Submission to Developing a Program to Prevent Harmful Sexual Behaviours for Children & Young People

Developing a program to prevent harmful sexual behaviours for children and young people: Response to consultation paper January 2019

About TasCOSS TasCOSS is the peak body for the community services sector in Tasmania. Our membership includes individuals and organisations active in the provision of community services to low-income Tasmanians living in vulnerable and disadvantaged circumstances. TasCOSS represents the interests of its members and their clients to government, regulators, the media and the public. Through our advocacy and policy development, we draw attention to the causes of poverty and disadvantage, and promote the adoption of effective solutions to address these issues.

Please direct any enquiries about this submission to: Kym Goodes CEO Ph. 03 6169 9500 Email: Kym@tascoss.org.au

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Introduction Thank you for the opportunity to comment on the consultation paper Developing a program to prevent harmful sexual behaviours for children and young people.

TasCOSS advocates on behalf of low-income Tasmanians who often live in vulnerable and disadvantaged circumstances. We advocate for public policy that values and respects the diversity of Tasmanians and makes a real difference to the lives of people who are experiencing vulnerability. We work to ensure that the human rights of all Tasmanians are integrated into government consultation processes, policy approaches and budget allocations.

TasCOSS submissions and advocacy are strongly informed by the expertise of our members and the lived experiences of the Tasmanians we represent. In preparing this submission, we have drawn on consultations with key members as well as on research and experience from other jurisdictions.

Context TasCOSS welcomes the development of a systematic response to harmful sexual behaviour among children and young people in Tasmania. The consultation paper is a strong contribution towards that end, with TasCOSS members pleased that it reflects issues that they have raised over the years.1 Children and young people are most likely to experience unwelcome sexual behaviour from their peers.

Australian studies suggest that 30-60% of experiences of child sexual abuse are carried out by children and young people who exhibit harmful sexual behaviours.2 The Sexual Assault Support Service (SASS) estimates that these figures would hold for Tasmania, potentially at the higher end of the range, and that around one third of their existing child clients are presenting with harmful sexual behaviours.

At the moment, Tasmania lacks:  Publicly funded specialist programs for children and young people exhibiting harmful sexual behaviours aged 12-17.  Programs or funding for specialist work with children and young people exhibiting harmful sexual behaviours who have disabilities, particularly cognitive disabilities.  Programs or funding for specialist work with children and young people exhibiting harmful sexual behaviours who have been in contact with the criminal justice system.

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See, for instance, SASS 2015.

El-Murr 2017.

Key Issues TasCOSS strongly supports the findings and recommendations of the Royal Commission into Institutional Responses to Child Sexual Abuse (RCIRCSA), in particular in relation to the value of a public health rather than punitive approach and the principles on which therapeutic interventions should be based (see Appendix A).

As noted by the Commissioner for Children and Young People WA, “Children and young people who display HSB are, first and foremost, children,”3 many of whom have experience multiple types of harm themselves, and none of whom will benefit from labelling, isolating, marginalising or condemnation.

Responses to harmful sexual behaviour therefore should be protective of the child that poses a risk to others as well as of other vulnerable children.4 The findings and recommendations of the RCIRCSA and other specialist literature, as well as the views of TasCOSS members Sexual Assault Support Service (SASS) and Engender Equality, that tying treatment for harmful sexual behaviour in children and young people to criminal sanctions is inappropriate and impractical.5 Available evidence points to the importance, substantially acknowledged in the consultation paper, of:  An understanding of children and young people who have sexually harmed others as being in need of a protective response themselves.  A non-stigmatising approach that externalises the behaviour from the individual and avoids categorising children and young people based on rigid or pathologising definitions regarding age-appropriate sexual behaviour.  A spectrum of prevention and response mechanisms, from primary to tertiary.  A public health, ecological framework that responds holistically to the needs both of children and young people and of their families.  A ‘no wrong door’ referral system for children and young people exhibiting harmful sexual behaviours.  Prompt response to warning signs, including through mandatory reporting – although this should not lead to the child or young person exhibiting these behaviours to be categorised based on rigid or pathologising definitions regarding age-appropriate sexual behaviour.  Developmentally appropriate therapeutic rather than punitive secondary and tertiary responses, including in cases where removal from the family or confinement is necessary for the safety of others. Background work for the Royal Commission indicates that these should be: o Based on specialised rather than non-specialised techniques o Mediated by the parent or caregiver where possible o Delivered individually rather than in a group therapy format.6

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CCYP WA 2018, p. 6.

SASS 2015.

5 Pratt 2013.

6 Sholosky et al. 2017, p. 10.

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Flexible treatment modalities that can meet the needs of diverse groups of children and young people and their families. Populations of children and young people requiring a tailored response include children under 10 years of age; children and young people with intellectual disabilities; children in out of home care; Aboriginal and Torres Strait Islander children and young people; culturally and linguistically diverse young people; and children and young people of diverse sexualities and gender identities.

An interagency approach to help identify and address additional issues that have an impact on the child/young person and their family.7

Services focused on responding to sexual assault and sexual abuse are well-positioned to provide therapeutic responses to harmful sexual behaviours not only due to their expertise, but also to ensure that the experiences of victim/survivors of abuse remain salient. 8 SASS has already done significant research around this issue.9 Multisystemic Therapy (MST), which uses an ecosystems orientation to combine potentially effective approaches delivered in close cooperation with family/caregivers, other important services providers and members of the neighbourhood or community, has received endorsement in the context of the Royal Commission; however, it is noted that it is not necessarily the only approach that can work, and that it may not be suitable in all cases.10 Program models from other states that have received positive evaluations include the New Street program (NSW) and the Male Adolescent Program for Positive Sexuality (MAPPS, VIC); other programs that have not been rigorously evaluated but that show promise are the Victorian Sexually Abusive Behaviour Treatment Services.11

Recommendations Based on the literature and evidence discussed above, we make the following recommendations: 1. A Tasmanian response must extend along the continuum from universal prevention to targeted response. Secure funding for primary prevention and early intervention programs aimed at preventing harmful sexual behaviours before they emerge is crucial. Without such programs, more will end up being spent at the secondary and tertiary levels, after harm has already been done to others. Primary prevention programs should be accompanied by clear referral and help-seeking pathways for young people, parents and community members to seek information and support.12

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El-Murr 2017; KPMG 2014; Meiksans, Bromfield and Ey 2017; Victoria 2012; CCYP WA 2018; Pourliakas et at. 2016; Shlonsky et al. 2017.

8 Pratt 2013.

9 See SASS 2015.

10 Shlonsky et al. 2017, p. 7.

11 KPMG 2014; El-Murr 2017.

12 CCYP WA.

2. Harmful sexual behaviour should be included in mandatory reporting to Child Safety Services, for the sake of all children involved. Please see the submission by SASS in regard to suggested thresholds for reporting.

3. Therapeutic Treatment Orders and Therapeutic Treatment Placement Orders should be available to divert children and young people whose behaviour is reported to Tasmania Police and/or who are charged with an offense.13 Please see the submission by SASS in regard to suggested thresholds for reporting.

4. All children and young people aged 0-17 should be eligible for a specialist therapeutic response. This includes voluntary treatment programs for children and young people up to 17 years of age who are displaying harmful sexual behaviours but who have not been found guilty of a sexual offence and/or are not subject to a Therapeutic Treatment Order or a Therapeutic Treatment Placement Order.14 5. A specialist therapeutic program should be designed in strong consultation with: 

Children and young people currently receiving services in order to improve understanding of their specific needs, the effectiveness of services, and how best to include them in further decision-making.15

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Community sector organisations with specialist knowledge of vulnerable groups, such as:  Advocates on behalf of children in out of home care: Create Foundation.  Disability advocates: Disability Voices Tasmania, Advocacy Tasmania, Association for Children with Disability (Tas) Inc., Citizen Advocacy, Speak Out Association of Tasmania, Tasmanian Disability Education Reform Lobby, Brain Injury Association of Tasmania, Autism Tasmania  Aboriginal organisations, particularly those providing counselling services: Tasmanian Aboriginal Corporation, Circular Head Aboriginal Corporation, Karadi Aboriginal Corporation, South East Tasmanian Aboriginal Corporation (SETAC)  Providers of services to the CALD/recent arrivals communities: Migrant Resource Centre/Phoenix Centre, Red Cross asylum seeker support/Bicultural Health Service, Tasmanian Refugee Legal Service, Catholic Care Multicultural Services  LGBTI services: Working It Out  Domestic and family violence services: Engender Equality, Catholic Care, Yemaya, Huon Domestic Violence Service.

6. In light of limited public transport options in rural areas of the state, outreach services will be necessary. Staff travel time and logistics must be taken into account in the development and funding of 13

See SASS 2015 for recommendations on the points in the youth justice/criminal justice process where these pathways can be made available.

14 SASS 2015.

15 For an example of a study with young people who have sexually abused, see McKibbin, Humphreys and Hamilton 2017,

programs.16 In addition, given that specialist staff may not always be easily on hand, there will be a need to build up the capacity in the surrounding community to help respond to harmful sexual behaviours, particularly among teachers, police, health professionals, youth justice/support workers, and school social workers and psychologists.

7. Evaluation of the Tasmania CYP-HSB program should involve:  Children, young people and families, including both those associated with children with harmful sexual behaviours and those who have experienced the impact of those behaviours, using evaluators with extensive individual experience of engaging children and young people.  The specialist community sector organisations outlined above.

8. More training is needed for adults, especially in the school system, within child safety services and for health care providers, in identifying and responding sensitively and effectively to signs of harmful sexual behaviours in children and young people, including encouraging children and young people to raise concerns themselves.17 9. An interagency panel should be established, bringing together representatives from the Departments of Communities, Education, Health and Justice, in order to develop common language and common approaches, and to deal with complex cases. It should receive specialist input from appropriate experts and service providers.

Conclusion Thank you for the opportunity to comment on this consultation paper. Please do not hesitate to contact us for further discussion.

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See KPMG 2014.

For an example of guidelines for educators from other states, see Government of South Australia 2019.

Appendix A Royal Commission into Institutional Responses to Child Sexual Abuse (RCIRCSA) Therapeutic intervention for children with harmful sexual behaviours should be based on the following principles: a. a contextual and systemic approach should be used b. family and carers should be involved c. safety should be established d. there should be accountability and responsibility for the harmful sexual behaviours e. there should be a focus on behaviour change f. developmentally and cognitively appropriate interventions should be used g. the care provided should be trauma-informed h. therapeutic services and interventions should be culturally safe i. therapeutic interventions should be accessible to all children with harmful sexual behaviours.

Bibliography Commissioner for Children and Young People (CCYP) WA (2018) Discussion paper – children and young people with harmful sexual behaviours.

El-Murr, A (2017) Problem sexual behaviours and sexually abusive behaviours in Australian children and young people: a review of available literature. AIFS CFCA Paper No. 46.

Government of South Australia/Catholic Education South Australia/Association of Independent Schools of South Australia (2010, revised 2019) Responding to problem sexual behaviour in children and young people.

KPMG (2014) Evaluation of New Street Adolescent Services: NSW Kids and Families.

McKibben, G, C Humphreys and B Hamilton (2017) “Talking about child sexual abuse would have helped me”: young people who sexually abused reflect on preventing harmful sexual behaviour. Child Abuse and Neglect, 70: 210-221.

Meiksans, J, L Bromfield and L-A Ey (2017) A continuum of responses for harmful sexual behaviours. An issues paper for Commissioner for Children and Young People, Western Australia.

Pourliakas, A et al. (2016) Review of approaches to prevent and respond to problem sexual behaviour in children and young people in out of home care. Report prepared by the Parenting Research Centre on behalf of the NSW Government Department of Family and Community Services.

Pratt, R (2013) A community treatment model for adolescents who sexually harm: diverting youth from criminal justice to therapeutic responses. International Journal of Behavioural Consultation and Therapy, 8(3-4), https://files.eric.ed.gov/fulltext/EJ1017928.pdf SASS (2015) Responding to problem sexual behaviour and sexually abusive behaviour in Tasmania.

Shlonsky, A et al. (2017) Rapid evidence assessment: current best evidence in the therapeutic treatment of children with problem or harmful sexual behaviours and children who have sexually offended. Royal Commission into Institutional Responses to Child Sexual Abuse.

Victoria State Government (2012) Children with problem sexual behaviours and their families: best interests case practice model. Specialist practice resource.