Friday, April 13, 2018

Supporting policy to prevent harm: Identifying gaps to support children with sexual behavior problems

By Hannah Laniado (Prevention Program Manager, MNCASA at & Julie Patrick (National Partners Liaison, Raliance at
Recently, the Minnesota Coalition Against Sexual Assault (MNCASA) published, Children with Sexual Behavior Problems: Improving Minnesota’s ability to provide early identification and intervention services through policy and practice recommendations (June 2017), a comprehensive report outlining the data collection, literature review, and formation of recommendations for implementation. This is the first in-depth look at how one state can create change to improve intervention, prevention and response to children with sexual behavior problems.
The specific key recommendations are a model for how the system could improve for all children and families. Earlier identification and appropriate response require: specialized training for all professionals working with youth; consistent guidelines and protocols for tracking behavior; clear written policies professionals who work with children can access on how to respond – including when and what to communicate; as well as education and awareness raising to reduce stigma.
MNCASA looked at what’s working and not working in Minnesota’s current systems for identifying children (12 and under) with SBPs through funding from Raliance, a national partnership among leaders in the prevention of sexual harassment, misconduct, and abuse. With seed-funding from the National Football League, Raliance is dedicated to ending sexual violence in one generation and supports an impact grant program with a specific funding category to prevent primary perpetration. 
MNCASA utilized ATSA’s definition of SBPs: children ages 12 and younger who initiate behaviors involving sexual body parts (e.g. genitals, anus, buttocks, or breasts) that are developmentally inappropriate or potentially harmful to themselves or others (Chaffin et al., 2006).
This project collected information and data in multiple forms. To facilitate the process, a set of guiding questions were identified at the outset of the project and then five chosen data collection methods answered the guiding questions (for details refer to Report #1). Exploratory interviews with 19 key informants, a scan of the empirical literature (42 documents published in the last 10 years), a web-based survey of professionals who work with children (1,022 responses total), investigative interviews with professionals who work with children with SBPs, and story gathering were collected between August 2016 and May 2017.
Key Findings
The literature review examined the latest research on incidence, identification, assessment, treatment, and policies for children with SBPs to provided an empirical basis for work to better understand how well Minnesota is doing in effectively identifying and intervening with children showing signs of SBPs.
Per the survey of professionals who work with children, parents and colleagues view them as a resource on differentiating between developmentally expected sexual behaviors in youth and concerning or problematic ones. Many professionals expressed interest in training on how to interact with children and their parents about children’s sexual behaviors.
Interviews with key informants also showed the lack of a clear process or procedure for where to report a child who is engaging in concerning or harmful sexual behaviors. In fact, many different systems (including social services, law enforcement, medical providers, child protection, probation, and school staff) all come into contact with children with SBPs and yet here is no one system charged with responding to or even tracking reports of children with SBPs. This results in great variations, county by county, to reports of a child with possible SBPs. Professionals who work with children need guidelines for how to treat behaviors as serious, educate about treatment being available, help set up effective supervision, and create protective environments. Without these guidelines, there is a tendency to either over-react or under-react resulting in children not receiving the help they need. There are also disparities across the state in terms of access to effective treatment for children with SBPs. Not all providers have specific training on children with SBPs and not all use evidence based treatment methods. Not all parts of the state have easy access to professionals who specialize in working with children with SBPs.
The specific policy recommendations in detail
1.      Make specialized training on best practices for identifying and responding to children’s sexual behaviors readily available to all professionals who work with children and families. This training needs to address the myths about children’s sexual behaviors and share the message of hope that with treatment, children are at no greater risk to grow up to be sexually abusive. A key element of this training should be how to effectively engage parents in discussions of and treatment for their child’s SBPs. Ideally this training would be incorporated into the educational requirements for students as well as offered as part of ongoing professional development or as a requirement for licensure.
2.      Develop consistent guidelines and protocols for tracking and responding to children’s sexual behaviors, including sexual behaviors between children. Ideally, all children would receive an assessment by a qualified professional who would make recommendations to address any SBPs and any safety risks the child poses to others.
3.      Create written policies professionals who work with children can access on how to respond to a child showing concerning or problematic sexual behaviors, when and what to communicate to parents/caregivers, and how to refer a child for an assessment.
4.      Develop an educational campaign that can be used to raise awareness about children’s sexual development and SBPs. This could be done by providing resources during well-child doctor visits, sharing handouts at school open houses, etc. This effort would go a long way in reducing the stigma and fear that gets in the way of effective response to children showing early signs of SBPs.
Chaffin, M., Berliner, L., Block, R., Johnson, T. C., Friedrich, W., Louis, D.G., Lyon, T., Page, I., Prescott, D., Silovsky, J. (2006). Report of the ATSA Task Force on Children with Sexual Behavior Problems. Association for the Treatment of Sexual Abusers
With gratitude:
MNCASA would like to recognize Joan Tabachnick for her guidance throughout this project including reviewing multiple drafts of the literature review as well as Jane Silovsky and Jimmy Widdifield from the National Center on the Sexual Behavior of Youth (NCSBY), part of the Center on Child Abuse and Neglect (CCAN) in the Department of Pediatrics of the University of Oklahoma Health Sciences. Many ATSA members added value to this report.

Tuesday, April 3, 2018

Four Articles for Newcomers

By David S. Prescott, LICSW

Recent discussions in a number of venues have involved which studies and other published papers are essential for people treating clients who have abused. Each offering has been useful, from the basics in risk, need, and responsivity to effective self-care and an understanding of how early adversity influences the lives and treatment of those who abuse. Each of these areas is vital.

Following on previous writings with Gwenda Willis (for example, our only partially tongue-in-cheek call for a “who works doctrine”), it has long seemed to me that our field has overlooked some basics, and that the evidence for these basics has been around for decades. Research continues to find that there is a greater difference between therapists practicing within various methods and models than there is between the methods and models themselves (Wampold & Imel, 2015).

In 2005, Bill Marshall summarized research both in and outside the field of treating sexual violence to ask what qualities make up an exceptional therapist. The four qualities at the center of his analysis, being warm, empathic, rewarding, and directive (guiding and moving the treatment process forward), seem incredibly simple at first. In fact, these four qualities have even produced the acronym WERD, which many practitioners try to live by. Critics have noted that this paper relies on studies outside the field of treating abuse, and yet a recent blog post has highlighted the work of Brandy Blasko and Faye Taxman, who have found that even probation officers who adhere to similar principles have clients who are less likely to return to prison.

Of course, many (likely most) professionals do not view themselves as in need of assistance becoming more “WERD”. Discussions within social media often focus more on scoring items on actuarial measures and what the rules for registration are in various jurisdictions are typically more common than questions about developing these qualities. As research has shown, however, professionals both within and outside our field can overestimate their abilities in a phenomenon known as self-assessment bias.

In one of the most striking studies of self-assessment bias, Steven Walfish and his colleagues found that the average therapist rates themselves at the 80th percentile compared to their peers. 25% rated themselves at the 90th percentile and no one rated themselves below average. Although there are many possible implications of this study, it is entirely possible that one reason that fewer people seek to develop themselves in the above key areas of competency (warmth, empathy, being rewarding and directive) is that they already believe they are as good as or better than their peers in these areas.

The results of these studies beg further questions: If the working alliance and core competencies of effective therapists are so easy to over-estimate and so difficult to excel at meaningfully, are they really the basic skills that many people believe them to be? After years of listening to people who are learning to put collaborative approaches into practice, I’ve concluded that these skills are only “basic” when you are practicing one of them at a time. It’s when one tries to be warm, empathic, rewarding, and directive while staying aligned with what works for each client that these skills become much more advanced and difficult to master. What is the best way forward with this knowledge?

Enter Daryl Chow and his colleagues and their 2015 paper on deliberate practice. Their abstract puts it succinctly: therapist characteristics (e.g., years of experience, gender, age, profession, highest qualification, caseload, degree of theoretical integration) did not significantly predict client-reported outcomes. Consistent with the literature on expertise and expert performance, the amount of time spent targeted at improving therapeutic skills was a significant predictor of client outcomes. Further, highly effective therapists indicated requiring more effort in reviewing therapy recordings alone than did the rest of the cohort.

So what is the take-home message from these four studies?

·         Professionals are often not as effective as they want to believe, but they can become better.
·         This is not to say that average therapy is not good therapy; indeed, people entering treatment typically do considerably better than those who don’t.
·         The most effective therapists attend to the core competencies of therapy and work to improve themselves in these and related areas.
·         Contrary to the practices and beliefs of many professionals, attention to the fundamentals of the working alliance apply to virtually all professionals involved in treating and supervising people who have abused.

If you’re an old master, this all means you can still get better. If you’re a newcomer, it means that many of the skills out there for learning will help you in many areas of your life. I hope you stick around!

Thursday, March 22, 2018

Good things happening in Denmark and Oregon

By David Prescott, LICSW, and Alissa R. Ackerman, Ph.D

Anyone who works with people who sexually abuse knows that human motivation can be multi-faceted. People who are motivated to change their lives for the better may not be motivated to enter treatment programs, and not all who enter treatment programs are truly motivated to change their lives. Likewise, many practitioners find that their clients are more motivated to change some aspects of their lives more than others. It is never as simple as simply going ahead and doing treatment in a purely straightforward or linear fashion.

Two professors at Aarhus University in Copenhagen, Denmark, Charlotte Mathiassen and Morten Nissen recently hosted a two-day conference and public event, also at the university (titled Motivational Interviewing: The Volitional Pragmatics of Conversation). It was an opportunity to explore elements of motivation that may not be apparent to those entering the field of treating abuse. David gave presentations on the nature of motivation and treatment with people who abuse, exploring how the directive and client-centered aspects of treatment in general and motivational interviewing specifically can interact and/or contrast with each other in a given case. For example, some clients in treatment respond well to a more directive approach, even as the clinician seeks to maintain that client’s autonomy and self-efficacy. Questions around roles and power dynamics are rife in the treatment of sexual violence, for example (see Prescott & Levenson, 2010).
Niels Åkerstrøm Andersen came at similar questions from an entirely different angle in his study of the Danish welfare state: How do state systems govern those who are inherently independent? Although this may seem abstract to many professionals, it is nonetheless important to consider when we consider that we are often treating clients who seek to be more autonomous within systems where independence of actions is severely limited. Likewise, in discussing a case, psychologist Morten Halberg described Jacques Derrida’s distinction between a predicted future versus the unpredicted future, leading to questions about how people arrive at their own solutions to challenges when so much of contentment with one’s own life is beyond our ability to predict or plan for?

Finally, E. Summerson Carr gave presentations on the process of motivational interviewing (MI) training in which she described that the process of learning MI can be as motivating as actually practicing it. In this way, she compared MI training to revival meetings of the past. For some who have studied MI deeply over time, her observations will be entirely familiar.

Meanwhile, the Oregon ATSA chapter held its spring retreat March 9-11th. Alissa opened the retreat with a conversation around restorative practices and how they might be useful with clients who have engaged in acts of sexual victimization. Speaking to treatment providers and probation officers provided an important learning experience for everyone. Approximately seventy people attended the training and the knowledge exchange that occurred inspired many of us to rethink our positions and assumptions.

Just as clients’ motivation for change are multifaceted, so too are treatment providers and others who work with those who sexually abuse. Many of us who work in this field are stuck in our ways and find it difficult to change our daily practices. This training provided multiple opportunities for attendees to discern how and whether restorative practices could benefit their clients, even if they entered the retreat unsure of what restorative justice was.

The conversations also affected the way Alissa will approach future trainings. Alissa has traditionally focused on client specific restorative justice. This entails focusing on how such processes can lead to empathy, insight, and understanding for those who have committed sex crimes, while also bringing closure, accountability, and healing to those who have had sexually traumatic experiences. During the training, a probation officer approached Alissa to ask how restorative justice might benefit those in positions like hers. It provided new insight for Alissa to think about how to integrate restorative practices into the larger community of individuals who work with those who have sexually abused.

Another moment of clarity occurred about halfway through the training. Alissa spoke about the current societal discourse around sexual violence and asked attendees what they thought the current discourse was. Several people spoke up about the lives of registered citizens and some of the inherent difficulties with living life on the registry. Interestingly, not a single person mentioned the people who have experienced sexual violence. The room fell silent when Alissa took notice of the lack of acknowledgement of victims of sexual violence.

Perhaps this is because providers who work with those who have offended have little dialogue with those who work with individuals who have been victimized. We remain in our silos, unaware of what others in the field are facing. Restorative practice moves beyond victims and offenders. Open and authentic dialogue is helpful for all of us to make positive changes in the way we work and live.

Thursday, March 15, 2018

Dismantling Racism: The Relevance to Prevention

A Summary of the October 26, 2017, ATSA Conference – Evening Prevention Event

By Cordelia Anderson, M. A.

At the 2017 ATSA Annual Conference, ATSA’s Prevention Committee hosted an evening panel titled “Dismantling Racism: The Relevance to Prevention.”  The room was packed with over 40 ATSA members exploring how dismantling racism is related to the work of ATSA members and for the prevention of sexual violence. This year’s topic on race and privilege was accepted as fundamental to prevention by some, while others were not as convinced of its relevance. Indeed, part of the purpose of the event was to draw further attention to the links between prevention, race and privilege. The idea for the event evolved from the positive response to an August 2017 blog written by ATSA prevention committee member, Cordelia Anderson. The Prevention Committees desired to do more to address the intersections between race, privilege and prevention both in terms of avoiding perpetration and promoting broader culture change.
The event began with ATSA’s Executive Director, Maia Christopher, explaining why this topic was important and how it fit with other related efforts ATSA was doing.  Cordelia Anderson provided a brief background on why the committee selected this topic and how she views race and privilege as fitting with prevention. She explained, “The committee was interested in these issues out of recognition that prevention is social justice which attends to the interconnectedness between all forms of oppression and injustice. Prevention also involves work to create an environment in which all people can thrive and develop in healthy ways. It requires challenging social norms that allow any one group more privileges than another just because of their gender, race, religion, social class, orientation, abilities, etc.” She noted that, “In our field we’ve historically addressed the imbalance of power and issue of privilege more between men and women than of race.”
The panel featured ATSA members who address race and privilege in their lives and work.
Elizabeth Griffin explained that the therapeutic relationship is a fundamental common denominator to the counseling process. She said, “Culture, race, and ethnicity are often viewed as secondary in sex offender treatment, after all, what do these issues have to do with preventing the future sexual abuse of children?  I often feel as if our field is behind other helping professions in understanding the importance of multiculturalism and diversity in the change process.  I supervise clinicians new to the field and many have never considered and examined their own biases and prejudices – making it more likely for these attitudes to play an unconscious role in treatment room.” She added, “Those who have never examined their own biases will certainly fail in facilitating clients in exploring their own –isms and how they contribute to the sexual abuse cycle.  Power issues are often at the core of these –isms; thereby, having sex offender treatment the perfect opportunity to address how power, racism, ethnic bias, and privilege, play a role in both sexual offense behavior and the treatment process.  Clinicians often find these issues difficult to discuss - even more reason to find ways to intentionally address power, racism, ethnic bias and privilege.” 
Elizabeth provided more specifics about what providers could do such as “Asking a client of color what they think/feel about having (1) a white woman from (2) a privileged background (3) who can make significant decisions regarding every aspect of their life for a therapist often takes them aback.” She noted “After all, they may have never thought the conversation was possible.  Maybe it’s time they did.  Maybe it’s time we all did.”
Alejandro Leguízamo, noted “Addressing race/privilege is important in the work I do, and we all do, because it impacts directly the development and maintenance of a therapeutic relationship and/or group cohesion.” He explained, “I address cultural issues not only in my research, but also when I conceptualize cases I am evaluating or individuals I’m treating. I address ethnicity/culture as I start treatment to create a space in which the client can raise issues in how I’m approaching treatment. I ask them to evaluate my feedback/recommendations to make sure they are pertinent to their experience and context, particularly in the communities in which they reside.
David noted that “As a white person, I work with fellow white people in the movement to look at the role that we can and must play in dismantling white privilege and systemic oppression, from our positions as white people.” He added that “while people of color are leaders in racial justice, there is work that needs to be done by white people to learn about race and white privilege, and then to work together for our total liberation.” He added that only addressing ‘Cultural Competency’ is insufficient as it reinforces thinking of ending racism of a ‘set of skills’ while it is actual broader social change work we must do.
Subsequent discussion with the audience highlighted additional examples of work being done to dismantle racism and identified challenges and opportunities. The event attracted a wide range of ATSA conference attendees, many of whom had never participated in prior prevention events and resulted in a spirited discussion from a range of perspectives.  Several participants indicated that they would be interested in additional ATSA conversations about race, privilege, and oppression.
At a recent PCAR/NSVRC staff meeting during a discussion about privilege and white supremacist culture, someone said “Just like you don’t have to be a rapist to contribute to rape culture, you don’t have to be a KKK member to contribute to white supremacist culture.” Clearly, this one-hour evening session at ATSA was only a step, but it offered many perspectives, a lot of food for thought and ideas for future action. We hope that the ATSA chapters will also host similar discussions and identify related actions, post relevant articles and other information on the list serve and share information through ATSA blogs. The prevention committee will be adding to the resource list which will soon be on the website where ATSA members are encouraged to add to it.

Maia Christopher

Executive Director, ATSA

PH: (503) 643-1023


Cordelia Anderson, MA

Founder, Sensibilities Prevention Services

(612) -207-1779

Elizabeth Griffin, MA, LMFT

Internet Behavior Consulting, LLC


Alejandro Leguízamo, Ph.D.

Associate Professor and Chair

Psychology Department

Roger Williams University

 (401) 254-3834


David Lee, MPH

Director of Prevention
California Coalition Against Sexual Assault
(916) 446-2520 Ext 309


Friday, March 9, 2018

ATSA Infographic: Preventing the Development of Harmful Sexual Behaviors in Youth

By Joan Tabachnick, MBA
The members of ATSA’s prevention committee believe that ATSA’s members have a unique role to play in prevention.  More than most professionals, our members understand the complexity of the issue and the complexity of the individuals who commit this crime.  

From a prevention point of view, we believe that early intervention with children or adolescents is an often-overlooked opportunity – and it may be the best use of our limited resources.  Early intervention with a child or adolescent with problematic sexual behaviors offers us to alter that child’s developmental trajectory and ensure that everyone lives safely in the community. 

We know this.  You know this. 

But the Prevention Committee is looking for ways to inform the larger community surrounding all of us about our unique perspective to this issue.  This year at the ATSA conference, the Prevention Committee created an infographic.  This visually engaging description is a simple way to convey, simply, critical information about these children and teenagers.  

To see the infographic, CLICK HERE!  We hope that ATSA members reading this will see the talking points that we all need to address if we want to talk about adolescents and children and prevention.  We also hope that those who many not know about ATSA, will see this information and realize how important it is to have ATSA members at the table when talking about stopping and preventing sexual violence. 

Below are the infographic’s five key talking points: 

1)      Each Child and Adolescent Is a Unique Individual

Children and adolescents who engage in harmful sexual behaviors have different motivations, risks, and protective factors as they face different risks, they have different histories, and therefore their need for support systems will be different.  A one size fits all intervention will not work for every child and teen. Our responses and support must be individualized for each child.

2)      Children and Adolescents are Still Developing

Children and teen’s bodies and brains are still forming and this continues into early adulthood.  To ensure the safety of our children and the development of healthy relationships and sexuality, adults need to understand what is normative and expected sexual development for each life stage.  Parents, caretakers, and other adults need training to understand these differences, learn what is usual for each developmental stage, and be involved in a child’s care, growth and treatment, if needed. 

3)      Adolescence is a Period of Exploration, Risk, and Great Opportunity for Positive Growth

Adolescence is a critical period to identify and understand a youth’s strengths and vulnerabilities.  There can also be a mismatch between their judgment and impulse control.  Parents, caregivers, and other adults need to support the strengths of each child and teenager, understand their need for healthy exploration–and when necessary, seek help to provide education, develop limit-setting skills, and even provide treatment, to address destructive or harmful patterns of behavior. 

4)      Change the Harmful to Helpful and Healthy Sexual Behaviors  

Research shows that prevention, early intervention, and treatment can guide a child or teen’s developmental trajectory towards a safe, productive life with healthy relationships.  Early education and support can establish constructive skills and minimize unhealthy patterns of behavior.  Every child needs to know their body and sexuality is under their control.  No one has the right to force or trick them into any type of sexual behavior. Likewise, they also need to learn that they don’t have the right to force or trick others.  Early interventions and support, when problematic sexual behaviors begin to emerge, can be a second opportunity to create a positive path before behaviors escalate into a reportable offense.

5)      A Healthy Environment Encourages Healthy Sexual Development and Healthy Choices 

Our children and teens need to navigate a huge number of healthy sexual developmentally related challenges, especially in their use of technology.  It is important to help them remember that they are not navigating these challenges on their own.   Their peers, social networks, schools, parents, involved professionals, and community can be the key to their success.  For example:

  • Given the strong influence of peer culture, we need to work with our youth to assure that peer norms support them in making the best choices and encouraging accountability.
  • To counter the influences of hypersexualized media and the all too easy access to pornography, educational approaches are needed to teach youth about healthy sexual development, positive identity, and healthy respectful relationships (i.e., including giving and getting consent for sexual behaviors)
  • Children and adolescents need accurate information, critical skills, and relevant supports to ensure healthy and appropriate sexual behavior on their part. 

This infographic and these prevention strategies is in direct alignment with the new ATSA guidelines for the assessment and treatment of adolescents with sexual behavior problems.  If you have not yet seen these guidelines, CLICK HERE.   And if you are moved by this work, please consider what you might want to do in your own community to get involved in this important prevention conversation. 

Thursday, March 1, 2018

The working relationship in community corrections

By David S. Prescott, LICSW, & Kieran McCartan, PhD

One of the main issues that plagues our field is the inherent contradiction between public protection and the factors or outcomes (in treatment, risk management) that contribute to it. Success in treatment can look different from, and be measured in a different way from, success in risk management and probation. However, the factors involved in successful community integration/reintegration share a lot of common features with the factors that make treatment work. We know that punishment-only approaches don’t work and that completing treatment programs is associated with reduced risk. What can supervision agents (i.e., Police, Probation, Parole, Social Workers, etc) look for as indicators of success in their efforts?
A new study in Criminal Justice and Behavior exemplifies a welcome trend in evidence-based community corrections (an idea which is essential; key performance Indicators are central to the success and continued funding as well as use of these programs). Quantifying success in supervision as well as treatment can be a challenge at the best of times and often results in success factors being external to the actual program (i.e., reoffending rates only rather than personal change or successful risk management procedures), but especially in terms of people who commit sexual offences.  
For this new study, authors Brandy Blasko and Faye Taxman examined a brief and practical measure for use by community supervision staff to assess the extent to which individuals under community supervision perceive the supervision process as fair. Important to emphasize is that this was fairness as perceived by the person in community supervision and not the agent or agencies.
Many people in the lay public may have no interest in measuring whether or not the person under community supervision perceives their treatment as fair; in fact, many members of the public reject the need for or utility of pro-social, support management and/or treatment for people who have committed sexual offences. Indeed, many will believe that community supervision is part of a person’s punishment for breaking the law; however, it isn’t the actual role of supervising agents around the world is to carry out court orders while simultaneously supporting efforts at rehabilitation. Unfortunately, many supervising agents (known by different names in various jurisdictions, and including probation and parole officers) often view their work as inherently punitive and/or make clear to the people on their caseloads that they hold them in some form of moral contempt. The continued austerity, privatization and bureaucratic drives in community supervision often exacerbate these aforementioned issues and can lead to staff feeling disengaged, unwanted, unwelcome and more inclined to leave the field.
Blasko and Taxman found that their “measure demonstrated significant relationships with supervision outcomes of both crime and technical violations across two independent community supervision samples.” In other words, the better the working relationship with the agent, as perceived by the supervisee, the less likely these people were to persist in problematic behavior. Questions on this measure include areas such as to what extent the person on supervision feels that their agent takes their perspective, follows established procedures and guidelines, and treats them like others who are on supervision. However, this raises issues of how we support staff to enable them to work more effectively with people who commit sexual offences when this “relationship” goes against perceived social, political and organizational norms. Staff want to draw a distinct line between themselves and the individuals that they work with as a defense mechanism, a minimization technique and adhering to what is often argued as good working practices.
This study’s results echo decades of psychotherapy research, finding that how clients in treatment perceive the working alliance with their clinician can determine much of the outcome of treatment. The power of positive relationships in the integration of people who commit offences, generally, is well evidenced in the literature in terms of from a peer support (i.e., research on the importance of social capital) but not in terms of practitioner/professional support which is interesting when one considers that a lot of people who commit sexual offences might try to interact with probation officers (and others like them) as though they are friends or colleagues. Although, potentially irritating to the supervising agent, these kinds of interactions can indicate that the relationship is considered important to the client. It is fascinating that these findings receive so little attention within the criminal justice literature and raise the question of, why not?