The Hackett Continuum: Revised

Since 2010 the Hackett continuum has been the shared language of harmful sexual behaviour (HSB) work in the UK: five strands running from “normal” to “violent”, embedded in NICE guidance, the NSPCC framework and most local safeguarding procedures. In a new open-access paper in the Journal of Sexual Aggression, Hackett revisits his own model and is candid about how it has been misused.

Practitioners have treated it as a risk assessment tool, read the strands as fixed boxes, used the lower strands in ways that trivialise abuse, and most worryingly placed children who were themselves sexually harmed on a model that was only ever meant to describe behaviour a child displays. Meanwhile the term HSB has drifted: an umbrella term in some services and shorthand for the most serious abuse in others.

The revised continuum keeps five strands but renames them: developmentally expected, worrying, problematic, harmful and sexually violent. Above them sit three overarching categories developmentally expected, problematic and harmful which formalise the green/amber/red triage that practitioners were already doing informally.

“HSB” is now explicitly reserved for the harmful end. Running beneath every strand is a developmental and contextual lens: the child’s age, developmental capacity and neurodevelopmental profile; consent, reciprocity, power and relational context; and the frequency, emotional tone, intrusiveness and impact of the behaviour. Online and in-person behaviours are read through the same lens. Hackett is equally clear about what the model is not: not a risk instrument, not a predictor of escalation, not empirically validated, and never a label for a child.

• Describe behaviour, not children. The vocabulary of “normal”, “inappropriate” and “abusive” should go. A behaviour can be problematic; a seven-year-old cannot be. This matters most in the documents that follow a child around referral forms, placement matching profiles, safe care plans where risk-laden framing shapes who will offer a home.
• Problematic is not HSB-lite. Behaviour in the problematic category calls for a wellbeing and needs assessment, carer support, educative or low-level therapeutic input and sensible supervision. It does not call for a specialist HSB assessment, and evidence drawn from adolescents who have sexually offended should not be imported into the formulation of a young child.
• Ask the lens questions before choosing a strand. How, with whom, in what context, with what understanding and with what impact? Compulsive or repetitive self-directed behaviour in a young child usually signals a regulation need, not a risk to others, and the response should follow the function.
• Reserve formal assessment for the harmful category. Structured professional judgement tools such as AIM3 sit alongside the continuum, not inside it, and are only warranted where there is victimisation, coercion, misuse of power or an absence of consent.
• Never map a victim onto it. A child who has been sexually harmed or exploited is not “on the continuum”. Where a child has both been harmed and displays concerning behaviour, the two need separate formulation.
• Use it as a heuristic and say so. In court reports and consultation records the continuum supports reasoning; it does not settle thresholds. State the strand, state the reasoning, and be explicit that placement is a professional judgement open to revision.