Turn the Page manualised treatment programme: final evaluation report

Key findings

• Practitioners tailored the material in the Change for Good manual to each child’s individual learning styles and need. They felt this was essential to help young people through the programme. Sessions were adapted if young people struggled to engage with particular exercises, raised additional problems they needed help with, or if their ability to focus on the material was affected by previous experiences that needed addressing, such as abuse or neglect.
  
  
• The level of change made by young people on the programme varied. Overall, the proportion of young people with a clinical level of need on any standardised measure fell from 27% at the start of the programme to 18% by the end of the programme. This was statistically significant, although it is not possible to attribute any change solely to the programme as the sample size was small and there was no comparison group.
  
  
• The most change over the programme was made in the area of psychological functioning – self-esteem, emotional loneliness and young people’s sense of mastery over their own life. All these changes were statistically significant.
  
  
• There was little change in young people’s level of openness over the programme, and some seemed to only engage on a superficial level. This may not be surprising given their age and the nature of the topics discussed, although it may affect the impact the programme has on their behaviour.
  
  
• 48% of the young people started the programme with low levels of sexual knowledge, and 22% still had low sexual knowledge by the end of the programme. Practitioners reported some difficulties with the programme material that focused on this area, sometimes using alternative materials to cover the topic, which may explain this result.
  
  
• Young people whose harmful sexual behaviour (HSB) was directed at younger children showed some improvements on abuse-focused measures, such as victim empathy and attitudes towards the offence. There was little progress on these measures for young people carrying out HSB against children of the same age, suggesting that the manual needs to focus on these areas in more depth. However, abuse-focused attitudes will always be more challenging areas to change.
  
  
• The relationship between young people and practitioners was an important factor in enabling them to discuss their HSB and resolve issues that had been worrying them.
  
  
• The young people found it helpful being given practical strategies to use to manage their behaviour.
  
  
• Some young people struggled to apply the learning from the programme once the sessions finished. Parents and carers and referrers were not always in a position to support the child in the long term and referrers had sometimes closed a child’s case at the end of the programme. It is important for post programme support to be in place so that the impact of the programme is not lost.
  
  
• A range of suggestions were made by young people, parents and carers, referrers and practitioners about how the Change for Good manual could be improved. This included making the material more interactive, having it online, and giving young people more opportunity to practice their skills. The homework projects were completed in less than half the sessions so need to be reviewed.
  
  
• We will be developing a complementary practice guidance document to sit alongside Change for Good, which will address the key findings from the evaluation and fill the gaps identified by the research.