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The Danish Efforts towards Children with Sexual Behavior Problems and Adolescents with Sexually Abusive Behaviour (ages 4-18) Conference on Sexual Abuse.

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Presentation on theme: "The Danish Efforts towards Children with Sexual Behavior Problems and Adolescents with Sexually Abusive Behaviour (ages 4-18) Conference on Sexual Abuse."— Presentation transcript:

1 The Danish Efforts towards Children with Sexual Behavior Problems and Adolescents with Sexually Abusive Behaviour (ages 4-18) Conference on Sexual Abuse against Children Preventive Measures in the Nordic Countries September 2nd 2014, Reykjavik Mimi Strange, CEO of The JanusCentre, certified MSc in Psychology; specialist in psychotherapy and supervision Ida Haahr-Pedersen, Scientific Assistant, The JanusCentre, MSc in Sociology

2 Agenda 1. Presentation of the National Project and The National Cooperation 2. Introduction to The JanusCentre – Treatment Unit and Research Centre 3. The First Danish Data Sample ( ) – A Brief Summary 4. Introduction to the Barometer of Concern 5. Cases

3 The Background for the National Project As part of the total effort towards protecting children and youths from sexual abuse – ‘Overgrebspakken’: ‘Coordinated Measures to protect Children against Abuse’, a new National Project has been established The JanusCentre, two new treatment projects outside Copenhagen and a national data collection project have received funding

4 The Background for the National Project The Minister of Social Affairs has emphasised (press/newspaper in April 2013) that: Focused work with children and adolescents with sexually abusive behaviour in Denmark should be increased The Danish Government has approved new initiatives to strengthen prevention of child sexual abuse ‘Coordinated measures to protect children against abuse’ -Prevention, earliest possible -Disclosure and Treatment in social services, earliest possible -(health-, and daycare system) -including all paediatric dentists

5 The National Treatment Units Research Center

6 The objectives of The National Project are: 1.To prevent sexual abuse against children committed by other children/adolescents via nationwide treatment units 2.To gather data and knowledge across the country for a nationwide documentation and knowledge production 3.To establish and develop a national consultative body to underpin and support the treatment units all around the country

7 The Target Groups of the National Project The primary target group of the project is children and adolescents (male and female) with sexual behaviour problems (SBP) and their families The secondary target group is psychologists/treatment providers who treat the children and adolescents with SBP. This target group receives supervision from The JanusCentre (The unit in charge of the data/knowledge collection and consulting service). Mutual development of further interventions

8 The National Cooperation The three treatment units are located in Copenhagen (Janus), Aalborg (The Seba Project) and Århus (The Juno Project) Together the three treatment units offer assessment and treatment for all the 98 local municipalities in Denmark The formation and development of the new clinics, The Juno Project and The Seba Project, take place in close cooperation with the established treatment unit The JanusCentre. All the units use the same assessment methods The National Project involves regular steering committee meetings (The national Board of Social Services and the heads of the treatment units) Regular network meetings, supervision, exchange of experience, theme days, presentation of data and treatment services, case cooperation across treatment units Children’s House

9 Evaluation The National Project includes an evaluation part The evaluation will be carried out by an external operator (choice of operator is underway) The assignment involves an evaluation and measurement of the efforts towards children with sexual behaviour problems and adolescents with sexual abusive behaviour (ages 4-18)

10 The JanusCentre The JanusCentre was established by the Ministry of Social Affairs in 2003 as part of the Danish Government strategy to prevent child sexual abuse The Centre serves to prevent sexual abuse of children through early intervention in the matter of children/ adolescents who exhibit sexual behaviour problems The JanusCentre offers outpatient assessment and psychological treatment to boys and girls aged 4-18 years old who have exhibited sexual behaviour problems /harmful behaviour, and their families Furthermore the Centre offers: -Mediation/Restorative meetings between victim and offender as well as others involved, including parents -Counselling and supervision to professionals who are in contact with children/ adolescents who sexually harm others

11 The JanusCentre At present The JanusCentre is partly financed by the Ministry of Social Affairs and partly financed by the Social Service System The JanusCentre also functions as a research centre gathering both quantitative and qualitative data based on client files/cases Up until 2013 The JanusCentre was the only clinic in DK with a main focus on assessing and treating children and adolescents (ages 4-18) with sexual behaviour problems towards other children In 2013 The Danish Government launched the new initiative ‘Overgrebspakken’. The JanusCentre received funding for: 1.Two new treatment projects in order to strengthen and expand the treatment praxis by establishing two new clinics outside Copenhagen 2.Increased support for the treatment practice of The JanusCentre 3.The creation of a national research centre through nationwide data collection

12 Assessment - Clinical Activity in The JanusCentre Sexual behavior problems or sexual harmful behaviour Assessment of the sexual behaviour Consequences of the behaviour (the child, the victims, the family and others) Ways to relate to the behaviour (the child, the parents, professionals) Reasons for the behaviour General conditions: the child and the environment Existing knowledge about the child and the family Psychological Assessment (cognitive, personality-related, function of attention) Parent sessions and interviews Network analysis (examination of the environmental factors) Assessing risk of recidivism Treatment planning in light of the factors above

13 Intervention - Clinical Activity in The JanusCentre Children and Adolescents Group therapy; differentiated groups for children/adolescents with normal intelligence, mental retardation, ADHD and autism Mediation - restorative meetings between victim and offender and their families Individual therapy Network-based treatment Home Parent- and family sessions Sibling sessions Parent groups Professionals Education Individual supervision and counseling Group supervision of foster parents, educational workers, etc.

14 Treatment - Includes other factors besides sexual abuse Treatment Focus on resilience Recidivism Family Competencies Adaptability Individual way of functioning Friends Relations to others

15 The Research Centre Ever since its inception in 2003 The JanusCentre has also functioned as a research and knowledge centre. Research centre activities include collection of both quantitative data and qualitative data (descriptive statistics, interviews, literature studies etc.) The JanusCentre maintains a database containing data from psychological assessment and/or treatment of 290 clients: children/adolescents who have exhibited sexual behaviour problems or sexually harmful behaviour With the new funding, the research centre activities have become national. Data is now gathered across treatment units in order to create a nationwide documentation and knowledge accruement in the field of sexual abuse amongst children/adolescents

16 The Research Centre Gender Age Residence Information about the parents Education Diagnoses Police involvement Psychological profile (results of psycological testing) Types of sexual behavior problems Victims characteristics: number of victims, type of abuse, abuse setting Disclosure Treatment Mediation The Danish Sample

17 The Danish Data Sample - A Brief Summary

18 290 clients Majority of boys: Male clients: 90% Female clients: 10%. Average age at referral to The JanusCentre: 13 43% of the children are placed in residential institutions or foster homes 70% of the clients are emotionally neglected Approximately one third have been victims of sexual abuse themselves The same share of the clients have been victims of domestic violence More than half of the clients go to special schools or remedial class at time of referral to The JanusCentre A large quantity have personal and emotional difficulties and neuro-psychiatric disorders like ADHD  (86% of the clients have attachment difficulties) Who are the Clients?

19 60% of the clients have exhibited Sexual Behaviour Problems (SBP) before the abusive act that prompted referral to The JanusCentre Almost half of the children have exhibited SBP for years Among the most common types of SBP are: - Sexualized behaviour (72%) - Insulting verbal actions of a sexual nature (40%) Average age when committing first sexual assault:12 Approximately half of the clients have one victim The most common types of abuse committed by the clients are groping (48 %) and penetration (anal, vaginal or oral) (40%)

20 Who are the Victims? 411 victims Male victims: 43% Female victims: 57% Average age at referral to The JanusCentre: 9,4 Average age when (first) sexually abused: 8,6

21 Abuse Setting and Disclosure Abuse setting: Disclosure: Most of the abusive behaviour take place in the home of the offender, the victim or in their shared home. 29% of the cases involving abusive behaviour take place in schools or day care institutions and 11 % in residential institutions The most common: The victim tells his/her parents about the abuse committed by the client (38%) Second most common: Parents or professionals working in (residential) institutions, schools etc. catch client and victim in the act (22%)

22 The First Data Sample The Juno Project and The Seba Project The Juno Project Assessment: 9 clients Data registration: 4 clients All male Age 9-14 years old The Seba Project Assessment: 4 clients Data registration: 4 clients 3 male, 1 female Age 9-16 years old

23 The First Data Sample The Juno Project and The Seba Project Small sample of 8 clients 7 males and 1 female Age 9-16 years old. Average age at referral to the treatment projects: 12,3 Half of the clients live with one or both parents. The other half are placed in residential institutions/ foster homes The majority of the clients are emotionally neglected (7 ouf of 8) Half of the clients have been victims of domestic violence 6 of 8 clients show signs of ADHD The majority of the clients have have exhibited Sexual Behaviour Problems (for years). SBP in particular/including: - Sexualized behaviour -Insulting verbal actions of a sexual nature -Groping Resemblance to the general sample

24 The Barometer of Concern The barometer of concern is a guideline for whether behaviour exhibited by children and adolescents should provoke concern and when to intervene Green indicates that the child or adolescent exhibits a normal and age- appropriate behaviour Orange indicates that the child or adolescent exhibits a behaviour which requires enhanced attention and potentially an intervention Red indicates that the child or adolescent exhibits a behaviour which requires immediate intervention

25 Normal Behaviour Examples of Normal Behaviour: Children, ages 2 to 5 years: Play age-appropriate sexualized doctor games with peers Children, ages 6 to 10 years: Play sexualised games with other children characterised by equality, reciprocity and curiosity Children/Adolescents, ages 11 to 14 years: Surf the internet for sites with sexual content and show an interest in pornography

26 Behaviour Demanding Enhanced Attention and Intervention Examples of Behaviour Demanding Enhanced Attention and Intervention Children, ages 2 to 5 years: Display age-inappropriate knowledge about sexuality, e.g. strikingly precocious or adult-like knowledge about sex Children, ages 6 to 10 years: Bribe, threat or force other children to participate in sexual activities Children/Adolescents, ages 11 to 14 years: Attempt to complete genital or anal intercourse

27 Behaviour Demanding Immediate Intervention Examples of Behaviour Demanding Immediate Intervention Children, ages 2 to 5 years: Lure or threaten victims such as weak children into sexual activities Children, ages 6 to 10 years: Sexualised behaviour towards animals Children/Adolescents, ages 11 to 14 years: Seem indifferent to whether his/her actions harm or hurt other children or make them unhappy

28 Case 1 Monika  Monika 12 years old  Referred to assessment and treatment at The JanusCentre  Since early childhood Monika has exhibited sexualised behaviour: from an early age she has been engaged in sexual activities with an older boy  Monika has severe sexual behaviour problems towards other children and adults, including groping, exhibitionism and advanced sexual games  Duration of the sexual problematic behaviour: 8 years  Monika has herself been a victim of severe sexual abuse  Her mother is an alcoholic who frequently changes partners  Psychological test results show an average intellectual functioning (IQ )

29 Case 2 Niels Niels 13 years old Referred to assessment and treatment at The JanusCentre Niels has an ADHD diagnosis (psychiatric assessment/screening) and shows symptoms of an autistic spectrum disorder (not yet clarified). He goes to a special school for children with ADHD Niels has exhibited sexual problematic behaviour for years (including groping) Two boys (10 and 11 years old) who appear weaker than Niels have told the following: Niels has abused them sexually 2-3 times, using force and threats Niels has touched the boys’ penises and has possibly been masturbating while the boys have been watching. Niels has also made the boys play sex games with each other One of the boys is particularly affected by the episodes. He has talked about committing suicide Before referral to The JanusCenter, Niels has participated in a child meeting with a social worker from the Social Security System. He has partly confessed the incidents

30 Thank you for listening (www.januscentret.dk)www.januscentret.dk

31 Danish Resources Targeting Adolescents with (Sexual) Problems ‘Break the Circle’ Specialised Telephone counseling service for adolescents with sexual problems, such as sexual fantasies about children The Children’s Telephone Telephone counseling and Chat counseling (bullying, divorce,grief sexuality ect.) ………… ……


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