Background and Aims: The importance of the involvement of parents in treatment approaches for Children and Young People (CYP) who have engaged in Harmful Sexual Behaviour (HSB) has been consistently highlighted within the literature. Given that HSB arises in a family context, parents are considered key agents for change where CYP remain in their care. Professionals may work with them as a means of improving the CYP's therapeutic outcomes. Despite this, little is known about their personal lived experiences and representations of meaning, which remain largely unexplored. The current study aimed to address this gap and gain a rich understanding of the experiences of parents, from their own perspective. Methodology: Semi-structured interviews were used with six biological parents who were recruited via purposive sampling from a specialist service working with CYP who have engaged in HSB and their families. During interviews, four broad areas of interest were explored: the personal psychological impact of their child engaging in HSB; the impact on the parent-child relationship; wider familial and community responses; and parental coping. Interviews were audio-recorded and their verbatim transcripts analysed using Interpretative Phenomenological Analysis (IPA). Findings and Conclusions: The analysis produced four main themes; 'A devastated and overwhelmed life'; 'Threatened and trying to feel safer'; 'A challenged relationship with son'; and 'Space for hope in the face of hopelessness?'. It was highlighted that parents' experiences and meaning-making appeared intimately woven with a complex web of powerful relational and socially constructed factors. The research outcomes provide valuable insights for professionals working with young people who have engaged in HSB and their families. In learning more about what it is like to be the parent of a CYP who has engaged in HSB, it is hoped that professionals will have a richer framework from which to provide support to both the parent and to their child. Implications for clinical practice, the strengths and limitations of the methodology and directions for future research are discussed.

Background: In high-income countries, parenting programmes have been shown to be effective in reducing the risk of child maltreatment. However, there is limited evidence of their effectiveness in low- and middle-income countries. This thesis focuses on the development and pilot randomised controlled trial (RCT) of a parenting programme to reduce the risk of child maltreatment in low-income families with young children in Cape Town, South Africa. Methods: This thesis is comprised of three studies submitted as papers for publication. The first study focused on the development of an evidence-informed, locally relevant parenting programme for families with children aged three to eight years in Cape Town, South Africa. Intervention development took place over three stages: (a) identification of core intervention components common in evidence-based parenting programmes; (b) formative evaluation using qualitative in-depth interviews and semi-structured focus groups with South African practitioners and low-income parents; and (c) integration of evidence-based approaches and local contextual issues to develop the intervention structure, protocols, and manual. The second study used a pilot RCT (N = 68 parent-child dyads) to examine the evaluation feasibility and initial effects of the parenting programme developed during the first study in Cape Town - the Sinovuyo Caring Families Programme. Parents of children aged three to eight years with clinical levels of parent-reported child behaviour problems were randomly allocated to either a 12-session, group-based parenting programme or a wait-list control group. Primary outcomes included parent-report and observational assessments of positive parenting, harsh parenting, and child behaviour problems; secondary outcomes included parent-report of parent depression, parenting stress, and social support. Assessments occurred at baseline and immediate post-test (i.e., 3-months after baseline). The third study was a mixed-methods process evaluation assessing the feasibility of the parenting programme based on three theoretical dimensions: participation, implementation, and acceptability. Quantitative data included attendance registers, fidelity checklists, satisfaction surveys, and parent-report of engagement in home practice activities. Qualitative data included post-programme focus groups with community facilitators (n = 8), individual interviews with a randomly selected group of parents (n = 15), transcripts from parenting sessions, and minutes from supervision sessions with facilitators. Results: In the first study, the formative evaluation suggested that many evidence-based parenting programme components and approaches were compatible with the local cultural context. These included managing child behaviour problems, learning effective discipline strategies, building positive parent-child relationships, and reducing parenting stress. Findings also suggested that programmes may benefit from including additional content on keeping children safe in violent communities, communicating about HIV/AIDS and poverty, involving fathers and alternative caregivers, and incorporating cultural values of social responsibility and respect. The pilot RCT in the second study showed high levels of study recruitment and retention, outcome measurement reliability and response rates, and a minimal effect of clustering due to delivering the intervention in groups of parents. Analyses showed moderate intervention effects for parent-report of increased positive parenting and observations of improved child-led play. However, observational assessments also found reduced frequency of positive child behaviour in the treatment group in comparison to controls. In the third study, quantitative results showed high levels of programme acceptability, implementation, and participation. Thematic analysis of qualitative data identified seven themes related to feasibility: (a) receptivity to strengthening existing parenting practices, (b) initial resistance to new parenting skills, (c) contextualising content within a cultural framework, (d) reinforcing implementation fidelity and improving quality of delivery, (e) challenges delivering content on nonviolent discipline, (f) supporting participant involvement, and (g) engagement in a collaborative learning approach. Conclusion: This thesis is the first in sub-Saharan Africa to use a systematic approach to develop and rigorously pilot a parenting programme to reduce the risk of maltreatment against young children in low-resource settings. Initial results indicate that a parenting programme derived from evidence-based approaches is feasible, culturally acceptable, and has the potential to reduce the risk of child maltreatment by improving positive parenting behaviour. Further intervention development and testing is necessary to strengthen core programme components and determine programme effectiveness.

Among the many researched outcomes of childhood sexual abuse (‘CSA’), relational difficulties have been well documented. However, male CSA survivors may experience several outcomes that are unique to their gendered experience and yet remain largely under-represented in the literature. A gap was identified in the research around the experience of the male survivor in therapy for childhood sexual abuse, particularly where it relates to relationship building. Therefore the research aimed to explore this from the perspective of the survivors, with a focus on trust within the therapeutic relationship. To achieve this, the researcher interviewed 6 male survivors of sexual abuse, all of whom had greater than one years’ experience in a therapy that focused on their abuse. The researcher adopted a semi-structured interview format which facilitates partial guidance by the new data introduced by the participant. Transcripts of the interviews were analysed using interpretative phenomenal analysis with a consistent curiosity stance that allowed the researcher to partially bracket their prior knowledge. The analysis resulted in four master themes emerging; i) Finding and Connecting; ii) Negotiating Masculine identity, iii) Accepting and Committing to the process; and iv) Trust. Findings highlighted the necessity of reducing epistemic vigilance in the early relationship and the importance of negotiating power dynamics with support for challenge by the client in order to facilitate trust. The experience of masculine social expectations in a male CSA survivor is explored with regards to the trust relationship and an unexpected finding was made in the importance of group work. These findings were linked to previous research in the area of male CSA, recommendations are made for future research and implications for practitioners were explored.

Background: Childhood sexual abuse (CSA) has the potential to compromise the socioemotional development of the victim resulting in an increased vulnerability to difficulties regulating emotions and one’s sense of self. Emotion is thought to play a key part in a number of psychological disorders which CSA survivors are at increased risk of developing. A better understanding of the basic emotions experienced in this population and emotion regulation will inform current treatment. Aims: This research aimed to develop a better understanding of the emotions experienced by survivors of CSA and the relationship between “implicit” and explicit emotions and psychopathology. Method: Two empirical studies were conducted. Study 1 employed a cross-sectional consecutive case series design involving 109 survivors of CSA. Participants completed a set of measures relating to basic emotions, emotion regulation and symptoms. Exploratory factor analyses were conducted on the Basic Emotions scale (BES). Regression analyses were used to explore the relationship between emotions experienced, emotion regulation strategies and psychological symptoms. Study 2 examined basic emotions, “implicit disgust self-concept” and psychopathology in a population of CSA survivors (n=26) and a group of individuals currently receiving psychological therapy who reported that they had not experienced childhood trauma (n=25). Participants completed self-report measures pertaining to emotion, emotion regulation, symptoms and cognitive fusion. Participants also completed an implicit association test. Results: Exploratory factor analyses supported the structure of three versions of the BESWeekly, General, and Coping in a sample of survivors of childhood sexual abuse. In all three versions of the scale, disgust explained the largest proportion of variance. The basic emotions of sadness, fear and disgust as well as external dysfunctional coping strategies appear to predict PTSD symptomatology in this sample. The results of Study 2 also support the finding that self-reported disgust is prominent in the emotion profile of CSA survivors. Implicit disgust self-concept was not significantly correlated with other emotions or psychopathology. However, implicit disgust self-concept was found to be significantly associated with cognitive fusion. Discussion: Psychotherapeutic approaches for survivors of childhood sexual abuse should address the emotional experience of this population. In particular, these findings suggest that sadness and disgust should be targeted in therapy.

‘Child trafficking’ as a phenomenon requiring a policy and practice response has, in recent years gathered considerable pace. ‘Child trafficking’ is a crosscutting social issue, relevant to policy areas of child protection, child migration, criminal justice, immigration, social policy and human rights. This thesis explores children’s own accounts and lived experiences of ‘child trafficking’, addressing a notable gap in hearing from children directly. The thesis critically engages with the social construction of the ‘trafficked child’ examining how contemporary concepts of childhood shape and inform ‘child trafficking’ policy and practice. How ‘child trafficking’ policy has been constructed politically is examined, in shaping how ‘child trafficking’ is defined in practice. The implications for children experiencing trafficking of a system built on current assumptions about childhood and ‘child trafficking’ are considered. The study explores how children’s experiences of their childhood and ‘child trafficking’ challenge many assumptions underpinning policy and practice. The findings reveal a disjuncture between immigration-driven and prosecution focused ‘child trafficking’ practice and children requiring a welfare and individualised response to their needs. Children needed practitioners to listen to them, believe them and take action upon child protection concerns. A conclusion is drawn that the way in which ‘child trafficking’ policy and practice in England is presently constructed, and experienced, appears not to reflect the lived ‘realties’ of young people in this study. A new approach to ‘child trafficking’ policy and practice is recommended underpinned by a conceptual shift in how we perceive childhood and adolescence. Intended audiences of this study include policy-makers and front-line practitioners including social workers, the police, immigration officers and other services. This qualitative study contributes in developing methods with a hard to access population addressing a difficult subject area, promoting children and young people’s participation in research.

An extensive review of research and policy literature revealed that links are made between: going missing and forced marriage; going missing and child sexual exploitation; and forced marriage and child sexual exploitation. However, despite these overlaps, no links are made between all three issues. Given that some South Asian young women will run away from home in order to avoid being forced into marriage and that young people who run away or go missing from home are at risk of, or abused, through child sexual exploitation a research proposition was developed on the basis that a three way link was theoretically possible. A case study methodology was developed to test the research proposition. Eight cases were identified in which South Asian young people (under 18 years of age) had experienced some combination of all three issues. However, the pattern identified within the research proposition was not the ‘final explanation’. Analysis of the research findings revealed that variation existed within the pattern proposed. Moreover, a second pattern was identified in which forced marriage emerged as a parental response to young people who were already being sexually exploited and going missing in this context. The patterns identified were confirmed through analysis of interviews undertaken with twelve subject experts (key informants) and resonated with a specifically selected group of nine young people who were presented with a composite case study during focus group discussion. I argue that awareness of patterns linking all three issues will help practitioners to identify and respond appropriately to cases where the issues of going missing, forced marriage and child sexual exploitation overlap. That said the complexity of the cases highlighted risks associated with overlooking diversities: social divisions related to age, gender, ethnicity, class, sexuality and disability were explored to see how they shaped the young people’s experiences. This process revealed that they were located within complex axes of power which then intersected with social systems, including family, community and public institutions. As a consequence, young people lacked relational support and had limited access to safe accommodation and economic resources. This resulted in some young people making attempts to try and self-manage the competing harms that they were facing. The practitioners who supported the young people highlighted the challenges involved in working with them. Analysis of practitioners’ accounts further revealed how power dynamics within multi-agency working arrangements also impacted their efforts to respond to the needs of young people. Through testing the research proposition, I addressed a recognised need for more focused research into the issue of going missing as it relates to young people from different ethnic backgrounds (Berelowitz et al. 2012; Berelowitz et al., 2013; OCC, 2012; Patel, 1994; Safe on the Streets Research Team, 1999; Stein et al. 1994) as well as furthering knowledge about how child sexual exploitation is experienced by young people from black and minority ethnic (BME) communities (Chase & Statham, 2004; CEOP, 2011b; Jago et al., 2011; Berelowitz et al., 2013; Thiara & Gill, 2010; Kelly, 2013; Ward & Patel, 2006). The development of a typology of patterns linking going missing, forced marriage and child sexual exploitation provides a unique contribution to the scholarly literature.

Research has shown that the reaction of the non-offending guardian following disclosure of child sexual abuse (CSA) is an important factor related to the adjustment of the victim. However, to date, comparatively little research has examined the characteristics of non-offending guardians, specifically factors related to their ability to support and protect their child in the aftermath of disclosure. A systematic review of the existing literature, specifically primary studies of intervening variables for guardian belief, support and protection, or various combinations thereof, is firstly presented. Here, the lack of consensus within the literature over definition of ‘guardian support’ is highlighted, a situation that has confounded the drawing of firm conclusions regarding associated factors. Secondly, an empirical study is presented where this area of research is broadened out to include a general population of mothers and female carers, and to specifically examine perception of future sex offending risk through the use of vignettes. It is postulated that risk perception is a mediating variable between a guardian’s belief in the occurrence of CSA and subsequent support and protection, a variable that has yet to be examined within the literature as it relates to non-offending guardians. Results showed that mothers tended to over-estimate risk of re-offending, although of concern was that, in general terms, younger offenders with male victims (rated as ‘high risk’ according to a widely-used actuarial measure of sex offender risk) were regarded to be the least risky. Finally, an existing measure of guardian support is critically appraised. It is hypothesised that this type of instrument, that only measures a narrow aspect of a non-offending guardian’s post-disclosure functioning, might be usefully employed within an overall ‘risk of failure to protect’ assessment framework. Drawing upon the current findings, a model upon which to base this type of assessment is outlined in the discussion.

Die empirische Untersuchung setzt sich mit der aktuellen Beratungstätigkeit der "insoweit erfahrenen Fachkraft" und deren Rahmenbedigungen gemäß § 8a Abs. 4 SGB VIII im Freistaat Sachsen auseinander.

The research dealt with the implementation of Gestalt play therapy for the treatment of the sexually abused primary school child who experiences problems to maintain himself. The need for research on the theme originated from the researcher's experience with sexually abused primary school children. The aim of the research was to render therapeutic support to the primary school child through Gestalt play therapy, in order to explore the influence of such support on the child's maintaining behaviour. The applied research design was used for this purpose. For the purpose of the research, one sexually abused child who experienced problems to maintain himself was identified by means of purposeful sampling. During each Gestalt play therapy session the child was brought into contact with his senses. Conclusions as well as recommendations were formulated as a result of the research. / Social Work / M. Diac. (Play Therapy)

The research dealt with the implementation of Gestalt play therapy for the treatment of the sexually abused primary school child who experiences problems to maintain himself. The need for research on the theme originated from the researcher's experience with sexually abused primary school children. The aim of the research was to render therapeutic support to the primary school child through Gestalt play therapy, in order to explore the influence of such support on the child's maintaining behaviour. The applied research design was used for this purpose. For the purpose of the research, one sexually abused child who experienced problems to maintain himself was identified by means of purposeful sampling. During each Gestalt play therapy session the child was brought into contact with his senses. Conclusions as well as recommendations were formulated as a result of the research. / Social Work / M. Diac. (Play Therapy)