This report describes the results of the interviews that were held with professionals, policy makers, and researchers (working in the field of sexuality and/or residential and foster care) in three countries in order to answer the following question: ‘Which competencies (i.e. knowledge, skills, and attitude) do professionals working in care need in order to support healthy sexual development of young people in care? Chapter 3 describes the characteristics of young people growing up in care. Young people in care are generally more vulnerable than their peers living in normal families since they have grown up in unsafe family environments. They are often insecurely attached, have a lack of positive role models and positive sexual experiences, have not grown up with clear norms and values concerning sexuality, have low self-esteem and little knowledge about (healthy) sexuality. This set of characteristics makes them more likely to cross their own boundaries and that of others and to make unhealthy choices with regard to sexuality. Therefore, young people in care have special needs with regard to sexuality that professionals working in care should know about and act upon. To meet the special needs of young people in care, professionals should create a safe environment and be there for the young people, in order to make them feel safe and secure again. In addition, they should act as positive role models, set boundaries, help young people to gain self-confidence, and give them space to have positive sexual experiences and to discover their own norms and values. Professionals working in care should provide sexual education that supports young people in their knowledge, skills, and attitudes concerning sexual development and teaches them to make wise and responsible decisions for themselves. Professionals need to put aside prejudices about boys and girls and treat them equally. Chapter 4 describes opportunities to start a conversation with young people in care about sex, intimacy and relationship and what professionals should teach foster parents. Opportunities to start a conversation with young people in care are: 1. When one of the boys or girls spontaneously starts to talk about sexuality; 2. When young people have discussions about boyfriends, girlfriends, or sex. 3. When young people watch clips on social media in which sexuality plays a role. Important topics to discuss are: healthy sexual behaviour, relationships, wishes, boundaries, making your own decisions, changing behaviour after regretting something, norms and values, and social media. Professionals working in foster care should teach foster parents that: 1. It is their task to speak about this topic with their foster child; 2. They should already start talking about this topic to toddlers; 3. It is normal to have difficulties talking about this topic; 4. They should not only speak about the risks of sex but also about sexual pleasure, desire, love, and respect. Chapter 5 describes the personal characteristics and general competencies that professionals working in care should have in order to support the sexual development of young people in care. These are: 1. Have a high degree of self-awareness concerning their own limits, norms and values, and how this influences the way they work, 2. Know that norms and values are dependent on time and culture, 3. Treat children, young people, and parents with respect, 4. Have a good sense of professional judgment, 5. Feel responsible for one’s actions, 6. Have knowledge about trauma theory. Chapter 6 describes what organisations can do to support healthy sexual development of young people in care. Organisations can do the following on the organizational level: 1. Provide structural resources for training and reflection, 2. Create a safe environment and reflective culture, 3. Create diversity among team members, 4. Create access to experts on the topic of sexuality, 5. Pay attention to competencies during hiring processes, 6. Have organisational and institutional policies on the topic of sexuality, 7. Have organisational structures and tools to support relationships and conversations with young people.Chapter 7 describes factors at the professional, organisational, and societal level that may contribute to sexuality-related difficulties in both residential and foster care. Some of these factors are not specifically related to residential or foster care, such as low self-efficacy of professionals, insufficient time for reflection and negative media influences. Other factors are specifically related to residential care, such as having insufficient possibilities to experiment with sexuality (in residential care) and fear of foster parents being accused (in foster care).
Not much is known about the etiology, or development, of deviant sexual interests. The aim of this systematic review was to provide a broad overview of current theories on the etiology of sexual deviance. We conducted a systematic search of the databases PubMed and APA PsycInfo (EBSCO). Studies were included when they discussed a theory regarding the etiology or development of sexual deviance. Included studies were assessed on quality criteria for good theories. Common etiological themes were extracted using thematic analysis. We included 47 theories explaining sexual deviance in general as well as various specific deviant sexual interests, such as pedophilia and sadism/masochism. Few theories (k = 7) were of acceptable quality as suggested by our systematic assessment of quality criteria for good theories (QUACGOT). These theories indicated that deviant sexual interests may develop as the result of an interplay of various factors: excitation transfer between emotions and sexual arousal, conditioning, problems with “normative” sexuality, and social learning. Neurobiological findings could not be included as no acceptable quality neurobiological theories could be retrieved. The important roles of excitation transfer and conditioning designate that dynamic, changeable processes take part in the etiology of sexual deviance. These same processes could potentially be deployed to diminish unwanted deviant sexual interests.
Background: Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers. Objectives: This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice,attitude towards responsibility and knowledge of SD. Design: A cross-sectional study was conducted using a 41-item online survey. Participants: Seventy-nine members of the Dutch Federation of Social Workers Nephrology. Results: It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p¼0.049), knowledge (p¼0.001), supplementary education (p¼0.006), and the availability of protocols on sexual care (p¼0.007).Main barriers towards discussing SD consisted of ‘culture and religion’ (51.9%), ‘language and ethnicity’ (49.4%), and ‘presence of a third person’ (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers. Conclusion: This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual care
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