Duffy

Report
INAPPROPRIATE
SEXUAL BEHAVIOURS
IN OUT OF HOME CARE
ACWA Conference
19 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
Legal system
involvement
School
disruption
Disrupted
attachment
Sexual
exploitation
Re-traumatisation
Carer/family/peer
stress and
rejection
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
Knowledge
Skills
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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
• Information gathering
• Making sense of the behaviour
• Support strategies
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
Where to next
Sub copy to go here
• Continue evaluation
• Training of trainers
• Roll out across other sites
• Systems to maintain skills
• Establish reference group
• Increase carer access
• Widen target group.
22
Contact Details
• David Duffy MAASW MSW (PQ)
Residential Clinician
Life Without Barriers
• Email: [email protected]
• Phone: 02 6690 3500

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