BLOG PODS #48 - HSB Practice Lessons #1 - Bucking the System and Avoiding Knee-Jerks

INTRODUCTION

I’ve published a few things in my career so far; not a lot, but a few (see more here). But I never get tired of the buzz I feel when something new comes out!

This month, a chapter I co-wrote with Sharron Wareham was published in Cultural Responsivity (Book 1): Treatment of Sexual Violence.

I know - not one to leave around on the coffee table, right! :0)

Our chapter lays out 3 detailed case studies of children who’ve run foul of the law because of their harmful sexual behaviour (HSB). Sharron and I use these examples to highlight systemic failings and encourage responsive and sensitive practice that takes full account of childhood as a developmental work in progress.

Anyway, as I’ve been on on a roll writing about HSB, I thought I’d lay out some basic practice ideas that can help keep us from making these mistakes in our own work.

Check out the book on Amazon here...

Bucking the system

Despite huge progress over the last 25 years or so, work with children and young people who have displayed harmful sexual behaviour (HSB) still sometimes gets pulled towards risk management, control and, perhaps most of all, adult assumptions about intent and psychopathology.

Iatrongenic harm is still rife. All too often, reactions are still knee-jerk in nature. Tabloids still rush to stick children with adult labels. It’s still easier for the common mind to assume inherent pathology than it is to pause, look for longer and see the story behind the behaviour.

Most specialist practitioners navigate this work in an appropriately child-centred way. But the vagaries of wider systems like safeguarding and youth justice don’t always do so well. As we’ve said, knee-jerk reactions, defensive practice and, occasionally, assumptions about adult risk patterns, can wind things back to the bad old days.

The trouble is, when fear dominates, development gets lost - children are, by definition, developing, so we must do everything we can to keep HSB (as with every other kind of ‘offending’ behaviour in kids) firmly in the child first zone.

Simply put, our chapter argues for something simpler and more demanding than easy tropes and regressive risk ideas: we need to understand sexual behaviour in children through a developmental and trauma-sensitive lens, not a criminal one.

What follows are some practice lessons for anyone working with children and young people where HSB is a concern - especially those who share our passion for bucking a system that doesn’t always serve these kids-or the public good-very well.

HSB Practice lessons

I’m going to lay out the first four here and then complete the list with five more next week.

1. Keep in mind that age is not the same as maturity

Chronological age tells us very little about a child’s actual capacity.

The baseline maturational processes of brain development, particularly the complex stuff around executive functioning, doesn’t complete until much later than was previously thought. ‘Brain childhood’ continues well into the mid-20s with some studies now saying as late as 28 years old.

Trauma, neglect, abuse, neurodiversity and disrupted education can significantly delay this development such that children may possess much less capacity to understand their impulses and control their behaviour than their number of trips around the sun might suggest. Age does not equal maturity!

Physical appearance often masks emotional, cognitive and moral immaturity. Many 15 year olds look like they’re 20; but many of them may be delayed in their development and functioning like primary school kids. Add to this the biologically turbulent and mesmerising forces of pubescence and things get tricky pretty quickly.

For me, the best thing to do here is to pause, step back, take time to properly scan the long view for this child, manage the risks and then begin the work of encouraging some developmental course corrections to get things back on track.

💡 Practice lesson summary: Never assume understanding, intent or responsibility based on age alone. Functional maturity must always be assessed. Current functioning is best seen in light of the child’s journey so far - which is why, in my view, life-course case formulation must be central to all assessment processes.

2. Harmful sexual behaviour is often developmentally ‘out of sequence’

When children show sexual behaviour that is clearly outside what would be expected for their age, something has usually gone wrong earlier in development. This is one of the many things I’ve long learnt to assume is happening - i.e. I screen it in until I have good reason to screen it out.

Many children with HSB have learned about sex too early or in unsafe ways. For example:

Being eroticised early due to long, frequent and severe exposure to pornographic material long before they have anything near the maturational wherewithal to filter and understand it.

Having grown up being abused sexually (and/or in any other way) such that the child’s concepts of care, relationships, adult behaviour and their own role in the family are terribly skewed.

Sexual behaviour may reflect copying, confusion or survival strategies rather than sexual intent. In my experience, there is almost always some element of abuse-reactivity going on - why wouldn’t there be?

When it comes to sexual behaviour that is out of sequence, pre-pubescent sexual behaviour is particularly significant and should never be dismissed. It’s very presence alone-nevermind the details of type, severity, frequency, etc.-should be enough to sound the alarm.

💡 Practice lesson summary: If behaviour doesn’t fit the child’s developmental stage, the key question is not, ‘what did you do?’ but ‘what happened to you?’ Ask yourself questions like: why does this HSB make sense for this child, what role does it play for them, where did they learn it in the first instance and how do they feel before, during and afterwards?

3. The victim–perpetrator split is a false one

Systems often divide children into two camps:

the harmed child, seen as vulnerable and deserving of care

the harming child, seen as risky and responsible

It’s this latter group that most often fall foul of adultifications and over-reactions.

I’m with Anne-Marie McAlinden here, that this split is a false binary that is deeply misleading at a conceptual level and completely unhelpful at a practice level. Even if we were in possession of all the necessary information to determine whether the weight of a child’s behaviour places them more in one camp than the other, what would it achieve?

What matters here is how this child got to this place, what meaning this has for them and those affected, and what we can usefully do to mitigate all this and move forward.

Children who cause sexual harm often have their own histories of abuse, neglect or exploitation

Protecting one child while ignoring the needs of another increases long-term harm, labels the ‘offending’ child (obviously!) and may actually increase future problems - not least if the child’s sense of who they are begins to form around what they’ve done.

A child can pose risk to others and be at risk from others. They can do things that are harmful and simultaneously be frightened, unsafe and traumatised - to split the two is to split the child. We should be working for coherence and a positively unified sense of self, not a clearer label to satisfy some vacuous and utterly useless systemic taxonomy!

💡 Practice lesson summary: Safeguarding and treatment must include all of the children involved, including those whose behaviour is causing harm. Keeping in mind that the reason they are now causing harm is almost certainly fuelled by the harm they themselves have endured at the hands of others, is key here. Let’s reject the victim-perpetrator split as an unhelpful falsehood.

4. Behaviour has a function, even when it is harmful

Sexually harmful behaviour in children is rarely about sexual pleasure. Pre-pubescent kids may well experience physical pleasure in bodily contact, but this is manifestly not the same thing as adult sexual sensation - because it lacks the maturity of thought and meaning, it lacks context and reciprocity.

Our problem, as adults, is that we can struggle to assimilate our own associations of sex and pleasure from abusive behaviour that is sexual. So we ask understandable but nevertheless nonsensical questions like: ‘how can they possibly get any pleasure from doing that to someone?’

Wrong question.

A better one, in my view, is to ask where the behaviour might have originated and what function might it have for the child now (if any).

Sexual behaviour in children, particularly in those with sexualised histories of one form or another, often serves other purposes, such as:

regulating fear, anxiety, distress or other difficult feelings

gaining a sense of mastery (over the self or their feelings or over others)

seeking connection, reassurance or attention

reenacting learned and skewed relationship patterns, messed-up displays of affection or downright abusive behaviours

Whether we’re assessing or treating, having a sense of how the child ‘sees’ the behaviour, what their expectations of it are and how they learned it (origins!) it critical.

Personally, I would always want to ask: what did you think would happen (if you did this), how did you think the other person would feel when you did this and where do you think you learned this behaviour from? Or some such.

Obviously when and how we ask these questions is based on our understanding of and relationships with the child concerned - timing is everything.

💡 Practice lesson summary: Assessment must explore what the behaviour does for the child and where it came from, not just what it does to others and how to stop it. Having a focus on behavioural function helps with this.

What good HSB practice with children looks like

Across the book chapter, and more so in this post, I’ve tried to summarise what effective HSB practice consistently involves. Here’s a bullet-point distillation:

- being mindful of how systems confuse children and responses to HSB

- take care to avoid unhelpful terminology

- remember age doesn’t equal maturity

- maintain a child-first, trauma-sensitive stance

- push for developmentally sensitive formulation-based assessment

- manage risk, don’t judge the child

Final thoughts

Children and young people who display harmful sexual behaviour are not telling us they are dangerous. They are telling us that their development has been disrupted, needs have gone unmet and they need our help to sort through it all and begin moving on.

If we respond with fear, punishment and labels, we risk reinforcing the very conditions that shaped the behaviour in the first place. For us, we must strive to ‘see’ the child themselves and, preferably, take the long view of how they came to where they are now - who influenced that journey, who disrupted it (and how) and where has that left them in terms of relationships, knowledge and readiness to navigate a complex sexual world.

If we respond with curiosity, compassion and developmental understanding, we can create the conditions for safety, recovery and change - all the time using our relational skills to engage the child with warmth, acceptance, good humour and empathy.

That is not being soft on harm. It is being serious about healing now and prevention later. Five more practice lessons coming in the next post.

See you in the next one.

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More information:

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BOOK: For a great book covering the range of issues around HSB in much more depth, see the excellent: Allardyce, S. & Yates, P. (2018) Working with Children and Young People Who Have Displayed Harmful Sexual Behaviour (Protecting Children and Young People). Dunedin Academic Press. (Link)

WEBSITE: The CSA Centre for expertise has a brilliant website - it’s a mine of information on all aspects of sexual abuse (link); there’s also good information of HSB there, too; check it out here (link)

BOOK: Cultural Responsivity Book 1: Treatment of Sexual Violence (Ours is chapter 4 - link)

BOOK: Children as ‘Risk’ - Sexual Exploitation and Abuse by Children and Young People by Anne-Marie McAlinden (link - this is a corker!)

PREVIOUS POST: For more on moral development see Theory Bites 6a - Lawrence Kohlberg’s theory of moral development (link)

JOIN NOTA: Thus is the U.K.’s only professional affiliate organisation supporting those working with sexual abuse - it’s brilliant. Check it out here and I hope to see you at the next event (link)

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