Sexual Education for Adults with Disabilities

Átírás

1 Sexual Education for Adults with Disabilities Tool 0 Bevezetés The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

2 Előszó Ahogy a múltban, 2015ben is rengeteg ember nem hajlandó elfogadni, hogy a fogyatékkal élőknek is vannak szexuális érzelmeik, szükségleteik és vágyaik. Ez vezet ahhoz a helyzethez, hogy a fogyatékkal élőknek gyakran nem biztosítanak szexuális nevelésre lehetőséget. Ennek eredményeként, illetve hogy a fogyatékkal élők gyakran nehezen értik meg saját szexuális vágyaikat és szükségleteiket alakul ki gyakran a lehető legrosszabb helyzet, az igen gyakori szexuális bántalmazás és kihasználás. A SEAD nevű Grundvig project összeállított egy tool kit nevű szerszámos ládát, abból a célból, hogy azt használhassák a fogyatékkal élők szexuális nevelésében, főleg azok, akiknek nincs lehetőségük a szakirodalom eléréséhez. Ezt a szerszámos ládát a célcsoport maguk, vagy szülők és nevelők segítségével is tudják használni. Nyolc európai országból érkeztek partnerek, hogy együtt dolgozhassanak valami új dolgon, a meglévő tapasztalataik alapján. A csoportot egy szakemberekből álló bizottság is támogatja, a szakemberek Németországból, Finnországból és Hollandiából származnak. Az eredmény valami, amire mindannyian büszkék lehetünk és a célcsoportok hosszú ideig használhatnak. Így a felhasználók könnyedén tudnak anyagokat és módszereket találni, melyek segítik a szexualitást érintő témák magyarázatát egy érthető könnyen olvasható módon, mindenki számára érthetően és láthatóan. Itt van például a Szó bank, az angol partnerektől, amely egyszerű nyelven magyarázza el a szexualitás során felmerülő szókincset. Különböző módszerek, melyeket kapcsolatteremtéshez lehet használni jöttek Magyarországról, és végül Hollandiából megérkezett a vizuális segédlet is, mely nagyban megkönnyíti a megértést. Az összes módszer és a vizuális segédletek nem egyformán alkalmazhatóak minden célcsoportnál. A foglalkozást tartó személynek kell eldöntenie, hogy mit vesz ki a dobozból, és mit használ fel az adott csoport esetében, környezettől és a kliensektől függően. Ez is a sokféleséget és a rugalmasságot mutatja, mely hosszú távon lesz így használható. A partnerek: Belgium: Németország: Anglia: Finnország Hollandia: Litvánia: Magyarország: Autism Europe Bergische Volkshochschule and EUConcilia Change (Leeds) Luovi Vocational College University Arnhem/Nijmegen Kaunas Centre for young disabled people Gábor Molnàr workshop foundation 2

3 A SEAD csoport boldog lenne, ha soksok felhasználót találna meg a szerszámos doboz, különböző területeken, jó eredménnyel és sok érdeklődőt kielégítve. Az, hogy a szexualitásról beszélhessünk az emberi jog. Ezzel az eszközzel a SEAD hozzájárul, hogy mindenki elérhesse ezt a célt. Disclaimer The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 3

4 Sexual Education for Adults with Disabilities Tool 1 Dráma játék The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

5 Dráma játék kérdések irányított beszélgetéshez Az irodalom világ kincsi között van egy csodálatos történet, ami minket egy drama játék megalkotására késztetett. Az Isten elhozta az embert két ajtóhoz, az egyik a pokol, a mésik a paradicsom. A pokolban a tömeg boldogtalan ember egy asztalnál ül, ahol próbálják megenni a legfinomabb ételeket melyek az asztal közepén vannak. Egy nagyon hosszú kanalat adtak minden étkezni vágyónak, elérik ugyan az ételt, de a kanál hosszú nyele miatt nem tudják az ételt a szájukba venni. Ők mérgesek, és egymást hibáztatják, mert nem tudnak enni. A paradicsomban mindenki boldog, pedig a helyzet ugyanaz, az asztal nagy, a kanál hosszú, de az emberek egymást etetik vele, nem próbálják a saját szájukba tenni az ételt. A történet morálja a szexuális nevelésben is működik. A dráma játék két részből áll, amit a szereplők szeméylei összefonnak, a történet is szervesen összekapcsolódik. A lényege az, hogy hogyan tanuljunk meg szeretni, nem csak szeretkezni. A második részben a hősök lelki világa megsérül, mnden értékeset megsemmisítenek, csak a személyt hagyják meg, hogy újra kezdhessen mindent egy forradalomal. 0:00 4:00 percig: Az ember születése, találkozása más emberekkel és a világgal. A lány találkozik egy fiúval, megfigyelik egymás testének viselkedését. 4:00 7:00 percig: A fiú és a lány között megszületik a kapcsolat. Kérdések: Mit néz a fiú? Milyen érzései vannak a lánynak? Mit gondolsz, mire gondol a fiú? 5:00 percnél: Mit csinálnak? Szerinted érdeklik egymást? Megbíznak egymásban? Hogy érzik magukat? 7:00 9:00 percig: Milyen érzéseket tapasztalnak meg? Milyen kapcsolat van köztük? Milyen változás történik a kapcsolatukban? Mi történik? Milyen érzése van a lánynak? Nem érzi magát magányosnak? 9:00 12:00 percig: Eldöntöttee a lány hogy rendesen segítsen a fiúnak? Elfogadjae a fiú a segítséget? Miylen érzelmeket élnek meg? 2

6 12:00 15:30 percig: Mit gondolsz, mit csinálnak itt? Megfelelően viselkednek? Mindkettőnek elfogadható ez? Vannak pozitív vagy negative érzelmeik? A fiú eléggé figyelmes, gyengéd a lánnyal? Ők most akkor egy pár? Biztonságban érzik magukat egymással? 15: perc Milyen féle társadalom veszi őket körül? A társadalom tagjai megfelelően viselkednek? Ők barátságosak? A társadalom hogyan foagadja el a fogyatékkal élők közötti szerelemi kapcsolatot? 20:00 25:00 perc A társadalom megkölünbözteti őket. Milyen érzései lesznek a lánynak? Az emberek normálisan viselkednek körülöttük? Szexuális bántalmazás? Hogy érzi a lány magát? Szüksége van segítségre? Az embereknek segíteni kéne neki?k neki segíteni? Akarnak neki segíteni? Miylen segítségre lenne a lánynak szüksége? Hogy tudnának neki segíteni? Megfelelően viselkednek, amikro háat fordítanak neki? végéig: Mi fog történni? Helyesen cselekszik a fiú, hogy vissza fogadja a lányt? Milyen érzéseik vannak? Közel érzik egymást magukhoz? Megbízanak egymásban? Disclaimer The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 3

7 Sexual Education for Adults with Disabilities Tool 2 Bevezetés a Bosch képekhez The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

8 Fejtől lábujjig : 96 képes mappa szexuális neveléshez Ezen képek célja, hogy a fogyatékkal élő fiatalokkal dolgozók, tanárok és speciális oktatást biztosító személyek egy jól használható eszköztárral rendelkezzenek a fogyatékkal élő fiatalok szexuális és párkapcsolati oktatásához szükséges jól használható képanyaggal. A képeket tudományos sztenderdek alapján állították össze, és különböző verziókban tesztelték, mielőtt a végleges verzió kialakult. Ellen Suykerbuyk és Erik Bosch Hollandiából, már 25 éve dolgoznak a szexuális nevelés területén, az ő tapasztalataik alapján állították össze a doboz képeit. Több könyvet is írtak, amiket németre is lefordítottak. Első ránézésre a sötét hatter és az igazi és a számítógéppel készült képek furcsának tünhetnek, de ez több éves szexuális nevelésben eltöltött évek tapasztán alapszik, amikor rájöttek, hogy az a legjobb, ha a képeken cask az szerepel, ami a kép témája, és semi egyéb figyelem elterelő részlet nincs rajtuk. Ez az anyag egy jó alap a szexualitás részeinek elmagyarázásához, gyakran más segédanyagokkal együtt használható, mint például a PAOMI modellek, melyek szintén a dobozban találhatóak, valamint könnyen olvasható anyagok. A legtöbb szexuális oktató sok oktató anyaggal rendelkezik, melyek közül az éppen aktuális célcsoport számára a legmegfelelőbbeket ki tudják választani, amely persze az aktuális témával is kapcsolatban van. Az hogy jó anyagunk van a szexuális neveléshez, az csak az érem egyik oldala, az oktató személy felkészültsége a másik. Elengedhetetlen, hogy az oktató személye megfelelő legyen, a tudása a szexualitás témájával korrektnek és naprakésznek kell lennie. Minden ezzel foglalkozó oktatónak szükséges, hogy folyamatosan továbbképezze magát, ha jó munkát akar végezni. A szakmai tudás, és oktató anyagok mellett, a tanítási módszerek terén is otthon kell lennie az oktatónak. Több módszer használata izgalmassá teszi az élményt mind a résztvevőknek és az oktatónak is, főleg, ha egyszerre több órát kell tartania. A dobozban különböző módszereket is lehet találni. És végül, de nem utolsó sorban, a professzionális hozzáállás, mely ebben az esetben azt jelenti, hogy visszatartjuk saját sztenderdjeinket és értékrendünket, és megfigyeljük, hogy a kliensek milyen attitűddel érkeznek, figyelni kell, nehogy bármelyik fél megsértse a másik érzelmeit. 2

9 Témák a dobozban: A szexuális nevelés ideális keretei: a férfi és a nő testi fejlődése, gyermekkortól felnőttkorig önkielégítés szexuális aktus homoszexualitás óvszer használata és egyéb fogamzás gátlás lehetőségek higiénia intimitás privát légkör szociális viselkedések pornográfia babavárás technikák és érzelmek szexuális zaklatás Ezek a témák végül négy nagy témába kerülnek a szexuális oktatás során: Egy megfelelő méretű terem, ablakokkal, amin senki sem tud benézni Ha a dolgozók, szülők vagy tanárok is részt akarnak venni, azzal a klienseknek és az oktatónak is egyet kell érteni. A részt nem vevő személyek csak a témákról tudhatnak, a bent elhangzott kérdésekről és érzésekről nem. Tisztán meg kell határozni a foglakozás elejét és végét. Privát légkör: bármiről beszél az oktató a kliensekkel, az köztük marad, akkor is a négyszemközt, vagy ha csoportban, tisztelik egymást és komolyan veszik a helyzetet. A női és férfi test bemutatása Ki vagy te? Tudode a különbségeket a férfi és női test között? A társadalmi normák és értékek Mi elfogadható, és mi nem? Hogyan viselkedhetünk és beszélhetünk megfelelően a társadalom részeként. Párkapcsolatok Mit jelent az hogy párkapcsolatban lenni? Hogyan figyeljünk a párunkra, érzékeljüke partnerünk kívánságait és határait? Hogyan beszéljünk egymással? Magabiztosság és öntudatosság Képes vagyoke megvédeni magam a szexuális abúzussal szemben? Képes vagyoke segítséget kérni, ha már megtörtént? A szexuális nevelés rendkívül fontos módja a szexuális bántalmazások megelőzésének. Tisztázni kell a csoporton belüli szabályokat, együtt. Tisztelni kell a saját és a partnerek határait, a résztvevők kijelenthetik, ha egy témáról nem akarnak beszélni, nem szabad erőltetni. Tisztelni kell mások véleményét, mindenki elmondhatja a sajátját. Együtt nevetünk, nem egymáson. Figyeljünk a nyitott, kellemes légkörre. 3

10 A szexuális oktatást végzők sok kérdést tesznek fel, és segítenek megtalálni a választ. A válaszokat dicsérettel jutalmazzák, így a résztvevők is egyre több kérdést mernek majd feltenni. Ha a kliensek új témát szeretnének, az oktató a dobozból hamar talál majd segédanyagokat hozzá, tehát mindig felkészült. Témák a képek és számok szerint: : a nő és a férfi fejlődése, újszülött kortól felnőtt korig : szexuális bántalmazás, és annak kezelése : pornográfia : baba várás, születés Az oktató természetesen keverheti a képeket az adott témának megfelelően. Floris Bottinga, pro familia Solingen, Germany kontakt: floris.bottinga@profamilia.de : férfi erekció különböző helyzetekben : női test változásai, gyermekként, fiatal nőként és a menstruáció : női test és az önkielégítés : férfi test, önkielégítés és ejakuláéció : hetero szexuális kapcsolatok, a szexuális aktus és testhelyzetek : leszbikus szexualitás : homoszexualitás : óveszer használat és egyéb fogamzásgátlók : hiegénia : párkapcsolat, közös időtöltés : kellemes érintések Disclaimer The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 4

11 Sexual Education for Adults with Disabilities Tool 3 Thematic Card Game The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

12 Thematic Card Game The Human Body Question Can you get pregnant if you are on your period and have sex without using a condom? Question Do you know the difference between a boy and a girl? Envelopes Puberty Puberty is when the body physically changes from that of a child into an adult. The shape of the body changes, hair starts to grow where it didn t grow before, and girls start their periods. These changes take place in all boys and girls but they will start at different times. Vagina and clitoris Vagina and clitoris are names of female sex organs. Menstruation or period A period is when blood leaves the womb through the vagina. This happens once a month. Penis and testicles Penis and testicles are names of male sex organs. Penis and testicles come in all shapes and sizes. Erection An erection is when the penis becomes hard and erect Friendships and Relationships Question Have you ever been in love? How did that feel? Did you know that Love is not the same thing as infatuation or being in love? A relationship starts with infatuation. When you re in love, you only see the good sides of a person. This changes after a while. Infatuation can turn into love. If you love someone, you want the best for them. That kind of love does not just go away. The feeling of being in love may come back every now and again, but not as intensely as in the beginning. 2

13 Envelopes Girlfriend or boyfriend (relationship) A girlfriend or boyfriend is someone you like and who you enjoy being with. This person feels the same way about you. Friend (relationship) A friend is someone you enjoy spending time with. Partner A partner is another word for girlfriend or boyfriend. Sexual Orientation Question Can homosexual couples have children? Did you know that In the past, people used to think that homosexuality was a disease. We know now that this is nonsense. However, there are people who still find gays and lesbians strange. They even call them names. What do you think about this? Envelopes Bisexual A person who is attracted to both men and women is called bisexual. Homosexual or lesbian Homosexual is when you are attracted to a person of the same sex. Men are attracted to men; women are attracted to women. Lesbian A lesbian is a woman who is attracted to other women. Heterosexual Heterosexual is when you are attracted to the opposite sex. Men are attracted to women; women are attracted to men. Transgender A transgender is a person who cannot identify with the sex he or she was assigned to at birth. A man feels that he is a woman, and a woman feels that she is a man. Transvestite A transvestite is someone who dresses temporarily in clothes of the opposite sex or pretends to be someone of the other sex. In other words, a woman pretending to be a man, or a man pretending to be a woman. Sexual Abuse Did you know that Loverboys use girls to traffic drugs, take out money loans, transfer a car title to their name or commit crimes such as shoplifting? Did you know that Victims of sexual abuse sometimes believe it is their fault? This is not the case! Nobody has the right to force another person to have sex. Not even if you are his girlfriend or if you said yes the last time. Or if you were wearing a sexy dress or let him buy you a drink. Or if you are a guy and your friends say that you are a loser if you say no. 3

14 Envelope Consent Consent is when you agree to something. It is important that both people agree to have sex. You don t have to agree to sex if you don t want to. Discrimination or homophobia Discrimination or homophobia is when someone is treated badly because of their sexual orientation. For example, when someone is picked on or hurt because he or she is gay. Rape Rape is when someone forces another person to have sex against their will and without their consent. Sexual abuse and rape are against the law. Sexual abuse Sexual abuse is when someone touches your body or private parts in a way that makes you feel uncomfortable. When someone has you touch his or her body against your will, this is also called sexual abuse. Loverboy or lovergirl A loverboy or lovergirl is someone who seduces and then abuses you. First they treat you wonderfully and shower you with attention and beautiful or expensive gifts, such as a new mobile phone or scooter. You do fun things together (go to the movies or out to dinner). When you have been dating for a while, they force you to have sex with other people. Some victims are forced to prostitute themselves: to have sex for money. Sex and Masturbation Question What is an erection? Question What is an orgasm? Envelope Anal sex Anal sex is when a man inserts his penis into his partner s anus. When you have anal sex, you should use a condom so that you don t get an infection or STD. Masturbation Masturbation is when people touch their own bodies for sexual pleasure. A man masturbates by touching his penis. As a result, his penis becomes hard. A woman masturbates by touching her breasts, vagina and clitoris. As a result, her vagina gets wet. Oral sex Oral sex is when you touch, lick or suck someone s penis or vagina with your mouth. Orgasm Orgasm is the name for the feeling of intense pleasure and excitement reached when you have sex with someone or masturbate. It is a feeling that builds up and goes through your entire body. When a man has an orgasm, sperm comes out of his penis. Most women find they get wetter during an orgasm. Sex Sex is when people touch, cuddle, stroke and kiss each other s body. A man puts his penis into the woman s vagina. This can cause a woman to get pregnant. 4

15 Talking About Feelings Did you know that One out of six girls and one out of 25 boys are talked into or forced into having sex? This means many young people have had sex against their will at some point in their lives. Remember that it isn t your fault when someone crosses a boundary that you have set. Sometimes people don t listen to you at all and there is nothing you can do. But there are things you can do to reduce the chance of this happening. For example, by being very clear about what you do and don t want. Question Have you ever had an experience where someone crossed your boundaries? Envelope Enjoyment RegretIn love Pain Startled Angry Afraid Happy Crying The Internet Did you know that Flirting and dating online can be fun and exciting? Although the Internet is great fun, it does have dangers. Adults can pretend to be your age and lure you into chatting with them. Question Have you ever chatted online? How did you like that? Envelope Online dating If you want to meet people, you can date via the Internet. You can fall in love with someone and meet up. Attention: always tell an adult that you are meeting someone. You can also bring someone along on your date. Webcam sex It is not only possible to see sex online, you can also have sex online. For example, by using a webcam or having erotic chatting sessions. Note: make sure you know who the other person is. Make clear agreements with each other. Values and Beliefs Question Is it allowed to walk around naked everywhere? Question Everyone is entitled to their own opinion. Perhaps you think differently about certain matters than your classmates or parents. This can be difficult and confusing. What is the truth? Tip: find out what feels right for you. Respect other people s views. Wouldn t you want to be treated in the same way? 5

16 Envelope Giving and receiving compliments Norms and Values Norms and values tell us how we should and shouldn t behave. Some norms are laws, other norms are formed by the environment. Values are what we consider to be right and wrong. Values are wishes and considerations. Values are usually determined by your environment. What is right and what is wrong? Norms and values are written down in laws, but can also be determined by your environment. Different religions have different values. Every person has his or her own norms and values. What behaviour is appropriate in public and what not? There are norms and values about what is appropriate or not. For example, it is okay to eat in public but you should have sex in your room. You can make agreements about this with your care worker. How should you treat other people? There are also norms and values for interacting with others. A norm is: it is not okay to make fun of people. A value is: treat others respectfully and kindly. Porn Pictures or movies of naked people having sex is called porn. In a porn movie, it seems as if people feel like having sex all the time and everywhere. They also immediately jump at the chance of having sex, in all kinds of positions. Porn is all fantasy. And in a fantasy world anything can happen and anything goes. This is very different from reality. In the real world, there are other norms and values. Safe Sex Question Do you know how to use a condom? Did you know that A penis or vagina can also get sick? This is called an STD. Your penis or vagina can get a disease when you have unprotected sex (sex without using a condom) with someone who has an STD. If you have an STD, you need to see a doctor. Envelope Condom A condom is a rubber covering which a man wears on his penis during sexual intercourse as a contraceptive. If a condom is used properly, it protects against infections, STDs and pregnancy. 6

17 Birth control or contraception Birth control, also known as contraception, are methods or devices used to prevent pregnancy when a man and woman have sex. There are various forms of contraception. Some contraceptives are available over the counter in shops, others require a prescription from a doctor. Birth control pill A birth control pill, also called the pill, is a medicine that a woman can take so that she doesn t get pregnant. You have to go to the doctor to get birth control pills. And you must take them exactly as the doctor tells you. Sexually Transmitted Diseases (STDs) STDs are infections which are passed from one person to another through sex. If you have an infection, it may hurt when you go to the toilet. Or your vagina or penis may be sore or itchy. Articulating Boundaries and Assertiveness Question Do you know how to say no? Question How do you know when someone wants or doesn t want to do something? Envelope Assertiveness Assertiveness is being able to stand up for yourself. When you are assertive, you know what you want and what you don t want. Articulating boundaries A boundary indicates what you don t want to happen or do. Each person has his or her own boundaries. It is important that you learn how to articulate your boundaries. Saying no It is important to say no when you don t want something. This can be learned. It is also called articulating boundaries. Getting attention There are several ways to get someone s attention. There are negative ways to get attention. For example, by hitting or yelling. You can also get attention in a positive way, for example, by tapping someone s arm or asking a question. Sexuality and Intimacy Question Do you know what sex is? Question Do you know what sexy is? What do you find sexy? Suitable distance If you stand too close to another person, he or she might feel uncomfortable. If you are uncomfortable yourself, you can show this by saying: Do you mind taking a step back? 7

18 Envelope Sexuality Sexuality has to do with your body and feelings. You can experience sexuality alone or with others. Sexuality is about making love, touching and how you feel as a person. Almost every human being has sexual feelings. Sexuality encompasses many different aspects of our lives. Baby A baby fully depends on his or her parents or caregivers. This costs a great deal of time and energy. Pregnant A woman can get pregnant. Being pregnant means there is a baby growing inside a woman s body. Intimacy You can be intimate with another person. You can feel close to your parents or a good friend. Giving someone a cuddle or sharing secrets is a form of intimacy. Making love is also an intimate connection. Reproduction Question Do you know how a women gets pregnant? Question Do you know how long the baby grows in the mother s belly before it is born? Envelope Contractions/pregnancy Contractions are cramps that start before the baby is born. Contractions are very painful, but they help push the baby out. Childbirth Childbirth is when a baby is born. Baby food & bottle Babies need to be fed frequently, both during the day and at night. Disclaimer The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 8

19 Sexual Education for Adults with Disabilities Tool 5 PAOMI modellekhez The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

20 A PAOMI modellek használata férfi és női nemi szerv modellek A PAOMI modellek, férfi és női nemi szervek plüss verziói, hogy segítsék a szexuális nevelést, a nemi szervek témában, hogy több érzékszervvel tudják befogadni a kliensek. A dobozban található egy nagyon egyszerű pénisz modell, fitymával, ami nem mutatja a belső szerveket. Ezeket külön meg lehet rendelni, valamint körbemetélt verziót, vagy húgyhólyaggal ellátott verziót is lehet rendelni. A női modell a dobozban méhhel, és petefészkekkel, és 3 féle szűzhártyával. A modellek segítenek elmagyarázni, megmutatni a nemi szervek részeit: Férfi nemi szerv esetén: pénisz makk fityma nyél húgycső herék herezacskó végbélnyílás Női nemi szerv esetén: vagina nagyajkak kisajkak csikló húgycső méh méhnyak száj petefészkek petevezeték Érdemes a modelleket nem önmagukban használni, hanem képekkel, rajzokkal kiegészítve. A BOSCH képek és a Change füzetei is jó kiegészítők lehetnek. A témák különbözőek lehetnek. 2

21 A témák különbözőek lehetnek. 1) nyelv: magyarázzuk el a modelleket, kérdezzük meg a klienseket, hogy milyen neveket ismernek a. írjuk le mindet, bátorítsuk őket, hogy mindent megnevezzenek, még azokat is amelyek nem feltétlen nyomdafestéket tűrőek b. beszéljük meg, hogy innentől milyen neveket használunk a szervek részeire c. ha lehet, kapjanak a kliensek képeket, amire rá lehet írni a neveket 2) Funkciók: magyarázzuk el a szervek funkcióit 3) Izgalmi állapotban a funkció hogyan változik, szexuális aktivitás esetén a. férfi nemi szerv: izgatás, erekció, orgazmus, ejakuláció b. női nemi szerv: csikló izgatása, vagina nedvesedése, orgazmus 4) Funkció: menstruáció bemutatása 5) Terhesség és születés 6) Higiénia fontossága a. Férfiaknál: mikor és hogyan kell tisztítani a nemi szervet, főleg a fityma alatt b. Metélés: előnyök, hátrányok c. Nőknél: nőknek tudni kell, hogy csak vizet szabad használni a szeméremajkak között, a szappan vagy egyéb tisztítószerek rossz hatással lehetnek az öntisztulásra 7) Női nemi szervcsonkolás 8) Lehetséges betegségek: fontos lehet, a rák megelőzésének említése 9) AIDS és egyéb fertőző betegségek 10) Információ fogamzásgátlásról és sterilizációról 11) Egyéb témák A PAOMI modellek nagyon népszerűek a kliensek közt, de vigyázni kell rájuk, nehogy széttépődjenek. Kézzel gyártottak, és kézzel moshatóak. Legegyszerűbb, ha egy dobozban vannak tárolva. A PAOMI modelleket egyéni és csoportos órákon is lehet használni. Floris Bottinga, pro familia Solingen kontakt: floris.bottinga@profamilia.de Disclaimer The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 3

22 Sexual Education for Adults with Disabilities Tool 8 SEAD kompetencia profil The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

23 SEAD kompetencia profil A SEAD egy olyan nemzetközi project, ami a fogyatékkal élők szexuális nevelésének a hiányosságaira fókuszál. A SEAD egy olyan Európai Uniós kezdeményezés, amelyet azzal a céllal alapítottak, hogy felhívja a figyelmet a szexuális nevelés fontosságára. A project célja, hogy javítsa a fogyatékkal élők szexuális nevelését. A project feladata, hogy terjessze az összeszedett ismeretanyagot Európa szerte. A SEAD project kutatásokat végzett és felismerte, hogy különböző kompetenciákra van szükség ahhoz, hogy a fogyatékkal élők, szüleik és gondozóik szexualitással kapcsolatos kérdéseinek megválaszolásához. A kutatások során a SEAD felmérte a célcsoportok igényeit a szexuális neveléssel kapcsolatban. A célcsoportok, a klienseket, a szülőket, a gondozókat és a leendő szakembereket is magukba foglalják, a szakemberek kompetenciáit is megvizsgálta a project. Ahhoz, hogy a szakemberek meg tudják válaszolni a kliensek, szülők és gondozók kérdéseit, különböző kompetenciákat kell elsajátítaniuk. A kompetencia profilban ezek a kompetenciák vannak megfogalmazva, a kompetenciák különböző fókusz területekkel vannak összekötve. A következő négy terület alakult ki a kutatás során: 1) A fogyatékkal élő fiatalok szexuális fejlődésének az ismerete 2) Megfelelő szakirodalom ismerete, hogy a fogyatékkal élők kérdéseire válaszolni tudjon a szakember 3) Szakismeret, hogy a szakember be tudja azonosítani a kliensek problémáit és tudja azokat kezelni 4) A saját attitűdök ismerete a szexualitás terén, valamint a fogyatékkal élők attitűdje Hogyan lehet ezeket a kompetenciákat alkalmazni? Szakemberként mindenki fel tudja ismerni, hogy melyek azok a kompetenciák, amelyeket már elsajátított. Meg fog jelenni, hogy mik azok a kompetenciák, melyekkel a szakember már rendelkezik, és melyek azok amelyeken még dolgoznia kell. Ez majd egy tiszta képet ad a szakemberek jelenlegi helyzetéről. A hiányzó kompetenciák megszerezhetőek a SEAD tool kit, szerszámos doboz segítségével. Ezek a tudásanyagok a SEAD honlapon megtalálhatóak. A weblapon minden egyes fókusz területről található magyarázat, és az is hogy a szakemberek hogyan fejleszthetik magukat az ott található segédanyagok használatával. 2

24 A weblapon mindenki találhat információt a fogyatékkal élők szexuális neveléséhez szükséges kompetenciákról: Disclaimer The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 3

25 Sexual Education for Adults with Disabilities Tool 9 Handbooks Appendices The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsi ble for any use which may be made of the information contained therein. 1

26 Appendices This booklet contains appendices to the instructional guide and toolkit. It includes interesting theoretical information, resources and references to sources and methods that stimulate educators of individuals with intellectual disabilities to look beyond the information provided in The Box. Contents Protocols for a Solutionfocused Approach Appendix 3: Protocol for Finding Exceptions (see also chapter 7) Appendix 4: Feedback and Task Framework (see also chapter 10) Figure 10 Appendix 5: Protocol for Followup Sessions (see also chapter 11) Appendices 2 Appendix 6: Guidelines for Crisis Situations 9 Social Development Stages in Children 2 Appendix 7: Guidelines for Involuntary Clients 10 Social development in infancy (03 years) 2 Social Development Stages in Children Social development in infancy (03 years) Social development in toddler and preschooler years (36 years) Social development in schoolage years (612 years) 3 4 Oneandahalf years: Basic trust versus basic mistrust: the child develops trust or mistrust, depending on how the parents respond to his or her needs. Social development in adolescence (1220 years) The Hermeneutic Circle 5 5 Autonomy versus shame: the child gains a sense of autonomy if he or she is encouraged to explore, whereas over protection or limitation of exploration foster feelings of shame. Recommended Methods and Sources for Training and 5 Professional Development 2

27 During infancy, attachment between the child and a specific individual is formed. This is usually one of the parents, but may also be a different caregiver in other situations. There are various styles of attachment: secure attachment, anxiousavoidant attachment, or anxiousambivalent attachment. Attachment classification in infants (Attachment classification in infants, Feldman, 2009) At the end of the first year, infants go through a phase known as stranger suspicion, where they become extra wary of people outside their immediate family. In a big and unfamiliar world, infants search for familiar things. Unfamiliar situations or objects elicit fear responses. When infants do not know how to respond to an unclear wsituation, they look at the facial expressions and behaviour that others display in order to obtain clarifying information (social referencing). Around the age of two infants start to show empathy, an emotional response that corresponds to the feelings of other persons. Social development in toddler and preschooler years (36 years) Initiative versus guilt: the child is faced with conflicting feelings the desire to act independently from his or her parents and guilt caused by unintentional consequences of his or her actions. Moral development is a process through which children develop a sense of justice, right and wrong, and associated attitudes and behaviours. During this development, children go through a stage in which they start thinking in terms of heteronymous morality. They see the world as an unchangeable collection of rules that are beyond anyone s control. 3

28 Abstract modelling ensures that toddlers no longer directly copy the behaviour of others, but start to develop abstract principles about the behaviour they see around them. Around the age of three children start to form real friendships. These friendships are based on the desire to have someone to play and have fun with. Older children also form friendships based on things such as trust, support and common interests. Social development in schoolage years (612 years) Industry versus inferiority: during this phase the child learns to master competencies to cope with problems relating to parents, peers and environment. Social comparison is selfevaluation through comparing own behaviour and skills with that of others. This may also have an effect on the development of selfesteem, i.e. how the child perceives himself or herself. During schoolage years, three stages of friendship can be distinguished: years: Friendships are based on likeability and sharing toys and activities. Friends are often children who the child spends most of his or her time with. Personal traits are not yet that relevant years: Personal traits and characteristics come into play when forming friendships. The rewards of friendships also start to play a role. Friends are children who are there when you need them. Abused trust is not forgiven that easily years: Views on friendship are often maintained in adolescent years. Intimacy and loyalty are important factors. This stage is characterised by psychological closeness and mutual openness. Less emphasis on common interests and the psychological benefits of friendship. Social development in adolescence (1220 years) Identity versus identity confusion: during this period the child, now an adolescent, learns how to answer Who am I by identifying what makes him or her different from other people. In the adolescent s social world, ties with people outside the family become increasingly important, while the relationship with family may change or become more difficult. In school years, adolescents develop autonomy, become independent and gain control over their lives. Adolescents often have a certain group of people who they identify themselves with. This reference group, or clique, exercises a lot of influence, which may lead to peer pressure. During this stage of life the composition of groups of friends often changes. While children usually have samesex friendships throughout their elementary school years, crosssex friendships are much more common as they grow older and adolescence kicks in. Social pressure to engage in (heterosexual) relationships increases and sexual organs start to mature, creating a strong interest in the other sex. Peer pressure can also be a factor in friendship formation. 4

29 Puberty opens the door to a significant new stage in terms of relationships. For many teens, sexuality is a big issue. Masturbation and various forms of intimacy (kissing, massaging, oral sex) often precede one of life s major milestones: sexual intercourse. Another important topic on the agenda of many adolescents is sexual orientation. However, the threshold to give into samesex attraction is often high due to prejudice and ignorance. The circle can be completed based on your experience with the individual, based on information from his or her file, or based on discussions where he or she explains the reasoning behind the decisions made. Note: good judgment is asked of the educator to ensure the individual is not overwhelmed by the process. (Feldman, 2009) The Hermeneutic Circle The hermeneutic circle is a circular understanding process that gives a complete picture of a person by looking at various developments in his or her life, as well as the person s life history and ability to cope. There are two ways to complete the hermeneutic circle: Problemfocused: the circle is completed by listing skills and resources that the individual lacks, for example on a social or cognitive level. Solutionfocused: the circle is completed by listing skills and resources that the individual possesses. This is done by taking his or her personal history into account and the challenges, if any, that were faced and overcome along the way. Crucial moments and their impact on the person s life can also be discussed here. Recommended Methods and Sources for Training and Professional Development To be completed by the country concerned. Protocols for a Solutionfocused Approach The following pages contain protocols to help you get started with a methodological, solutionfocused approach. The tools and tips provided can be used in teaching sexual education. 5

30 Appendix 1: Protocol for First Session 1 Role clarification Information on the structure and duration of the session, whether there will be a break to reflect, and, if necessary, an explanation of the solutionfocused approach. 2 Matching your client s style/worldview The first step consists of building a positive working relationship with the client by going along with the client s worldview. 3 Improvement prior to first session What has changed since we last met or spoke with each other? The improvement question taps into the change process that may have already been initiated. 4 Formulation/acknowledgement of problem What brings you here? How is that a problem for you? What have you already tried and what has been useful? Acknowledgement is important: listening in a respectful manner, reflecting on feelings, giving compliments, defining the type of relationship between the professional and the client (customer, complainant, visitor), walking on two legs. 5 Goal formulation/miracle question (or related question) You will go to sleep tonight, and in the middle of the night, a miracle happens and the problem that prompted you to talk to me (name specific problem) is solved or nearly solved. What has changed when you wake up tomorrow morning? What else? 6 Exceptions Are there any exceptions? When is the problem absent or less noticeable? Together with the client, the professional looks for differences and exceptions, and the extent to which the client is able to control the occurrence of the exceptions. 7 Scaling If 10 is: I have reached my goal and 0 is: I have yet not reached my goal, where are you now on a scale of 10 to 0? Scaling is often used to gain insight into the following areas: The client s progress during the sessions; The degree of hope the client has; The amount of energy the client is willing to invest in improving his or her life; The confidence the client has in terms of reaching his or her goal; The client s willingness to put the necessary effort into reaching his or her goal. 8 Competency questions The professional compliments the client directly, asks competency questions (indirect compliments) and gives positive character interpretations: How brave of you to Where did you get that good idea to? It takes a strong person to Please tell me more. 6

31 9 Feedback Feedback to the client consists of three components: Compliments for what the client has accomplished and positive character interpretations. Compliments are a positive way of reinforcing past successes and competencies. A reason (rationale or bridge) for the task (preferably in the client s own words). The bridge connects the compliments to the homework suggestions or tasks. The bridge often begins with and because... A task or homework suggestions. This component consists of one or more behavioural or observational tasks. The solutionfocused professional can introduce a fiveminute break before the feedback, allowing time to think about what feedback to give. The feedback provided differs for visitors, complainants and customers : Visitors are not given suggestions for homework assignments (they do get compliments). Complainants are only given suggestions for observational tasks. Customers are given observational tasks and/or behavioural tasks. Appendix 2: Protocol for Goal Formulation 1 Goal formulation (miracle question or another goaloriented question) What is your goal? What would be a good result for you? What do you want to replace the problem with? 2 Elicit details After the miracle: What is the first thing you notice? What else? Who else will notice when the miracle happens? What will you do differently? What else? What will your day be like after the miracle? And so on. 3 Towards solutions What is needed to have (a small) part of the miracle happen?, How might that happen?, Who could help you with that? 4 Task Visitors are not given tasks. Complainants are given suggestions for observational tasks. Customers are given suggestions for observational or behavioural tasks. Appendix 2: Protocol for Finding Exceptions 1 When the clients talks about the problem, ask: 2 When was the problem absent? Or When was the problem less intense or less frequent, even if the difference was small? Or What days were better? Or When was your last good day? 3 Ask for details and explore how the exception came to be What did you do to make that happen?, What did you notice?, What did you say?, What happened?, What was different?, What did you find useful?, How did you manage that?, How did that feel?, What else?, Please, tell me more! 7

32 4 Reinforce/Pay compliments Nonverbal: lean forward, raise your eyebrows, make notes (do what you would naturally do when someone tells you something important). Verbal: show interest. Was this new for you?, Did it surprise you that this happened? Pay compliments and ask competency questions: That must have been pretty difficult for you, It required courage for you to do that, Where did you get such a good idea? 5 Project exceptions on situations in the future What is needed to make this happen again? What should you do? Who can help you with that? Appendix 4: Feedback and Task framework Feedback: compliments; rationale or bridge (reason for the task); task suggestions for when client wants to do a task Figure 10 8

33 Appendix 5: Protocol for Followup Sessions EARS: Eliciting (drawing out stories): What is or what is going better? Amplifying (asking for details): How does that work?, How exactly do you do that?, Is this new for you?, What effect does that have on?, What is different between you and...? Reinforcing (confirming): Give compliments and positive character interpretations and ask competency questions. Start again (start over): And what is or what else is going better?, What else?, What is needed to do that again or more often? If nothing has improved: How do you manage?, How do you survive that?, How come things aren t worse than they are?, How do you do that? Scaling progress: Where are you now on a scale from 10 to 0?, How did you manage that?, What would a higher rating look like?, What would be different?, What do you need to accomplish this?, Who will be the first to notice?, How would he or she notice this?, How would he or she respond?, What rating is your ultimate goal? Optional: scaling motivation and confidence Feedback: compliments; rationale or bridge (reason for the task); task suggestions for when client wants to do a task. Is it necessary or would it be useful for you to come back? If so: When would you like to come back? Or: Is it necessary for you to talk more about If so: When shall we meet? Appendix 6: Guidelines for Crisis Situations Acute care Chevalier (1995), Berg and Szabó (2006), Gersons and Olff (2005) provide guidelines for initial therapeutic care for people in acute crisis situations. These guidelines mainly consist of natural responses given by the client s family and friends: Give comfort and hope. Listen to the client s story. Accept the client s view of the world. Relate to the client s language. Create a sense of calm and order in chaos. Inform significant others. Use important people from the client s immediate environment to cope with the crisis. Ensure the client drinks and eats enough. Make a followup appointment. Solutionfocused approach Contrary to a general misconception, it is possible to deal with crisis situations in a solutionfocused manner. Because a crisis takes care professionals by surprise, they are often inclined to take control of the situation in a problemoriented way. However, most clients in a crisis situation stabilise quickly if they are encouraged to focus their attention on what they would like to be different (goal formulation) and make use of past successes and competencies. Solutionfocused interventions include: Inquire about the client s competencies. Explore how the client is coping with the current crisis: How are you managing?, How are you taking care of yourself? Pay compliments. How did the client solve a previous crisis? Focus on the client s strengths. Ask goaloriented questions: What helps you the most? 9

34 Ask relationship questions. Ask scaling questions that focus on the goal. Ask scaling questions that focus on progress in terms of coping. Please refer to chapter 18 for solutionfocused questions for clients in a crisis situation. Appendix 7: Guidelines for Involuntary Clients Lans, Medema & Rakers (2003) give practical advice for working with clients who find ambulant care to be intrusive (involuntary clients). The following pointers and strategies may prove useful: Sit next to the client. Show that you are working from a position alongside the client, rather than confronting the client. Frequently use the word together. Getting a foot in the door is an expression that symbolises a personal approach: the professional who is often (literally) confronted with a closed door shows that he or she is involved by visiting the client more often, leaving an invitation, calling or by getting information from neighbours or housemates. Show respect for the client by asking questions without being dismissive or judgemental. This is essential for maintaining a good relationship. Find solutions that result in a winwin situation for all parties. In doing so, display a cooperative attitude. Explore, together with the client, how broken or distorted relationships with other persons or institutions can be restored within the context of common interest. Show an interest in the client. Generating trust, informing and building up a relationship is essential in times when the client is not under pressure of the problem. Make good use of these calm periods. Clients with intellectual disabilities are considered involuntary clients if they do not acknowledge their part in the problem s creation and set goals to solve it, while others (e.g. parents or care workers) do acknowledge this. Involuntary clients include clients with uncontrollable anger issues who professionals don t know how to deal with, or ambulatory patients with financial or addiction problems who refuse help. De Jong and Berg (2004) give a number of guidelines for conversations with involuntary clients: Approach the client from a visitor relationship perspective. Assume that the client has good reasons to think or act in the way that he or she does. Do not pass judgement and accept the client s viewpoints causing his or her cautious, defensive attitude. Listen to who or what is important to the client, especially when the client is angry or critical. When the client openly expresses anger or criticism, find out what the person or institution could have done differently to change the outcome. Ask the client what would be in his or her best interest. In other words, what would the client like to achieve? Listen to the client s terminology and parrot his or her language when summarising, paraphrasing or giving feedback. Make use of the client s context in the conversation by asking relationship questions. Provide information about nonnegotiable conditions in a respectful way, and ask how the client feels about these conditions. Work from a notknowing position. 10