Brief Counselling in Schools
Publication Year: 2011
Steeped in vivid case examples, therapeutic dialogue and points for reflection, Brief Counselling in Schools, Third Edition is a highly practical and accessible guide to helping and supporting young people experiencing difficulties both at home and at school or college. Covering issues from low self-esteem and sexuality, to substance misuse and aggression, Dennis Lines draws on a method of brief integrative counseling to illustrate how a time-limited therapy can work effectively in an often pressured and time-limited setting.
- Front Matter
- Back Matter
- Subject Index
- Chapter 1: Brief Counselling
- Chapter 2: Brief Counselling Approaches
- Chapter 3: Counselling in School
- Chapter 4: Legal and Ethical Codes in School Counselling
- Chapter 5: Adolescence
- Chapter 6: Low Self-Esteem: Depression, Anxiety and Reaction to Abuse
- Chapter 7: Self-Harm and Suicide Ideation
- Chapter 8: School Bullying
- Chapter 9: Anger, Aggression and Violence
- Chapter 10: Loss and Bereavement
- Chapter 11: Parental Separation and Step-Parent Conflict
- Chapter 12: Smoking, Drugs and Alcohol Misuse
- Chapter 13: Teenage Sexuality
© Dennis Lines 2011
First edition published in 2002. Reprinted 2003, 2005.
Second edition published 2006. Reprinted 2007, 2008, 2010.
This third edition published 2011.
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, this publication may be reproduced, stored or transmitted in any form, or by any means, only with the prior permission in writing of the publishers, or in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers.
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About the Author[Page vi]
Born in 1947 to a Birmingham factory worker and Staffordshire nurse, Dennis Lines was educated in Birmingham. Leaving school at 15, he became an apprentice toolmaker and spent the first 12 years of his working life in engineering. A change in career occurred when Dennis was 30 after training at Newman Teacher Training College. He became a teacher in religious education, science, and physical education at Shenley Court School. This was not his first engagement with young people. From the age of 18 onwards he ran youth clubs in the local area where he lived and took many young people on camping expeditions. He managed a children's home in Bromsgrove for a short while and has fostered many young people. He is an approved Foster Carer of the Birmingham Teenage Fostering Team.
A tragic accident occurred in 1986 when Dennis sustained a broken neck and spent the 10 months in Oswestry Spinal Injury Unit. Having become a tetraplegic, he was now dependent on the support of others, and notably the young people in school who enthusiastically rally to his aid in routine support. Dennis studied under Bill O'Connell, a Solution-Focused practitioner, and Windy Dryden, a therapist-trainer in REBT
Following his broad experience in youth work, and formal education in engineering, teacher training and counselling theory and practice, Dennis has gained insight over adolescent difficulties as they arise in school, and has found that intergrative and pluralistic approaches applied briefly to be highly effective in educational setting. He has published widely in academic journals on various topics of teenage difficulties, as well as writing four books: Brief Counselling in School, now into its third edition, a personal biography following his accident called Coming through the Tunnel, another book published by Sage entitled Spirituality in Counselling and Psychotherapy, and The Bullies, by Jessica Kingsley Publishers, which examines the dominant-submissive dynamics within close-knit relationships.
Preface to the Second Edition[Page vii]
My thanks are extended to the team at SAGE for giving me an opportunity to write this second edition. Apart from more up-to-date referencing, this edition reflects current British law on child protection and new legislation that applies to counselling in school, together with the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy (2002). A broader perspective on adolescent development arising from social constructionist thinking is given in this edition to give the book a more universal feel. The text is laid out differently, with boxed case examples and key points at the end of each chapter, for quick reference. I am grateful to Nathan Marsh for his illustrations.
One major criticism of the first edition was that it was too Eurocentric, and I have attempted to rectify this in order to make the work more accessible to a multicultural audience. A further shortcoming was the absence of attention to violence and aggression in school, as pointed out by an American reviewer. Coincidently, I was working with one youngster who was unable to stop fighting in school, and so much additional material in the new chapter is indebted to what was learned from that experience. The closing chapter prompted an encouraging review from one journal where the different emphasis of brief counselling from task-centred working towards being-psychology was welcomed. I particularly enjoyed composing this chapter and was very pleased that SAGE gave me the opportunity of expanding these therapeutic insights in a much fuller treatment.January 2006
Preface to the Third Edition[Page viii]
When first asked to produce a third edition, I had presumed this would be a light task, a mere updating of referencing and perhaps a slight re-editing of the text to accommodate new findings in neuroscience. After rereading each chapter, however, it became apparent that the whole book had to be recomposed in order to be up to date. Whereas the second edition was a slight modification, with an additional chapter on violence and aggression in schools, this edition is virtually a new book, with a much more inclusive stance, a challenge I have enjoyed immensely.
At the time this book is published, the UK will be undergoing a period of austerity that has not occurred for a considerable time, and this will result in yet another challenge for school counselling. Indeed, my own post may be under threat of government cutbacks and redundancy. Such changing times endorse the need for the practitioner to be adaptive.
Counselling and psychotherapy has attempted in recent times to have a greater foothold in research validation, and the professional bodies have had to adjust to changing needs and requirements. There have been in-house tensions within the profession between research-informed and intuitive practice, and the requirement for accreditation. For nearly a decade, there have been strides to regulate the profession, even though the pace of regulation slowed down under a different government administration. Academies are likely to become a more popular means of delivering education at the secondary level, where private-public partnerships take over from local authority control. All such changes will have implications for practitioners. Counselling in schools and colleges will need to be flexible and adaptive, then, if it is to survive. This third edition is an attempt to support the practitioner and trainee therapist in becoming better equipped in finding a niche within the rapidly altering therapeutic marketplace. The particular emphasis of this book in regard to adaptation is to promote the merits of practising briefly.
One factor is certainly constant and no less pressing in this than at any other time of social change. It is that teenagers – in their inner emotional being and social relationships – are struggling no less today to meet the challenges of independent and fulfilled living. Making the most of educational opportunities in preparation for adulthood is an essential task that counselling has an important part to play in, not only for disadvantaged pupils but for others experiencing occasional difficulties.
I am grateful to the publishing team at SAGE for giving me the opportunity to produce yet another edition of Brief Counselling in Schools. I extend my gratitude also to those who have critically appraised and reviewed former editions and who [Page ix]have helped anonymously to steer this project. As ever, I am grateful to those students who have enriched my practice and to two particular students – Connor Tierney and Ellie Gibbs – and their parents for granting permission for the front cover photograph. Thanks also to Charlotte Hessey, who provided the sketch of the human brain, and to Teresa Hotchkiss who drew the cartoon figures for the chapter on school bullying., April 2011
Acknowledgements from the First Edition[Page x]
Without the sharing of minds, the individual's thought becomes sterile and unimaginative: I have benefited enormously from theoreticians and practitioners whom I have consulted. A number of colleagues have supported me in the composition of this book. First, I am grateful to Janet Bellamy and Bill O'Connell, my tutors in training, for their insistence on academic rigour and for their patience and imagination when nurturing my counselling skills; particularly Bill in pointing me forward to where brief counselling was moving. I acknowledge also the inspiration and encouragement of Ron Best, an academic I have never met personally, but with whom I have corresponded frequently. I am grateful also to Alison Poyner, Commissioning Editor, and the rest of the team at SAGE, for their encouragement in steering me through this project and for giving me an opportunity to put into writing all that I have learned in brief school-based counselling. To all my teacher colleagues who have taught me so much in adjusting my idealism to the practicalities and constraints of a school-based setting, I remain grateful. I especially acknowledge Marie Woods and Wendy Oldfield-Austin for their suggestions on early drafts of chapters. I acknowledge also my former headteacher and current headteacher who, along with the Birmingham LEA, have supported the provision of counselling in school and who thereby have given weight to the need to support the emotional literacy of pupils. I thank also Deirdre Barber for her painstaking work in correcting proofs.
Finally, and more importantly, I express my gratitude to my daily tutors of life's rich experience: the pupil-clients who come forward for counselling. I have learned from them more than I can express, and every problem presented in the counselling room has been a means of developing my practice and refining my technique. One 15-year-old pupil once presented a series of paintings through which she articulated her stormy relationship with her father. Through brief art therapy, we explored her world, and this was one of the most poignant contacts I have ever made with a young client. Regretfully, she would not grant me permission to publish her story or reproduce her paintings. I remember feeling sad about this because the material would have contributed something to this book, but obviously I have respected her wish. It struck me afterwards that the learning I had acquired was being absorbed in my practice almost imperceptibly with further clients. It seems that each client adds something to the counsellor that has the potential to develop practice if the practitioner can remain intuitive to what the client is saying and feeling on different levels., August 2001
Appendix I: Counselling Report: Academic Year 2009/2010[Page 243]Abstract
94.7 per cent of pupils engaging in brief therapy (on average 3–4 sessions) reported improvement by up to 4 points on a 10-point scale, and 97.3 per cent said they had felt ‘better, or ‘much better, or were fine now’, to such a degree that 68.4 per cent of these claimed they had no need of further counselling support. A good number, 84.2 per cent, of clients said that their problem was ‘serious’, ‘quite serious’ or ‘unbearable’. The major causes that brought them to therapy were issues to do with anger, bereavement, serious arguments with parents and issues within the family, and bullying. There was found to be a tendency for many pupils to overrate their ability level when compared with SATS attainment levels. Finally, factors to do with low potential attainment included 60.5 per cent of families having no adult in full-time work, one in every five pupil-clients, conceivably, having no ‘place for private study’, and six in every ten coming from families dependent on state benefit.Method
This report is a triangulation study of anecdotal experience and self-evaluation questionnaires given to pupil-clients engaged in counselling for three sessions or more during the summer of 2010. Every client counselled through the academic year was not reviewed in detail, but 38 were randomly selected to serve as subjects for analysis. The responses of the pupils who benefited from single session interventions (by far the majority) were not asked for and are therefore not reflected in this report.
The first questionnaire required a tick response to a series of six questions, and a numerical rating (1–10) to indicate how students felt before in contrast to after counselling (41 questionnaires were given out, but three were discarded owing to evident confusion on self-rating scales). The second served as a blind cross-reference, but also contained questions of client demography – family composition, ethnicity, [Page 244]economy – that may have a bearing on learning potential and social mobility. Pupils completed questionnaires anonymously. Because of the sensitive nature of the data, the questionnaire was piloted by four students before arriving at the final form, largely to ascertain the level of intrusiveness of the questions.
Although it was stressed that honesty was paramount – with me not being present during the completion of the questionnaires – the subjective nature of the first questionnaire and parts of the second is accepted. It is acknowledged, particularly in the health service, that self-evaluation questionnaires on the quality of service and management of received healthcare have inherent weaknesses. Patients have a sense of loyalty towards their doctors and nurses, and it is in their personal health interests to overrate performance by exaggerating outcome scores. In the same manner, many pupils will intuitively overrate my performance and anticipate a ‘required’ response by recording what they think I would like them to say. Owing to the managerial logistics of having others compile and complete such a questionnaire instead of me (job description, available time, etc.), however, it is difficult to see how any alternative could be carried out in school at this time.Counselling Evaluation Questionnaire: Results (Per Cent)
[Page 246]Demography Questionnaire: Results (Per Cent)
- General nature of the problem
- Feelings evoked by the problem[Page 245]
- Resultant behaviours
- Seriousness of the problem
- After counselling clients felt
- Scored improvement of 1–10
Regarding the last question, all clients felt there was an improvement on a numerical scale of at least three points, 94.7 per cent felt improved by up to four points, and 73.6 per cent recorded improvements over five points on a self-report scale.
- Termination of counselling agreements
Matters are fine now I no longer need counselling Request for further counselling 15.9 68.4 15.9
Of the 15.9 per cent of pupils reporting that they would like further counselling, none were asked specifically whether it was because the problems were ongoing or whether there were ‘new problems’ occurring.
- Ethnicity – self-described
- Gender and year group composition (Option 2 and 3 on demographic questionnaire)
Regarding Years 12 and 13, four students were counselled but were unavailable for recording.
- Disparity of ability self-rating compared with English SATS scores (KS2 or KS3, if taken)
It seems that reporting ‘average’ was safe. Comparing self-assessment with previous KS2/3 results showed that 53 per cent of clients (20) made accurate assessments, and 47 per cent (18) reported inaccurately – of these, 15 (83 per cent) overrated and 3(17 per cent) underrated their ability.
- Detailed nature of the problem
No. % Description 9 24 problems with anger 6 15.8 loss and bereavement 6 15.8 experienced conflict with parents No. % Description 5 13 had been bullied 3 7.9 got into too much trouble 2.6 had a fall out with friends 2.6 depression 2.6 self-harm 2.6 impending split of parents 2.6 clash with a teacher 2.6 unable to control aggression 2.6 suffered abuse on an internet site 2.6 disappointment over a football trial 2.6 confidence building 0 0 worried about health, disability, diet or obesity[Page 247]
- Number of arranged appointments
- Feeling of change
No clients felt worse and 97.3 per cent of clients said that counselling had helped them feel better.
- Siblings living in the family home
Correlating the data with reported employment status of parent/s, it may be assumed that 44.7 per cent of pupils (i.e. those living in a family with three siblings) might suffer from crowded conditions in the family home, and that 18 per cent, or one in five pupils coming for counselling, might find ‘a place for private study’ very difficult. This has massive implications for learning potential.[Page 248]
- Parent/carer from infancy
One client was brought up initially by grandmother but later by mother and father, two clients by mother and father then by mother alone, three by both parents then by mother and stepfather, two by mother then by father and partner, and three by mother and father then by father alone.
- Regarding employment
Overall, 60.53 per cent of families (or 6 in every 10) of a child receiving counselling had no parent or carer employed and therefore were on state benefit. This matched free meal figures, where 24 (63.10 per cent) clients (or 6 in every 10) had a free meal and 14 (36.8 per cent) clients paid for their own.
- Plans for the future
In sum, 84.2 per cent of students had a clear idea of what they wanted to do after the SLA. Apart from further education, vocations selected included:
Army (2), author, chef, child carer, dance teacher, doctor, driver, footballer (3), game designer, hairdresser, hypnotherapist, carer for sick children, mechanic (2), musician, nursery nurse, paramedic, policeman, builder.
One reported she ‘wanted a career, not like my brother’, two said they’ wanted good grades’, one ‘wanted a family’ and two just ‘wanted a job’.
These results illustrate that those young clients receiving counselling felt that this had been beneficial to them, and it would be interesting to see what other measures could be used to record improvement more objectively (‘feeling better’ is not ‘becoming better’), such as improved attendance figures or raised scholastic attainment. But, as already acknowledged, self-report ratings are notoriously subjective.
Further, identifying the specific factors attributable to client outcome is virtually impossible, as largely recognised in the field of psychotherapy research. It is extremely difficult to isolate counselling intervention from concurrent changes in individuals’ lives – such as changing friends, moving forms or learning groups, healing after losses, changes in family circumstances (such as step-parents or elder siblings leaving the family home), a troublesome neighbour being evicted or a change in the family's economic situation, etc. – to be able to state with certainty that counselling alone has brought improvement. It may be that after one counselling session a pupil's attendance improves, but other influences could cause the same to happen, such as a firmer resolve from the parent, a visit from an attendance worker, an absent father taking more control, a warning from the school or the Educational Social Worker (ESW) threatening legal action.
Correlating a counselling intervention (particularly in brief therapy, where sessions may be as short as three or four) with raised academic performance and then making dogmatic assertions is questionable. Counselling is aimed at insight into behavioural patterns or the encouragement (through CBT) of modified behaviour, and, as such, improvement – assessed by individuals and/or their parents – can be relatively quick, albeit subjective, but learning measures through schooling are much more timely, so that claiming that any one has influenced the other is difficult to substantiate.Conclusions and Observations
A few observations arise from the demography questionnaire. Bearing in mind that the 38 questionnaires were merely a sample of counselling work, and did not include single or double session therapeutic interventions (by far the most), it was judged that there was an even distribution of clientele in terms of ethnicity and gender (compared with on-roll composition), but not, surprisingly, of year groups. Owing to curriculum demands of Years 10 and 11, particularly Year 11, the bulk of longer-term work engaged Years 8, 9 and 10 early on into the year. But Year 7 occupies proportionally a low take-up. I think this is because, in the early secondary years, the form tutor, the nurse, attendance workers and other pastoral staff engage with them quite frequently (and have relatively more parental contact) through conventional care and behaviour correction methods, before the particular skills of the school counsellor are brought in and ‘Gillick competency’ issues arise.
[Page 250]Although it was clearly ‘safe’ for pupil-clients to report their ability level as ‘average’, it surprised me that 83 per cent of the cohort making inaccurate assessments of their ability – when compared with English SATS level attainments – had overestimated their ability in comparison to the 17 per cent that had underrated themselves. There maybe issues to do with ‘false’ or ‘inflated’ beliefs that might delude some low-ability pupils into believing they are more able than they are. While ‘high expectation’ in psychology is recognised to deliver better attainment results in education and counselling, there may be a need for some accurate ‘reality testing’ lower down the school earlier on to inform pupils ‘where they currently are’ and ‘where they need to be’.
It was no surprise that ‘anger’, ‘bereavement’ and ‘conflict with parents or carers’, followed by ‘bullying victimology’ and ‘getting into too much trouble’, took up most of the therapeutic work.
The 93.7 per cent of clients who had reported that counselling had made them ‘feel better’ was not surprising, in view of the comments made above, but nevertheless was reassuring.
The data on family composition and employment status was interesting. It was heartening to see how many pupils were brought up from birth to the present by both parents, or still had continual contact with the other parent not living at home. Nevertheless:
The figure of over 60 per cent of families having no parent or carer in full-time work is a major concern in terms of behavioural modelling, and the relative high proportion of families receiving state benefit can leave an impression of ‘inevitability’ – of ‘one's lot – or a preference that such becomes ‘a life choice’ as opposed to ‘bettering oneself or furthering a career. Considering that two outcome measures of the Every Child Matters agenda are to ‘make a positive contribution’ and ‘achieve economic well-being’, there are great challenges for any school in this area in terms of curriculum planning and exploring roles in voluntary work.
There are grave consequences of sibling crowdedness in regard to learning potential that will have implications for home-based study. Crowded conditions (confirmed by anecdotal data), which are due to more than three siblings in three-bedroom homes, makes private study space for pupils quite problematic. Coursework set to be completed away from school, which has relative low importance to other family tasks, and where highly motivated adult guidance and leadership may be lacking, may not yield the best results and become a limiting factor for students to become upwardly mobile.Counselling Evaluation
(Place a tick in the box √)[Page 251]
Before I came for counselling my problem was:
After having counselling I now feel:
Note a number from 1 to 10, with 1 feeling slightly bad and 10 feeling unbearableDemographic Questionnaire
Clients Receiving Three Sessions of Counselling or More
Please complete the following:
Please state your ethnic origin, or the group to which you feel you belong socially:
_____________________ (for example, British, English, Welsh, Scottish, Irish,
Asian, African descent, Pakistani, Chinese, or other)
[Page 252]Underline which applies:
- I am male/female
- I am in Year 7/Year 8/Year 9/Year 10/Year 11/Year 12/Year 13
- I consider myself to be below average/about average/slightly above average/very bright
- In my last English SATS results I achieved level 3/level 4/level 5/level 6
- I came to counselling myself/my parents asked me to come/my teacher advised that I should come/my friend said I should come/counsellor sent for me/I don't know
- My problem had something to do with:
being bullied/being angry/getting into too much trouble/someone dying and being sad/being angry about my parents/being worried about my health/my disability/being obese and needing dietary help/falling out with my friends/feeling low/being depressed/cutting myself/refusing to eat/not seeing my dad or mum/my parents being about to split up/other reasons____________________
- I came for up to three sessions/between four and five sessions/over five sessions
- I now feel just the same/a little bit better/much better/fine now
- In my family I have one brother or sister/there are three of us children/four of us/five of us/six of us/or______ of us
- I now live with my mother and father/my mother only/my father only/my older brother or sister/my grandmother or grandfather/another relative/a foster parent/my adoptive parent(s)/in a care home/my friend's family home/or other
- For most of my life I was brought up by___________________________
- In the family my main carer is in full-time work/has not been able to find employment/is unable to work through disability/has to look after young children/is in training
- I am currently on free school meals: YES/NO
- My plans for the future are to:_________________________________________
3 September 2010
Appendix II: Counselling Referrers[Page 253]
Appendix III: Counsellor Responses Mini Survey[Page 254]
School counsellors (as individuals and in groups) were presented with ethical dilemmas, some via email and others after being led in discussion. The latter group were led by a counsellor whose school had announced a new policy of requiring all staff to report to the Designated Senior Teacher for child protection (DST) any student who had disclosed that they were sexually active.
With those counsellors having the benefit of discussing the dilemmas, questions were raised as to whose needs are being met under the ‘duty to report’. Are anxious adults reporting to help make themselves feel better?
The Every Child Matters agenda and results of serious case reviews have resulted in practitioners on the ‘coal face’ feeling vulnerable. ‘We need to protect ourselves’ and, for one group, ‘there was a concern expressed that in doing this we are in danger of becoming defensive practitioners. With these cases it often feels we are walking on a tight rope’. The combined results were as follows (Group response in italics: The Group for Counsellors in Education Settings, Oxfordshire, 10 January 2011).Case 1a
A child of 12 years 11 months is known by you to be having sex with a 13-year-old partner. Should this youngster be your client who had disclosed this, would you pass on the information to the child's parent, the Designated Senior Teacher of child protection or to Children's Services as a referral?Case 1b
What difference would your course of action be if your client's partner was known to be 14 or 15, and in your judgement you felt your young client was ‘Gillick competent’?Case 2
Suppose your client is a boy of 14 years (quite mature in your judgement and quite able to give consent, again in your judgement) who was engaged in intimate sexual relations with a girl of 17 years at the same school or youth club. Supposing you could determine no power differential, and it was a question of different levels of maturity, would you feel compelled to inform the parent, the Designated Senior Teacher of child protection or Children's Services? (Assuming that the contractual arrangements of the school, youth club or therapy agency permits engagement with young clients without, of necessity, involving the parents or a statutory service.)
As above, my main concern would be the protection of the child in respect of infection/pregnancy.
This feels more uncomfortable. I find it hard to imagine a 14-year-old with the maturity the scenario describes wanting to relate sexually with a 17-year-old girl, and vice versa. Leaving that aside for a moment, for the reasons given above, I would not report this to anybody, unless I had concerns about the 17-year-old girl. I might wonder what her family culture was like (abusive?) and be on the alert to gain some information regarding this through the counselling process.
First, I would be pleased for him that he felt (due to our therapeutic relationship) he could talk to me about his relationship. I would take the matter to Supervision (he would be aware from our initial session that I access personal supervision and that I might need to ‘take him’ at some point).
OK at school – only three years difference and no exploitation or abuse issues.
Contain in youth setting.
The focus here would be on curious inquiry regarding the relationship. For example, what impact is this relationship having on the young person?
We would be curious and alert to any wider CP issue that might be present.
We wondered if our responses would be different if it were a 14-year-old girl and a 17-year-old boy. There was a sense that within the decision making, we need to be mindful that we are not sexually discriminating.Case 3
Two young clients approach you who are involved in a gay or lesbian relationship with each other. They are 14 and 15 years of age and there is no power differential but a fully consenting engagement. They approach you because they are afraid of homophobic taunting from peers in school and also because of what their parents may say should they find out – they have not come out publicly within the family. Would you as a counsellor ‘contain’ these two young clients or feel compelled to pass on this information to a third party?Case 4
A youth of 14 years shares information about an argument at home the previous evening whereby his stepfather (with whom he had been living with his mother since he was 3) had hit him across the mouth with the back of his hand for ‘swearing at his mother’ who had challenged him over ‘theft of money and drinking alcohol in the park in the evening hours’. He had a red mark showing on his face and he was still angry. He said in counselling that he had never been hit like this before and that his stepfather had no history of being abusive. The pupil was known to be challenging in school.
Appendix IV: Anger Management Screening[Page 260]
[Page 261]State of Being
Describe two incidents that have left you feeling very angry. On a scale of 1–10, score how angry you were left feeling:
What has to happen for you to calm down?
Do you follow anyone in the family in regard to anger?
1. Other meta-analysis indicates more modest figures of 7–17 per cent (Beutler et al., 2004). Other research suggests that while a quality relationship may be related to outcome, this does not necessarily mean it is the cause of improvement (Cooper, 2010).
2. Such claims have been questioned by some authors (Moore et al., 2008:13).
3. Jenga, also called a Stress Tower, is a game where each player removes carefully a wooden block from an erected tower and places it on top. It is a game of fine-motor skills where the winner is the one whose re-placed block keeps the tower standing.
4. It is known that 11 per cent of young people under 16 experience penetrative sex, oral sex or attempts at these/against their will’, by people known but unrelated to them and that 25 per cent of all rape victims are under 16 years of age (Cawson et al., 2000).
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