Turn the Page


Overcoming harmful sexual behaviour

Turn the Page helps children and young people overcome feelings that have made them display harmful sexual behaviour (HSB).

It aims to help young people:

  • increase their socially acceptable behaviour and refrain from sexually harmful behaviour
  • improve their psychological functioning, optimism about the future and their sense of wellbeing.
How it works

How Turn the Page works

Turn the page consists of 30 weekly sessions with two practitioners. This includes 26 structured sessions and four sessions addressing individual issues, and includes activities like playing games and storytelling.

The sessions cover four main modules:

  • engagement
  • relationships
  • self-regulation
  • road map for the future.

There are also projects for participants to complete at home between sessions.

Turn the Page is underpinned by a cognitive behavioural approach and draws on attachment theory, mentalisation theory, psychodynamic and systems theories.

We talk to children and young people about their strengths, to help them feel better about themselves and learn to handle problems positively.

Turn the Page is the only manual-based intervention for adolescents with harmful sexual behaviour in the UK.

It uses the Change for Good treatment manual (McCrory, 2011), which was developed from the work and experience of our National Clinical Assessment and Treatment Service (NCATS).

Evidence base

The evidence base

Around one-third of sexual abuse is committed by children and young people (Hackett, 2014).

There has been little research on what treatment approaches are effective for harmful sexual behaviour (HSB), and provision is variable in terms of volume, content and quality (Home Office et al, 2006).

However, there is evidence that treatment should attempt to change a young person’s behaviour as well as addressing the reasons they engage in HSB, their family relationships and context (Hackett, 2004).

Who it is for

Who is Turn the Page for?

Turn the Page is open to children and young people aged 5- to 18-years-old with evidence of harmful sexual behaviour and safeguarding issues.

Any outstanding criminal proceedings must have been addressed.

Before we start delivering the service, we make an assessment with the child or young person to determine their needs and suitability. If the young person has already been assessed in this way, you can supply the assessment to us.

Making a referral

To see if Turn the Page is delivered in your area or to make a referral, email help@nspcc.org.uk.


Evaluation of Turn the Page

What we learnt

Our findings provide promising evidence that Turn the Page can help some young people to understand and manage their own sexual behaviour.

Our evidence shows that the Change for Good manual allows practitioners to tailor the programme to each young person’s individual needs.

> Read the final Turn the Page evaluation report

To improve the evidence base in this area, we’ve carried out research into specific areas. We profiled the characteristics of children under 12, children with a learning difficulty and girls who took part in Turn the Page. This enabled us to learn more about how to support these groups of children appropriately.

> Read our summary report

We’ve also produced a literature review and report on the characteristics of children and young people who display technology assisted harmful sexual behaviour.

You can find a full list of evaluation reports for this service in our references and resources section.

How we’re evaluating this service

We have been assessing Turn the Page in 11 UK locations since 2011.

We’re carrying out a process evaluation to understand:

  • how the service is delivered
  • the content of the intervention work carried out with children and young people
  • the views of the practitioners.

Information on the needs of the children and young people taking part in the service is also gathered using standardised measures during the assessment.

Evaluation tools

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

  • Adolescent Sexual Behaviour Inventory
  • Child Sexual Behaviour Inventory
  • Strengths and Difficulties Questionnaire
  • Trauma Symptom Checklist for Children
  • Trauma Symptom Checklist for Young Children
References and resources

References and resources

Evaluation reports

Belton, E. (2017) Turn the page: manualised treatment programme: final evaluation report. London: NSPCC.

Belton, E. (2017) Turn the page: manualised treatment programme: technical report. London: NSPCC.

Belton, E., Barnard, M. and Cotmore, R. (2014) Turn the page: learning from a manualised approach to treating harmful sexual behaviour. London: NSPCC.

Hollis, V. (2017) The profile of the children and young people accessing an NSPCC service for harmful sexual behaviour: summary report. London: NSPCC.

Evidence base

Belton, Emma and Hollis, Vicki (2016) A review of the research on children and young people who display harmful sexual behaviour online: what is developmentally appropriate online sexual behaviour, do children and young people with online versus offline harmful sexual behaviours (HSB) differ, and is there an association between online and offline HSB? London: NSPCC

Hackett, S. (2014) Children and young people with harmful sexual behaviours. London: Research in Practice Research Reviews.

Hackett, S. (2004) What works for children and young people with harmful sexual behaviours? Essex: Barnardo’s.

Hollis, Vicki and Belton, Emma (2017) Children and young people who engage in technology-assisted harmful sexual behaviour: a study of their behaviours, backgrounds and characteristics. London: NSPCC.

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

McCrory, E. (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.