National Clinical Assessment and Treatment Service (NCATS)


Treating young high-risk harmful sexual behaviour

National Clinical Assessment and Treatment Service (NCATS) is a national service that offers assessment, treatment, consultation and training for and about children and young people who have sexually abused others. We run NCATS in partnership with Oxleas NHS Foundation Trust.

How it works

How NCATS works

NCATS works with children and young people up to the age of 21. They may have emotional and behavioural disorders, developmental disorders, or learning disabilities.

An NCATS team is multi-disciplinary, consisting of four social workers, a consultant clinical psychologist, a consultant child and adolescent psychiatrist, and a systemic family therapist.


Assessment reports are produced after meeting with the young person, their parents or carers, and people within their support network such as social workers, psychologists, youth offending officers, education professionals or mental-health workers. This report includes:

  • an explanation of their harmful sexual behaviour
  • analysis of risks posed by the young person
  • recommendations, for professionals working with the young person, about case-management, placement and treatment options.

Treatment services

Depending on the results of the initial assessment, they may receive individual or family-based interventions. This will usually happen alongside other care and treatment the young person is receiving. This can include things like helping the young person to:

  • make sense of their behaviour
  • develop ways to prevent the harmful behaviour happening again
  • manage their emotions and relate to others.

Professional support

We also offer consultation services such as advice and recommendations to professionals about managing complex or high-risk harmful sexual behaviour cases. It’s available as a one-off service, which includes an assessment report, or ongoing consultation to a team.

NCATS provides tailored training packages to social-care and health agencies, universities or at conference events around the UK.

Evidence base

The evidence base

Service provision for children and young people displaying harmful sexual behaviour is patchy across the UK. There is, in particular, a shortage of assessment and treatment provision for the children and young people who are displaying some of the most serious behaviour (Home Office et al, 2006).

Many of the children and young people who develop harmful sexual behaviour have experienced some kind of abuse or trauma, such as:

  • physical abuse
  • emotional abuse
  • sexual abuse
  • severe neglect
  • parental rejection
  • family breakdown
  • domestic violence
  • parental drug and alcohol abuse

(Hackett, 2014).

Who it is for

Who is NCATS for?

Children and young people up to the age of 21 are referred to NCATS by professionals because they have:

Making a referral

We welcome initial telephone or email enquiries about NCATS services from a wide range of organisations, including local authorities, youth-offending services, courts, and Child and Adolescent Mental Health Services (CAMHS) throughout the UK.

Before we can accept a referral to NCATS, we’ll ask you about any safeguarding measures in place for the young person’s own safety and any measures helping to prevent further harm to others.

Call 020 3772 9905 or email for more information, costs and to make a referral.

Guidance about case management or treatment

Professionals can also contact us if they’re in need of detailed guidance about case management or treatment of harmful sexual behaviour cases.


NCATS locations

Where the NSPCC is delivering NCATS:

NCATS is based in north London but is available nationwide.

Call 020 3772 9905 or email for more information, costs and to make a referral.


Evaluation of NCATS

What we’ve learnt

Evidence from NCATS has been used to develop the practice guide, A treatment manual for adolescents displaying harmful sexual behaviour: change for good (McCrory, 2011).

This treatment manual is used in delivering Turn the Page and we’ve evaluated its use.

> Find out more about our evaluation of the way the Change for Good manual is used in Turn the Page

How we’re evaluating this service

We’re evaluating NCATS using a range of standardised psychometric measures before and at the end of the programme.

Evaluation tools

We’re using the following tools to evaluate the service:

  • Adolescent Clinical Sexual Behaviour Inventory
  • CHI Experience of Service Questionnaire (CHI-ESQ)
  • Child Sexual Behaviour Inventory
  • Goal-Based Outcome
  • Revised Child Anxiety and Depression Scale
  • Session by Session rating scales
  • Sexual Behaviour Inventory
  • Strengths and Difficulties Questionnaire
  • Trauma Symptom Checklist and Trauma Symptom Checklist for Young Children.
References and resources

References and resources

Evaluation reports

Hawkes, C. (2011) Description of a UK study of onset of sexually harmful behaviour before the age of ten years in boys referred to a specialist assessment and treatment service. Child Abuse Review, 20(2): 82-101.

Hawkes, C. (2009) Sexually harmful behaviour in young children and the link to maltreatment in early childhood: conclusions from a UK study of boys referred to the National Clinical Assessment and Treatment Service (NCATS), a specialist service for sexually harmful behaviour. London: NSPCC.

Evidence base

Hackett, S. (2014) Children and young people with harmful sexual behaviours: research review. Dartington: Research in Practice.

Home Office et al (2006) The needs and effective treatment of young people who sexually abuse: current evidence (PDF). London: Home Office.

McCrory, E. and Walker-Rhymes, P. (2011) A treatment manual for adolescents displaying harmful sexual behaviour: change for good. London: Jessica Kingsley.

Other resources

Harmful sexual behaviour
Find out what harmful sexual behaviour is, how to recognise it and to respond to concerns.

Working with the health sector
Evidence-based resources to help health sector professionals respond to children and young people displaying HSB, mitigate risk and prioritise children's safety.