A mixed methods study measuring the outcomes of a sexual health progam designed to reduce incidents of harmful sexual behaviour in a special school setting

Harmful sexual behaviour (HSB) among young people (YP) is a pressing concern, with estimates suggesting that approximately one-third of all instances of child sexual abuse experienced by children are carried out by their peers. What is less recognised however, is the disproportionately high prevalence of HSB among young people with Special Educational Needs or Disabilities (SEND). Despite their overrepresentation in referrals to sexual assessment and treatment services, there's a dearth of psychological interventions for this group. This study aimed to evaluate the outcomes of a sexual health program designed for young people with learning difficulties (LD) in a special school setting and to investigate its potential to reduce instances of HSB among the students. The ‘Live your Best Life’ (LYBL) sexual health program was created by modifying the ‘Keep Safe’ Intervention Program. Keep Safe is a manualised intervention for young people 12 years and over with learning disabilities who have engaged in Harmful Sexual Behaviour. A feasibility study has been carried out and although the intervention is currently unvalidated, 300 practitioners have been trained in its use. The modified, preventative LYBL program evaluated in this study was designed to create a safe space for students with learning disabilities to actively explore and engaged with issues related to relationships, sex, and sexuality. The aim of the program was to increase student knowledge on topics like healthy relationships, safe sexual behaviour, consent, and managing sexual feelings in a safe way with a goal of mitigating harmful sexual behaviour between students.

A six-week program comprising of two 50-minute classes a week was delivered to four separate special classes and 18 staff members, and 34 students aged between 13 and 18 participated (n=52). The study employed a mixed methods design, collecting both quantitative and qualitative data from student and staff using a variety of data collection tools including reflective notebooks, student evaluation forms, a staff survey, behaviour frequency recording charts and semi-structured interview. The researcher encountered substantial challenges during the data collection phase, with many participants withdrawing from research activities towards the end of the study, which affected the extent to which a comprehensive analysis could be conducted. The study findings unveiled three primary outcomes. First, the program's impact varied considerably among different classes and students, signifying diverse experiences and outcomes. Second, students became more comfortable discussing relationships and sexuality throughout the program. Lastly, the study revealed that teachers reported that they observed an overall moderate increase in the sexual knowledge of their students. Diverse perceptions and opinions were reported by both students and staff regarding the program. While staff widely recognized the program's merits and deemed it beneficial, there was a significant lack of engagement in research activities. No direct evidence of HSB reduction from the program was found, but staff expressed optimism about its potential impact in this regard.

This study significantly contributes to the emerging literature on intervention programs for young people with SEND who engage in HSB. It offers valuable insights and recommendations for the research, development, and evaluation of such programs. The study highlights the potential barriers to teacher engagement in research activities and offers recommendations on how to mitigate these challenges for future research. In summary, this study highlights the pressing need and potential for preventative interventions targeting HSB in young people with SEND in special school settings. It also underscores the importance of supporting and promoting teacher engagement in research and development of these interventions.