Derbyshire Children and Young People’s Health Promotion Programme
An Education Resource to support young people’s awareness of gaining consent, negotiating peer pressure and where they can go for help with their intimate relationships.
Contents Page
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Background
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Aims of the Resource
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Creating a Safe Environment
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Consent and the Law
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How to use the Resource
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References
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Session discussion points and guidance
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Chapter 1 -
Libby and Kieran’s story (choice 1)
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Chapter 2 -
Libby and Kieran’s story (choice 2)
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Chapter 3 -
Libby and Kieran’s story (choice 3)
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Chapter 4 -
Josh’s story
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Chapter 5 -
Sophie’s Story
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Chapter 6 -
Where to go for help and support
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Background The Home Office Action Plan, A Call to End Violence against Women and Girls (2014), calls for more to be done to ‘promote the teaching of sexual consent and the importance of healthy relationships in schools’. A recent survey carried out by the Sex Education Forum in 2013 suggested that most young people reported that they had not been taught about consent and how to gain it. During a consultation with a student focus group in a Derbyshire school the young people reported the same gap in their knowledge and with the support of the Locality Manager for Children’s Services, their School and Donut Creative Arts Studio, decided to develop a DVD to support this gap.
Aims of the Resource To enable young people to: • Understand what a healthy relationship looks like, appreciating that relationships take many different forms but are always characterised by equity and mutual respect whatever sexuality • Understand the concept of consent and what it means in a healthy relationship • Know that both ethically and in law it is the person seeking consent who is responsible for ensuring that consent has been given, and that this cannot simply be assumed • To have understanding of the different types of contraception and sexual health screening available to them in Derbyshire • Know where they can go for help in Derbyshire
Creating a Safe Environment When talking about sexual consent it is important to provide a safe environment by: • Having a shared group agreement at the start of all sessions • Starting from where pupils are in terms of their existing knowledge, under standing, skills, beliefs and attitudes • Challenging unrealistic social norms • Having a non-judgemental approach • Avoiding personal disclosure by using distancing techniques • Ensuring effective signposting/referrals for young people if disclosures are made • Be facilitated by professionals who feel confident to teach the subject and know where to go to get further support • Assessing young people’s progress and adapting ‘teaching’ styles accordingly to allow for differentiation
Consent and the Law The Sexual Offences Act 2003 states that a person has consented ‘if she or he agrees by choice, and has the freedom and capacity to make that choice’. There are three important parts to this. Firstly, there is the emphasis on choice: a deliberate, active decision. Secondly, there is the question of capacity to consent: is the person old enough; are they capable of understanding what is happening; are they intoxicated by alcohol or affected by drugs; do they have a mental health problem or learning difficulties; and are they conscious?
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Finally the law asks whether a person makes their choice freely, that is to say without manipulation, exploitation or duress. This may include the use or threat of force, or may be more subtle, to do with whether the person seeking consent is in a position of power or authority, or is significantly older than the other person. The law is clear that it is the responsibility of the person seeking consent who has the responsibility to ensure that the other person agrees by choice and has the freedom and capacity to make that choice. The Crown Prosecution Service (CPS) is clear that the seeker of consent must seek continuing consent, rather than treating it as a one off.
How to use the resource The DVD is suitable for one to one work, mixed gender groups and also specific boys or girls targeted groups from the age of 13 upwards (Year 9); you just need to decide which story best suits the message you want to deliver. The film is made up of 3 different stories. The film total running time is 30 minutes. However there are suggested stop points where the film asks questions for discussion to reinforce key messages. The following discussion points and guidance will help you to facilitate this more easily. Topics that can be covered by using this DVD are; • Healthy relationships • Consent and gaining consent • Confidentiality • Negotiating peer pressure • Contraception • Sexually transmitted infections • C-Card registration • The role of the Young Person’s Public Health Nurse/Community School Nurse (formerly School Nurse) • Where to go for help It is suggested you show one story at a time working through the discussion points. The DVD can be used either from start to finish over 4 to 6 weeks (allows for key messages to be repeated and built upon) or to just use whichever story and discussion points you think will work best with your group or individual. The first chapter, Libby and Kieran’s’ Story has 3 different choices and outcomes, whereas Josh’s and Sophie’s Story only has one outcome. A suggested time required for each story and outcome is given in the guidance. It is important to include the 5 aspects which are core to discussions about consent: i. ii. iii. iv. v.
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That getting consent is as important as giving Applying ideas about consent to real life situations The gendered double standard Positive and active communication that goes beyond expecting partners to say yes or no Challenging victim blame i.e. she shouldn’t have come into my bedroom
All the stories are based on a heterosexual discourse, but it is important to ask young people within the discussions to consider if they had been same sex relationships would the issues be any different.
References www.sexeducationforum.org.uk www.pshe-association.org.uk www.thisisabuse.direct.gov.uk http://derbyshireyouthinc.com/ http://www.nspcc.org.uk www.childline.org.uk https://www.gov.uk/government/publications/teenage-relationship-abuse
A Call to End Violence against Women and Girls (2014) Home Office “Sex without consent, I suppose that is rape”: How young people in England understand sexual consent (2013) CWASU, London Metropolitan University Sexual Offences Act (2003) Teaching about Consent in PHSE Education at Key Stages 3 and 4 (2015), PHSE Association The Derbyshire Guide to Quality Relationships and Sex Education (2012), Derbyshire Community Health Service United Nations Convention on the rights of a child (UNCRC) (1989) Unicef, London To download an electronic .pdf version of this booklet please go to:
http://bit.ly/1IFdZ71 5
Session discussion points and Guidance Chapter 1 - Libby and Kieran’s story (choice 1) (Video length: 1m, 26s) Time suggested approx. 30 - 60 minutes
Key points for discussion following this clip • How easy/realistic is it to talk about when you are ready for sex? • What do we mean by sexual intimacy other than penetrative sex? • What qualities/skills are needed in a relationship to make sexual intimacy between two people equal and comfortable? • What key qualities/skills are needed in a relationship to make it easier to delay sexual intimacy? • What ways can you demonstrate you care for someone other than through sexual intimacy? • What signs would you see in someone to be sure they have consented to sexual intimacy? • How does Libby help Kieran talk about his concerns?
Key points for the facilitator It is important to stress that in the last Natsal Survey (2010-2012) most young people reported being 16 plus before they engaged in sexual intimacy.
Chapter 2 - Libby and Kieran’s story (choice 2) (Video length: 3m, 54s) Time suggested approx. 1 hour but could expand to 2 hours (two sessions)
Key points for discussion following this clip • • • • • • • •
What pressure does Libby put on Kieran to move their relationship forward? What other methods could be used to put pressure on someone to have sex? What signs are there that Kieran is not ready for sex? What other signs may you see that indicate that someone doesn’t want to do something? Has Libby ensured she has gained consent? Explore with the group what the legal definition of consent is. How might Kieran be feeling the next day? Where could he go for support?
Key points for the facilitator The definition of consent is: Consent is defined in law as agreement by choice by someone who has the freedom and capacity to make that choice. Depending on the age/maturity of the pupils, you (the facilitator) might want to make it easier for young people to understand and would suggest using the following definition - “consent is someone giving permission or agreeing to something, after they have thought carefully about whether or not they want to do something”.
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• To be able to give your consent you should be sure that it is your decision and not one you have been pressured to make. • The law in Britain says that both people need to give their consent before sex including oral sex or any physical closeness. • The law also says that to consent to sex a person must be over 16 and have the ability to make informed decisions for themselves (e.g. they have to be mature enough and not so drunk or high to be unable to make the decision). • The law is clear that the seeker of consent has the responsibility to make sure that the other persons is able to make the informed decision to give their consent. • Despite what young people may feel in a given situation, there are legal boundaries to their ability to give consent, so any voluntary agreement to sexual activity by someone under 16 cannot be defined as consent in law, according to the Sexual Offences Act 2003 (i.e. any sexual activity involving one or more person who is under the age of sixteen is illegal). CPS states that “children of the same or similar age are highly unlikely to be prosecuted for engaging in sexual activity, where the activity is mutually agreed and there is no abuse or exploitation”. This applies unless it involves one or more person who is under 13 and then it is an absolute offence and the issue of mutual agreement is irrelevant. • It is important for young people to understand that in cases where a person over the age of 16 has sex with someone under 16, it is the person over 16 who commits the offence, not the younger person, assuming there is no other offence being committed by the younger person (i.e. in the case of a violent sexual attack on a 16-year-old by a 15-year-old, the 16-year-old would clearly be the victim.
Key points for discussion following the scene with the School Nurse • Explore with the group what the School Nurse can offer to support young people. • Ask young people to design a promotion to raise awareness of the School Nurse role for other students in school. • Explore where a young person could go for a pregnancy test and emergency contraception if they are not in school. • Should Libby and Kieran be concerned about sexually transmitted infections? • How might they recognise that they have a sexually transmitted infection? • How could you recognise that your partner has a sexually transmitted infection? • What can you do to protect yourself against a sexually transmitted infection? • Where could they go for a sexual health screen after unprotected sexual intercourse?
Key points for the facilitator • It is important at this session to provide the young people with information about the School Nurse ‘drop in’ and how they can access the Nurse. • There is a either a Young Person’s Public Health Nurse or a Community School Nurse attached to all Schools both Primary and Secondary in Derbyshire and they are NHS Professionals employed by Derbyshire Community Health Services. The Young Person’s Public Health Nurses in Derbyshire run a weekly ‘drop in’ session usually at lunchtime in all secondary schools and can offer confidential advice and support for young people on a variety of health and emotional issues which can include pregnancy testing, emergency contraception and condom provision.
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• Pregnancy testing is only accurate up to 3 to 4 weeks following unprotected sexual intercourse, so if a young person takes a test before this time it may be inaccurate, so would need to be repeated. • If unprotected sexual intercourse has taken place within 72 hours emergency contraception can be given orally. • If more than 72 hours has passed since unprotected sexual intercourse a young person can be referred to sexual health clinics in Derbyshire for an emergency copper intra uterine device (coil) to be fitted which will prevent pregnancy up to 5 days following unprotected sexual intercourse or if appropriate another type of oral tablet containing Ulipristal Acetate can be given. • The efficiency of the tablet form of emergency contraception is 98% when given less than 24 hours following unprotected sexual intercourse but reduces the longer you leave it, therefore by 72 hours it is only 50% effective at preventing pregnancy. • However the copper coil efficiency is 99% up to 5 days post unprotected sexual intercourse so within sexual health clinics the first line of emergency contraception that is generally offered is the copper Intra uterine device (coil) due to its efficiency. • It is important to say that if there is a suspicion of unprotected sexual intercourse to encourage young people to attend at a sexual health clinic even if they think they have past the time frame for emergency contraception. There may be something that they can do to help support that young person. • When talking about sexually transmitted infections avoid using scaremongering tactics, knowledge of individual infections is unnecessary, what young people need to know is how they can pass an infection on sexually, what signs and symptoms to look out for and where to go for help and advice. • Sexual health screening can be done at most sexual health clinics in Derbyshire which includes testing for chlamydia, gonorrhoea, syphilis and HIV which includes either urine or a swab and a blood test. • You can do a chlamydia test (which is the most common STI in young people) by collecting a chlamydia screening kit to test a urine sample from a variety of venues/ professionals other than sexual health clinics including the School Nurse, Pharmacies, Doctor’s Surgeries, A& E and Minor Injuries Units. • Possible routes for infection other than penetrative sex are digitally (fingers), orally and anally. • Signs of generic sexually transmitted infection are vaginal/penile discharge, pain when urinating, sores on genital area, rash and inflammation. Most important to stress that there may be no signs of infection at all, therefore you cannot tell by looking at someone. • It is important to stress that in order to protect against sexually transmitted infection condoms and oral dams should be used for all sexual activity including oral sex. • Other ways of protecting against an STI is to abstain from sexual activity or make sure you have a sexual health screen before starting a new relationship.
Chapter 3 - Libby and Kieran’s story (choice 3) (Video length: 8m,17s) Time suggested approx. 1 hour but could expand to 2 hours (sessions)
Key points for discussion following this clip
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• Where can you access youth workers locally?
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What do we mean by a confidential service? What does C-Card offer? What is meant by mutually consensual? Who can you talk to about your sexual health concerns? What gender of professional would you prefer and why is that important? What is the legal age of consent? What forms of contraception are available for a young person? What is emergency contraception? How can you protect yourself against sexually transmitted infections?
Key points for the facilitator • There is a youth worker attached to all Secondary Schools through the Multi-Agency Team in Derbyshire who can support young people with a variety of issues. To find out who the youth worker is for your area you can contact your local Multi-agency team or email
[email protected] • Every young person has a right to confidential advice and support that doesn’t involve parents being informed from professionals within health or youth work. However in some circumstances a professional may need to share information with another professional or parent when there are concerns with regard to the young person’s safety in order to keep them safe. If this was required then the young person would be informed that the professional could not keep the information that was disclosed confidential. • Condoms are available from any C-Card site for age 13 upwards. Registration for a C-Card takes approximately 30 minutes to complete then you will be given a card to collect condoms from any local collection point in Derbyshire. Periodically you will need to return to a registration point to renew your details and receive a new card. • For consent issues see points for the facilitator chapter 2 Libby and Kieran’s story – Choice 2. • Condom - 2 types, male and female condoms. Female condoms are not very popular. Male condom most popular form of contraception and the only form of contraception that protects from sexually transmitted infections. Efficiency for male condom is 98% and 95% for female condom. Unfortunately if not worn correctly condoms can become very ineffective and are one of the main reasons for emergency contraception to be required. • Oral contraception - there are 2 types a combined pill with 2 hormones in, oestrogen and progesterone that you take orally daily for 3 weeks with 1 week pill free and a progesterone only pill which you take every day. Both pills if taken correctly and on time every day are 99% efficient but if there is a poor pill taking routine their effectiveness drops drastically. • Implant - this is a small flexible rod placed under the skin in your arm. Releases progesterone hormone and lasts for 3 years. Very effective form of contraception at over 99% and what makes it more efficient than oral pills is that it does not need user compliance to be effective. • Injection - this is progesterone injected into your buttock lasts for 12 weeks then is repeated. Efficiency is 99% and does not rely on user compliance as much as oral pills to remain efficient.
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• Coil - 2 types of coil, the copper coil as described in the emergency contraception, can be used for long term contraception as well. Lasts between 5 to 10 years. The other type of coil is called a Mirena coil which is impregnated with progesterone and works for up to 5 years. Both are inserted into the womb by a trained practitioner and are more than 99% effective and are safe as a form of contraception for young females. • Emergency contraception - see points for the facilitator Chapter 2 Libby and Kieran’s story - Choice 2. • For sexually transmitted infections see points for the facilitator Chapter 2 Libby and Kieran’s story - Choice 2.
Chapter 4 - Josh’s Story (Video length: 8m,45s) Time suggested approx. 1 hour but could expand to 2 hours (sessions)
Key points for discussion following this clip • • • • • • • • • • • • • • •
How do Josh’s mates put pressure on him? Why do you think they are doing this? Do you think Josh’s mates are well informed? What concerns does Josh have about his relationship with Emily? Is he breaking the law if he has sex with Emily? Where can he go for help and advice? In what situation would a professional need to share information about a young person’s visit for sexual health advice? What is the legal age of consent? What other types of relationships can you have which require you to gain consent? What protection does a condom offer? What other myths have you heard about condoms and sex? What is an STI, can you name any? How would you recognise if you had a sexually transmitted infection? Where could you go if you are concerned about an STI? How can you protect yourself against an STI?
Key points for the facilitator • For sexually transmitted infections information see points for the facilitator from Chapter 2 - Libby and Kieran’s story - Choice 2. • For consent issues see key points for facilitator from Chapter 2 - Libby and Kieran’s story - Choice 2. • For Confidentiality information see key points for the facilitator Chapter - 3 Libby and Kieran’s story - Choice 3. • Condoms are 98% effective when worn correctly. • They are the only form of contraception that protects against some sexually transmitted infections. • They come in a range of colours, sizes and flavours; there is one to suit everyone.
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• Condoms are free from C-Card sites, Sexual Health Clinics, GP surgeries, A&E, Minor Injuries Units and School Nurses. • There are latex free condoms available. • Care should be taken not to use oil based products i.e. creams, lipsticks near condoms as they damage the latex and make them less effective. • Always check they are in date, undamaged and have the British kite mark before using them.
Chapter 5 - Sophie’s Story (Video length: 3m,55s) Time suggested approx. 30 to 60 minutes
Key points for discussion following this clip • • • • • • • • • • • • • •
Where are you allowed to touch someone without repercussions? Is it ever ok to touch someone without permission? Why is Sophie pleased that Josh has touched her? Do you agree with Libby that you have a right to personal space? Where in the United Nations Convention of the Rights of a Child is this reflected? Has Josh broken the law by touching Sophie without permission? Can females inappropriately touch males? Is it regarded by law and society as the same as when a male inappropriately touches a female? What influence does the media have on gender behaviour? What unwritten laws about gender behaviour have you heard about? Where do you think these unwritten laws come from? Discuss how you can challenge these? What impact would there be on an individual who was accused of inappropriately touching another person? Is this different if the other person is the same sex?
Key points for the facilitator Sexual Assault is classed as; 1. A person (A) commits an offence if: a) he intentionally touches another person (B), b) the touching is sexual, c) B does not consent to the touching, and d) A does not reasonably believe that B consents. 2. Whether a belief is reasonable is to be determined having regard to all the circumstances, including any steps A has taken to ascertain whether B consents. A person guilty of an offence under this section is liable: a) on summary conviction, to imprisonment for a term not exceeding 6 months or a fine not exceeding the statutory maximum or both; b) on conviction on indictment, to imprisonment for a term not exceeding 10 years. It is important to note that the law doesn’t talk about females intentionally touching males, please debate this gap in the law with young people.
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Chapter 6 - Where to Go for Help and Support (Video length: 1m,32s) Time suggested approx. 1 hour but could expand to 2 hours (sessions)
Ideas for further work • Ask young people to come up with a poster, flyer or young person information board with all the places that young people can go to get help and advice about relationships. • Ask young people to research on the internet good sources of information for young people about relationships; ask them to critique the websites in terms of user friendliness. • Ask young people to think about why it is difficult for young people to ask for help about relationships from professionals and services. • Ask young people to develop an action plan for services/professionals to make their services more young people friendly and accessible.
Key points for the facilitator Check contact numbers and websites that the young people research for their suitability. Key contact numbers for Derbyshire include: • Sexual health service central booking/ information line is 0800 328 3383 or www.yoursexualhealthmatters.org.uk • C-Card Information, 0800 328 3383 or search on www.dchs.nhs.uk • Derbyshire YouthInc to talk to a Youth Worker at www.derbyshireyouthinc.com or email at
[email protected] • Unit 10 in Chesterfield is where young people can access youth workers for support about any concerns they may have, contact 01246 217331 • Young People’s Public Health Nurses and Community School Nurse central contact line for Derbyshire is 01158 554053 • Minor Injuries Units in Derbyshire where young people can access emergency contraception and condoms, search www.dchs.nhs.uk • Derby and Chesterfield Genito-Urinary Medicine (GUM), contact 0800 328 3383 • Children Centres where you can pick up condoms from the C–Card scheme for more information about where they are in Derbyshire, click on http://bit.ly/1Qcebi5 for national information and support: • NHS Choices search on www.nhs.uk • Childline for support with relationships contact 0800 1111 or search on www.childline.org.uk Other useful resources about dealing with consent https://www.youtube.com/watch?v=oQbei5JGiT8 www.thisisabuse.direct.gov.uk Teaching about consent in PHSE Education at Key Stages 3 and 4 (2015), PHSE Association.
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