None listed
Conditions
Brief summary
Stand Strong, Walk Tall (SSWT) is a joint clinical and research initiative centred on child sexual abuse prevention. The current study represents Phase Two of the research team’s work, comprising the pilot delivery and evaluation of the SSWT intervention (developed within Phase One). The SSWT intervention was designed to be accessible on a self-referral basis for individuals in the community who experience sexual interest in children, with the dual aims of prevention alongside improving client wellbeing. Pilot study participants will be individuals meeting inclusion criteria (experience sexual interest in children; aged at least 18) who learn of the study, choose to self-refer, and provide informed consent. Participants will engage in an initial assessment, an individualised case-formulation informed intervention, and re-assessment (they may also be invited for subsequent follow-up assessments). The study thus has a prospective longitudinal design. Intervention evaluation as part of the study will comprise change analyses comparing pre- and post-intervention assessment data. In time, follow-up data will be used to explore the maintenance of change and behavioural outcomes. The SSWT intervention framework, including theoretical underpinnings and treatment target selection, was informed by research bases including: cognitive-behavioural theory and therapy; risk-needs-responsivity and strengths-based Good Lives Model rehabilitation frameworks; trauma-informed care principles; etiological/process models of child sexual abuse; Hauora Maori clinical guide (incorporating the hui process and Meihana model); characteristics of effective prevention interventions, and emergent findings on the treatment needs and preferences of persons who experience sexual interest in children. To date internationally, therapeutic interventions aiming to address the risk of engaging in harmful sexual behaviours towards children have typically been limited to the tertiary level of prevention; i.e., justice-system rehabilitation programmes for those convicted of relevant offences, aiming to reduce re-offending. Whilst the shift towards earlier preventive efforts by making help available to those in the community who may be at risk of offending is intuitive and has the potential to reduce harm, secondary prevention or "prehabilitation" is a newer focus of researchers and clinicians in the field. As such, there is not yet an existing gold standard effective intervention. SSWT has been designed to fill this gap, as a research-informed intervention with research protocols built in to enable robust evaluation and continuous improvement. The principal aim of the study is to evaluate the impact of the SSWT intervention on participants in terms of: therapeutic change on key identified targets (e.g., self-efficacy, self-regulation, stress/emotion management, interpersonal functioning); general wellbeing and quality of life; and behavioural outcomes.
Interventions
Brief name: Stand Strong, Walk Tall (SSWT)
Intervention objectives: These are twofold and include both improved psychological wellbeing for individuals who experience sexual interest in children; and prevention of child sexual abuse.
Materials: https://ir.canterbury.ac.nz/handle/10092/100828. SSWT is a psychotherapeutic intervention. Project clinicians are guided by an intervention framework document, Clinician's Guide, three-day training, and regular project-focused clinical and cultural superv
Brief name: Stand Strong, Walk Tall (SSWT) Intervention objectives: These are twofold and include both improved psychological wellbeing for individuals who experience sexual interest in children; and prevention of child sexual abuse. Materials: https://ir.canterbury.ac.nz/handle/10092/100828. SSWT is a psychotherapeutic intervention. Project clinicians are guided by an intervention framework document, Clinician's Guide, three-day training, and regular project-focused clinical and cultural supervision, in addition to their pre-existing relevant psychological knowledge and expertise in psychotherapeutic processes. Procedures: Study participants will be individuals meeting inclusion criteria who learn of the study, choose to self-refer, and provide informed consent. Participants will engage in an initial psychological assessment (including anticipated 2-3 hours of clinical interviews and 2-3 psychometric testing sessions), an individualised case formulation-informed psychotherapeutic intervention (encompassing a number of 60-minute cognitive-behavioural therapy sessions with key targets/content including: strengthen general and sexual self-regulation, emotion management, and coping with stress; build self-efficacy; address maladaptive thoughts/schema surrounding child sexual abuse; explore stigma and strategies to navigate stigma; strengthen skills for adult intimate relationships; good life planning), and re-assessment immediately post-intervention (1-2 testing sessions). Intervention providers: New Zealand registered psychologists with expertise and experience in the relevant field. A three-day training event specific to SSWT delivery is provided (by the SSWT research team members, remotely via videoconference across a three-day period, in the month prior to trial commencement) to all project clinicians who are external to the research team, along with monthly clinical and cultural supervision, as noted above. Mode of delivery: Individually, in person or via secure audio/visual connection. Intervention location: University-based clinical psychology clinics; service sites of participating community-based harmful sexual behaviour (HSB) agencies, and/or secure virtual setting. Intervention timing/amount: Varying according to individual need. Using best practice recommendations published by National Institute for Health and Care Excellence (NICE) as a guide, we expect intervention duration could range between approximately 6-10 therapy sessions of 8-12 weeks for someone with few intervention needs; at least 16-20 sessions over 3-4 months in the context of diagnosable mental health problems; more sessions may be required in the context of mental health problems coupled with sexual self-regulation difficulties. The maximum duration that intervention sessions will be delivered within the pilot is 12 months post-enrolment. Tailoring: Intervention will be personalised based on the range and level of treatment needs identified during the pre-intervention assessment and individualised case formulation, and planned collaboratively with the individual. Modifications: The intention is to refine the Clinician's Guide across the course of the pilot, in preparation for any future broader roll-out or future clinical use. Fidelity: Fidelity-enhancing strategies include provision of 3-day clinician training, and regular group clinical and cultural supervision with members of the SSWT research team for all pilot clinicians. A purpose-designed checklist will also be employed to monitor fidelity to the SSWT clinician training including the intervention framework and philosophy.
Sponsors
University of Canterbury
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Individuals residing in the community in New Zealand - Aged 18 years or older - Experience sexual interest in children (i.e., aged under 16 in line with New Zealand law); and - Self-refer to the pilot
Exclusion criteria
- Individuals with cognitive functioning in the very low range - Individuals who self-refer but upon assessment are found to not meet inclusion criterion regarding sexual interest in children - e.g., those whose thoughts about children occur exclusively in the context of an obsessive-compulsive disorder, those who experience concerning sexual ideation not involving minors, etc.
Outcome results
None listed