What is Harmful Sexual Behaviour (HSB)?

Harmful sexual behaviour (HSB) is a term used to describe developmentally inappropriate sexual behaviour displayed by children or young people which is harmful or abusive (Hackett, 2014). The term ‘developmentally inappropriate’ highlights the importance of considering the behaviour within the context of the child’s age and stage of development. This is important because behaviours that may be developmentally appropriate at one stage of development, may be problematic or perhaps harmful in another.

Why is understanding HSB important when working with children and young people?

It is difficult to determine the precise prevalence of HSB. However, recent research estimates that between 30-50% of cases of sexual abuse against a child involve another a young person engaging in harmful sexual behaviour (Campbell et al., 2020). 

Research also suggests that the majority of children who display HSB have experienced significant trauma, such as exposure to domestic violence, physical or sexual abuse, and neglect. 

Of all referrals to local authority children’s services in England between 2021 and 2022 where sexual abuse concerns were reported, 40% were reported to involve HSB. 

In 2021, a rapid review of sexual abuse in schools and colleges in England reported that, for some children and young people, sexual harassment and online sexual abuse  in school occurred so frequently that it was considered “normalised” or “commonplace”.

Despite the prevalence of HSB, there remains a need for increased knowledge and understanding amongst professionals working with children and young people. Children and young people’s sexual behaviours exist on a continuum (from normal/developmentally appropriate to inappropriate, harmful, and abusive) and they occur within the cultural, social, and multi-system context within which a young person lives. As such, understanding where a behaviour fits on this continuum, and how best to support the young person/people involved, can be a complex process. This is further complicated when we consider the role of technology in a young person’s everyday life and interactions, the accessibility of pornographic material, and what might be considered developmentally ‘normal’ or ‘problematic’ online behaviours. 

Assessment and Support

It is paramount that assessments consider more than just the level of risk that may be presented by a young person. Considering the broad and multi-layered context within which a young person may begin to display harmful or problematic sexual behaviour(s) is central to ensuring that interventions, both at the individual and systemic level, are child-focused, needs-led, and responsive. 

At Meadows Psychology Service, our specialist team is trained and experienced in carrying out detailed, holistic assessments of HSB that are responsive to developmental, systemic, and behavioural changes of the young person, and their environmental context, family and/or caregiving system. Our assessments are guided by evidence-based frameworks (e.g., AIM3) to ensure they provide carers with:

  • A comprehensive understanding of how a young person’s sexualised behaviour has likely developed.
  • An understanding of the young person’s current strengths and resources (at an individual, family and community level) that can be harnessed to support desistance from further HSB. 
  • An understanding of the young person’s specific needs and risks.
  • Individualised safety and intervention planning which is responsive to the identified needs. 

Our work recognises the impact of this work on care professionals, and the important role professionals play in supporting a young person to have a positive and fulfilling future. We offer specialist consultation for staff teams working with young people who display HSB, in addition to bespoke, tailored support for carers and families who may be affected.  For more information about the services we provide,  please get in touch via our online form. 

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