Young people, parent/carer, and professional experiences of harmful sexual behaviour assessment, intervention, and support: a qualitative evidence synthesis

Introduction: This qualitative evidence synthesis (QES) was guided by three research aims: (1) What do young people, parents/carers and professionals say about their experiences of harmful sexual behaviour (HSB) assessment, intervention, and support? (2) What aspects of HSB assessment, intervention and support could be considered as distressing from the perspective of young people, parents/carers, and professionals? (3) What aspects of HSB assessment, intervention and support could be considered trauma-informed from the perspective of young people, parents/carers, and professionals? Experiences of adversity are common amongst young people with HSB and their parents/carers. These experiences should be accounted for in HSB provision to support the experience and impact of services to prevent further victimisation. This research is a novel contribution to the evidence base; a trauma-informed conceptualisation of HSB provision has yet to be formulated. Method: A systematic search was conducted; thirty-seven studies met the criteria for inclusion. Thematic synthesis was used to synthesise the content of the ‘Results/Findings’ sections of the included studies. A quality appraisal of the studies was undertaken and an assessment to determine the confidence in the analytical themes was completed. Results: Five descriptive findings were identified in response to research aim one. The overarching theme ‘Shame and Disempowerment’ captured the nine analytical themes identified in response to research aim two. The overarching theme ‘Relationships’ was identified to capture the five analytical themes in response to research aim three. Discussion: The findings revealed the aspects of HSB provision that could be considered potentially distressing, or trauma-informed, based on the voices and lived experiences of the three groups. Data synthesis highlighted commonality in experiences of HSB provision, particularly amongst young people and parents/carers. Clinical implications for the development of trauma-informed HSB services are provided.