A programme for children aged 8-12 (and up to 14 if they have a learning disability) with problematic sexual behaviour and
their parents/carers in Bristol and South Gloucestershire
Pre Referral
Referral
Alleged behaviour reported
New referral from Tier 3 CAMHS,
investigation is undertaken
Use of standard referral form sent on
and completed.
CYPS, Education, YOT or Police.
Consent is
obtained from
parents/carers and
If prosecution child needs to
Young person discussed at Be Safe
10+) but could still be
legal process.
confirm receipt of referral.
child for referral.
be referred to YOT (aged
considered at completion of
request. Written confirmation provided to
Unclear if child
meets criteria.
Children’s Programme allocations
meeting and Case coordinator allocated
if appropriate.
Further
Child ideally will have named
Social Worker to attend the
Children’s Programme but
information
requested from
referrer.
unlike the Be Safe Service
Safe and Children’s
Programme Professionals
leaflets may be helpful.
Children’s Programme practitioner,
level of concern, age,
significant behavioural
difficulties, nature of
behaviour.
professionals. To agree on the way
Plan of intake
referral criteria is met. Be
Planning meeting is held with Be Safe
referral criteria due to
referrer, school, family and other key
will still be considered.
Referrer to ensure that
allocated if appropriate.
Child does not meet
children’s Programme
assessment will
forward and engage family. Intake
Reason for not offering
planned.
explained to referrer.
assessment process discussed and
be developed and
a programme is
circulated to
Consultation is offered if
professionals.
Safe Service or referred
family and
indicated by the Be
Once work is agreed, confirmation letter
sent to family and referrer, with GP and
on.
other key professionals copied in.
Consider whether
Information leaflets included. Case co-
safeguarding issues need
Multiagency advice may
alongside referral.
e.g. regarding substance
addressing before or
Be Safe Children’s Programme
team before referral form is sent as
to appropriateness.
.
be sought at any stage
misuse/forensic issues/
Please enquire with member of the
ordinator allocated.
cultural issues.
Intake assessment begun as to
suitability for group or family
intervention.
Intake report completed
within 6 weeks and shared with
parents/carers, young person, referrer &
key professionals.
If consultation provided
consultation report
completed by Be Safe
Service.
Service
THINK EARLY
INTERVENTION
THINK RISK
THINK SAFEGUARDING
to CYPS/ Police/CAMHS. An
THINK MULTIAGENCY
WORKING
Be Safe Stay Safe Children’s Programme Care Pathway
Children and
Intervention
families
participation
valued throughout
Intake/intervention programme assessment agreement and
consent forms signed by all parties before work can begin.
throughout.
Recommendation made as to whether Group Programme
or Family intervention most suitable or comprehensive
Be Safe assessment indicated (see Be Safe Care
Pathway) or signing post on intake report and shared
with parent/carer, young person, referrer and appropriate
THINK RISK
THINK SAFEGUARDING
partners.
Intake assessment will consist of:
- Up to 4 sessions with the child and their parents/carers in
Programme, Agreement, consents Contract signed by all
programme, understanding of safety, ability and an
and child with referrer, school and GP copied in.
order to explore and assess motivation to engage in
parties. Letter sent confirming start date to parent/carer
understanding of the problematic sexual behaviour and to
consider suitability for the programme.
- Review of background papers.
- Further discussions with other professionals.
-
Goals for intervention programme agreed upon by
practitioner, child, parents/carers and support network and
goals monitored throughout.
(Intake assessment period 6 weeks)
Completion of psychometric questionnaires
Multi-agency review meeting held with child,
Completion of Be Safe Children’s Programme intake
assessment and outcome measures (See attached)
Be Safe Children’s Programme intake assessment report,
formulation and action plan prepared and shared with all
involved.
Be Safe Children’s Programme review meeting held with all agencies
involved and the parents/carers at session 9 of programme or if
significant concerns emerge. Child involved in this process if
appropriate.
parents/carers, referrer and key agencies/support network
at session 9 of programme or if significant concerns
emerge.
No further Be Safe involvement
Further Be Safe involvement
indicated.
indicated. Referral to Be Safe
Service.
Case closed
Consider 1:1 and/or Family Therapy
completed with outcome and
pathway)
and discharge report
recommendations. Made
available to referrer and other
No further Be Safe involvement
indicated.
Sessions. (See Be Safe care
key agencies and explained to
child and their parents/carers.
Multi agency meeting only if
there are significant concerns.
N.B. Disengagement
at any stage triggers consultation
with referrer and review. Also
safeguarding concerns and/or and
further harmful sexual behaviour
may trigger multiagency review.
THINK MULTIAGENCY THINK EARLY
WORKING
INTERVENTION
Intake Assessment
Be Safe Children’s Programme Psychometric Measures- Parent/Carer measures
Name of measure
What does it measures?
Why do we wish to
What does it look like?
measure this aspect?
The Strengths and
Difficulties questionnaire
(SDQ)
Child Sexual Behavior
Inventory (CSBI)
Parent support, stress and
skills (PSSS)
SCORE-15
Emotional symptoms, conduct
problems,
hyperactivity/inattention, peer
relationship problems, prosocial behaviour
Measure of sexual behaviour in
children
Adapted from APQ (measure of
several dimensions of parenting
that have proven to be
important for understanding the
causes of conduct problems
and delinquency- Positive
Reinforcement, Parental
Involvement, Inconsistent
Discipline, Poor Monitoring and
Supervision, and Harsh
Discipline.’ And from the MSSM
(Measures perceived adequacy
of support from three different
sources: family, friends, and
significant other)
Aspects of family life, family
communication and process. It
generates three dimensions:
Strengths and adaptability,
Overwhelmed by difficulties,
Disrupted communication
Meets RA’s criteria 3.1
Improve mental health
and 3.5 improved
emotional regulation.
Part of NBT’s expectations
Main aim of group is to
decrease/eliminate
inappropriate sexual
behaviours.
Hope that group will
increase positive parenting
skills and help parents to
reflect upon their support
networks and how they
access support.
Asks about 25 attributes, some
positive and others negative.
Then some further questions
about the effects these are
having on the families life and
in what areas behaviours are
having the most impact (e.g.
home school)
38 questions regarding sexual
behaviours.
We hope that through
15 questions and
parent learning, child’s
supplementary sheet
increasing abilities to
manage emotions and joint
group enabling positive
experiences together in
and out of group there may
be some shift in these
aspects.
Used by Mark in FT. Meets
RA’s criteria 4.2 Improved
family management
How long does it
take to administer?
5/10 minutes
Time: 10-13 minutes to
administer and score
45 questions-10-15
mins
5 mins
We will also measure incidents of sexually problematic behaviours rated weekly from child and parents reports.
Be Safe Children’s Programme Psychometric Measures- Measures for Young People
Name of measure
What does it measures?
Why do we wish to
measure this aspect?
What does it look like?
How long does it
take to administer?
Strengths and Difficulties
questionnaire (SDQ)
Emotional symptoms, conduct
problems,
hyperactivity/inattention, peer
relationship problems, prosocial behaviour
We hope that there may
be a shift in these
elements as the
programme targets
managing emotions and
behaviours (transferable
learning from sexual
behaviours to other
behavioural difficulties)
We hope that self esteem
will improve as children
are praised and feel
successes/ have positive
social interactions
throughout the group.
We will measure this
initially in order to assess
whether it is appropriate
for individual to enter the
group/ need more support.
‘Re-experiencing’
subscale, in our
experience, linked to
difficulties and drop out.
Asks about 25 attributes, some
positive and others negative.
Then some further questions
about the effects these are
having on the families life and
in what areas behaviours are
having the most impact (e.g.
home school)
5/10 minutes
25 items using a 0-6 Likert type
scale. Child rates ‘how I am’
on the 25 different aspects as
well as ‘how I would like to be’.
The discrepancy score gives us
an estimate of self esteem.
54-item self-report measure
15 mins
ONLY FOR AGE 11+
Self Image Profiles (C-SIP)
A brief self report providing both
a visual display of self image
and self-esteem.
Trauma Symptom Checklist
for Children (TSCC)
A measure of posttraumatic
stress & related psychological
symptomatology in children who
have experienced traumatic
events, such as physical or
sexual abuse, major loss, or
who have witnessed violence. It
has 6 clinical scales (Anxiety,
Depression, Anger,
Posttraumatic Stress,
Dissociation, Sexual Concerns).
Aspects of family life and
process, along with other
indicators of the state of the
family. It generates three
dimensions: Strengths and
adaptability, Overwhelmed by
difficulties, Disrupted
communication
ONLY PRE-GROUP
MEASURE
SCORE-15
We hope that through
15 questions and
parent learning, child’s
supplementary sheet
increasing abilities to
manage emotions and joint
group having positive
experiences together in
and out of group there may
be some shift. Used by
Mark in FT. Meets RA’s
criteria 4.2 Improved family
management
15-20 minutes
10 mins
Appendix i: Be Safe Service Referral Form
Be Safe Service
Fairfield Resource Centre
Fairfield Road
Montpelier
Bristol
BS6 5JL
Tel: 0117 3533811
THIS FORM MUST BE COMPLETED FOR ALL REFERRALS
TO THE BE SAFE PROJECT
Further to your enquiry, please find attached a Referral Form for the Be Safe Project.
Before making the referral, please ensure that:
 the young person has an allocated CYPS social worker
 all child protection/safety issues have been addressed
 the young person and their parents/carers have agreed with the decision to refer to the Be Safe
Project and are aware that information may be shared with other professionals including existing
information held on file as a result of previous consultation/s.
The form should be returned to the above address within three weeks of receipt along with copies
of any supporting documentation.
If you have any queries please do not hesitate to contact me on the above number.
Yours sincerely
Stephen Barry
Principal Highly Specialist Clinician
THIS FORM MUST BE COMPLETED FOR
ALL REFERRALS TO THE BE SAFE SERVICE
CHILD/YOUNG PERSON BEING REFERRED
Surname:
First name:
Male/female:
Date of birth:
REFERRER DETAILS
Date of referral:
Name:
Agency
Address:
Phone number/s:
E-mail:
DATE OF MULTI-AGENCY
MEETING WHERE REFERRAL AGREED:
Job title:
CHILD/YOUNG PERSON DETAILS:
Is the child/ young person living in the family home? YES
NO
Current address: ………………………………………………………………………………
……………………………………………………. Post Code: …………………………….
Is child young person Looked After?
Yes / No
If yes – date of placement: ……………………………… Nature of placement:
Adopted
Care order and fostered
Care order placed at home
Care order placed with relatives
Care order placed in residential
Care order placed in secure
Voluntarily fostered
d
ETHNICITY – Mandatory for completion
White
Indian
Other
Black African
Pakistani
Mixed Origin
Black Caribbean
Bangladeshi
Welsh
Black Other
Chinese
Asian Other
Not Known
History of CYPS Social Care involvement with family- please give details:
Is the child subject to a Child Protection Plan?
Has the child been subject to a Child Protection Plan in the past?
CRIMINAL STATUS:
Is the young person subject to a Court Order:
Please specify if yes:
Date order commenced:
Date order to conclude:
Order :
Yes
No
Length :
C
PROBLEM BEHAVIOURS - Outline history of the following problem behaviours
(include when and where displayed):

Sexually abusive behaviours - (include ages and relationships of victims and
details/reports of any assessment/treatment services/indicate whether convicted/not
convicted/level to which young person admits or denies abusive behaviour).

Self harm and/or suicide attempts:

Violence:

Alcohol and drug use:

Behaviours related to mental health diagnosis:

Other behaviours of concern (eg criminal behaviour, fire setting, cruelty to animals):
EDUCATION
School attended: ……………………………………….
Yr Group ……………………….
School attendance history, including number of schools attended and information on
school exclusions, learning disabilities, literacy problems:
History of Educational Psychology involvement (please include copies of reports):
Key contact person in school ________________________________
Phone/Fax _________________________________________________
IQ Assessment Level (if relevant) _______________________________
PARENTS/GUARDIANS DETAILS
Name
Phone ____________________________
Address ______________________
Mobile Tel No _____________________
Does this person hold parental responsibility
Yes
No

If no please specify:
CAREGIVERS (if different)
Names: ____________________
Phone ____________________________
Address: ____________________
Mobile Tel No _____________________
____________________________
Nature of relationship ______________
SIBLINGS/OTHER CHILDREN LIVING WITH CLIENT
Name _________________________________________________________
Age ___________ Gender ________________
Living with client
Yes / No
Name _________________________________________________________
Age ___________ Gender ________________
Living with client
Yes / No
Name _________________________________________________________
Age ___________ Gender ________________
Living with client
Yes / No
SIGNIFICANT OTHERS/SUPPORT PERSONS
Name: ______________________________________________________
Address: _______________________________________________________
________________________________________________________
Relationship ____________________________
Living with client
Phone ________________
Yes / No
Name: ______________________________________________________
Address: _______________________________________________________
________________________________________________________
Relationship ____________________________
Living with client
Phone ________________
Yes / No
Name: ______________________________________________________
Address: _______________________________________________________
________________________________________________________
Relationship ____________________________
Living with client
Phone ________________
Yes / No
FAMILY INFORMATION:
(include any reports/summaries of family history). Quality of relationships of young person
with key family members:
Family issues relevant to referral: (please include psychiatric, legal and abuse issues)
Placement History: (including residential, foster care, extended families, secure)
OTHER AGENCIES INVOLVED:
Agency 1 - Contact Person _________________________________
Agency
_________________________________
Phone
_________________________________
Reason for referral _____________________________
Date of involvement
___________________________________
Agency 2 - Contact Person _________________________________
Agency
_________________________________
Phone
_________________________________
Reason for referral _____________________________
Date of involvement
___________________________________
HEALTH:
Current GP Name ________________________________________________
Address ________________________________________________________
_____________________ Phone/Fax ___________________
GP informed of referral? Yes / No
Significant medical history: (eg allergies, asthma, epilepsy, disabilities, specialist reports)
Mental Health Problems:
FORMAL REPORTS & RECORDS CHECKLIST:
It is important that you ensure copies of the following reports and records (if in existence) are
attached to this referral following discussion with the Be Safe Service (Please indicate which
reports are attached).

Police summary of facts and evidential interview reports

Incident Reports

Relevant CYPS reports including Core Assessments and Case Conference Reports

Chronology

Assessment/Treatment Reports

Court Reports including criminal and/or care proceedings, list of convictions and
disposal

Psychiatric/Psychological/Medical Specialists reports

Statement of Educational Need/Review

Safety/Risk Management Plan

Other (Specify) …………………………………………………….
INFORMATION
SHARING
By signing this form, parents/guardians and the young person are giving permission for
information to be used for the following purposes:
 By staff of the Be Safe Service for the purposes of the service delivery
 Information may be shared with other professionals where it is considered to be in the best
interests of the individual concerned and for matters of safety.
 Existing information held by the Be Safe Service as a result of earlier consultations may also
be used to help provide appropriate services.
______________________________
Signature of referrer
________________________
Young Person
________________________________
Parent / Carer
_______________________________
Date
Appendix ii
Referral Criteria for the Be Safe Stay Safe Children’s Programme
Before a referral will be accepted the concerning behaviour must have been properly investigated
by the appropriate CYPS Social Work Team and/or Police and the investigation concluded, and
where applicable a prosecution concluded. Appropriate multi-agency meetings should have taken
place, i.e. Strategy Meetings, Child Protection Conferences, Child Care Reviews/Planning
Meetings, and/or Family Group Conferences.
The primary service for young people convicted of a sexual offence is the Youth Offending Team,
although joint work will be considered for young people on a referral order or final warning when
requested by the YOT.
In the first instance consideration will be given to the suitability of the group intervention and if not
appropriate, a family intervention.
For a referral to be accepted for the Be Safe, Stay Safe Children’s Programme:

The child must be aged 8 to 12 years (up to 14 for children with Learning
Disabilities/developmental delay at point of referral.

To meet the threshold to the AIM checklist ( Carson et.al., pp 51-56, 2007) which provides a
continuum from Healthy to problematic to harmful sexual behaviour and take into consideration
the following factors:
 the frequency/pattern/duration of the problematic/harmful behaviour,
 context for the behaviour and how it came about,
 evidence of coercion and/or grooming behaviours,
 seriousness/severity of the behaviour,
 age of the child/young person being referred, and age of the person harmed,
 nature of their relationship,
 and the child/young person’s response to previous interventions.

The child/young person’s parents/carer(s) willing to participate in the intake assessment and
ongoing group or family intervention programme and support the child to do so.

The child has to have accepted/admitted their problematic sexual behaviour to some degree
and be willing to engage in the intake assessment and subsequent intervention programme.

The child would need to be considered to be in a safe enough environment to participate in
the intake assessment and any subsequent intervention programme. This would be indicated by
the presence of a safety plan, and willingness from the child’s parent/carer to adhere to the safety
plan and address any ongoing concerns.

Consent must be obtained from the child and their parents/carers for the referral and
ongoing participation in the intake assessment and intervention programme.
* Refer also to the Be Safe Service Care Pathway and Referral Criteria
Be Safe Stay Safe Children’s Programme Referral Process (Refer to the Be Safe
Children’s Programme Care Pathway)
Referrals will be accepted from CYPS Social Care staff, CAMHS staff, YOT staff and the
Police. A common referral form will be used and sent to a practitioner on request after
discussion with the Be Safe.
The decision to provide Children’s Programme Team an intake assessment and/or the
intervention programme lies with the Be Safe Children’s Programme Team in line with the
above criteria. Consent is required from the child and their parents/carers or the
person/agency who holds parental responsibility to participate in the intake assessment
and intervention programme.
The child/young person is required to have a named social worker, who is willing to
support them and their family to participate in the intake assessment and / intervention
programme, and to attend Be Safe Children’s Programme Multi-agency Planning and
Review Meetings.
A multi-agency Child Protection Strategy meeting/ Child Protection Conference/Child in
Need Planning meeting or Child in Care Planning meeting must also have taken place
which has included referral to the service as part of its’ action plan. It will be good practice
to invite a representative from the Be Safe Service or Children’s Programme Team to
attend such meetings. If not possible Be Safe practitioners will be able to advise
colleagues on the appropriateness of a referral.
The service referral form would then need to be completed and forwarded with records of
Child Protection discussions/Strategy/Care Planning meetings/Child Protection
Conferences, relevant background material including details of incidents of concern, a
chronology, statements from the child or young person who has been abused where
appropriate, and risk management/safety plan. Failure to provide this information may
lead to a referral being declined.
The Be Safe Team will decide as to the appropriateness of the referral at its’ regular
referrals and allocations meeting as outlined above. They may choose to consult with
other key agencies or professionals prior to accepting a referral e.g. CAMHS, Police,
Young Persons Drug Treatment Service, Youth Offending Team.
All referrers will be notified in writing within 10 working days of whether a referral is
accepted or not, with a recommended course of action for the Children’s Programme.
Intake Assessment – Children’s Programme
The Intake Assessment primarily considers the suitability of the Children’s Intervention
Programme for the child and their parents/carers. Primarily the programme is a Group
Intervention for the child and their parents/carers. If a Group Intervention is not suitable a
family intervention will be considered. Consideration will also be given to whether a more
comprehensive assessment is necessary and whether a 1:1 and/or family therapy service
provided through Be Safe is more appropriate or other type of service.
The Children’s Programme Intake Assessment is not a risk assessment but an
assessment of the suitability for the Be Safe Stay Safe Children’s Programme. An intake
report will be made available to the referrer and key agencies once reviewed with the
child and their parents/carers which include recommendations and a case formulation.
Monitoring, Review and Discharge Reports.
-Bonner, B.L., Walker, C.E., Berliner, L.
References
Treatment Manual for Cognitive-behavioural Therapy for Chilren
with Sexual Behaviour Problems and their Parents/Caregivers, Administration of Children, Youth, and
Families, DHHS, Washington D.C., 1999.
-Carson, Carol, AIM: Education Guidelines for identifying and managing sexually harmful and problematic
behaviour in education settings, Education Leeds, Nass, October 2007.
-De Luc K. (2001) Developing care pathways-the handbook. Oxford: Radcliffe Medical Press Ltd, 2001.
-Kahn, Timothy, J., Roadmaps to Recovery: A Guided Workbook for Children in Treatment, Safer Society
Press, 2007.
-McCrory, Eamon, A Treatment Manual for Adolescents Displaying Harmful Sexual Behaviour- Change for
Good, Jessica Kingsley Publishers, 2011.
-Morrison, Tony, O’Callaghan, Print, Bobbie, Quayle, Jeremy, and Wilkinson, Lisa, Comprehensive
Assessment and Intervention Guides for work with Children and Young People who Sexually Harm, AIM,
G-MAP,
-O’Callaghan, David, A Framework for undertaking initial assessments of young people with intellectual disabilities
who present problematic/harmful sexual behaviours, 2003, G-MAP.
- Pote, Helen, and Goodban, David, A Mental Health Care Pathway for Children and Young People with
Learning Disabilities. A resource Pack for Service Planners and Practitioners. CAMHS Publications 2007.
-Print, B.; Griffin, H.; Beech, A.; Quayle, J.; Bradshaw, H.; Henniker, J. and Morrison, T.) AIM 2: an
initial assessment model for young people who display sexually harmful behaviour. G-Map; Manchester,
2007.
- Silovsky, Jane F., Swisher, Lisa, and Widdifield, Jimmy, Treatment for School-Age Children with Sexual
Behavior Problems and Their Families- Session Manual, Fourth Edition, Oklahoma University Health
Sciences Centre, 2013.
NICE Guidelines
Department of Health, The needs and effective treatment of young people who sexually abuse: current
evidence. Department of Health; London, 2006.
-Depression in children and young people
-Promoting the social and emotional wellbeing of young people in primary education
-Anxiety
-ADHD
-Conduct disorder in children- parent training/education programmes
- Self-harm
-When to suspect child maltreatment
-Obesity
-Obsessive-compulsive disorder
-Bipolar Disorder
-Eating Disorders
-Post-traumatic stress disorder
-Antenatal and postnatal mental health
-Looked after children
Authors: Elisabeth Archer, Assistant Psychologist, Stephen Barry, Principal Highly Specialist Clinician,
Paul Loader, Administration Coordinator, Mark Rivett, Family Psychotherapist, Mel Turpin, Clinical
Psychologist, Mick Wood, Service Manager
April 2013.