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Decide if and when the child with sexually reactive behaviours can return home

If a decision is made to separate the child with sexually reactive behaviours (SRB) from the home, the next decision to be made is when (or in some circumstances if) they can return home. When working with the child with SRB, remain focused on the safety and wellbeing of the child who was sexually abused, keeping their experience at the centre of your work.

Review the factors explored in the previous section Decide whether the child with sexually reactive behaviours can remain at home. Talk with the child, their parents and the safety and support network and gather information to determine if enough factors relating to the child, their family and the environment have changed to ensure the safety and wellbeing of the child who has been sexually abused.

Strategies to plan for the safe return of the child with sexually reactive behaviours

This section focuses on safety planning for the child with sexually reactive behaviour to return home.

Note

The term ‘triggers’ is an umbrella term that encompasses psychological, emotional, mental and physical factors that evoke a trauma response. It also encompasses environmental factors that are not necessarily trauma responses but require attention when safety planning. These include factors such as routines, sleeping arrangements and arrangement of space.

This part explores triggers for SRB and provides suggested additions to a safety plan to moderate these. It also helps practitioners implement effective supervision, and to help people in the child’s safety and support network to be effective supports against risks to each child in the household. For information on determining who is appropriate to supervise a child with SRB in the home, refer to Effective primary supervisors.

Work with the child, parents and safety and support network

As part of planning for a child’s safe return home, work with the child, their parents and their safety and support network to explore and moderate triggers for the sexually reactive behaviours.

There will be times where it is relatively easy to identify triggers for the SRB. The child with SRB may be able to identify what was happening for them before the reactive behaviour happened, or the parents or child who was abused may be able to link specific events to the onset of reactive behaviours. There will be other times when it is difficult to determine any clear trigger for the behaviours. The information below will help you assess the presence of likely triggers for SRB.

Attention

Talk to the child with SRB and their family. Ask questions about each item below, even if they were not identified or discussed in the initial assessment:

  • privacy
  • sleeping arrangements
  • nudity
  • pornography
  • bullying
  • physical punishment
  • emotional connection (this is, does the child with SRB have a secure and reliable attachment with someone who will meet their emotional needs when required).

Understanding these factors is critical for robust safety planning. These factors are explained further in depth below.

When planning interventions, assess whether or not the parent is able to recognise the child’s SRB and monitor them. Be realistic about the parent’s strengths and limitations. You may set a parent up to fail if they are still ambivalent about the sexual abuse occurring, or do not have a close attachment with the child who has SRB, or the child who has been abused.

Understand triggers for the harmful behaviours

The presence of the factors below does not mean that the child (with SRB) should not return home, but it does mean that work with the parents must occur to assess their capacity to moderate or remove the trigger. The table contains suggested safety plan inclusions that could be implemented to minimise the risk of these occurring. These safety plan inclusions are suggestions only and need to be changed to reflect the circumstances of the child and family you are working with. This table introduces the idea of a supervisor which is explored in more detail in the Effective primary supervisors section below.

Practice prompt

The children in the household are the experts in how their household functions. To understand the home environment and potential triggers for the sexually reactive behaviour, talk to children in the home (where age appropriate and safe to do so) including the child with sexually reactive behaviours, the child who was sexually abused and any other children. Understand the views of children on how certain inclusions will work in real life.

Practice considerations

Conversation ideas

Talk with the child with SRB about times they have behaved in sexually reactive ways. Explore with them:

  • the emotions they were feeling
  • what was happening in the home
  • what was happening at school
  • the time of day or week.

Important: Many children struggle to identify clear triggers in the early stages of therapeutic work. Some may struggle to ever identify triggers themselves. This is particularly true for children who have experienced abuse, neglect and other kinds of developmental trauma. These experiences impact on their brain development and can make it difficult for them to make sense of their behaviour.

“Sometimes our feelings or thoughts, or what other people do and say, can make us want to do things that are hurtful to us and to others.

When you [describe the SRB], what was happening? What were you doing? What were others doing or saying? What was happening in your body?

Is there a feeling or thought you get that tells you that you might want to [describe sexually reactive behaviour]?”

Explore with parents if they can identify any events or changes that happened close to the time the harmful behaviour started.

“We think the behaviour started when [child] was around 11 years old. Can you think of any things that happened around that time? They may not have been big events to you but may have had an impact on [child with SRB].”

Experiencing domestic and family violence is traumatic for children.  It also may trigger their SRB.

Returning a child (with SRB) to a home where there is a risk of domestic and family violence is not recommended without intensive support.

Ensure the safety of the child and mother when talking about domestic and family violence. Refer to the practice kit Domestic and family violence for guidance on working safely with children and mothers where domestic and family violence is suspected or known.

Talking with the child [with SRB]:

“Sometimes kids get scared or upset when their parents fight or argue. What does this looks like in your family? Who does what?”

“If I was watching an argument or fight like in a movie, what would I see, hear and maybe even feel? Has that happened to you? Can you tell me about that?”

Talking with parents:

“What do the children do if you have a fight or an argument with your partner?

“Do you ever feel frightened or intimidated by your partner?”

“How do you think your partner will react when I talk to him / her about my worries?”

Sexual abuse is a known risk factor for SRB.

The dynamics of sexual abuse also mean that it may not have been identified previously. Assess the child protection history for the child (with SRB) and family thoroughly, and review previous reports and case notes to see if they indicate historic or current sexual abuse.

Be curious about:

  • the opportunity for the child (with SRB) to disclose sexual abuse
  • any sexual abuse concerns held by the parents
  • sexual abuse experienced by friends or family members of the child (with SRB).

Talking with the child (with SRB) and other children in the home:

“Sometimes kids have worries and sometimes they feel that they need to keep these worries a secret. They might hide their feelings, or get angry and yell, and some [describe SRB].  Have you been worried about anything? Has anyone else in your family been worried?”

“Do you have any ideas about why [child with SRB] might be doing this?

Talking with parents:

“Some kids with SRB have not experienced sexual abuse.  We also know that experiences of sexual abuse can make it more likely for kids to display SRB. Have you ever been worried that your child has been sexually abused? What made you worried? What did you do? What did you say?”

“Do you know of anyone in the community who people think has sexually abused kids? Do they still spend time with your family? Who are they? How often do you see them? Tell me more about their relationship with your family.”

Physical discipline is a traumatic experience that may trigger sexually reactive behaviour.

Suggested safety plan inclusion:

The children will not be hit or touched on any part of their body as a punishment. If the child needs to be disciplined, the parent / supervisor will wait until they are calm and will discipline the child by [discipline that does not involve corporal punishment appropriate to child’s age and developmental stage], for example:

  • take away privileges (such as computer or TV time)
  • talk with the child about their behaviour
  • assign additional chores.

Talking with the child (with SRB) and other children in the home:

“What is the worst trouble you have ever got into with your parents? What did they say or do?”

“If you do the wrong thing at home, what happens? How are you usually punished?”

Talking with parents:

“Which of your kids generally require more discipline? Tell me about a time when [child with SRB] did something wrong – what happened? Tell me about a time when [child] did something wrong- what happened?”

“When the kids are doing something wrong, or out of line, what does [supervisor / other parent] think should happen?”

“Does [supervisor / other parent] ever punish the kids or tell them off? How do they do that?”

Parental disconnection and lack of empathy may cause children to seek comfort from their siblings or other children in the home. This comfort seeking may be a trigger for sexually reactive behaviour.

Suggested safe family rule:

[Parent] will notice when [child / child with SRB] is upset. [Parent] will talk to [child / child with SRB] about their feelings and will comfort [child / child with SRB]. [Parent] will check each day to see if the [child / child with SRB] has moved the safety object and will help them talk about their worries or fears.

Talking to the child with SRB and other children in the home:

“How do you show [parent / carer] that you are upset? What does [parent / carer] do when you are upset?

“Are there other people in the house you go to when you are upset? What do they do?

What do you wish they would do?”

Talking with parents:

How do you know what [child] needs?

If [child] is upset, what do you do? Are there ever times when you do something different?

Shared sleeping arrangements can be a trigger for sexually reactive behaviour.

Sleeping arrangements can change significantly depending on the time of the week / month / year or other family circumstances.

Shared sleeping can also be a cultural practice for some people. Talk with an Aboriginal and Torres Strait Islander practitioner or a multicultural practitioner who shares the same cultural background of the family to understand this practice. It is not harmful on its own however in the context of sibling sexual abuse, it is a known trigger for harmful behaviour and needs to be addressed.

Suggested safety plan inclusion:

[Child with SRB] will always sleep by themselves or on a mattress next to [parent]’s bed.

Talking with the child (with SRB) and other children in the home:

“Are there times when you sleep in the same room as [siblings / other children in the home]? What is happening then?”

“What happens when you are scared at night? Where do you go? What do you do?”

Talking with parents:

“Where do the kids sleep? What about when family stays over?”

“Are there ever times when the children share a bed or sleeping arrangement?”

Children who take on responsibility for their siblings may be given particular power and responsibility over the child. This may be a trigger for the harmful behaviour.

In some cultures, particularly for Aboriginal and Torres Strait Islander peoples, it is appropriate for older children to care for their younger siblings and family members. This is not a risk factor in isolation but relates to the dynamics of a child being in a position of power over younger siblings which can be a trigger for SRB.

Suggested safety plan inclusion:

The only person who can tell the children what to do is [parent / supervisor]. The only person who disciplines the children is [parent / supervisor].

Talking with children:

“Do you ever look after [siblings]? How do you look after them? What are [parents] doing when you are looking after them?”

Talking with parents:

“What generally happens if you are sick? Who looks after the children? What responsibilities might [each child] have? How does that change when you are well again?”

“Are there times when [child with SRB] needs to tell the [child] what to do? What happens if [child] doesn’t do what they say?”

Sexually reactive behaviour can be an extension of other types of bullying behaviour. This means bullying behaviour that is not addressed and moderated may be a trigger for the sexually reactive behaviour.

Suggested safety plan inclusion:

Children will not tease, yell at or hurt other children in this house. Children will not make other children feel scared. If anyone is teased, hurt, yelled at or feels scared, they will tell [parent / supervisor].

Talking with the child with SRB:

“How do you get [child] to do something you want them to do. What happens if they say no?”

“What happens if you get angry with [child]? What do [parents / other children in the house] do?”

Talking with parents:

“Is there ever any bullying that occurs between [children]? How do you address this behaviour effectively?”

Access to pornography is a known risk factor and trigger for SRB. Indicators of problematic pornography use may include:

  • less interest in human interaction than computer-based interaction
  • a tendency to use the internet in private and to block others from seeing content the child [with SRB] is viewing
  • obsessive deletion of browser history
  • comments that show the child [with SRB] has sexual knowledge that is beyond an age-appropriate level
  • obsessive or harmful sexual activity for example, compulsive masturbation
  • fetish-like interests of a sexual nature
  • obsessive degree of anxiety, frustration or anger when denied access to pornographic websites.

Suggested safety plan inclusion:

Pornography will not be seen by any children by accident, or on purpose. This includes legal and illegal pornography in magazines, on the internet or on television. The child [with SRB] will only use a computer or a device in a room with the parent.

Talking with the child [with SRB] and other children in the home:

“When do you look at the internet? What do you like doing on the internet?”

“Where do you look at the internet?

Who is there when you are looking at the internet?”

“Do you have rules about looking at the internet?”

“Have you ever seen something on the computer or internet you shouldn’t have?”

Talking with parents:

“Are there times you know of when your child [with SRB] has seen pornography? How did they see it? Is it something they did alone or with friends? Who did they do it with?”

“Where do the children look at the internet?

What does [child with SRB] tend to look at?

How do you monitor what they are looking at?”

“Are there times when you try to stop [child with SRB] looking at the internet? What happens?’”

An overtly sexualised environment in the home may trigger SRB.

Discuss:

  • whether sexual language is used in front of the children
  • sexual acts that happen in view of the children
  • nakedness
  • a lack of reasonable privacy (children are able to clean themselves and toilet in private).

Suggested safety plan inclusion:

There is to be no adult nakedness / near nakedness around the children. All adults will be fully clothed. The children will not be naked or nearly naked around each other. The children will only be naked / nearly naked around the parent or the supervisor if they need help with bathing or going to the toilet.

Talking with children:

“When are people naked in your home? Do you ever see anyone else naked? When would that happen?”

“Who is with you when you’re showering / going to the toilet?”

Talking with parents:

“Have the children ever seen any sexual activity? How did they see it?”

“When are children in the home naked?

What about adults in the home?”

“How did your children learn about sex?

Who taught them? What do they know?”

Incorporate supervision in the safety plan

The constant line of sight supervision recommended for children with sexually reactive behaviour requires significant input from parents. Parents and the safety and support network need to be willing and available to monitor the interaction of the child (with SRB) with any other vulnerable children at all times, both inside and outside the home.

There will be times when the parent or supervisor is not able to have direct line of sight supervision of the child (with SRB). Discuss what will happen during these times with the parent and network members, and come up with routines and expectations to cover short breaks (like going to the toilet) and longer breaks (like sleeping).

Practice prompt

When having these discussions with parents and network members, remain aware of how difficult constant supervision is. Check in regularly with them to find out how they are coping and what support they need to maintain this difficult role.

Parents and network members need to:

  • be aware of warning signs and triggers for the SRB and implement intervention strategies to stop them from occurring
  • be able to maintain a connection to the child with SRB
  • not minimise the harmful behaviours
  • remain responsive to the needs of the child who was sexually abused.

As the child with SRB progresses in developing new skills and is able to demonstrate some of the key protective behaviours, the level of supervision may change. As this occurs, discuss this with both children’s therapists and any other practitioners involved.

The involvement of a safety and support network to assist in supervising the child (with SRB) supports the effective implementation of safety plans. Having these conversations can be difficult for parents. In partnership with the parents:

  • arrange meetings with the safety and support network
  • explain the child’s SRB, known triggers, and so on
  • explore the capacity of the network to participate in safety planning and ongoing support for the family.

Tip

Depending on who is in the home or spends time with the child and whether they have a supervisory role will depend on the amount of information they require. Work with the child and family to decide how much each person needs to know.

For example, a family friend who visits the home with their children while the parent is there may only need to know that ‘[Child with SRB] has problems with boundaries with other children and needs to be supervised at all times’. On the other hand, a family friend who has the child (with SRB) stay at their home for a sleepover while other children are in the home is a primary supervisor and needs to know everything.

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