Evaluating the Acceptability and Feasibility of the Kolvin Intervention Programme for Harmful Sexual Behaviour (KIP-S) Pilot – Carol Nixon, Aisling Martin & Katie Burgess

Having successfully delivered an intervention with a cohort of ‘difficult to engage’ young people, we were excited to share findings from our pilot evaluation of the Kolvin Intervention Programme for Harmful Sexual Behaviour (KIP-S) as a research presentation at the NOTA international conference 2019 in Belfast.

The context

There is limited evidence for what works within the population of adolescents who engage in Harmful Sexual Behaviour (HSB), and yet interventions provided during adolescence have been shown to be more effective with individuals who sexually offend than in adulthood (Kim, Benekos & Merlo, 2016). We know that this group are deemed to be a ‘high risk, high harm, high vulnerability’ population, and yet are the least likely to seek support from services (The Mental Health Taskforce, 2016).

In line with the existing evidence for what works with this population, the KIP-S is a strengths-based, resilience focussed programme, with an emphasis on the development of protective factors, such as an increased awareness of offending, and promoting positive regulation skills (Worling, 2013).

The development of the programme has been guided by the NSPCC HSB framework (Hackett, Holmes, and Branigan, 2016) and NICE guidelines (NICE, 2016), and we also hope to contribute to the evidence base through developing and evaluating interventions with the young people we work with.

The KIP-S programme

The KIP-S is a CBT informed psychoeducational programme individualised to meet the young person’s specific needs. The aims of the programme are to increase motivation to change their future behaviour, understand factors influencing their behaviour, develop their skills and develop a safety plan to reduce their risk of future harmful sexual behaviour. There is a focus on resilience and skill-building throughout the programme. Delivery of the content is multi-modal and interactive.

Pilot and evaluation

In the pilot phase, the programme was provided to 8 adolescent males, aged between 11 and 18 years. Six participants resided within a secure children’s home and had been convicted of a sexual offence. The remaining 2 participants resided in the community and presented with harmful sexual behaviour.

The KIP-S is comprised of 16 individual, multi-modal sessions; sessions are delivered on a weekly basis over a 1 hour period. Questions relating to participants understanding of their behaviour, motivation to change their behaviour and understanding what is required of them to change their behaviour, were asked before and after each individual session. Participants were asked to rate how interesting they found each session, how much they learnt within each session and how useful each session was following its completion. These questions allowed for an evaluation of the KIP-S to be completed. 

Analysis shows participants rated an increase in understanding of their behaviour, motivation to change their behaviour and understanding what they need to do to change their behaviour following completion of the KIP-S programme. Additionally, participants found the programme interesting and useful and reported that they had learned a lot from it.

Participants demonstrated that they had good knowledge before the programme in the areas of consequences of breaking the law; changes that occur to a boy during puberty; relationships; age of sexual consent; and sexual behaviour online. Qualitative analysis indicated that the young people found it useful to revisit these areas in a different format.

Reflections

During the workshop discussion, we reflected on the small sample size and generalisability of the findings. This is recognised as a limitation of the study, however the findings are nonetheless positive, and we would estimate that in a larger sample size the reported improvements would reach significance.

We discussed issues with adolescent engagement, and specifically, issues with regards to compliance within this population. It was evident from qualitative feedback received during the pilot that participants’ motivation for the programme was related to their own perceived progress through the youth justice system, and the need to demonstrate this progress to professionals.  Regardless of their motivation to engage, all of the young people we worked with engaged in a meaningful programme which uses rehabilitative, strength-based approaches. For us, we view this as a great achievement as well as of great clinical importance given the complexities of this population.

Post-Pilot Developments

In response to feedback from the pilot evaluation, an ongoing review of the KIP-S is in progress, which to date has led to the following changes:

  • Increased content relating to online safety (in response to Technology-Assisted HSB).
  • Increased collaboration with the young person both in terms of programme content and preferred modes of delivery.
  • Formulation-based (modular) approach whereby young people can access programme content specific to their individual needs, as opposed to completing the programme in its entirety, as per the pilot.
  • Adaptations made in collaboration with young people with visual impairments, young people with a learning disability and young people with Autistic Spectrum Conditions in response to their individual communication needs.

Conclusions

Overall, this pilot evaluation has indicated that:

  • The KIP-S is acceptable to young people who display HSB however this must be viewed in the context of socially desirable responding, i.e. their compliance to state interventions.
  • The programme successfully engaged a complex and challenging client group.
  • Further evaluation is required to ascertain feasibility of the programme in reducing recidivism.

Dr Carol Nixon, Principal Counselling & Forensic Psychologist, Kolvin Service (FCAMHS), Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust. (Corresponding Author: Email. Carol.Nixon@cntw.nhs.uk)

Dr Aisling Martin, Principal Clinical Psychologist, Kolvin Service (FCAMHS & Secure Children’s Home Integrated Mental Health Service), Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust. 

Katie Burgess, Assistant Psychologist, Kolvin Service (FCAMHS & Secure Children’s Home Integrated Mental Health Service), Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust.   

Acknowledgements

Dr PJ Kennedy, Consultant Clinical and Forensic Psychologist; Katie Burgess, Assistant Psychologist; Philip Sinfield, Assistant Psychologist; Clive Bellis, Trainee Clinical Psychologist; Richard Johnson, Specialist Nurse Practitioner.

References

Hackett, S (2014). Children and young people with harmful sexual behaviours: Research Review. Dartington: Research in Practice.

Hackett, S, Holmes, D, and Branigan, P (2016). Operational framework for children and young people displaying harmful sexual behaviours. London, NSPCC. Retrieved from https://www.nspcc.org.uk/services-and-resources/research-and-resources/2016/harmful-sexual-behaviour-framework/

Kim, B., Benekos, P. J., & Merlo, A. V. (2016). Sex Offender Recidivism Revisited: Review of Recent Meta-analyses on the Effects of Sex Offender Treatment. Trauma, Violence, & Abuse, 17(1), 105–117.

The Mental Health Taskforce (2016). The Five Year Forward View for Mental Health. Retrieved from: https://www.england.nhs.uk/wp-content/uploads/2016/02/Mental-Health-Taskforce-FYFV-final.pdf

National Institute for Health and Clinical Excellence (2016). Harmful sexual behaviour among children and young people. NICE Guideline (NG55). Retrieved from https://www.nice.org.uk/guidance/ng55

Worling J. R. (2013). Desistence for adolescents who sexually harm (Unpublished document). Retrieved from http://www.erasor.org/new-protective-factors.html

Examples of pictorial adaptations developed in collaboration with a young person with a learning disability

 

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