Safeguarding the safeguarders:

Supporting workers with children who

sexually abuse peers
Sarah Hatfield
Working with children and young people who sexually abuse peers is arguably one of the most professionally
demanding roles in the context of safeguarding and child protection. The field is, therefore, at a potentially
higher risk for employee attrition, implying a need for local authorities to make a commitment to training
and service evaluation and improvement. This paper is a report on research commissioned by one committed
local authority to evaluate training, professional supervision, organisational support and the dynamics of
the local teams delivering a front line service to this vulnerable group of young people and their care
providers. Of particular concern was the identification of factors that play a role in encouraging
professionals either to remain in the safeguarding team or to leave. Twenty-four keyworkers were followed
through specific training with pre- and post-measures of resilience and follow-up structured interviews 14
months into service delivery post-training. The occupational attrition rate amongst participants was very
high, with only two of the original sample remaining in post. This study found that the training had no
impact on personal worker resilience, and although organisational commitment was perceived to be high,
neither of these factors proved sufficient to motivate a higher retention rate of trained keyworkers. The results
indicated that the real difficulties arose within the smaller local safeguarding/child protection teams in
relation to role confusion, structural difficulties and a lack of the necessary level of specialist support.
Keywords: safeguarding; child sexual abuse; peer sexual abuse; training.
HE FIELD OF WORKING WITH
CHILDREN displaying inappropriate
sexual behaviour has involved much
debate about definitions. Johnson (1999)
called for clear labels describing categories
of sexual behaviour problems and associating the term sexually abusive only with
the category of child deemed to have the
most serious difficulties and to engage in
more intrusive sexual behaviours involving
coercion or aggression. When defining
whether sexual activities are harmful, there
appears a consensus in the literature that it is
important to consider the ages and developmental levels of all children involved in incidents. Where there is a large age or
developmental gap between a perpetrator
and victim, and where activities have taken
place for the gratification of the older or
more advanced child, it seems more likely
that harm may have occurred. Williams and
New (1996) proposed consideration of the

Educational & Child Psychology Vol. 31 No. 3

The British Psychological Society, 2014

following key factors to inform any working

definition: an explicit description of the abuse
that occurred including details of the major
sexual acts, frequency of the abuse and the
use of coercion or aggression; information
about ages and developmental levels of both
victims and perpetrators; and a description
of the attitudes and involvement of other family
members and of the prevailing cultural
attitude about sexuality in the community.
Although there is often an assumption
that children displaying sexually inappropriate behaviour have themselves been
abused this is generally not the case, and
even where sexual abuse has occurred the
link is not always straightforward. Silovsky
and Nice (2002) reported that in a sample of
children with sexual behaviour problems
65 per cent had no history of sexual abuse.
More recently, Hershkovitz (2011) found
that of 3554 children who had engaged
in sexually intrusive behaviour just under
33

Sarah Hatfield
10 per cent had an abuse history. Friedrich
and Davies (2003) investigated sexually
intrusive behaviour in both sexually abused
and non-sexually abused children and indicated that sexually intrusive behaviour was
correlated with low family income, low
education, single parent, domestic violence,
physical abuse and sexual abuse (in order of
statistical significance).

Resilience and burnout

The concept of resilience was first widely
reported following studies involving
children
of
schizophrenic
mothers
(Garmezy, 1970) and Werners innovative
study of resilience of children in Hawaii
(Werner et al., 1971). Discussion and investigation of a wide range of factors involved in
resilience led to a growth in studies
exploring socio-economic disadvantage
(Rutter, 1979), parental mental illness
(Masten & Coatsworth, 1995), effects of
various cultures (Grotberg, 1995), urban
poverty (Luthar, 1999) and the influence of
biological mechanisms (Rutter, 2002).
Historically the majority of projects in
resilience research were around child or
adolescent resilience, followed by studies of
adult resilience (Bonanno, 2004; Kelley,
2005; Luthar et al., 2000; Maddi, 2005; Reich
et al., 2010).
There seem to be at least two dimensions
to the concept of resilience: surprisingly
positive outcomes despite early negative
experiences and the ability to bounce back
from further problems, setbacks and critical
incidents. This study used a framework
which focussed on protective and vulnerability factors in relation to keyworkers. No
studies specifically investigating protective
and coping factors in workers involved in
managing cases of child sexual harmers
could be located, so investigation was based
on studies of workers within the areas of
mental health, child protection and hospice
work. On an individual level, protective
factors included the personality trait of
hardiness (Kobasa et al., 1982), social
support, both in the workplace and outside
34

(Holahan, Moos & Schaefer (1996), religious belief (Yang & Meilfatrick, 2001) and
good self-esteem and self-enhancement abilities (Bonanno, 2004). At a systemic level,
factors supporting resilience included supervision from a respected supervisor who
upholds values perceived to be closely
aligned to the values of the organisation
(Eisenberger et al., 2002), financial reward,
although this may not apply equally to
different professional groups (Rhoades &
Eisenberger, 2002), clear career prospects
and seeing that ones work is moving things
forward or having a beneficial impact (Eisenberger et al., 2002). Vulnerability factors
included personal views, thoughts or experiences that may be evoked by a child or
family. Trowell et al. (2008), in a study of a
multi-professional group very similar to that
in current study, focussed on enabling
keyworkers to have opportunities to reflect
on their own emotional experiences of
stressful work encounters to increase their
capacity to cope with their emotions and
therefore enhance their resilience.
Those working in care-giving or public
service occupations are most likely to suffer
from burnout (Maslach et al., 2001).
Working with child clients may be particularly difficult in terms of burnout levels experienced. Bennett et al. (1993) reported that
social workers involved in child protection
work, as opposed to other social work areas,
showed higher levels of emotional exhaustion, more negative feelings and greater
difficulty in maintaining professional boundaries and emotional distance from the cases
with whom they were involved. Burnout is
considered to have three dimensions, which
are related to work overload and role
conflict or ambiguity: emotional exhaustion,
depersonalisation (tendency to treat clients
as objects) and reduced personal accomplishment (Maslach et al., 2001). Rhoades
and Eisenberger (2002) highlighted low
perception of organisational support in relation to employee turnover and Sardiwalla et
al. (2007) reported a correlation between
job insecurity and lack of career prospects
Educational & Child Psychology Vol. 31 No. 3

Safeguarding the safeguarders

and emotional exhaustion and burnout in
workers. Use of coping strategies inappropriate to the stressful work situation may
increase emotional exhaustion, whereas
knowledge and use of a variety of effective
and appropriate coping strategies can
support successful functioning and increase
a workers sense of personal accomplishment
(Sardiwalla et al., 2007).
This study aimed to investigate whether
current local authority training for
keyworkers supports resilience levels, to
investigate if keyworker perception of organisational or supervisor support is involved in
choosing to continue to work in stressful
work situations and to inform future training
of teams working in this area.

Method
Participants
The participants were 24 adults working in a
local authority. They came from a range of
departments including educational psychology, social care, education, clinical psychology and specialist workers from a jointly
funded (social care/health authority) family
centre. All took part in a special training
course for those working with the target
group of children and young people in a
new multi-agency team. The participants
studied in two groups at two separate times.
Design
The investigation was conducted in three
stages. In the first stage participants
completed the Resilience Scale for Adults
(Friborg et al., 2003). This corresponded
most closely to the concept of adult
resilience reported in the literature (for
example, Bonanno, 2005) and enabled
investigation of resilience in relation to
personal strength and structure, social
competence, family cohesion and social
resources. Participant responses were
collected both before and after completing
the training programme and conducting
work applying training skills in cases of
children displaying inappropriate sexual
behaviour.
Educational & Child Psychology Vol. 31 No. 3

The second and third stages aimed to

investigate why so many participants had
chosen to stop working in the new multiagency team. Of the original 24 participants,
18 remained working in the local authority
in the same job title 14 months after the final
training course. Two participants did not
return to work after having children, two
were still working for the local authority but
in very different roles and two had left to
pursue careers elsewhere. Of the remaining
18, only two continued to work in the new
multi-agency team. In the second stage
participants responded to key questions
based on research findings on aspects of
resilience seen to be important for
sustaining working in demanding contexts
their perception of the supportiveness of
their organisation, their perception of the
supportiveness of their supervisor, the extent
to which their supervisor was seen to have
the skills to support and develop them in
their role, their clarity regarding their role in
the team and the impact of their own
emotional needs. Sixteen of the remaining
18 responded at this stage, and their
responses served as a prompt for the third
stage, a semi-structured interview conducted
by telephone with 15 of these participants.
Data analysis
For quantitative analysis of the Resilience
Scale for Adults the study had one
dependent variable, the resilience level of
participants, and two independent variables,
time of training and training group. The
questionnaire yielded results for six factors
(Perception of Self, Perception of Future,
Social Competence, Family Cohesion, Social
Resources and Structured Style). A univariate ANOVA was completed to investigate
effects of time and training group on
resilience levels. Results were further
analysed using a MANOVA for the six individual factors of the questionnaire.
For the qualitative analysis, the semi-structured interview, which was informed by the
responses to the key questions asked of participants at the second stage, yielded data
35

Sarah Hatfield
which were transcribed and coded into 115
statements, resulting in 22 codes (Ahern,
1999). These codes were then reduced into
themes and cross-coded with three independent coders (after Braun & Clarke, 2006),
using a percentage of agreement to ascertain
an index of inter-rater reliability. These
themes were reduced to a final selection in
discussion with two trained coders.

Results
Although the experimental measure selected
(the Resilience Scale for Adults) had good
published reliability and validity figures, the
experimental data obtained from the questionnaire were further checked using SPSS.
Investigation of reliability showed that
removal of one questionnaire item (Item 30)
from one of the five experimental factors
(Structured style, factor 5) would give
improved reliability. Item 30 was, therefore,
removed from further statistical analysis.
A univariate ANOVA (dependent variable
total resilience level, independent variables
time and training group) was conducted.
There were no main effects of time on
resilience levels: F(3,1)=0.37, p>0.5. There
were no significant differences between
average resilience levels pre- and posttraining: T1 (M=5.36); T2 (M=5.22).
A MANOVA on resilience subscales x training
x time x training group (two factors of time
and training with six subscales and six
dependent variables) further indicated no
significant changes in factors related to social
competence, social resources and personal
strength. In addition, an independent t-test
showed no significant differences in
resilience measures between the two
different training groups both before and
after the training programme.
The responses to the key questions at the
second stage provided broad pointers which
helped to formulate the semi-structured interview. Of the 16 participants who responded to
the key questions, almost all felt that both
their organisation and their supervisor was
supportive. Issues were raised, however,
regarding the skills of their supervisors in
36

supporting their work in this area and the

demands of the work on their own emotional
resources. Only five gave a positive response
to the question, Do you have a clear understanding of your role in the team?
The aim of the semi-structured interview
at the third stage, 14 months after training,
was to establish why so many keyworkers had
left the multi-agency team. The data
obtained from the 15 participants who
responded were organised by thematic
mapping into three over-arching themes.
Nearly all the statements obtained were
accounted for under these three themes
(114 of 115 data units) support for the
worker, structure of the team and needs of
the child. Stemming from these three main
themes were a number of sub-themes, shown
in Figure 1 (overleaf).
Theme 1: Support for the worker
The responses under this theme pointed to
different aspects of support required. Participants highlighted the need for more
training:
to stay the team would need to be more
clinically supported and have a commitment
for ongoing training and study.
despite the training I needed some
moreonce I worked a few cases I realised
I needed more (training).
In addition to training, support to manage
the impact on oneself as a worker was also
highlighted:
Id have needed ongoing supervision on a
weekly basis to keep working like that.
the system does put enormous pressure on to
professionals working in this area, partly
about buck-passing partly about (people)
having struggled to get a service.
Specific difficulties in dealing with cases
involving sexual matters were also reported:
sometimes ones own thinking was
challenged and one needed to acknowledge that
there were difficulties in detailing the sexual
activity and linking it to motivations/causes,
etc., which needed to be worked through.
the subject is never easy either for the child
or the assessor.
Educational & Child Psychology Vol. 31 No. 3

Safeguarding the safeguarders

Figure 1: Thematic map.

Some participants went further, suggesting

ways in which emotional needs could be
supported:
The professional and personal stresses are very
different. Fortunately I am able when away
from work to compartmentalise my job. Over
35 years I have trained myself to be able to do
this. This doesnt mean that I do not think
about my job away from work but it doesnt
dominate.
I felt I needed some therapy myself more
input was needed here about what we were
dealing with.
One participant was particularly frank about
his thoughts in this area:
It (the project) was a total waste of the
departments money, getting a counsellor in for
staff members would have been better.
The findings on this theme are particularly
pertinent, as it supports the analysis of
earlier questionnaire data which showed that
a lack of support (or perceived support) for
ones own emotional needs was linked with
participants decisions to leave the team.
Educational & Child Psychology Vol. 31 No. 3

Theme 2: Structure of the team

Thematic analysis of this theme also uncovered interesting information in an area not
hypothesised by the researcher as important.
Comments about the structure of the team,
or comments that related to sub-themes
around the structure of the team, were made
by all but two respondents. Direct comments
on this subject had the highest level of coded
statements for any themes or sub-themes in
the analysis. This suggests it is an important
area to consider for any future training in
this area. Participant reports included direct
statements:
To stay in the team it would have to have been
more structured.
It needed someone to say who you should be
co-working cases with, etc.
A realistic structure which meant that such a
group had substance and the ability to exist as
a group.
Other comments were more prescriptive:
To stay I would have needed to carve out a
clear job plan, a service level agreement
37

Sarah Hatfield
around who was doing what was needed
a commissioner discussion with all the
agencies should have taken place so as to
separate roles.
Many responses went further than just criticising the basic structure, suggesting that coordination both within and outside the team
was a factor in their decision to leave:
It needed more co-ordination, a co-ordinating
point so that all professionals were working
together.
All professionals working together not just
selectively.
It must be noted that there were no positive
comments about the structure of the team.
In addition to difficulties with structure,
individual job roles, co-working and co-ordination, several participants also expressed
frustration at the location of the team at a
wider organisational level:
How does such a team bolt on to things like
CAF, Family Welfare? A more co-ordinated
approach alongside other teams was needed.
Senior managers were aware of the project so
why was it not better co-ordinated.
The department didnt acknowledge the work,
we just had to fit it in.
The need for a clearer referral process into
the team was also mentioned by several
participants:
It needed more robust referral processes, ideally
a centralised system for referrals so there was
consistency countywide (the local authority
is divided into five areas that are
managed separately).
Thematic analysis of Theme 2 suggests why
perception of organisational support and
supervisor support was good in the previous
questionnaire responses. This earlier finding
had been difficult for the researcher to
understand. If support was perceived as
good why had so many left the team? This
further analysis shows the issue was more
fundamental than perceived support by
supervisor or organisation. The difficulties
were actually within the team.
The diverse professional groups and
views within the team were never explored or
explicitly acknowledged. Research into
38

multi-agency working explicitly outlines the

need for this. Edwards (2004), reported on
the need for constructing common protocols or group frameworks to facilitate
successful multi-agency working. Research
also shows that an opportunity to investigate
both the attitudinal and emotional aspects
of a multi-agency group is necessary for
effective inter-professional collaboration
(Atkinson et al., 2002; Walker, 2003).
Theme 3: Needs of the child
The final theme was needs of the child.
During this final participant follow-up the
purpose was to determine factors which may
have contributed to keyworkers leaving the
team. One question involved asking
keyworkers who had left what they had
valued about working in the team. Earlier
questionnaire analyses had established that
the vast majority of keyworkers had rated the
training courses offered as very good and
informative to their practice, and one of the
questions in this final follow-up, therefore,
simply asked what they had found personally
satisfying by working in this area. Interestingly, the majority of responses for this area
cited the importance of feeling better able to
understand the needs of the child:
I hadnt before understood many aspects of
inappropriate sexual behaviour from the
childs point of view the training changed
my thinking.
After training I knew how to work these sort of
cases.
The satisfaction is self-evident as cases move
more into the mainstream and the child starts
to make sense of his life and learn more about
self-control and their own self-worth.
It really helped me to think through stuff
it was extremely good at making you think
about risk.
Knowing that there was a way to work with
these children.
Many participants also cited as satisfying the
chance to influence positively the lives of
children with sexually abusive behaviour:
For both me and the foster carers I work with,
it helped me to understand the process.
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Safeguarding the safeguarders

The experience was helpful knowing how to
operate best for a child making disclosures.
I believe we set in train some alteration of
behaviour often a lack of self-esteem was
involved.
Its always good to offer the chance to make a
difference to their future life.
There was also acknowledgement of the
potential negative aspects of involvement
with cases involving sexual behaviour:
I think it is dangerous to go on two/three day
courses and then be expected to work at this
level the kids go out of county anyway.
(This comment could be interpreted as a
participant that had perceived a lack of
support or adequate supervision in keeping
with the earlier theme.)
The chronic abuse laden families are probably
hardest to work with.
The implications of labelling a child as low or
high risk need to be carefully considered.
This theme identified that even participants
who had left the team had valued the opportunity to understand such difficult behaviours in children and as expected by
professionals working in childrens services
many valued the opportunity to offer a positive contribution to children in difficult
circumstances.

Discussion
In summary, although participant perception of organisational support and supervisory support did not appear involved in
choosing to leave the team, questionnaire
data and thematic analysis demonstrated
that support factors within the team itself
and lack of specialist support for the specific
needs associated with managing cases
involving inappropriate sexual behaviour
were important factors in participant decisions to leave the team. Support was, therefore, a vital component within this current
project, but support within the team and of
the team was the difficulty, as opposed to the
wider organisational support and supervisory support outlined as in the research
considered.

Educational & Child Psychology Vol. 31 No. 3

Although this study did not provide any

statistical evidence that could be used to
inform future training, the indications were
that all participants found the training useful
to their practice, suggesting that there was
no need to review the actual content of
training for future projects. The study also
suggested that participants felt supported by
both their organisation and their supervisor
when training in this challenging context.
Participants also reported that work overload
was not a difficulty, perhaps surprisingly as
there is currently a big demand for services
in this area within the local authority. Questionnaire responses and thematic analysis
indicated that many participants reported
feeling that their supervisor did not have
adequate skills or knowledge in the area of
children with inappropriate sexual behaviour, to provide effective supervision. In
answer to the final research aim, this study
can positively inform future training in many
practical ways (Appendix 1).
In terms of contributing to professional
practice, it is suggested that this study illustrates the need to conduct further research
around the underpinning concepts of supervisory skills, team structure and support and
management of different agency perspectives within the context of inappropriate
sexual behaviour. The study has also
provided factors to consider when
supporting workers within child sexual
behaviour work. It has indicated that
personal resilience is not enough to enable
workers to continue to practise in
demanding contexts of this kind. This has
implications for future training, as the
priority is not to target support or training
around personal resilience or its constituent
elements (the one exception to this being
the concept of managing ones own
emotional needs) as the keyworkers in this
study had considerable personal resilience
but this did not stop them from choosing to
leave the team.
The author acknowledges the methodological weakness of selecting resilience as
the key concept to investigate. It is suggested
39

Sarah Hatfield
that a concept such as self-efficacy could have
perhaps yielded more detailed results about
participants rating of their own abilities
within the work context. Such an approach
could have been further enhanced by asking
participants to rate their supervisors efficacy
within this area and also the collective efficacy of their department. This would enable
triangulation of factors within the three
areas. Another methodological weakness was
that the author was not able to match participant scores pre- and post-training, or
between the initial resilience questionnaire
and the follow up questionnaire because of
participant anonymity. Ethical approval was
obtained for the study under the understanding of participant anonymity.
As safeguarding is currently of such
major national and local prominence, skills
such as those obtained by working in this
area are much in demand. This study

contributes to wider research in this field by

suggesting that personal resilience of
keyworkers is not enough to support
continued practice in demanding areas and
offers some practical considerations that
may help to support keyworkers within the
safeguarding context.

Acknowledgements
The author wishes to thank Sean Cameron at
UCL and Val Haarbosch at Norfolk County
Council for their support.

Address for correspondence

Dr Sarah Hatfield
Senior Educational Psychologist,
Room 14,
Professional Development Centre,
144 Woodside Road,
Norwich, NR7 9QL.
Email: sarah.hatfield@norfolk.gov.uk

References
Ahern, K.J. (1999). Ten tips for reflexive researching.
Qualitative Health Research, 9(3), 407411.
Atkinson, M., Wilkin, A., Stott, A. & Kinder, K.
(2001). Multi-agency working: An audit of activity.
Berkshire: National Foundation for Educational
Research.
Bennett, P., Evans, R. & Tattersall, A. (1993). Stress
and coping in social workers: A preliminary
investigation. British Journal of Social Work, 23,
3144.
Bonanno, G.A. (2004). Loss, trauma, and human
resilience: Have we underestimated the human
capacity to thrive after extremely aversive events?
American Psychologist, 59(1), 2028.
Bonanno, G.A. (2005). Clarifying and extending the
construct of adult resilience (Comment).
American Psychologist, 60, 265267.
Braun, V. & Clarke, V. (2006). Using thematic
analysis in psychology. Qualitative Research in
Psychology, 3, 77101.
Edwards, A. (2004). New forms of professional knowledge
in multi-agency delivery of services for children.
Swindon: ESRC.
Eisenberger, R., Sucharski, I. & Stinglhamber, F.
(2002).
Perceived
supervisor
support:
Contributions to perceived organisational
support and employee retention. Journal of
Applied Psychology, 87(4), 698714.

40

Friborg, O., Hjemdal, O., Rosenvinge, J. &

Martinussen, M. (2003). A new rating scale for
adult resilience: What are the central protective
resources
behind
healthy
adjustment?
International Journal of Methods in Psychiatric
Research, 12(2), 6576.
Friedrich, W. & Davies, W. (2003). Sexual behaviour
problems in pre-teen children: Developmental,
ecological and behavioural correlates. Annals of
the New York Academy of Sciences, 989, 95104.
Garmezy, N. (1970). Process and reactive schizophrenia: Some conceptions and issues.
Schizophrenia Bulletin, 2, 3074.
Grotberg, E. (1995). A guide to promoting resilience
in children: Strengthening the human spirit (The
Early Childhood Development: Practice and Reflection
Series). The Hague, The Netherlands: The
Bernard van Leer Foundation. Retrieved 21 June
2014, from:
http://resilnet.uiuc.edu/library/grotb95b.html
Hershkowitz, I. (2011). The effects of abuse history
on sexually intrusive behaviour by children:
An analysis of child justice records. Child Abuse
and Neglect, 35(1), 4049.
Holahan, C., Moos. R. & Schaefer, J. (1996). Coping,
stress resistance, and growth: Conceptualising
adaptive functioning. In M. Zeidner & N.S.
Endler (Eds.), The handbook of coping: Theory,
research, applications (pp.2543). New York: Wiley.

Educational & Child Psychology Vol. 31 No. 3

Safeguarding the safeguarders

Johnson, T. (1999). Understanding your childs sexual
behaviour: Whats natural and healthy? Oakland,
CA: New Harbinger.
Kelley, T.M. (2005). Natural resilience and innate
mental health. American Psychologist, 60, 265.
Kobasa, S.C., Maddi, S.R. & Kahn, S. (1982).
Hardiness and health: A prospective study.
Journal of Personality and Social Psychology, 42,
168177.
Luthar, S. (1999). Poverty and childrens adjustment.
Newbury Park, CA: Sage.
Luthar, S., Cicchetti, D. & Becker, B. (2000). The
construct of resilience: A critical evaluation and
guidelines for future work. Child Development,
71(3), 543562.
Maddi, S.R. (2005). On hardiness and other pathways
to resilience. American Psychologist, 60, 261262.
Maslach, C., Schaufeli, W.B. & Leiter, M.P. (2001). Job
burnout. Annual Review of Psychology, 52, 397422.
Masten, A. & Coatsworth, J.D. (1995). Competence,
resilience and psychopathology. In D. Cicchetti &
D. Cohen (Eds.), Developmental psychopathology:
Risk disorder and adaptation (Vol. 2, pp.715752).
New York: Wiley.
Reich, J., Zautra, A. & Hall, J. (Eds.) (2010).
Handbook of adult resilience. New York: Guilford.
Rhoades, L. & Eisenberger, R. (2002). Perceived
organisational support: A review of the literature.
Journal of Applied Psychology, 87(4), 698714.
Rutter, M. (1979). Protective factors in childrens
responses to stress and disadvantage. In M.W.
Kent & J.E. Rolf (Eds.), Primary prevention in
psychopathology: Social competence in children
(pp.4962). Hanover, NH: University Press of
New England.

Rutter, M. (2002). The interplay of nature, nuture

and developmental influences: The challenge
ahead for mental health. Archives of General
Psychiatry, 59, 9961000.
Sardiwalla, N., Vandenberg, H. & Esterhuyse, K.
(2007). The role of stressors and coping
strategies in the burnout experienced by hospice
workers. Cancer Nursing, 30(6), 488497.
Silovsky, J. & Nice, L. (2002). Characteristics of young
children with sexual behaviour problems: A pilot
study. Child Maltreatment, 7(3), 2740.
Trowell, J., Davids, Z., Miles, G., Shmueli, A. & Paton,
A. (2008). Developing healthy mental health
professionals: what can we learn from trainees?
Infant Observation, 11(3), 333343.
Walker, S. (2003). Interprofessional work in child
and adolescent mental health services. Emotional
and Behavioural Difficulties, 8(3), 189204.
Werner, E.E., Bierman, J.M. & French, F.E. (1971).
The children of Kauai. Honolulu: Hawaii,
University of Hawaii Press.
Williams, B. & New, M. (1996). Developmental
perspective on adolescent boys who sexually
abuse other children. Child Psychology and
Psychiatry, 1(4), 122129.
Yang, M. & Meilfatrick, S. (2001). Intensive care
nurses experiences of caring for dying patients:
A phenomenological study. International Journal
of Palliative Nursing, 7, 435441.

Appendix 1: Considerations for future similar projects.

l
l
l
l
l
l
l
l
l

After training a clear system to access specialist support.

On-going training opportunities to enable keyworkers to continue to develop their skills in
the area of sexual abuse.
Discussion around the impact of the work on the keyworker and a system of support,
if required, outlined.
A clear overall team structure, with different multi-agency perspectives acknowledged and
included in agreed team working protocols and frameworks.
Individual job roles clearly outlined.
A defined system of co-working, detailing who works with whom and when. This should
ideally include opportunities to work across as well as within professional groups.
An agreed referral process to the team.
Clear, explicit co-ordination points both within the team and at a wider level within the
organisation.
An acknowledgement that although the work is challenging, many participants report that
understanding and working with such difficult behaviours in children is professionally
rewarding.

Educational & Child Psychology Vol. 31 No. 3

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