Friday, August 29, 2014

Minority status & the perpetration of child sexual abuse


Child sexual abuse is a difficult issue to discuss at the best of times. The conversation around child sexual abuse is more challenging when we move from a stereotypical offender-victim paradigm (i.e., white male perpetrators and young white female victims) to non-traditional offender-victim paradigm (e.g., learning disabled offenders, minority offenders and/or female offenders).  The main issue is that the conversation surrounding the non-traditional offender-victim paradigm can become conflated with issues of political correctness, potential racism, potential sexism and discrimination. I am not saying that these concerns are not real or important, but rather they should not be used as a roadblock for avoiding difficult sexual abuse questions, as has seemed to be the case in the recent child sexual abuse scandal in Rochdale, England. Child sexual abuse is a wide and varied field and, as such, it is important to recognize that anyone can be a sexual abuser and/or a victim.

On Tuesday 26th August 2014 Professor Jay released her independent enquiry into the sexual abuse of children by members of the Asian community in Rotherham, England, between 1997 and 2013. The independent enquiry was called for by Rotherham city council (BBC) and suggests that (at a conservative estimate) 1,400 child victims were violently and systematically abused over a period of at least 15 years by organised “gangs” of Asian male perpetrators in the Rochdale area. In the report Professor Jay highlights a number of systematic failings made within and across a range of public services (i.e., social services, child services, the police and local government) which enabled the abuse to continue. The main failing appears to be an inability to respond appropriately to the role of minority groups in the perpetration of child sexual abuse. Professor Jay highlighted in the report  (as well as in her press release) that “Several staff described their nervousness about identifying the ethnic origins of perpetrators for fear of being thought racist; others remembered clear direction from their managers not to do so” (Jay, 2014; 2).In the subsequent media coverage that has emerged over the last couple of days, since the publication of the report, it has become evident that the race and minority status of the perpetrators played an important role in Rotherham city council’s reaction to the reports and prosecution of the sexual abuse (i.e., that victims were not listened to, stories where downplayed and opportunities to investigate/follow up where missed) (BBC News, Telegraph). The Rotherham case is not the only large scale case to come to light in the UK over the last couple of years involving the preparation of child sexual abuse within and by minority communities, with recent cases in Oxford, Derby, Rochdale & Peterbough (BBC). This is not to say that minority communities are more, or less, likely to commit child sexual abuse anymore than non-minority communities; rather we are starting to learn more about abuse that exists within these communities.

Minority communities can often be classed as “hard to reach” communities in respect to sexual issues (including sexual health and sexual abuse) because of perceived beliefs, culture, social structure, and approaches in discussing sexual matters (Cowburn, Gill & Harrison, 2014; ESRC online debate 2 - Access to and the impact of sex offender disclosure on minority groups). This means that traditional/mainstream approaches to policing, public engagement and education around sexual abuse may not work as well with these communities. Hence, we need to talk with different “publics” about sexual abuse in different ways (McCartan, 2013).  In this case, talking to a minority community will not be the same as talking to a mainstream “white” community, the same way that talking to a working class community might not be the same as talking to a middle class one  (ESRC Online discussion 1: Public understandings of sexual abuse and sexual abusers; Leverhulme Online discussion 1: Sexual abuse as a Public Health Issue). This means that prevention, ideally, shoule be multifaceted and tailored to the communities at hand.   A one-size-fits-all model can present both ethical and logistical dilemmas.

When the mainstream engages with minority communities in conversations about sexual violence and prevention this needs a two-track approach:   respecting their cultural beliefs and own ways of engaging on the topic, while simultaneously conveying the broader social and cultural approach in a way that they can engage with. One of the best ways of doing this is through the use of community “stakeholders”; people from the community who are invested in the community (Kemshall, 2012; NIACRO Base 2), and therefore accepted by them, and willing to work with the mainstream in developing a coherent, achievable approach to sexual abuse.

The development of a systematic, far reaching, and in-depth approach to sexual violence is challenging, and, to do it properly, means that we have to be willing to have the uncomfortable conversations as well as the easy ones. As a society we need to recognise that sexual abuse can be perpetrated by anyone regardless of education, economic means, or community status ., We should not  avoid confronting uncomfortable sexual abuse claims because it may be challenging or politically difficult. We should pursue every claim of sexual abuse with the same rigour, customize prevention efforts to respect cultures and demographics, and only then will all of society truly understand the reality and pervasiveness of sexual abuse.

Kieran McCartan, PhD

References
Cowburn, M., Gill, A. K., & Harrison, K. (2014). Speaking about sexual abuse in British South Asian communities: offenders, victims and the challenges of shame and reintegration. Journal of Sexual Aggression. iFirst – http://www.tandfonline.com/doi/full/10.1080/13552600.2014.929188

Kemshall, (2012) Public sector and voluntary responses: dealing with sex offenders. In: J. Brown and S. Walklate (eds.) Handbook on Sexual Violence. London: Routledge

McCartan, K. (2013) From a lack of engagement and mistrust to partnership? Public attitudes to the disclosure of sex offender information. International Journal of Police Science and Management, 13 (3), pp. 219-236.


Friday, August 22, 2014

The anonymity debate

This was not the blog I sat down to write, that’ll come in a couple of weeks. 
This blog was instead prompted by recent events and news on the evening of Monday 18th August 2014 in the UK. Last week Sir Cliff Richard’s house was searched by the police in regard to sexually inappropriate offences that took place in the 1970’s, while that may have been challenging for some to accept that was not the main furore; the police tipped of the BBC, who recorded the whole “raid” live, and did not inform Cliff (Daily Mail). Both sides are blaming the other and claiming that they themselves were not in the wrong (the independent). Reaction has condemned the Police and the BBC (Yorkshire postTelegraph), and society (the independent); however, people came forward with allegations against Cliff [London evening Standard]. The whole event has left an uneasy feeling.
The ITV News (one of the main news broadcasters'in the UK) on 18th August 2014, commissioned a poll to look at public attitudes to anonymity for sexual abuse defendants prior to being deemed guilty by a court [ITV News],  which is a hotly debated issue raised a number of times in the press (Huffington Post;The Scotsman) and in parliament (House of Commons - Home Affairs - Fifth Reportthe independent), as well as by defendants (ITV news). Part of the explanation for the argument for anonymity is because sexual abuse allegations are so stigmatic and tend to linger in the public mind set regardless of whether the defendant is found not guilty or not (i.e., “no smoke without fire”). The ITV poll found that 74% believed that people facing sexual abuse allegations should receive anonymity prior to a guilty verdict.
This debate is not a straightforward one, it is exceptionally complex one with a number of  interested as well as invested players; the aim of this blog is not to answer the question but to prompt debate and reflection. Some of the main arguments, as I can see them, are from;
Victim – Identifying there defendant gives credence to the victim in the sense that it recognises and validates their abuse claims; it shows them that the criminal justice system is taking them seriously and in doing so it helps them in their journey for justice. It progresses the fight for victims rights. However, outing the defendant can sometimes out the victim, especially if they are vulnerable (i.e., victims of child sexual abuse have anonymity in the UK and there have been cases where poor reporting has resulted in the victim’s identity being outed) and make them feel vulnerable, under pressure pre-trial.
Defendant –The identification of the defendant means that those others around them are aware of their offences, potentially stopping them going underground, making sure that they stick to their pre-trial arrangements, preventing them from reoffending and/or making sure that they do not approach the victim. In addition, other defendants get named in other offences, why should sexual abuse be any different? But sexual abuse has a massive social stigma attached that negatively impacts the defendant, regardless of guilt or the court’s decision, which can impact their current and future lives (i.e., jobs, family life, etc) (ITV news), affecting their mental health and (potentially) increasing their potential risk as well as dangerousness to themselves and/or others. Interestingly, we spend so much academic and professional time discussing community notification post release, forgetting that we notify the community and disclosure their information pre-trial.
Criminal Justice System - This one is most complex position as there is a requirement to protect the public balanced against upholding victims’ rights, defendant’s rights and the integrity of the case (i.e., not to negatively impact the outcome of the case in court or in getting to court through inappropriate procedural behaviour). In short, maintaining the “innocent until proven guilty” aspect of the criminal justice system regardless of related social, personal or professional attitudes. Sexual abuse cases generally fall within a punishment paradigm which means that the core tenants of the criminal justice system can be diametrically opposed, rather than work in tandem.
As I said at the beginning this is a complex issue with no straight forward answer, there are a lot of involved, interested and concerned parties. I for one am not suggesting any distinct course of action, but instead saying that the identification of sexual assault defendants pre-trial outcome has consequences on them, their families, their victims and the criminal justice system: if we are reframing the sexual abuse debate we should look at all angles of it, including this one, regardless of how it makes us feel.
 Kieran McCartan, PhD

Friday, August 15, 2014

Correcting Course: Have We Missed the Boat on our Clients’ Adverse Experiences?

A recent discussion on the ATSA listserv was worth following. It began with the simple question of what sorts of trauma-informed systems of care exist for adolescents who have sexually abused, and extended well beyond. One member basically asked why it is only now that the notion of trauma-informed care seems to be coming into vogue in our field. It is an excellent question with no clear answers for now. One member commented on how in the past many therapists noted that their clients seemed to excuse their abusive actions by claiming that they had themselves been abused. Clearly, a side effect of helping clients in the direction of becoming accountable for their behavior could be the therapist’s implicit or explicit minimizing of their past experiences. This ATSA member commented that while it can be necessary to help people move through defensive excuse-making into a more honest conversation, the original intent of holding clients accountable was never to dismiss the harm that had been done to them.

A case from the author’s experience is haunting and illustrative. In one agency that employs polygraph examinations, it was routine to polygraph clients on their disclosures of past victimization, apparently with the underlying assumption that their clients often sought to excuse their behaviors. While this use of polygraph could itself be the subject of many other discussions, an interesting situation arose when the therapist ordered a polygraph to verify the account of a client in treatment who claimed a lengthy history of sexual abuse as a child. He had received individual therapy for this over the course of a year. Upon failing the examination, the client said that in fact he had been lying to his therapist about this abuse all along. He went so far as to use uncouth language to assert that his treatment team were na├»ve and foolish for believing him.

Whatever the truth in the above client’s case (and setting aside other florid concerns about his functioning), one is still left with the question of whether other adverse, even traumatic, experiences in this client’s life contributed to his offenses and his behavior in treatment. What events in his background led him to believe that it was in his interest to interact with others this way? In other words, when we ask about abuse, are we asking the wrong questions? Often the question seems to be dichotomous: was he abused or not? Perhaps it’s better to explore all the formative events of one’s life. What are the many ways in which our clients might have been hurt? What sense did they make of these events? How have these events contributed to their views/schemas of themselves and others?

Very little research has shown a direct link between one’s victimization and propensity to abuse. Although controversial, authors as diverse as Susan Clancy and Bruce Rind have observed that not everyone who has been abused experienced their situation as abusive, and many believe that it had little or no effect on them. Certainly, the vast majority of people who are victimized do not go on to abuse others. Yet in our rush to treat only those factors that proximally contribute to re-offense risk (in adherence to the need principle) we could be overlooking important ways to make our treatment more meaningful to our clients (in adherence with the responsivity principle). Ultimately, the question is how effectively can individual clients build safer futures when they don’t have an adequate opportunity to transcend their own past?

A couple of recent studies are worth mentioning. Reavis, Looman, Franco, & Rojas (2013) administered the Adverse Childhood Experience (ACE) Questionnaire to 151 people who had been violent towards children, engaged in domestic violence, sexually abused, and had stalked others. They found that these types of offenders had significantly higher rates of adverse childhood experiences than men in the general population. Only 9.3% of the sample reported no adverse events in childhood, compared to 38% of the male sample in the ACE study, and 48% reported four or more adverse experiences, compared to 9% of the men in the ACE study. Sex offenders in particular had significantly higher ACE scores than the general population. Likewise, Levenson, Willis, & Prescott (2014) administered the ACE questionnaire to 679 adult males who had sexually abused. Compared to males in the general population, sex offenders had more than three times the odds of child sexual abuse, nearly twice the odds of physical abuse,thirteen times the odds of verbal abuse, and more than four times the odds of emotional neglect and coming from a broken home.

Of course, not everyone responds to adverse and traumatic events equally. Authors such as Geral Blanchard have written on the understanding of post-traumatic growth, that ability not only to integrate traumatic experiences, but to find meaning from them and flourish as a result. Many clients who have sexually abused simply enter treatment looking to prevent further abuse and are not interested in an archeological expedition into their distant past. If there is anything the trauma field has learned, it’s that people who have experienced abuse need to discuss and move beyond it in their own way and in their own time. Sadly, there is far more high-quality research into recovery from abuse than recovery from sexual violence.

Perhaps the biggest question our field has yet to ask is how adverse experiences contribute to the areas that can make meaningful change seem unlikely to therapists and clients alike. It is tempting to think of the sequelae of abuse as being only things like distress and nightmares. It is easy to forget that therapy-interfering factors such as restricted affect, memory problems, relationship issues, and avoidance of situations that remind one of abuse (such as treatment for sexual aggression) are themselves trauma symptoms and not always attempts to avoid responsibility.

So how is it that our field is only now talking about trauma? Perhaps because we’re finally moving past thinking solely in terms of abuse-abuser hypotheses and understanding the nuances of adversity.

David Prescott, LICSW

Gwenda M. Willis, Ph.D., PGDipClinPsyc

PS. This blog was written with advice and contributions by Jill Levenson

References

             Levenson, J.S., Willis, G.M., & Prescott, D.S. (2014). Adverse Childhood Experiences in the Lives of Male Sex Offenders and Implications for Trauma-Informed Care. Sexual Abuse: A Journal of Research and Treatment. Avance online publication.doi: 10.1177/1079063214535819.

Reavis, J., Looman, J., Franco, K., & Rojas, B. (2013). Adverse Childhood Experiences and Adult
Criminality: How long must we live before we possess our own lives? The Permanente Journal, 17,
44-48.


Monday, August 4, 2014

Sexual Abuse Prevention Blog - A focus on New Zealand

Introduction to the NEW Prevention Blog Series

What is your answer to the question, “What do you do for work?”  ATSA’s Prevention Committee hopes that your response is something like… “I work to prevent sexual violence.”  And if that person asks for more information, you can let them know that you care deeply about keeping communities, children and other vulnerable populations safe, so you have chosen to work with adults, adolescents and/or children who abuse.
ATSA’s Prevention Committee has reached out to the membership to uncover the unique collaborations that ATSA members are forming in their communities and explore what ATSA members are doing to prevent the first time perpetration of sexual violence.  In this first interview, the conversation created even deeper collaborations (e.g., Gwen Willis was invited to become a part of the organization’s board of directors).
As you read the blogs in this prevention series, we hope you will be as inspired as we have been by the work that ATSA members are doing in the world.  And if you are doing primary prevention in your community – working to prevent first time perpetration of sexual abuse – or know of an ATSA member who is doing this important work, please let us know.  You can reach us through ATSA at aniss@atsa.com.

ATSA members truly do have a unique perspective to offer.    

Joan Tabachnick and Karen Baker [Co-chairs of ATSA’s Prevention Committee]

Sex ‘n’ Respect: Prevention in New Zealand

“Consent is sexy, because it means both people are into it.”  That’s one of the many messages being delivered to thousands of New Zealand young people through Rape Prevention Education’s (RPE) sexual violence prevention programs.  While the majority of ATSA members’ work focuses on preventing repeat sexual violence, many members share a commitment to preventing sexual abuse before an offence is perpetrated.  This post is the first in a series from ATSA Prevention Committee members to showcase different prevention initiatives around the world. 
I recently met with Dr. Kim McGregor, Executive Director of RPE and some of her staff to learn more.  RPE is an Auckland based organisation with national prominence for prevention activities which include education and health promotion programs as well as catchy print and online media materials.  Delivered by a team of passionate professionals, many with a background in health promotion, theatre and/or survivors themselves, Sex ‘n’ Respect and BodySafe are examples of prevention in action in New Zealand.

BodySafe (ages 13 – 16) and Sex ‘n’ Respect (ages 16 – 18) comprise of a series of one-hour workshops delivered in high schools which share the motto of working with young people to promote respectful sexual relationships and prevent sexual violence.  Both programs utilise a mixture of discussion, stories, scenarios (e.g., about what is/isn’t sexual violence), worksheets, art and videos, with the content tailored to developmental level.

BodySafe focuses on educating students about consent using four steps: ask, listen, respect, reflect; and building participants’ confidence to negotiate consent in sexual situations.  In addition, BodySafe includes content about how to support people after sexual violence has occurred, exploring healing strategies, and developing bystander intervention skills.  Elements particularly well received by students include the use of role plays and scenarios.  The following quotation comes from a focus group ran as part of an external evaluation of BodySafe  (Dickinson, Carroll, Kaiwai, & Gregory, 2010, p. 43):

“The thing that really stands out for me was like the scenarios and we got to say what we thought of them, if it was rape or just sex”

A post program survey of 1104 students from ten schools found that 93% of participants were able to describe the legal definition of consent and 85% were able to describe what constitutes sexual violence.  When asked if BodySafe had changed the way students thought/acted in situations where they might be at risk, 48% responded “very much” or “extremely” (vs. 45% “moderately” or “a little” and 7% “not at all”; Dickinson et al., 2010).

Tailored towards senior high school students, Sex ‘n’ Respect includes workshops on consent and alcohol, gender stereotypes, and ethical action at parties – for example, identifying rights and responsibilities at parties and risk and safety management in social settings.  While RPE is clear that they do not support underage drinking and drug use, they recognize that both are common among young people in New Zealand.  A pre/post program survey administered to 250 students as part of an internal evaluation found decreases in rape supportive attitudes and significantly more students in the “action” stage of change (based on the Transtheoretical Model; see Prochaska, DiClemente, & Norcross, 1992) following program participation (Rape Prevention Education, 2012).

Consistent with US statistics, in New Zealand at least one in four females and one in eight males will experience some form of sexual violence in their lifetime, many before the age of 16 (Fanslow, Robinson, Crengle, & Perese, 2007; Fleming et al., 2007; van Roode, Dickson, Herbison, & Paul, 2009).  The high prevalence rates of sexual violence underscore an urgent need to prioritize sexual violence prevention in relevant social, health, and educational policy and ensure sufficient funding is allocated to the development and dissemination of effective sexual violence primary prevention activities.  While “what works” research in primary prevention of sexual violence is scarce, BodySafe and Sex ‘n’ Respect adhere well to principles of effective prevention programs identified in other fields (see Nation et al., 2003).  Perhaps most evident was a focus on fostering healthy, positive sexuality and relationships and attending to the developmental stages of different year groups.  For further information see www.sexnrespect.co.nz and www.rpe.org.nz.

Gwenda M. Willis, Ph.D., PGDipClinPsyc

References

Dickinson, P., Carroll, P., Kaiwai, H., & Gregory, A. (2010). BodySafe Programme Evaluation Report. Auckland: Massey University.

Fanslow, J. L., Robinson, E. M., Crengle, S., & Perese, L. (2007). Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women. Child Abuse and Neglect, 31, 935-945. doi:10.1016/j.chiabu.2007.02.009

Fleming, T., Watson, P., Robinson, E. M., Ameratunga, S., Dixon, R., Clark, T., & Crengle, S. (2007). Violence and New Zealand Young People: Findings of Youth2000 - A National Secondary School Youth Health and Wellbeing Survey. Auckland: The University of Auckland.

Nation, M., Crusto, C., Wandersman, A., Kumpfer, K. L., Seybolt, D., Morrissey-Kane, E., & Davino, K. (2003). What works in prevention: Principles of effective prevention programs. American Psychologist, 58, 449-456. doi:10.1037/0003-066x.58.6-7.449

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviours. American Psychologist, 47, 1102-1114. doi:10.1037/0003-066X.47.9.1102

Rape Prevention Education. (2012). Sex "n" Respect Parties Programme: Formative and Outcome Evaluation Report. Auckland: Rape Prevention Education.

van Roode, T., Dickson, N., Herbison, P., & Paul, C. (2009). Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: Findings from a birth cohort. Child Abuse & Neglect, 33, 161-172. doi:http://dx.doi.org/10.1016/j.chiabu.2008.09.006