INAPPROPRIATE SEXUAL BEHAVIOURS IN OUT OF HOME CAREACWA Conference19 August 2014

David Duffy MAASW MSW (PQ)Residential Clinician

© 2014 Life Without Barriers

Role of Life Without Barriers

Life Without Barriers’ family support and out-of-home care services include:

• Foster care• Residential care• Supported accommodation• Family contact• Case management• Education• Clinical services• Cultural planning• Family support• Transition support• Respite

Sexual Development

• Sexual behaviours begin to emerge in infancy• Overt behaviours peak between the ages of two and six

• Overt behaviours decline with age and re-emerge in adolescence

• Sexual development is an individualised process.

(Friedrich, 1997; Friedrich, 1998; Tarren-Sweeney, 2008).

Inappropriate Sexual Behaviour

Inappropriate sexual behaviour on the part of a child or young person includes, but is not limited to, sexual behaviour or activity that:

• places the person at risk

• places others at risk

• causes offence

• or impacts on the person’s social and community inclusion.

Complexity

• Young people in out of home care typically have complex maltreatment histories (complex trauma)

• Young people in Out of Home Care have a high rate of sexual behaviour problems, especially children and youth in residential care

• It may lead to more serious behaviour• Extreme reactions from carers and others

Consequences

Placement breakdown

Sexual exploitation

Re-traumatisation

Carer/family/peer stress and rejection

Disrupted attachment

School disruption

Legal system involvement

Challenges

• Lack of Australian research• No single definition of inappropriate sexual behaviour

• Misconceptions about inappropriate sexual behaviour

• Secretive nature of some sexual behaviour• The need for non-stigmatising responses• Few specialist services in regional and remote areas

TRAINING PROGRAM

Training Overview

• Target population: Carers of children 12-17 years of age with inappropriate sexual behaviours

• Training parameters: 2 x 3 hour workshops and a participant workbook

• Homework (optional): Homework is used to help reinforce the practices supportive of effective use

• Resources required: This program is implemented into an existing therapeutic environment that will have individual offices, group rooms, and administrative assistance

• Recommended provider qualifications: Bachelor’s degree with 2 years appropriate clinical experience in a relevant field

Training Goals

• Provide carers a practice framework• Prevent, eliminate or reduce the behaviours• Enhance documentation and timely communication

• Build attachment relationships• Reduce carer stress and reactivity• Increase carer understanding and behaviour support skills

• Increase collaboration and consistency in response from carers, young people and needed services.

Theoretical Foundation

• Adolescent development (Rich, Steinberg & Scott; Zimring)

• Childhood sexuality (Fredrich, Ryan)• Trauma (Briere, Herman, Perry)• Attachment (Bowlby, Fredrich, Rich, Schore)• Psychoeducation groups (Dixon, Marsh, Brown)• Functional analysis and positive behaviour supports (Horner & Sugai, LaVigna & Willis).

Training Modules

•Adolescent development

•Development of sexual behaviours

•Inappropriate sexual behaviours

•Sexual behaviours and the law

•Young people living in OOHC

•Risk factors•Cultural

considerations•Carer reactions•Consequences

Knowledge

•Information gathering

•Making sense of the behaviour

•Support strategies

Skills

How do we decide whether the behaviour is inappropriate?

Age appropriate

sexual behaviours

Concerning sexual behaviours

Very concerning sexual behaviours

(Ryan and Blum, 1994)

Information Gathering

• Sources of information

• Requesting further information

• Collecting behavioural observations

Making sense of the Behaviour

• While the behaviour may appear overtly sexual in nature, the motivation for the behaviour may not be sexual at all.

• Silovsky and Bonner (2003) argued that the behaviours may be related to natural curiosity, anxiety, imitation, attention-seeking, or self-calming.

Domains

Safety Stability

Wellbeing

How we can increase safety?

• Monitoring• Documentation and communication• Reporting risk of significant harm

How we can increase stability?

• Psychoeducation• Relationship building• Self Care

How we can increase wellbeing?

• Behaviour support• Referral to specialist supports

Putting it all together

Training Outcomes

22

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Where to next

• Continue evaluation• Training of trainers• Roll out across other sites• Systems to maintain skills• Establish reference group• Increase carer access• Widen target group.

Contact Details

• David Duffy MAASW MSW (PQ) Residential Clinician Life Without Barriers

• Email: david.duffy@lwb.org.au

• Phone: 02 6690 3500