A Chance to Change: An Intervention with Young People Who Have Sexually Abused Others - Research Findings

DescriptionThis study, carried out in 1994-95, examines the Project's approach, procedures, clientele, and methods of assessing risk.
ISBN
Official Print Publication Date
Website Publication DateDecember 24, 1998
Social Work Research Findings No. 10(1998)
A Chance to Change: An Intervention With Young PeopleWho Have Sexually Abused Others

Main Findings

Background

The Study

The Projects approach

Setting up the Project

Project Workload

Programme Components

Assessing Risk

Lessons and Ways Forward

A Project established in 1993 in a Scottish city receives referrals of young people who have sexually abused other children, and provides assessment, consultancy and direct work. This study, carried out in 1994-5, examines the Project's approach, procedures, clientele, and methods of assessing risk.
Main findings
The Project has worked predominantly with teenage boys. Its approach is influenced by a feminist view of sexual abuse, and it uses cognitive-behavioural methods, which involve the systematic challenge of attitudes which support abusive behaviour.
At the end of the first two years the project had received 43 referrals, primarily from social workers, after an initially slow start. About half of these had been dealt with on a consultancy basis.
Young people receiving cognitive-behavioural programmes were aged from 12 to 17, and had committed offences involving varying degrees of sexual contact, victims having included both younger siblings and children outside the family.
Many came from families with serious problems of emotional and material deprivation. Some families had complex histories of abuse and tended to be particularly difficult to engage.
Direct work, involving individual sessions, groupwork and family sessions, focused on young people accepting responsibility for abuse, victim empathy, parenting and victim protection in the family, building self-esteem and social skills, and relapse prevention.
It was common for disclosures of further abuse to be made during programmes, which had the effect of increasing the assessed risk and extending the planned length of programmes, such that none had been completed by the end of the study.
Background
The phenomenon of sexual abuse committed by children and young people has been recognised relatively recently. While understandings of the origins of the behaviour and of effective methods of responding to it are imperfect, the development of intervention has been fuelled by a growing awareness of the problem, and by the belief that adolescence is a critical period in the development of a pattern of sexually abusive behaviour.
A pioneering project working with young people who have sexually abused others was established in 1993 in a Scottish city by a national voluntary organisation in partnership with the local authority social work department. The Project receives referrals from local professionals, primarily social workers, carries out assessments, offers advice and consultancy to referrers, and provides programmes for young people designed to reduce the risk of further offending.
The study
The research documents the work of the Project at an early stage in its development. Information was collected from case records and by interview with Project staff and local authority social workers about the Project's general approach, its workload and the young people referred. Long-term outcomes were not addressed in the study, nor were the young people themselves interviewed. Four detailed case studies illustrate the challenge of working with this group.
The Project's approach
Project staff adopt an eclectic approach to understanding the causes of sexual abuse, but have been significantly influenced by feminist perspectives on sexual offending and by the cognitive-behavioural approach to intervention. In this they are broadly in line with much current thinking about what works with sexual offenders.
A feminist perspective would see sexual abuse as consistent with rather than in conflict with prevailing sexual norms, especially among adolescent males: abusive behaviour may not always be acknowledged as such, or it may be widely tolerated. Key features of the cognitive-behavioural approach include systematic challenge of young people's attitudes which support abusive behaviour, the development of their awareness of factors which trigger abuse in their own lives, fostering their social skills and teaching them techniques of relapse prevention.
The Project also seeks to engage young people's families in the work, in order to clarify parents' understanding of the behaviour of their children, to improve their parenting skills and to promote victim protection. Collaborative working with local authority social workers, who retain case accountability, is a key element.
Setting up the Project
The Project began its work in January 1993 with a professional staff of three. Its first year was marked by a lower rate of referrals than expected. Although this is not uncommon with new units, the Project team believed that it was in part due to a reluctance among practitioners to acknowledge the phenomenon of sexual abuse by young people. Measures were taken to increase awareness among professionals, and to ensure that referral to the Project was considered at child protection case conferences or planning meetings where perpetrators were young people. By the end of the second year of operation the Project was working to capacity.
Project workload
After two years the Project had received 43 referrals, predominantly boys aged 12 to 17. They had committed a range of contact and non-contact sexual offences, their victims including both siblings and children outside the family. The 'grooming' of victims and the planning of abuse were common features of their behaviour. Increasingly referrals concerned children in residential establishments. Families often had complex histories of multiple abuse.
About half of those referred had been offered programmes of direct work or were receiving assessment with the expectation that a programme would follow; the remainder were dealt with on a consultancy basis.
Programme components
Programme planning derived from careful setting of objectives at assessment and an estimate of the risk of reoffending.
Programme components included work directed at accepting responsibility for the offence, victim empathy, self-esteem and social skills, parenting and victim protection in the family, and relapse prevention. Objectives were pursued by individual work and groupwork, although the development of the latter was inhibited by the slow initial rate of referrals. Families with a history of abuse often proved especially hard to engage.
It was common for disclosures of previously unknown abuse to occur during programmes, which had the effect of extending the planned duration of intervention. Although it had been envisaged that programmes would be time-limited, none had been completed by the end of the research, the longest having lasted two years without the assessed risk having been reduced sufficiently for closure.
Local authority social workers worked collaboratively or jointly with Project staff. They valued this experience, but sometimes found it difficult to protect the time that had been agreed as necessary for the work.
Assessing risk
Procedures for assessing risk in the Project were based on those indicated by the literature, which suggests that 'clinical judgement' should supplement objective measures such as the standard tests or checklists advocated by some commentators. Risk categorised as 'high', 'moderator 'low'- was estimated at assessment and regularly reviewed. Because of new disclosures during programmes, assessed risk could appear to increase rather than decrease as work proceeded.
In the absence of reliable measures of long-term outcomes, the assessment of the risk of reoffending is the closest available approximation to a measure of effectiveness in a unit of this nature. No programmes having been completed, it is not appropriate to base an assessment of the Project's effectiveness on this measure.
Lessons and ways forward
While some difficulties facing the Project are inevitable in the process of establishing any innovative unit, others are rooted in the nature of the work and result in a number of tensions.
There is a problem of compliance with this group. The Project preferred to work with a mandate from the hearings system, but this did not necessarily ensure that young people attended regularly. It could also result in delays between incidents of abuse and the start of programmes.
The Project generates work relating to offenders, to families and to victims. It therefore straddles different social work systems and ways of thinking. It is essential that professionals and planners think clearly about the implications of this for allocating different tasks arising from the intervention.
The length and intensity of cognitive-behavioural programmes is a difficult issue, on which the literature is not helpful. Project programmes lasted longer than planned, mainly as a consequence of late disclosures of the full extent of offending. It may be necessary for the Project to review the frequency of sessions in order to address more speedily the problem of denial. When programmes are extended, it is Important to keep in mind the need to achieve effective outcomes.
Project staff stressed the need for raising awareness among professionals about sexual abuse by young people; for early discussion of potential referrals before decisions were made; for ensuring that the work of specialist units was embedded into child protection systems; and for improved training for staff applying cognitive-behavioural methods to work with sex offenders.
Wider-reaching questions raised by the research include that of risks to other vulnerable children posed by a residential home placement for young people who have abused others; the lack, notwithstanding, of satisfactory alternatives to such placements for those unable to live at home; the potential of alternative mechanisms for engaging parents, including the use of peer support groups rather than professionals; and the need for research to address the issue of long-term outcomes.
Maureen Buist and Roger Fuller
The study was conducted by the Social Work Research Centre at the University of Stirling. It was Jointly funded by the Social Work Services Group of The Scottish Office and Barnardos.
'A Chance to Change: An Intervention With Young People Who Have Sexually Abused Others', the research report summarised in this Research Findings, may be purchased (price £5 per copy).
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