Turn the page: final evaluation Evaluation of a treatment programme for young people displaying harmful sexual behaviour

Teenage boy talking Turn the Page is a service for 12-18-year-old boys with harmful sexual behaviour (HSB), which is delivered at 12 NSPCC sites across the UK. It uses the Change for Good manual to look at the social and emotional challenges a young person is facing, help them change their behaviour and improve their wellbeing.

This is the final evaluation of Turn the Page. It focuses on the real world application of the Change for Good manual, looking at what works to help young people engage with and make progress on the programme.

We’ve also produced a technical report which describes the measures used to evaluate the programme in more detail. Our first evaluation shared findings from interviews held with young people, parents and carers, NSPCC practitioners and local agencies.

These reports are part of our Impact and evidence series.

Author: Emma Belton
Published: 2017

    • 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.
Acknowledgements 6
Executive summary 8
Main report 15
Chapter 1: Introduction 15
Chapter 2: Methodology 22
Chapter 3: Young people included in the evaluation and implications for the findings 30
Chapter 4: Use of the manual 37
Chapter 5: Change during the programme 47
Chapter 6: Factors influencing change 61
Chapter 7: Conclusions and recommendations 70
Bibliography 78

"I learnt quite a lot about my family history and stuff that had happened to us that I just couldn’t remember and all that, which was actually very helpful but also, I…just learnt a bit of self worth… and control and stuff."

“They always listened, whereas you get some people at school and some people at home, they’re just there, they pretend to listen, but the [practitioners] really did listen. They actually just said, ‘Well why do you think this? How did this make you feel?’ and actually got you to think how you feel a lot more.”

Please cite as: Belton, E. (2017) Turn the Page: manualised treatment programme: final evaluation report. London: NSPCC

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