Tackling and preventing inter-partner abuse in young people through evidence based relationships and sex education

By Sophie King-Hill, Ph.D., & Kieran McCartan, PhD.

Editor’s note: This is an extended version of a blog post by the authors for the conversation - Kieran 

A new report by the Youth Endowment Fund (YEF) has demonstrated that 49% of children and young people aged between 13-17 have experienced violent or controlling behaviours when in a relationship. This is based on a survey of 10,000 young people in England and Wales, of which 27% have been in a relationship in the past year. The survey outlines that children and young people who are excluded from school, those who are involved in gangs and/or exploitation, those with special educational needs (SEN) and those supported by a social worker are at higher risk of experiencing inter-relationship violence and control. The violent and controlling behaviours include forced sexual activity, physical violence, causing fear of breaking up and/or disagreeing with a partner, and explicit content of themselves being shared online. Additionally, 27% of the sample stated that they had experienced threats or images of sexual assault and 33% had been exposed to content involving violence against women and girls.

The importance of Prevention

The findings of the study paint a concerning picture as to the position of young people in England and Wales and highlights the reality that enough is not being done in relation to prevention and early intervention. Evidence highlights that effective prevention of harm and abuse is important in all domains of life and that with the correct knowledge, skills and intervention proactive work can be carried out to reduce the risk and impact of social harms. Current policy and practice guidance argues that there needs to be better integration between health and justice so that a developmental, life-course approach can be taken to understanding social issues and deliver the correct intervention to the right population in the most appropriate ways. Therefore, consideration needs to be given different populations are engaged with, underpinned by evidence. In the context of young people and peer harm and abuse it means hearing and valuing the voice of young people so that relationship and sex education suits their needs, is grounded in their lived experiences, and helps them safeguard themselves and others. However, many current policies and resources on the prevention of sexual abuse are focused on adults (see 2PS, ECPAT and EU for more information) but this focus is starting to shift to include and talk to CYP about their problematic and concerning behaviour (see Moore centre and Lucy Faithful Foundation, Together for Childhood for more information).

The findings also highlight that violent and controlling behaviours are embedded in a complex intersection of issues requiring multi-level solutions. Although this is not a new idea, it is important to reiterate. Further, it encourages us to think about our responses to violent and controlling behaviours across all levels of society (i.e., individual interpersonal, community, societal) and across all the populations within society, and how best to deliver these messages and interventions. A key aspect of addressing these issues is through robust, evidence-based, relationships, sex and health education. The Youth Endowment study also demonstrated that these were lacking, with only 55% having lessons on consent and only 40% having education on healthy relationships and recognising unhealthy relationships. It is important to recognise that while the content of the relationship and sex education is important, equally important are the skills and knowledge of those delivering the education.

The importance of relationships and sex education

It is evident that we are failing many children and young people through the lack of robust, incremental, research-based education on sex and relationships. Research in this area demonstrates that many children and young people are receiving education on sex and relationships that is too little too late, and schools are teaching students what they already know. Only 39% of children and young people in the Youth Endowment study who reported experiencing violence and controlling behaviour stated that they had received sessions on consent, with only 31% of this subgroup receiving sessions on sexual harassment. This is in the context of the 2021 Ofsted rapid review (involving interviews with  900 pupils in England, who reported that sexual harassment is a common aspect of school life for a majority of pupils) and the Everyone’s Invited website, which has received over 50,000 testimonials of sexual harassment and violence in schools since it began in 2021. Additionally, over half of the 106,984 child sexual abuse cases recorded across the 42 police forces in England and Wales in 2022 where offences committed by young people aged between ten and 17; which was a rise from the previous year previous figures.

Recommendations

First, it is important for educators to involve parents and carers in these conversations to ensure that consistent messages are being received across the school and home contexts.

Schools and educational establishments need to create safe spaces for learning and open, frank conversations with children and young people about both healthy and toxic relationships. These can be both formal sessions and informal learning contexts but must be centred around non- judgemental approaches. This can be fostered through group agreements that encompass both the young people and the educators.

Bystander intervention is another approach that has gained traction in public discourse in recent decades. However, this must be considered carefully, as young people can risk putting themselves in psychologically and physically damaging situations. Additionally, most bystander intervention programs are designed for the physical environment and with children and young people living their lives across online and offline environments what does an online/digital version of bystander intervention look like.

 

More work need to be completed with young men and boys as some of the highest reports of sexual abuse and violence comes from girls aged 15-17 and carried out by men and boys. This needs to be carried out with the best interest of all genders in mind and to be free from blame and judgement, rather including young men and boys in being part of the solution and teaching them aspects that they need to know. It is also useful to be aware that the term 'violence against women and girls' immediately takes boys out of the discussions around being victims of all forms of violence themselves.

The changing landscape of children and young peoples relationships

Understanding the seamless interplay in the online and offline worlds for young people should also be at the forefront of sessions on healthy relationships. This learning, by professionals can only come from the perspectives of children and young people themselves. One of the most important aspects of approaching sessions such as these are the voices of young people, who are experts in both the digital and non-digital world around them and how these two aspects interconnect and what they need from professionals to understand and negotiate these worlds. With the introduction of the Online Safety Act over the next year there is an opportunity to do some more development in this area and really understand what online support looks like and how problematic behaviours transition across the real world/digital world interface. With the development of services, like Shore by the Lucy Faithful Foundation, we can see that professionals and policymakers are starting to develop resources for the prevention of sexual abuse ion CYP.

Conclusions

What is clear is that what we are currently doing is not working and many children and young people are suffering as a consequence. Early, robust, young person-led relationships, as well as health and sex education can be a vital step to reducing the adverse outcomes seen in the YEF report. The challenge that the YEF report indicates that engagement and work in this area needs to move forward. Byn taking a public health approach conversations can be opened up in new and different ways that allow us to think outside of the box and do something innovative. For too long the conversation about relationships and sex education has been separate to other aspects of the lives of children and young people. Young people need to be spearheading work in this area, supported by professionals, to ensure positive outcomes in all areas of relationships and sex.

 

Methodological Differences in Risk Assessments

 By Sharon M. Kelley

Sand Ridge Secure Treatment Center – Evaluation Unit, Madison, Wisconsin

A few years ago, at a conference in Australia, Katie Gotch, MA, LPC asked me how I would characterize my research. I replied, “Things that annoy Sharon Kelley.” A joke of course but with some level of truth since there are questions I have had to answer in court but did not know (e.g., what is the rate of undetected sexual offending?). I would characterize the focus of my research as best practices in risk assessment. As part of this, I have published and co-published articles on static and dynamic risk tools, protective factors including the Structured Assessment of Protective Factors against Sexual Offending (SAPROF-SO), undetected sexual offending in risk assessment, practical guidance in applying time free and long-term risk estimates, and potential differences in evaluators’ judgment outside of empirically predictive factors. I suppose when some professionals are persistently not attending to best practices in the field, I can sometimes find this annoying, too (I am not a perfect human). This is not to say people cannot have different opinions than me. Absolutely. Which risk tool is better for a particular population or referral question? That is certainly debatable. When is a brand-new methodology ready for use? It certainly depends on a variety of factors (e.g., Does it need to meet admissibility standards in court? Is one using it for a treatment needs assessment versus an assessment that considers the ultimate risk probability?) There are plenty of issues still arguably up for debate especially in certain contexts. Where I struggle is around issues, which I believe have been previously debated for the past decade, and where there are undoubtedly sufficient empirical studies that should largely resolve the argument, and still the dead horse in not yet in the ground. I would like to talk about some of those issues.

Not Using a Measure of Dynamic Risk

There was some discussion of this in professional circles recently, and I want to expand on this discussion. The meta-analysis by Mann et al. (2010) on dynamic risk factors / criminogenic factors / psychologically meaningful factors was, by all accounts, an important and oft cited study. According to Google Scholar, it has been cited 1,326 times since the article became available. At the time the paper was written – over a decade ago – the authors noted that formal measures of dynamic risk factors (DRF) were “still sufficiently underdeveloped that important questions remain concerning the conceptual foundations of these scales, whether they target the most relevant factors and the extent to which it is possible to associate recidivism rates with specific scores.” This made sense in 2010; tools like the STABLE-2007 and VRS-SO had only been in circulation for a few years and did not offer the type of norms and validation studies they have now. It was also important to explore any potential DRFs that had insufficient studies when earlier meta-analyses were conducted. However, the Mann et al. (2010) article was never meant to replace a formal measure of dynamic risk. Indeed, the authors make the final conclusions:

First, evaluators should avoid being overinfluenced by the presence of any single risk factor, however floridly manifested. Second, only relatively comprehensive assessment of a range of psychological risk factors will make it possible for this kind of assessment to have useful predictive power. Third, this is precisely the kind of situation (a relatively large number of risk factors, each making only a small contribution to prediction) in which mechanical integration of risk factors can be expected to outperform human judgment (Kahnemann & Klein, 2009).

The authors were directly telling us not to use this paper in lieu of a formal risk tool. As the authors alluded to in their conclusion, using an “empirically-guided” approach to risk assessment involves the evaluator attending to the risk factors listed in the Mann et al. (2010) article but assigning their own definition and coding instructions to the factor as well as its predictive weight and importance. There is no reliability between evaluators, no reliability within evaluators (i.e., the same evaluator can be inconsistent in how this is applied between cases), no known predictive validity, and no known error rate. Further, evaluators can be unduly influenced by one or two factors despite the Mann et al. (2010) article clearly specifying that none of these factors are hugely predictive by themselves or “super factors.” Meanwhile, there are well established and validated mechanical instruments that measure DRFs. This includes studies in a variety of samples, independent validation studies, published test manuals, known error rates, general acceptance in the field, and sufficient reliability and validity. Why professionals opt for a method that has been shown to be less predictive and potentially more fraught with problems and influences not related to prediction (e.g., differences among the evaluators themselves) continues to puzzle me.

Double Counting Risk Factors and Clinical Overrides

The second issue I sometimes see is when evaluators use a formal measure of DRFs but override the result. This is done in one of several ways. First, the evaluator will identify a clinical factor that appears especially important in the treatment needs/risk profile and see it as needing to have additional predictive weight to account for its perceived importance. Take, for example, an individual who is demonstrating a high sexual drive, which raises concerns. The evaluator scores the Static-99R and a DRF tool like the STABLE-2007. The evaluator assigns high scores (2) for both Sex Drive and Sex as Coping among several other items relevant to risk. When integrating the Static-99R and STABLE-2007 scores, the evaluator finds the individual to be in the average risk range. Yet, in the evaluation report, the evaluator concludes that this is likely to be an underestimation given that the individual is preoccupied with pornography and has a high rate of masturbation in their current setting. This might also be linked to the individual having a high sexual drive at the time of past sexual offenses, so the evaluator specifies this is especially risk relevant. What the evaluator is doing is using the relevant data that justifies giving the individual a score of “2” and then adding the same data as if it is a separate risk factor that will incrementally contribute to risk. There is no empirical study I can think of that would support this methodology. Here the evaluator is treating this as a “super factor,” even though Mann et al. (2010) found no such evidence of super factors.

Second, the evaluator will identify the person as having “unique” features outside the tool’s sampling frame (aka the individual is a “black swan” which justifies an override. This is usually done for men over the age of 60 for whom the evaluator continues to see as risky and not aging in a “normal” manner. The conclusion is to disregard the protective effect of age, which has otherwise been repeatedly identified as an important predictive variable even when the index offense occurred when they were in their 60s (see Jeff Sandler’s work). Without diving too deep, any conclusion by the evaluator that their case is unique should be done rarely, with caution, and with good justification. If one is finding “black swans” frequently, it’s probably not a black swan. 

Third, when considering clinical overrides, this should be well justified. Sometimes overrides are understandable. Within their ATSA Forum article (2021, Vol. 34, Issue 1), Hanson and Thornton mention exceptional factors or Meehl’s broken leg factors that could invalidate actuarial assessments. This includes “clear evidence that the individual has decided to reoffend” or is imminently at risk for reoffending. This can include actively setting up an offense that would happen imminently or making statements about intention to reoffend. A clinical override should not be used because the individual is demonstrating DRFs that are already captured in a formal dynamic tool.

Evaluators may wish to disagree with me. Perhaps they might argue that clinical judgment separate from scoring DRFs is of critical importance in risk assessments and provides predictive value above and beyond formal tools. However, since a succession of studies have found clinical overrides not to improve prediction, the person making this clinical judgment needs to show why their clinical judgment is far superior to other clinicians. 

Overall, the impact of evaluators relying on empirically-guided clinical judgment or “super factors” when completing high stakes assessments is potentially far more concerning in court than contending with admissibility issues related to established DRF tools like the STABLE-2007 or the VRS-SO. Evaluators appear to have internal differences that contribute to risk assessment conclusions especially when using less structured techniques (i.e., research by Marcus Boccaccini and Daniel Murrie among others). Rachel Kahn, myself, and others at Sand Ridge found this includes over-weighting risk factors as well as factors not empirically related to risk. Further, we found that some evaluators tend to be more risk-sensitive despite available base rates of sexual recidivism. As a result, the assessment outcome was best predicted by the evaluator assigned to the case. Risk assessments, especially in high stakes settings, should not be about the luck of the draw. After more than a decade of research, we can do better.

Addressing Harmful Sexual Behavior in Youth: Insights from the NL-ATSA Conference

By Minne De Boeck, Nina Stalpaert, Zohra Lkasbi, & Kasia Uzieblo

Sexual offenses committed by young people often remain underexplored in the forensic field. However, addressing this issue is essential due to significant differences between adult and youth offenders, including the underlying characteristics, motivations, recidivism rates, and treatment needs. To spotlight this critical topic, NL-ATSA, the Dutch-speaking association for the prevention of sexual offenses, organized a specialized conference on November 7, 2024, at the University of Antwerp. The event focused on individuals under 23 years old who have exhibited harmful sexual behavior (HSB). Both national and international experts shared their knowledge and experiences on the prevention, guidance, and treatment of these individuals.

Youth and Harmful Sexual Behavior: Prevention and Treatment

Stuart Allardyce, Director of Research at the Lucy Faithfull Foundation and Stop It Now! UK and Ireland, opened the conference with a presentation on prevalence rates and the unique characteristics of this group. Global studies reveal that 18% of girls and 7.6% of boys report being victims of sexual abuse, with a significant portion—between one-third and half—of these offenses committed by minors. Allardyce highlighted key patterns within HSB cases: Most offenses are committed by boys, many of them have experienced abuse themselves, victims are predominantly girls and the majority occur within domestic settings.

Not all HSB qualifies as abuse; one-third falls into the broader category of inappropriate behavior. Interestingly, there is limited overlap between adolescent and adult sexual offenders. Adolescent behavior is often situational and opportunistic rather than rooted in deviance, although persistent adult offenders often begin in adolescence.

Allardyce underscored the profound impact of HSB not only on victims but also on the young offenders and their families. Crucially, he stressed the importance of recognizing these individuals as children first. This necessitates a holistic and child-centered approach tailored to their developmental stage. He advocated for avoiding stigmatizing labels like "young sexual offenders," instead referring to them as "young people exhibiting harmful sexual behavior."

Despite research indicating low recidivism rates for new sexual offenses among youth, these individuals often struggle with forming healthy relationships and achieving stability later in life. Effective interventions should, therefore, not only aim to reduce recidivism but also focus on broader developmental goals and the overall well-being of these youths.

Allardyce outlined several key principles for effective interventions:

• Trauma-informed and systemic approaches;
• Contextualized support;
• Prioritization of the young person’s broader development;
• Strong relationships between professionals and young people, as genuine care and active listening foster trust;

·       Ongoing aftercare to address challenges these young people may encounter later, such as in relationships or the workplace;

Preventive measures, including comprehensive sexual education and early identification of risk factors—such as past victimization, antisocial tendencies, poor sexual boundaries, and problematic pornography use—are equally critical to addressing HSB in youth.

He also emphasized the importance of self-care for professionals working with this population to maintain their capacity for support.

Recidivism and Desistance in Young Sexual Offenders

Chantal van den Berg, criminologist and researcher at the University of Amsterdam, presented her extensive longitudinal research (>20 years) on youth sexual offenders. Her study explored the factors contributing to sexual delinquency, their lives following the offense, and the impact of stigma and social context.

Van den Berg’s findings challenge the stereotype of the chronically reoffending young sexual offender. Over 20 years, only 7.7% of the studied individuals reoffended sexually. Familial factors, such as upbringing and substance use, alongside personal traits like low self-esteem, were significant contributors to delinquent behavior.

Among recidivists, those who reoffended sexually often had a history of similar offenses, while non-sexual recidivists tended to commit a broader range of crimes. Stigma and social context, including responses from parents and schools, played a substantial role in their trajectory. Parents often reported difficulties with constant monitoring but appreciated treatment efforts despite the challenges.

Van den Berg stressed the importance of interventions addressing both individual traits and the social context to prevent recidivism effectively.

Practical Approaches in Treating Harmful Sexual Behavior

The youth team from I.T.E.R., a Flemish treatment center for sexual deviance and prevention, presented their structured approach to addressing HSB in residential settings. Their method, referred to as “the sex reflex,” revolves around:

1. Encouraging open conversations about sexuality;
2. Supporting the healthy sexual development of youth;
3. Appropriately responding to problematic or harmful sexual behavior.

The approach balances safety with allowing space for exploration and emphasizes a positive perspective on sexuality. It also involves creating safety plans to guide recovery following incidents, helping professionals foster secure environments. Regular evaluation of interventions ensures they remain clear, concrete, and future-oriented.

Self-care for professionals, multidisciplinary collaboration, and fostering the youth's perspective are also central to this approach, which aims to build confidence and reduce apprehension in addressing HSB.

The Viersprong, a Dutch specialized treatment center for people who exhibit personality disorders, shared their application of Multi-Systemic Therapy for Problem Sexual Behavior (MST-PSB). This family-centered therapy focuses on creating safety, fostering accountability, and restoring family dynamics. The approach involves identifying risk factors, creating safety plans, and fostering acknowledgment of the behavior by both the young person and their family. Where appropriate, reunification with victims may also be facilitated. MST-PSB has shown promising results, including reduced recidivism, fewer out-of-home placements, and improved parenting skills.

Conclusion

The NL-ATSA conference highlighted the importance of a holistic approach to addressing harmful sexual behavior in youth. Such interventions must focus on the development and recovery of the young person, prioritizing both recidivism prevention and their overall well-being. Central to this is a systemic understanding of the individual’s context and the challenges they face. By fostering supportive environments and emphasizing developmentally appropriate, trauma-informed care, we can create pathways for young people to heal, grow, and build positive futures.

 

Helpful Ways (Hopefully) to Think About Sexual Abuse Prevention

By Joan Tabachnick & David Prescott

It’s no secret that ATSA has become increasingly focused on its role in preventing sexual abuse. Plenary addresses at the ATSA conference in the early and mid-2000s urged attendees to think about and describe themselves as involved in prevention efforts. Within recent years, ATSA changed its name to the Association for the Treatment and Prevention of sexual abuse (while keeping the familiar ATSA acronym). At this year’s conference, prevention was central to nearly all the plenary addresses. Prevention is an idea whose time has come.

Within ATSA, we typically talk about prevention from a public health point of view.  We speak about primary, secondary, and tertiary prevention.  This powerful framing allows us to consider preventing sexual abuse both before and after someone has been sexually harmed.  It means that all of the work of ATSA and its members is prevention. 

However, we wanted to also offer insights into criminal justice approaches to prevention.  ATSA members are often inextricably tied to criminal justice systems and yet we don’t typically use criminal justice language and approaches when we talk about prevention. 

While there are huge similarities between public health and criminal justice approaches, the differences allow us to amplify other methods.  It can also be helpful to be “bilingual” in discussing these so that we can use the language that is most often familiar to the people we want to fully engage.  In particular, Welsh and Farrington identified two critical approaches to prevention within a criminal justice framework:  Situational prevention and Developmental prevention.  Within a public health framework and the ecological model, these two approaches would refer to the middle two layers – a relational approach and a community approach – both allowing for interventions before anyone is harmed and before someone engages in any problematic sexual behaviors. 

A recent article published by the US National Institute of Justice (and authored by Joan) dives into these criminal justice approaches to prevention: 

Briefly, the goal of situational prevention is to reduce the opportunities for a crime through systemic rather than individual strategies.  It explores the settings to look at factors that increase or decrease the likelihood of someone committing a crime.  It makes common sense.  Why put someone into a setting that encourages or at least does not discourage a behavior?  An extreme (but familiar) example is hiring someone with an active alcohol addiction as a bartender in their local bar.  Perhaps a more common example is to offer parking on campus to freshman, the most vulnerable on campus, furthest from their dorms.  This approach to sexual violence prevention has gained traction for many youth serving organizations as well as campuses. 

In very stark terms, ATSA looks at the complex differences in individuals who have engaged in sexually abusive behaviors or are at risk to do so.  Our mantra is to look at the wide diversity in the people who have committed a crime.  This approach also demands that we look at the environment surrounding that individual – not to take away their responsibility but to offer better opportunities to change their behaviors. 

Developmental crime prevention aims to stop the development of harmful sexual behaviors in children and adolescents in response to risk factors and risky behaviors.  What we do know is that children and teens are more receptive to interventions and will naturally have fewer static risk factors.  Because sexually problematic behaviors often emerge in early adolescence, this is a particularly promising age to intervene.  Programs have been developed to help identify children or teens with a higher number of risk factors.  Programs have also been developed to look at the family systems and intervene earlier to address a high number of risk factors within that family and thereby shifting the balance of risk and protective factors for those children and teens. 

Although further research is needed, both of these approaches have considerable evidence that these are promising practices for our field.  While we can all recognize that we can’t arrest ourselves out of sexual violence alone, having each of our various disciplines committed to preventing is a landmark shift in our approaches. 

Whatever our first language (criminal justice or public health), having a solid grasp of these prevention concepts can take us a long way on our journey towards healthier lives and safer communities for all!

 

Evidence to the Northern Ireland Education Committee on Relationship & Sexualities Education

By Sophie King-Hill, PhD

Editor’s note: This is a transcript of part of Dr King-Hills evidence  to the Northern Ireland Assembly Education Committee mini-inquiry into relationships and sexuality education (RSE) on the 13th November 2024. This evidence focussed on three core issues in RSE. The importance of youth voice in RSE, RSE as a means to prevent child sexual abuse and harmful sexual behaviour in all its forms and the importance of working with boys and young men to support better outcomes for all genders. 

A recording of the proceedings, including the question and answer session can be found here –Committee for Education Meeting, Wednesday 13 November 2024 - Northern Ireland Assembly TV. Kieran

Introduction

I am an Associate Professor at the University of Birmingham in the Health Services Management Centre. My research is focussed on sexual behaviours and assessment in children and young people, sexual health, misogyny, masculinity, relationships & and sex education and the importance of youth voice. Much of my work is cross-sector, cross-disciplinary and centred around participatory and co-design approaches with young people. I have researched and written extensively about sibling sexual behaviour and abuse and led half of the research for the Home Office and Ministry of Justice funded National Sibling Sexual Abuse Project in England and Wales. I have carried out research in a number of fields that link strongly to RSE, for example Incels (exploring online extreme hatred of women), young men and boys and designing resources for schools with young people on Relationships and Sex Education (RSE). I have been an academic for 10 years and I think it is useful to highlight to the committee that I used to work within the third sector. I was the national impact co-ordinator for a leading young persons sexual health charity, used to teach RSE in schools to all ages and and prior to that I worked with teenage parents. These young parents were some of the most inspirational young people I have ever met – and this work demonstrated to me, over 20 years ago, the importance of relationships and sex education and its link to the choices that young people make. I am going to focus upon three components of my work: Young peoples voices, the importance of RSE to safeguarding children in relation to the prevention and early intervention of child sexual abuse in all its forms and the importance of working with boys and young men for the better outcomes of all genders.

Young peoples voices

The research that I have carried out demonstrates that young people are eager to be involved in the design and delivery of the RSE that they need. By doing this schools and leadership teams can ensure that the RSE that is provided is fit for purpose and supports the children and young people in negotiating and making sense of the world that they live in. Consistently young people are telling us that they are being taught what they already know. They also tell us that because of poor RSE they are using other means to learn about relationships and sex. The majority of this learning comes from the internet. This includes going to pornography or various social media platforms or discussion forums. These platforms and forums can be incredibly informative and positive or incredibly damaging and negative. This aspect also links strongly to the opt out aspect of RSE for parents. This is incredibly dangerous. It does not mean that children and young people are not getting information on relationships and sex, it means that they will get information however this may be diluted off their peers or from flawed internet sources. I would also like to highlight here that my research is not stand alone and echoes a wealth of research from a number of fields in this area.

 

I do appreciate that tangible examples are needed of how this may look. Leading RSE with young peoples voices can be carried out by involving children and young people in session planning, school policy design and evaluation. Participatory approaches also support teachers, parents and schools leadership teams in understanding the landscape that children and young people have to negotiate in modern society. This approach works well and ensures that all children and young people can flourish. Children and young people are not passive in their learning, they have agency, and professionals need to work with them to ensure good, robust, realistic and supportive RSE can take place that meets their needs.

 

In relation to this more work with parents and carers does need to take place. It needs to be acknowledged that many parents and carers are not comfortable talking with children and young people about RSE. With this we have to be supportive and bring parents and carers in to the schools to understand the research that underpins good RSE and how it protects, rather than harms, children and young people. In the same vein teachers and educators need to be extended the same understanding in a whole school, proactive approach to RSE.  Good, robust and evidence based training is crucial for teachers and there also needs to be an avenue for them to state when they feel they cannot teach aspects of RSE. As my research with children and young people clearly indicates - if a teacher is uncomfortable teaching certain sessions then no deep learning will take place. It is useful to note that early, evidence based RSE does not encourage sexual activity and abstinence education does not work, this approach fosters shame and shuts down important dialogue. Good RSE has been shown to delay sexual activity in young people by supporting informed choices. This is not only echoed in my research but that of the Sex Education Forum, UNESCO and the National Institute for Health and Care Excellence for example. Despite this evidence, education on developmentally appropriate sexual behaviours in Children & Young People (CYP) is still fraught with issues due to the perceptions of sexual behaviours and the position of CYP and how they are perceived in wider society. However, it is vital to keep in mind that CYP are entitled to robust and evidence based RSE that can support them to negotiate the sexual world around them and make informed decisions about their own sexual behaviour. Schools also require flexibility when responding to urgent contextual needs of children and young people - the sharing of pornography for example. Evidence clearly indicates a need to be led by the context into which the RSE is situated, underpinned by the perspectives of children and young people. Not accounting for this can create inadequate learning environments and prevent the urgent needs of children and young people being met.

 

Safeguarding

Robust, incremental and well planned RSE can also be the first step in combatting and reducing child sexual abuse, sibling sexual abuse and behaviour, child sexual exploitation and harmful sexual behaviour in children and young people. My research and that of others makes a clear link as to why robust, evidence based RSE can work as a vehicle for encouraging young people to engage with safe adults in their lives which fostering early reporting of experiences of harm and abuse. Inhibiting RSE is proven not to work and results in barriers to reporting and compromises safeguarding. Children and young people are more vulnerable when information, concepts and education in RSE is hidden from them. The school should be a safe place to raise awareness of what abuse is and to model healthy relationships. All aspects of harmful sexual behaviour and child sexual abuse can be prevented and recognised early though good, realistic and well taught RSE. An example of this can be seen thought the National Sibling Sexual Abuse Project in England and Wales where I co-led the research. This project found that sibling sexual abuse and behaviour was often contextualised in a dysfunctional family setting and that a large proportion of reporting took place when the survivors were adults. This was due to the lack of recognition of the harm that was taking place as a child. The study found that good RSE can support children and young people in this situation to recognise earlier when they are being sexually harmed – resulting in earlier reporting leading to more positive life-long outcomes. This is also strongly links to Article 34 of the United Nations Convention on the Rights of the Child which states that ‘Governments must protect children from all forms of sexual abuse and exploitation’.

Boys specific work

One of the key components of my recent work relates specifically to young men and boys.

My research and that of others strongly indicates a need for sexual violence prevention strategies that directly engage with young men and boys to reduce violence against women and children by facilitating the inclusion of their voices. Working with young men and boys appears to be the solution when aiming to reduce sexual and gender based violence and negative outcomes for young men and boys. Toxic influencers have gained traction of late – negatively influencing young men and boys – which tells us, as a society we have failed our young men and boys. In England for example, the Ofsted review in 2019 of sexual harassment in schools found that nearly 9 in 10 girls said that they or their peers were sent unwanted explicit pictures or videos, with nearly 50 per cent of boys reporting the same. 92 per cent of girls and 74 per cent of boys said that sexist name-calling happened to them or their peers. Since March 2021, over 50,000 testimonials of young people's experiences of sexual harassment and violence in schools have been shared on the Everyone's Invited website, this includes all of the UK and Ireland. Despite this there is very little work that specifically captures the voice of the boy in relation to sexual harassment. However, there is a wealth of research that states that dialogue, understanding and communication is a key aspect to culture shift. The Women and Equalities Committee (2023) in England, Scotland and Wales suggests an urgent need to directly engage young men and boys. However, in my work and research with young men and boys I have found that blame culture compounds, rather than solves the issue. Blaming boys is counter-productive. I would like to highlight, this is not an apologist position, women are overwhelmingly beaten, raped and murdered by men. However, a new perspective needs to be taken under the RSE umbrella because what we are doing to combat this problem is seemingly not working. Young men and boys need to be supported and empowered to be part of the solution. Violence experienced by boys from boys needs more recognition. Consent education needs to also focus upon young men and boys and whether they consent to sexual activity, as this is not part of the current conversation. Mental health issues in young men and boys needs more attention. At the moment no gender is winning.

Summary

So to summarise, there is a wealth of evidence that supports robust and well-planned RSE that is incremental from a young age. RSE is nuanced and complex. The voices of children and young people should be central to RSE design. Little or no RSE and RSE that is not grounded in robust research results in long term, lifelong negative outcomes for many children and young people. Good, research based, RSE can prevent, reduce and foster early intervention of all aspects of child sexual abuse. Good and realistic RSE can create safe space for children and young people to both recognise and report sexual harm. More training and support for teachers is required. More direct work is needed for young men and boys. This needs to be done with the well-being of all genders in mind and to complement violence against women and children strategies that are in place. This also has to be completed with a positive perspective given to young men and boys to foster successful male mental health outcomes. To conclude, I would like to highlight that it is the right of children and young people to have access to robust and realistic RSE.

 

The utility of developmental perspectives for teens with problematic sexual behaviors as a part of parent and youth counseling

 By Norbert Ralph, PhD, MPH, San Leandro, CA

An important part of treating youth with problematic sexual behaviors (PSB) is helping them and their parents understand contributing factors. Various treatment models have been developed to address causal factors contributing to PSB, including relapse prevention (Steen, 1999), cognitive-behavioral interventions (Hunter, 2011), trauma-focused therapies (NCSBY, 2019), the Good Lives Model (Van Damme et al., 2017), dialectical behavior therapy (Birgersson, 2024), and Multisystemic Therapy (Satodiya, 2024).

The National Center on the Sexual Behavior of Youth identifies factors such as family adversity, child vulnerabilities, modeling of coercion, and modeling of sexual behavior (NCSBY, n.d.). Bonner (2009), in her pamphlet Taking Action: A Support for Families of Adolescents with Illegal Sexual Behavior, identifies contributing factors such as curiosity/experimentation, impulsivity, immaturity, delinquency/aggression, psychological problems, exposure to sexual materials, sexual abuse, and sexual attraction to children. Finkelhor, Ormrod, and Chaffin (2009) mention immature impulse control, cognitive distortions, and delayed moral development. Ralph (2015) emphasizes delays in prosocial reasoning and psychosocial maturity as contributing factors to PSB.

In clinical settings, parents are often in extreme distress, seeking to understand these behaviors and asking, "Did we do something wrong?" They worry whether these behaviors will continue or escalate. Parents benefit from clear, relevant, evidence-based, and compassionate answers about why PSB occurred and how to prevent it.

Framing PSB partly in terms of developmental factors and psychosocial immaturity is useful. Adolescents are developmentally different from adults, as recognized by the juvenile justice system and Supreme Court rulings (Steinberg, 2014). Adolescents, while responsible for their actions, are "less guilty" due to immaturity. Research shows that youth with delayed psychosocial maturity have a higher risk for probation involvement (Férriz et al., 2018). Also, as youth mature psychosocially, they are less likely to engage in criminal behaviors (Steinberg, Cauffman, & Monahan, 2015).

I use a practical example: comparing adults and teens swimming in a pool. Adults stay in their lanes, while teens often swim into others' lanes, motivated by having fun with friends. This behavior illustrates how adolescents may not fully understand social rules or respect others' boundaries. This immaturity is reflected in crime statistics, where the peak rate of PSB in Canadian data occurs at ages 13 and 14 (Allen, 2016). Adolescents' brains are highly responsive to rewards and novelty, but impulse control doesn't fully develop until the mid-20s (Steinberg, 2014). This biological mismatch, combined with heightened sexual development during adolescence, creates a vulnerable period for risky behaviors, including PSB.

Research shows that recidivism rates for PSB are low—around 3–5% in some studies—likely due to increased psychosocial maturity over time (Caldwell, 2016; Lussier et al., 2024). Effective psychosocial interventions that promote prosocial development may help reduce general delinquency and PSB (Kettrey & Lipsey, 2018). The right type and amount of treatment, especially if started promptly, contributes to positive outcomes. Following the Goldilocks principle of "not too much and not too little" treatment is essential (Peck et al., 2023).

In my experience, explaining factors like brain development, psychosocial immaturity, and the potential for positive outcomes with effective treatment has been immensely helpful for parents. They often gain a clearer understanding that their child's immaturity contributed to the behavior, which eases fears and helps them develop a constructive path forward. Shifting from a narrative of fear to a developmental, evidence-based explanation helps parents feel more hopeful and less burdened by pessimistic scenarios.

This developmental perspective is also helpful for adolescents. Many youth express deep regret and confusion about their actions, often saying they don’t know why they did what they did. Like their parents, they are overwhelmed by distressing thoughts about their behavior. By providing a developmental framework, I help them understand that immature thinking and poor judgment contributed to their actions. This understanding doesn't absolve them of responsibility but fosters self-compassion for their younger selves, who lacked awareness of the harm they were causing. It helps them see their history of PSB will not define who they are and understand how treatment will help them develop more effective, prosocial responses.

This approach also provides youth with a more optimistic view of their future. As they engage in treatment and develop problem-solving skills, they build a healthier self-image and hope for a better future. Many youth, through counseling, understand that their actions don’t define their future. With time and support, they develop better decision-making skills, become more prosocial, and reduce the likelihood of harmful behaviors. They see a realistic hope for a positive, rewarding life.

Framing PSB as a result of psychosocial immaturity helps parents understand these behaviors and reduces fear while fostering self-compassion and optimism in youth. With proper treatment and maturation, recidivism rates are very low. This approach shifts families from fear to understanding, providing a realistic basis for hope and a positive, prosocial future for the youth.

 References

Allen, M. (2016). Young adult offenders in Canada, 2014. Juristat, 36(1), 1-8. Statistics Canada. https://www150.statcan.gc.ca/n1/en/pub/85-002-x/2016001/article/14561-eng.pdf?st=ZbsUpckq

Birgersson, A. (2024, April 17). Using dialectical behavior therapy in schools and mental health counseling [On-demand training]. Safer Society Continuing Education Center. https://safersociety.org/using-dialectical-behavior-therapy-in-schools-and-mental-health-counseling-not109-a/

Bonner, B. (2009). Taking action: A support for families of adolescents with illegal sexual behavior. Safer Society Press.

Caldwell, M. F. (2016). Quantifying the decline in juvenile sexual recidivism rates. Psychology, Public Policy, and Law, 22(4), 414–426. https://doi.org/10.1037/law0000094

Férriz Romeral, L., Sobral Fernández, J., & Gómez Fraguela, J. (2018). Moral reasoning in adolescent offenders: A meta-analytic review. Psicothema, 30(3), 289-294.

Finkelhor, D., Ormrod, R., & Chaffin, M. (2009). Juveniles who commit sex offenses against minors (NCJ 227763). Office of Juvenile Justice and Delinquency Prevention. https://www.ojp.gov/pdffiles1/ojjdp/227763.pdf.

Hunter, J. A. (2011). Cognitive-behavioral treatment of adolescent sexual offenders: Theoretical and practical considerations. In M. C. Calder (Ed.), Contemporary practice with young people who sexually abuse: Evidence-based developments (pp. 123-145). Russell House Publishing.

Kettrey, H. H., & Lipsey, M. W. (2018). The effects of specialized treatment on the recidivism of juvenile sex offenders: A systematic review and meta-analysis. Journal of Experimental Criminology, 14(3), 361–387. https://doi.org/10.1007/s11292-018-9329-3

Lussier, P., McCuish, E., Chouinard Thivierge, S., & Frechette, J. (2024). A meta-analysis of trends in general, sexual, and violent recidivism among youth with histories of sex offending. Trauma, Violence, & Abuse, 25(1), 54–72. https://doi.org/10.1177/15248380231162469

National Center on the Sexual Behavior of Youth (NCSBY). (n.d.). Problematic sexual behavior: Protective factors and vulnerabilities [PDF]. https://www.ncsby.org/sites/default/files/Problematic%20Sexual%20Behavior%20-Protective%20Factors%20and%20Vulnerabilities%20(1).pdf

National Center on the Sexual Behavior of Youth (NCSBY). (2019). Implementing trauma-focused cognitive behavioral therapy for children with problematic sexual behavior. Oklahoma TF-CBT. https://oklahomatfcbt.org/wp-content/uploads/2019/05/Implementing-TF-CBT-for-Children-with-PSB-H.pdf

Peck, R. W., Shahin, M. H., & Vinks, A. A. (2023). Precision dosing: The clinical pharmacology of Goldilocks. Clinical Pharmacology & Therapeutics, 113(4), 685–686. https://doi.org/10.1002/cpt.2112

Ralph, N. (2015). A follow-up study of a prosocial intervention for juveniles who sexually offend. Sex Offender Treatment.

Satodiya, R., Bied, A., Shah, K., Parikh, T., & Ash, P. (2024). A systematic review of Multisystemic Therapy in adolescent sex offenders. Journal of the American Academy of Psychiatry and the Law, 52(1), 117-123. https://doi.org/10.29158/JAAPL.230117-23

Steen, C. (1999). The relapse prevention workbook for youth in treatment (guided workbooks for juvenile sex offenders). Safer Society Press.

Steinberg, L. (2014). Age of opportunity: Lessons from the new science of adolescence. Houghton Mifflin Harcourt.

Steinberg, L., Cauffman, E., & Monahan, K. C. (2015). Psychosocial maturity and desistance from crime in a sample of serious juvenile offenders (NCJ No. 248391). Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice. https://www.ojjdp.gov/pubs/248391.pdf

Van Damme, L., Fortune, C.-A., Vandevelde, S., & Vanderplasschen, W. (2017). The Good Lives Model among detained female adolescents. Aggression and Violent Behavior, 37, 179-189. https://doi.org/10.1016/j.avb.2017.10.005

Honoring Our Colleague, Diane Langelier

By David S. Prescott, LICSW

Organizing conferences and other trainings is tough work that requires just the right people–just ask anyone who has worked for ATSA and its chapters. Having had the privilege of participating in conferences on five continents, one recognizes a kind of archetype of the person who makes it all happen. Not an event planner in the traditional sense, this person always seems to be working quietly behind the scenes. They avoid the limelight, calling no attention to themselves, and make complicated things seem simple to the attendees. When such organizers do their work effectively, they tend to pass only barely noticed in the conference experience.

Above all, these people believe in, and quietly embody the mission of preventing abuse. Diane Langelier is the ultimate example.

I first met Diane Langelier in the final days of September 1999–25 years ago! She was managing the registration and operations for a ten-day training event on adolescents who had sexually abused. The training, coordinated by New England Adolescent Research Institute (NEARI), gradually morphed into several different conferences, including the annual conference of MASOC and MATSA (the Massachusetts chapter of ATSA). She has been involved at every turn in every one of these conferences, and related trainings.

The people who benefit most from the diligence of people like Diane never know to say thank you because they won’t have been abused. Through her efforts, it is impossible to know how many people owe a debt of gratitude to Diane for her work in furthering the education that prevents abuse.

To round out this blog post, I turned to some of her closest colleagues. What do they say?

First, MASOC Executive Director Emerita, Joan Tabachnick, noted:

“I could tell so many stories about Diane.  How she sits at the front desk from the beginning of each conference until the end.  She knows each name and remembers stories about each person, and she treats every single one of us with incredible kindness and respect. THAT is exactly what our field is or at least should be about, and she models it for everyone as they walk in the door.  

“Everyone always saw Steve Bengis (Founder of MASOC, NEARI Press, and the NEARI School) as the face of MASOC and this conference, and he was out in front.  But it was Diane who did ALL of the detail work to make sure that the conference ran smoothly.  From reaching out to sponsors, to registering individuals and whole groups from state agencies, making packets of information (in the old days), editing our brochure for typos and then our website, to making sure that there were signs for each room and putting the right workshops in each room, and I could go on and on.  And in the old days?  This was all done by hand, and we had 15 workshops for each session!  

“And in addition to this, if you sit with Diane during any of the sessions or in the down time, she has a wicked sense of humor that she also used when she got a particularly challenging phone call (e.g., a question that was answered at least five times on the website and in the brochure)–but always after she hung up the phone.  

“I can't say enough about Diane!”

Meg Bossong, the Executive Director of MASOC (along with that organization’s board of directors), had this to say:

“As NEARI’s fiscal manager, Diane Langelier has shepherded MASOC from its roots as a tiny, all-volunteer organization existing on in-kind contributions, work trades, and the donations of time and treasure by its founding members to its current form. Diane has done the often unsung but deeply essential work that makes organizations run: opening the mail, managing the books, and being the voice on the other end of the phone whether someone needed an invoice for a conference or was a parent or a clinician looking for help. She has welcomed thousands of people to MASOC’s conferences and helped people with problems big and small for decades. We are profoundly grateful for her work and her deep knowledge and care.”

Finally, Past MASOC Board Chair Kevin Creeden added his own thoughts in his own inimitable style:

“Diane:  patient, kind, incredibly competent, funny, does not suffer fools.  At MASOC we have been incredibly fortunate to have leaders like Steve Bengis and Joan, but Diane is the cornerstone that they both have leaned on.  I would say she is the “Conference Queen”, but I don’t think queens tend to work as hard as Diane does.  I propose that we rename the conference center at the Best Western (where the MASOC and MATSA conferences have traditionally taken place) after Diane (or at the minimum the Princess room: Princess Di ?)”

In my own final analysis, most important of all is that Diane Langelier has helped thousands of professionals and assisted in improving the lives of countless thousands more. That is a fantastic track record for someone who is only rarely acknowledged. I trust I speak for all attendees and readers when I say a heartfelt “thank you!” to Diane.