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Young people who had harmful sexual behaviours rarely repeated criminal behaviour into adulthood. But only about a quarter had successful life outcomes, such as decent housing and employment and stable partner relationships. In fact, 43 per cent had poor outcomes, such as drug and alcohol problems, poverty, and institutionalization.
These were the findings of a U.K. study that looked at the long-term outcomes for adults who had received treatment for harmful sexual behaviours when they were 17 years old or younger.
In his presentation for the International Forensic Psychiatry Lecture Series, Dr. Simon Hackett discussed his team’s research into whether the treatments made a long-term difference in the lives of these children and youth.
He and his colleagues found that other factors — such as supportive family members, professionals, and intimate partners — tipped the scales to help these people avoid harmful behaviours and succeed in life. Treatments focused solely on the harmful sexual behaviour failed to prepare young people for a better future, he concluded. Young people also need support for the physical and sexual abuse they experienced and aftercare — support with developmental needs into adulthood — not just short-term follow-up.
Research Findings
The researchers interviewed adults who had received treatment for harmful sexual behaviour as children or adolescents. Many professionals avoid terms such as juvenile or adolescent sex offender, which can carry a lifelong stigma. Also, the behaviour may not have been criminal conduct.
The researchers found 700 files for young people (aged 8 to 17 years) referred for treatment over nine years at nine locations in the United Kingdom. Only three per cent were girls, and more than a third had a learning or cognitive disability. Nearly a third were in care.
While many of the harmful sexual behaviours involved inappropriate or assaultive touching, more than half involved penetration, and about a fifth involved violence or significant force.
Half of the young people in the study had been sexually abused, and half had been physically abused, with many having experienced both.
The researchers selected a sample from the original files. Among those the researchers could find, 69 agreed to be interviewed.
Dr. Hackett an his team classified the long-term outcomes for participants as successful, mixed, or unsuccessful, based on criteria from Farrington et al.’s resilient outcome factors.
Participant Outcomes
Few participants committed offences later in life. There were three convictions for sexual assault, two for physical assault, two for drug and violent offences, one for murder, one for arson, and one for property crime. Two of the people were responsible for several of the crimes, including one convicted of murder, arson, and a violent offence.
Those with the worst outcomes had poor body image and physical health, difficulty managing anger and aggression, and chaotic, frantic lives. Social isolation, financial problems, poverty, and drug and alcohol problems affected some of these people.
Those who did best found long-term, supportive intimate partners. They showed a belief in themselves, a sense of being in control of their lives, the ability to plan, a sense of humour, and optimism. Many took responsibility for their past behaviour but separated themselves from it, saying, “I’m no longer that person.” Employment, friends and colleagues, interests and talents, housing, and cultural identity were helpful factors.
Insights
Treatment needs to support longer-term developmental success, including many factors beyond sexual behaviour. For participants who turned around their lives, factors outside of treatment played a role. These included finding a partner, support from trustworthy professionals or caregivers, opportunities to participate, and meaningful goals in adult life.
Dr. Hackett said he believes such turning points should not be left to chance but should form part of treatment, incorporating both practical life-course goals and therapeutic goals for sexual behaviour (refer to diagram).
Participants appreciated the chance to tell their story, which they may not have discussed with anyone since treatment in childhood or adolescence. Yet their previous behaviour may be raised again when they are adults. This reflects the disconnect between the child and adult welfare systems.
For some, their sexual behaviour was less important compared with the other difficult life situations they faced (such as abuse), yet the system focused on the sexual behaviour. Mental health professionals need to find a balance between treating the sexual behaviour and helping the young person address other life issues.
Because good social supports and relationships helped participants turn their lives around, approaches should stress social development. The support systems and treatment should therefore focus more on life pathways and development and less on the specific incidents or managing potential future risk.
For more details, watch the recording of the May 29, 2025, lecture, “Case Closed, Then What? Recidivism, Desistance and Life Course Trajectories of Youth with Harmful Sexual Behaviors” on our website.
Written by Carolyn Brown and approved by Dr. Simon Hackett.
Simon Hackett is a professor of Child Abuse and Neglect, Durham University, U.K., and President of Association for the Treatment and Prevention of Sexual Abuse. simon.hackett@durham.ac.uk
