’s age and/or on offender–victim age discrepancies.MethodsUsing data from a Norwegian clinical sample, we aimed to investigate the characteristics of two subgroups of adolescents: those with younger/child victims (HSB-C) and peer victims (HSB-P). The sample was collected from a public child and adolescent psychiatry outpatient clinic. N = 54 boys, mean age 14.1 (younger age: HSB-C, n = 30, equal age: HSB-P, n = 24). Based on patient records, all patient registries within the sample were reviewed retrospectively. The data were analysed in R with different statistical tests (e.g. N − 1 chi-square test, Fisher’s exact test).ResultsAfter adjusting the p values for multiple comparisons, none of the test statistics showed significant results. Based on the magnitude of the effect-size estimates, the following tendencies and potential meaningful differences emerged: more adolescents in the HSB-C group had experienced their own trauma early (V = 0.42), had more than one victim (V = 0.32), and had displayed repeated HSB (V = 0.27), and their caregivers required extensive interventions (V = 0.20). More adolescents in the HSB-P group had cognitive abilities in the normal/high range (V = 0.32), and their caregivers more often had difficulties acknowledging the need for support and treatment (V = 0.20).ConclusionsThe nonsignificant differences between the subgroups, despite some strong and moderate effects, bring about a discussion on the utility of using “victim age” in combination with the “offender–victim age differences” as the sole classification criterion for adolescents who have displayed HSB. The heterogeneity of the adolescent HSB population and lack of reliable information on more homogenous subgroups dynamics will remain challenges for clinicians and other practitioners needing a broad assessment and intervention focus.

Designing Effective Digital Advertisements to Prevent Online Consumption of Child Sexual Exploitation Material

ABSTRACT The necessity of developing effective and innovative primary prevention strategies is a pressing objective in stemming the harm caused by the production and consumption of child sexual exploitation material (CSEM). Digital media interventions – including search engine advertisements – hold promise as prevention tools to deflect potential users away from CSEM and redirect them to therapeutic services. This study aimed to establish an evidence base for effective advertising in this context by creating mock-up helpline advertisements and testing them in focus groups and interviews with staff and clients of New Zealand’s major treatment service providers for harmful sexual behavior. Prior to testing these advertisements in situ (on online platforms), this paper reports on a foundational creative and qualitative investigation of effective advertisements – what imagery, text, and design features are most likely to succeed in diverting people away from seeking CSEM and encouraging them to reach out to a helpline? The findings of this study offer deeper understanding of the mindset, emotions, and barriers to reaching out that are experienced by onset CSEM users, as well as suitability of certain imagery and text for advertising in this context, and thereby contribute to strengthening primary prevention efforts in combatting CSEM consumption.

Working with Children and Young People Who Have Displayed Harmful Sexual Behaviour, Stuart Allardyce and Peter Yates

Working with Children and Young People Who Have Displayed Harmful Sexual Behaviour, Stuart Allardyce and Peter Yates