Harmful or Problematic Sexual Behaviors (PSB) Impacting a Child Outside of the Family
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This guidance is designed for parents and caregivers of children whose sexual behaviors impact a child outside of the family. Doesn’t sound like your family’s situation? You can learn about general harmful sexual behaviors here or view our other tailored guidance here.
What It Means When Harmful or Problematic Sexual Behaviors (PSB) Impacts a Child Outside the Family
Sometimes, children engage in sexual behaviors with a peer, classmate, or neighbor. Perhaps you observed the behaviors yourself or heard about them from your child or someone else. Don’t wait to intervene: taking action early on gives your child the best chances of overcoming the behavior. The steps below can help guide you through this discovery and what to do next.
For children, sexual behaviors are not always related to sexual stimulation. Often, children who exhibit these behaviors do so out of curiosity, anxiety, lack of accurate information about their bodies, as part of self-calming or attention-seeking strategies, or imitation. Imitation may stem from exposure to adult sexual behaviors.
Additionally, research shows that many of these behaviors can come from trauma. Many children with harmful sexual behaviors have experienced physical, sexual, and/or emotional abuse. Many others have been exposed to domestic or community violence. 1 Other risk factors include inadequate family boundaries around sexuality and nudity, as well as early exposure to pornography. 2
What Should I Do if I Learn that my Child is Engaging in Harmful or Problematic Sexual Behaviors (PSB) with a Child Outside the Family?
Step 1: Focus on You and Your Child
When you learn your child engaged in harmful sexual behaviors, you may experience many different emotions. Feeling anger, shame, guilt, disappointment, confusion, or distress is common and normal.
Try to manage your emotions. Staying calm helps us have better responses to stressful situations. If you feel overwhelmed, count to ten, take deep breaths, drink some water, or sing your favorite song. If you still feel upset, find someone who can help you immediately, like a professional, a partner, or a friend.
Talk to your child. Tell them you love them, and that their behavior is/was not appropriate. Make sure they know you are on their team and that you will help them learn and make safer choices. Avoid shaming them, as this is not helpful and can cause further harm.
Step 2: Think of Your Child’s Safety
Try to understand more about the situation surrounding their behaviors. This can help a child overcome and resolve their behavioral issue. Some questions to think about include:
- Where did you learn to …?
- What made you want to …?
- Have you ever … before? How often/how long have you been doing this for?
- Do you feel safe at school?
- Did something scary happen to you?
The answers to these questions can help you figure out how to move forward. If you don’t feel comfortable asking these questions, don’t worry. A therapist can help better understand the root causes of your child’s behaviors and assess their safety.
The next section will help you figure out who to contact and where to find help.
Step 3: Find Help
These situations are complex and may require interventions from various professionals.
If a child shares that they were sexually abused, you can contact DCF (Department of Children and Families) or your local Child Advocacy Center for help. If the disclosure happens after business hours, you can contact the DCF hotline at 800-792-5200, or your local law enforcement agency.
If your child needs therapy:
PSB-specific therapeutic treatment is highly effective in helping children overcome their problematic sexual behaviors. To find local PSB treatment providers, visit the MASOC Resource Directory.
If your child is facing issues at school:
- If you think your child is unsafe at school, contact a school employee you feel comfortable sharing this information with. This can be your child’s teacher or the school’s counselor, nurse, or the principal.
- If your child is not receiving the supports they need at school, check out the Office of the Child Advocate’s Education Resources page to explore groups that can help.
- If a Title IX complaint was filed against your child, read up on what Title IX is. Then, contact your school district’s Title IX Coordinator to better understand your child’s rights to supports at school.
Your child’s wellbeing depends on your wellbeing. Parental support is one of the most important ways children can overcome their PSB. The following resources can help you find services that can support YOU during these difficult times:
- The Massachusetts Behavioral Health Help Line (BHHL) is available to connect you directly to behavioral health services in your community. The BHHL is for everyone, including LGBTQIA+, Black, Indigenous, and People of Color (BIPOC), individuals who are deaf or hard of hearing, individuals with disabilities, and individuals whose first language is not English.
- The Parent/Professional Advocacy League (PPAL) is a statewide family organization that advocates for improved access to mental health services for children, youth and caregivers. PPAL offers support groups and 1:1 peer support for parents navigating the behavioral health systems for their child.
- Stop It Now! is a resource for all adults with questions about child sexual abuse, including youth problematic sexual behaviors and Massachusetts specific resources. In addition to a resource-filled website, they offer a free, confidential helpline to answer your questions, navigate sexual behaviors, and access resources and professional support. Call them at 1.888.PREVENT, or visit their Get Immediate Help page to contact the helpline by email or chat.
In Massachusetts, some child-serving professionals, called mandated reporters, are legally required to report to the state when they have reasonable cause to believe a child is being neglected or abused. This includes allegations of child sexual abuse, regardless of who is believed to have perpetrated the abuse. This means the mandated reporter will contact the Department of Children and Families (DCF).
Step 4: Learn More About PSB
Understanding harmful sexual behaviors will help you stay calm and support your child. Here are a few resources that can help:
- Parent 2 Parent is website designed to prevent child sexual abuse by providing parents and other caretakers of children and youth with PSB with resources and tools to ensure children’s healthy sexual development and behavior. It includes information on:
- Parent stories
- A toolkit
- Cultural Awareness
- Pornography and Sexting
- Healthy Sexuality
- “Now What? A Caregiver’s Survival Guide” is a seven-page newsletter that provides suggestions for caregivers who have just learned of PSB. It includes information on what to do while your child is waiting for treatment, how to know when you need more support, and how to take care of yourself during this time. It also discusses appropriate supervision and activities for a child with PSB, how to handle electronics usage, and what to expect out of treatment.
- What’sOK? is a free and confidential resource for children and teens that provides helpful and accurate information about sexual behaviors and offers space for questions about their thoughts, feelings, interests and behaviors or someone else’s. Specifically, this webpage answers common questions about sexual content and media involving children.
Does your child have a developmental or intellectual disability?
While much of the information and resources about harmful sexual behaviors are applicable to all children, children with intellectual or developmental disabilities may have unique reasons for engaging in harmful sexual behaviors and require unique approaches to treatment. To read tailored guidance on sexual behaviors in children with developmental or intellectual disabilities, click here.
A Note for Foster Parents: Foster parents are mandated reporters. This means that if a foster parent (in their professional capacity) becomes aware that a child’s PSB caused harm that would amount to abuse or neglect to another child, the foster parent must file a 51A report of suspected abuse or neglect with the Department of Children and Families (DCF). You can also reach out to your child’s DCF case worker for further guidance, but this does not replace your obligation to report.
Sources
1 Children who harm other children by engaging in PSB are often victims of abuse themselves. Research shows that between 20% and 48% of children with PSB have experienced sexual abuse and that between 32% and 48% of children exhibiting PSB have experienced physical abuse. Studies have also highlighted that PSB is more common in children exposed to domestic violence. Allen, B. (2017). Children with sexual behavior problems: Clinical characteristics and relationship to child maltreatment. Child Psychiatry and Human Development 48, 189–199. https://doi.org/10.1007/s10578-016-0633-8; Silovsky, J., Niec, L., Bard, D., & Hecht, D. (2007). Treatment for preschool children with interpersonal sexual behavior problems: A pilot study. Journal of Clinical Child & Adolescent Psychology, 36(3), 378–391. https://doi.org/10.1080/15374410701444330 ; Bonner, B. L., Walker, C. E., & Berliner, L. (1999). Children with sexual behavior problems: Assessment and treatment – final report. Grant No. 90-CA-1469. U. S. Department of Health and Human Services, National Clearinghouse on Child Abuse and Neglect; Silovsky, J. F., & Niec, L. (2002). Characteristics of young children with sexual behavior problems: A pilot study. Child Maltreatment, 7(3), 187–197. https://psycnet.apa.org/doi/10.1177/1077559502007003002 ; Friedrich, W. N., Davies, W., Feher, E., & Wright, J. (2003). Sexual behavior problems in preteen children. Annals of the New York Academy of Sciences, 989, 95–104. https://doi.org/10.1111/j.1749-6632.2003.tb07296.x ; Mesman, G., Harper, S., Edge, N., Brandt, T. and Pemberton, J. (2019, May). Problematic sexual behavior in children. Journal of Pediatric Health Care, 33(3), 323-331. https://doi.org/10.1016/j.pedhc.2018.11.002.
2 “PSB-CY: Clinical Assessment and Treatment Overview Course Series. Course 1: Clinical Assessment of Children and Youth with Problematic Sexual Behavior”. https://www.ncsby.org/sites/default/files/Problematic%20Sexual%20Behavior%20-Protective%20Factors%20and%20Vulnerabilities%20(1).pdf. Adapted from: Friedrich, W. N., Davies, W., Feher, E., & Wright, J. (2003). Sexual Behavior Problems in Preteen Children. Annals of the New York Academy of Sciences, 989(1), 95-104. Retrieved from: https://doi.org/10.1111/j.1749-6632.2003.tb07296.x.
3 Massachusetts Department of Elementary and Secondary Education. 2023-24 Student Discipline Data Report. https://profiles.doe.mass.edu/statereport/ssdr.aspx
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