Know

花点时间想想你小时候的家庭。你与主要照顾者、兄弟姐妹、姑姑、叔叔或祖父母的关系如何？想想你的家庭对你成长的巨大影响。相反，想想你对家庭成员的影响。例如，当你面对一个紧张的情况或重大的生活变化时，你的家庭成员是如何受到影响的？这些反思性的想法有助于你考虑家庭动态的影响。

考虑您在您的计划中密切合作的儿童受到他们的家庭的影响可能是自然的。然而，很容易忘记一个家庭是一个复杂的系统，经常变化，取决于每个家庭成员的兴趣，发展和生命阶段。照顾者，兄弟姐妹，阿姨，叔叔或祖父母都可以受孩子的行为和经验的影响。Bowen的家庭系统理论（1978）承认家庭的复杂性，并提出了家庭系统任何部分的变化对家庭中的所有其他人产生了影响。

Let’s think about a family that consists of a mother, grandmother, and twins. The family plans for the grandmother to care for the twins at home until they are 3 years old, while the mother is at work. How will the family dynamics change when the twins enroll in a child care program? Perhaps the grandmother will be able to participate in hobbies and visit her friends, which could improve her well-being. Maybe the mother will be able to talk with the grandmother about various interests and ideas, instead of most conversations concerning caring for the twins. A change in one element of this family can have a significant impact on all other family members and change the family dynamic. Next, imagine that one of the twins begins exhibiting sexual behavior challenges in their new child care setting. How would this situation affect the mother or grandmother? Perhaps the mother or grandmother would need to go to more appointments or connect with community resources or agencies for support. The family would have to shift and adapt to meet the needs of the child.

The Importance of Rapport and Family Engagement

作为一名儿童护理专业人士，你的大部分工作都花在了项目中的孩子身上。可能很难找到时间与照顾者或家人联系；但是，与家人建立融洽的关系是必不可少的，这有利于你照顾的孩子。友好、提问、提供参与机会、表达兴趣都是与家人建立牢固关系的方法。与家庭建立牢固的关系是有益的，因为如果出现性行为挑战，你已经与孩子的家庭建立了基本的信任，从而创造了一个更有利的环境。有关家庭参与的更多信息，请访问虚拟实验学校家庭参与课程。yabo11vip

Communicating with Families

In Lesson Five, you had the opportunity to read how a staff member, Crystal, responded to a sexual behavior challenge in a school-age program. You learned how to马上回应and engage in the necessary follow-up proceduresafter the fact. Now that you have learned how to manage the immediate needs of children in the moment, you can turn your attention to supporting the family through this experience. Prior to communicating with a family about their child’s sexual behavior, you can prepare yourself for the conversation by doing the following:

评估自己的反应和偏见：In Lesson One, you learned the importance of reflecting on your own attitudes and assumptions that you hold toward this highly sensitive topic. Acknowledging your biases or discomfort around this topic prepares you to communicate with families about their children’s sexual behavior.

Start with empathy:Empathy is commonly described as being able to put yourself in someone else’s shoes and consider what they may be going through. Developing empathy for children and families coping with sexual behavior challenges is important because it can improve understanding, communication, and relationships. For parents or caregivers, caring for a child who exhibits sexual behavior challenges can be immensely stressful. It can be difficult to know how to respond or help their child. Furthermore, caregivers may feel like they are being judged by others for their child’s behaviors or that others will think of them as “bad” parents or caregivers, which adds an extra layer of complexity. Families with children who exhibit sexual behavior challenges may experience any of the following (NCTSN, 2009):

• Difficulty believing that the sexual behavior actually occurred
• Anger (toward their child, other children involved, at themselves, or at the world)
• 撤离他们的孩子
• 悲伤或沮丧
• 内疚和羞耻
• 隔离
• Disappointment (in child or self)
• 混乱和不确定性，特别是如果尚不清楚为什么孩子正式起来
• Nightmares or other traumatic stress reactions, particularly if the parent was sexually abused a child

Identify strengths:Prior to your difficult conversation with a family about their child’s sexual behavior challenges, take a moment to consider the strengths of the child or the family. What makes them unique? What makes them strong or resilient? A strengths-based approach empowers the family and encourages program staff to identify and leverage the incredible strengths of families.

与家人分享信息：有效沟通

你说什么，你对家人说的方式都很重要。当性行为挑战发生时，家庭很可能会对以下问题产生疑问：（1）什么是儿童的规范性或预期性行为，而不是性行为挑战；（2）你观察到的性行为挑战情况。

家庭不希望或预期的需要upport children with sexual behavior challenges and may not be familiar with the range of normative and challenging sexual behaviors or how to handle such a situation. It’s important to keep in mind that, based on their own experiences or cultures, not all families will have the same perceptions or expectations regarding their child’s behavior. When speaking about the topic with families, try to create an environment where questions and discussion about sexual development are welcomed and encouraged.

Each child is different, each situation is complex, and it can be difficult to answer questions about sexual development and behavior in the moment. For example, you may have families ask you if the sexual behavior they observe at home is “normal.” If a family member asks you a question about sexual development that you are unsure of, it’s OK to admit you are unsure. While admitting you don’t know can feel uncomfortable, it’s important not to make assumptions or guess. Instead, let the family know that you will find out more information after consulting with a member of your program leadership. You can say “I’m not sure, but I can find out more and ask my program administrator. One of us will follow-up with you as soon as possible.” This response shows transparency and can help strengthen your relationship with the family. It may also be useful to have resources readily available to consult or to use when discussing this topic with families. You may find it helpful to refer to the规范的儿童性发展与行为handout in theApply section of Lesson Two.

In addition to discussing the range of normative and challenging sexual behaviors, families may also have questions for you about the instances of challenging sexual behavior you observed. When discussing sexual behaviors with families, here are some important considerations:

坚持事实	描述您个人目睹的行为，并务必分享第一手知识。坚持你所知道的，专注于客观信息，而不是个人观点，意见或猜测。与家庭分享在发生行为发生后所采取的步骤支持孩子。 “Yesterday afternoon as the children were coming back into the room from lunch, I observed Jacob imitating sexual intercourse with a stuffed animal. Once I saw this, I redirected his behavior by asking him to help me set up for our next activity.”
“We’re on a team”	强调您、项目工作人员和家庭都在同一个团队中，孩子的安全和幸福对所有相关人员都至关重要。 “Thank you for coming in to speak with us, we appreciate your perspective, so we can all work together to support Jacob.”
Communicate strengths	记住尽可能地结合孩子的优点，而不是只关注孩子的行为。 “雅各布是我们教室的领导，很多孩子都尊敬他。”
鼓励家庭支持	作为一个团队一起制定一个安全计划。确定所有成年人都认同的界限和行为。 “Let’s come up with a plan together to best support Jacob in our program; how does that sound?”

Ineffective Communication: What to Avoid

虽然有很多有效的沟通策略，你可以使用与家庭，重要的是要意识到无效的沟通，或陈述，可能会使一个家庭感到不舒服或防御。下面是一些要避免的例子。

避免标签或诊断：When speaking with families about their child’s sexual behavior challenges avoid making assumptions or generalizations. Behavior is complex and children’s behavior is a form of communication that can be interpreted. Because behaviors can be interpreted, we may speculate about what a child is attempting to communicate through a behavior; however, it’s important not to jump to conclusions by diagnosing or labeling a child. Only specialists, who as part of their scope of practice can diagnose or suggest diagnoses, should introduce discussion about specific diagnoses with families. For example, a child care professional can say, “I have observed Jacob repeatedly using unsafe touch,”但不应该发表陈述，“我认为你的孩子有性发生性行为障碍。”如果您不确定您所说的，请参阅您的专业指南，并咨询教练，培训师或管理员。

Avoid judgment or criticism:Remember that children’s sexual behavior challenges can be a tremendous shock to the family. Think back to the many ways families may experience or react to these behaviors and use empathy when working with them. If families feel judged or criticized, it’s possible they will shut down and withdraw from working cooperatively with program staff. For example, a comment like “If you were more involved with your daughter she wouldn’t be exhibiting these behaviors” can be offensive for families to hear and would likely make them feel attacked and defensive.

做n’t compare one child to another:避免将一个孩子的行为或行为与节目中的另一个孩子进行比较。例如，像“我房间里的其他孩子都没有这样的孩子一样的陈述可以伤害你正在使用的家庭的感受和损害你与他们开发的关系。

Supporting Families through Their Child’s Sexual Behavior Challenges

Depending on the sexual behavior concern, you may work with a family whose child exhibits the behavior, or a family whose child has experienced the behavior. Think back to the case study in Lesson Five about Cameron and Makayla. The families of both Cameron, the child that exhibited the sexual behavior challenge, and Makayla, the child that experienced the sexual behavior need support.

As you’ve already learned, one way to be immediately supportive of these families is to utilize your effective communication skills with them regarding the sexual behavior incidents. In addition to the way you share information with them, it can be helpful to connect them with mental health or other community resources.

值得注意的是，对某些人来说，心理健康服务可能会带来耻辱感。记住这一点，你介绍心理健康服务的方式很重要。与其说“你需要咨询”并给他们一个电话号码，不如展开一场关于咨询及其好处的对话，这样会更有成效。你可以问他们的家庭是否愿意考虑咨询，并说明咨询可以成为处理儿童具有挑战性的性行为的支持来源。如果家人在谈话中表示有兴趣，可以主动帮助他们安排约会或其他他们可能需要的事情。这表明你的支持。采取第一步注册心理健康服务可能是非常困难的。你可以通过强调咨询服务的好处、提供有关当地资源的详细信息以及提供帮助来帮助建立第一次预约来支持家庭。参加心理咨询服务的决定取决于家庭，所以你必须尊重他们的决定。别逼他们在那一刻做决定。为了帮助支持一个处于危机中的家庭，只要表达你在那里帮助他们联系，如果他们在任何时候都选择这样做的话。

See

Initiating conversations with families about sexual development and behavior can feel uncomfortable for everyone involved, especially if you have limited knowledge and experience discussing this topic. Watch as two experts share recommendations for respectful ways to communicate with families.

与家人的支持性沟通

做

As you’ve learned, discussing sexual behavior challenges with families can be a difficult conversation for all adults involved. So far, you’ve explored ways that you can use effective communication skills to support families in crisis, now let’s turn your attention to programs. It’s important to examine program policies, procedures, and available community resources that can help support families who are dealing with their child’s sexual behavior challenges.

Take a few moments and consider the following questions regarding your program:

• Are you aware of local mental health community resources?
• Are you aware of when referrals to services may be appropriate?
• com是munity mental health resources readily available at your site? Where is this information? Is it in a place that families can see? How is this information presented? Is the information offered in the native languages of the families in your program?

While considering how information is displayed and readily available for staff and families is important, building strong partnerships with local agencies can also be beneficial. By connecting with local mental health resources, coaches, trainers, and administrators can create a seamless transition to needed services. For example, getting to know the point person for scheduling intake appointments for families, allowing families to have their first meeting with a counselor at your site, or inviting staff from community agencies in to lead discussion groups or speak with parents can work to reduce stigma around mental health and make it more approachable for families.

To better support families dealing with sexual behavior challenges, consider how your program can create stronger connections to community resources or how your site can work to reduce the stigma around mental health services.