Harmful or Problematic Sexual Behaviors (PSB) Impacting Another Child in the Family
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This guidance is designed for parents and caregivers of children whose harmful sexual behaviors impact another child in the family. Doesn’t sound like your family’s situation? You can learn about general harmful or problematic sexual behaviors generally here, or view our other tailored guidance here.
What are Harmful or Problematic Sexual Behaviors (PSB) Within the Family Context?
Sometimes, children engage in harmful sexual behaviors with other children in their family. This can include biological siblings, foster or stepsiblings, cousins, or nieces and nephews. This is often called “sibling sexual abuse.” In these cases, all family members are affected. It is important to consider the needs of everyone in the family.
For children, harmful 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 these behaviors can come from trauma. Many children who exhibit harmful sexual behaviors have experienced physical, sexual, and/or emotional abuse. Others may 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
The steps below can help guide you through this discovery and what to do next.
What Should I Do if I Learn that my Child is Engaging in Harmful or Problematic Sexual Behaviors with Other Children in the Family?
Step 1: Prioritize the Emotional Wellbeing of Your Family
When you learn that your child has engaged in sibling sexual abuse, you may experience many different emotions. Feeling anger, shame, guilt, disappointment, confusion, or distress is common and normal. You might feel torn between supporting the child that has been harmed and the child that has caused harm.
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 each of your children one-on-one about the incident. At times, it may not be clear which child was harmed, and which child has caused the harm. Reassure all of your children that you love them and that you are committed to keeping everyone safe moving forward. Avoid any shameful language, as it is not helpful and can cause further harm.
Step 2: Focus on Safety
When harmful sexual behaviors involve another child in your family, it is important to focus on everyone’s safety.
Make sure there is a safety plan in place at home to avoid further harm. You can use the National Center on the Sexual Behavior of Youth’s Safety Plan or Rules for Parents and Caregivers as guides and adjust them to meet your family’s needs.
Think about the safety of the child(ren) who engaged in the harmful behaviors and try to understand more about the situation surrounding it. This can help them 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.
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.
There are resources that can help guide you and your family through this challenging time.
If your child needs therapy:
- Harmful or Problematic Sexual Behavior (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.
- For help selecting a therapist who can address sibling sexual abuse, you can read these Tips for Choosing a Therapist to Treat Harmful Sibling Dynamics.
Your child’s wellbeing depends on your wellbeing. Parental support is one of the most important ways children can overcome their harmful sexual behaviors. 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 Sibling Sexual Abuse
Understanding harmful sexual behaviors will help you stay calm and support your child. Here are a few resources that can help:
- “Taking Action: Support for Families of Children with Sexual Behavior Problems” is a booklet that provides a detailed, educational overview for caregivers of children with PSB. It covers topics such as:
- What harmful sexual behaviors are
- How harmful sexual behaviors develop
- How to make a safety plan
- How to advocate for your child
- Placement and reunification
- Taking care of yourself as a caregiver navigating this issue
- The Sibling Aggression and Abuse Research and Advocacy (SARAA) Initiative provides information on sibling sexual abuse, including fact sheets, guidance on how to promote positive sibling relationships, and the latest information on SSA. In addition to resources for caregivers, the website includes information for siblings themselves. You may find the following resources useful:
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- Recognizing and Responding to Sibling Sexual Abuse, which defines this form of harmful behaviors and provides guidance.
- When Is It Unsafe for Siblings to Live Together?, which discusses when it is unsafe for siblings to live together due to physical or psychological abuse, severe aggression, or harmful sexual behaviors.
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- 5WAVES is a website established by five individuals who were personally impacted by sibling sexual abuse. Through information, resources, and online peer support groups, 5WAVES seeks to support caregivers, professionals, and those who are impacted by sibling sexual abuse.
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 these behaviors and require unique approaches to treatment. To read tailored guidance on harmful sexual behaviors in children with developmental or intellectual disabilities, 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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