The power of change

By Kieran McCartan, Ph.D.

People change! For better or worse, they change. Behaviour, cognition, and personality are dynamic traits in people. Circumstances, contexts, and interactions change them. Change can be rapid or slow depending on the individual.

In criminal justice, individuals can change into people who commit offences and they, can, change out of people that commit offences. Change is motivated by many reasons and is always personal. The role of the criminal justice system, in its broadest sense, is to hold people accountable for their actions and to facilitate pro-social change in behaviour, actions and personality. People who exit the criminal justice system should be changed for the better, more pro-social and safer. Research and practice have demonstrated the benefits of pro-social behaviour change programmes that promote social inclusion and shared social values at reducing risk of re-offending. Additionally, there is an emerging literature on the impact of pre-offence or early career interventions at stemming offending behaviour. Change is possible, but its complex, dynamic and individual.

Currently in Scotland, England and Wales there is a crisis in our prison system. Our prisons are overcrowded with the criminal justice system relying on punitive measures, often short term, rather than looking at alternatives to justice (i.e., community supervision, electronic tagging, accommodation in hostels, etc). This has meant that there are too many people in our prisons, and we have recently reached an impasse. If we are not going to build more prisons but still send more people to prison, we have a fundamental problem. This impasse has resulted in a review of the prison population and the release of low-risk prisoners, a release of prisoners near the end of their sentence, or a reorganisation and reallocation of the prison population to lower security estates.

This is all based on risk of reoffending and dangerousness. Although in the majority of cases decisions being made mainly on the risk people opposed to the public (for instance low risk and lower tariff people being released to the community under the supervision of police and probation, and others being moved within the secure estate to lower risk/open establishments) certain offences (i.e., domestic violence, sexual abuse and terror related cases) are often off the table in terms of reallocation or release. The message here is that regardless or risk the index offence is paramount.

This is problematic. Severity of the legal system’s response should be based on assessments of risk more than on the severity of the index offence. There has been social and political commentary on whether this is endangering the public and whether the right decisions have been made. We have to trust the trained professionals in our criminal justice system. Decisions on release are not taken lightly given the socio-political context and media optics of early release and the risk management and audit culture that we live in. This, in turn, raises another issue related to change: trust. Trust in the system to know what its doing, trust in people to manage their behaviour and not reoffend and trust in society to accept them back in; all of which are challenging. Trust does not come easily. This means that we as individuals, communities and a society must change our views on rehabilitation, the power of change, and the potential for social integration. We must understand and start to trust more in the evidence, and work towards accepting change, not matter how difficult, in people.

In the UK, as across much of the world especially westernised and global north countries, we are at a crossroads in the way that we that we think about and respond to offending behaviour. Do we accept that people can change, regardless of their risk level and index offence, and work towards their postive social inclusion based on our trust in the professions that work with them? Or do we not? If not, what do we do? Build more prisons and incarcerate them indefinitely? These are challenging and nuanced questions, but ones that we need to start addressing. If we expect change in people whop have offended so that they can return to society, do we not have to change as well to enable them to do so?

The Changing Context of Self-Care

By David S. Prescott, LCSW, LICSW, ATSA-F

It was just a few years ago that professional organizations began to include self-case in their codes of ethics. The American Psychological Association, Canadian Psychological Association, National Association of Social Workers, and American Counseling Association, to name a few, have all increased their focus on self-care. For many, this is not news. It has long been known that exposure to the traumatic actions and experiences of our clients can take a toll. Forensic psychiatrist John Bradford is an excellent example of someone who has been honest about this.

Looking back to an APA article from 2014, it can be interesting to see how self-care is described:

“Self-care has been defined as providing adequate attention to one's own physical and psychological wellness… As trainees, we receive mixed messages — perform at a high level and meet all rigorous training demands, while making time for outside activities, relaxation and fun… It is an ongoing challenge to make time for self-care (relaxation, sleep, time with family and friends) in graduate school… I feel that I have finally learned the value of self-care, in addition to the value of work. It is possible to find balance.”

 Likewise, the APA website has the slides from a presentation on “psychological wellness and self-care as an ethical imperative.” The slides describe that self-care is necessary due to distress, burnout, vicarious trauma, and (preventing) impaired professional competence. The slides are silent on what kinds of activities count as self-care. Elsewhere in media, much is made about the role of gratitude; less is made of kindness.

How have self-care activities been framed in the past? The examples above include outside activities, relaxation, and fun; finding balance; sleep; time with family and friends. A more in-depth article from a positive psychology resource includes things like treats and delineates micro and macro self-care. Macro self-care includes “’the important traditional category of self-care that includes the big stuff,’ such as eating well, getting enough exercise, taking a vacation, and forming positive relationships.”

Interestingly, there is rarely any mention in the primary texts of the role of spirituality, including spiritual pathways or religious activities. These are significant sources of comfort as well as meaning and purpose in the lives of so many. Amid all the discussion about eating right and exercising, why isn’t more attention paid to the activities that bring us closer to the core of our identities? Why is there so little about what brings us joy? Or fills us with awe and wonder? A friend colleague recently described going outside on a clear night and looking at Polaris (the North Star) and reflecting on all the roles that it has played to others across time, place, and culture, including as a navigational aid for mariners trying to find their way.

Of interest here in the current era is how much clearer the context of our stresses has become. Where we have long talked about vicarious traumatization, we are only beginning to recognize the role of workplace toxicity as a broader issue. A 2022 survey found that one in nine US workers described their workplace as toxic (with the primary causes being bad leadership, unclear job roles, and harmful social norms). Likewise, a recent report in the UK notes:

“We surveyed over 2,000 employees across various industries and a staggering 75% of them have experienced a toxic workplace culture. Of those, 87% of respondents also agreed that a toxic workplace culture has negatively affected their mental health” (Emphasis in original).

Attempting to ameliorate similar effects, a colleague recently advertised a training on workplace bullying in social media and received vicious responses from anonymous strangers. One might wonder where on Earth self-care begins in this scenario, with one obvious solution being a social media hiatus and digital detox.

Likewise, in this time of uncertainty, many of us are seeing workforce and funding cuts and the resultant anxiety, stress, and depression. It is no surprise that there has been an increased recognition of institutional betrayal and betrayal trauma. It is no wonder that our colleague and meditation advocate, Janet DiGiorgio-Miller frequently emphasizes the importance of simply checking in with colleagues and asking, “How are you doing?”

Where self-care was once about bubble baths and beach vacations,  we realize that it’s not as simple as taking time off from stress; sometimes it’s inescapable. A strong meta-message in the past has been that if you’re burned out or otherwise can’t cope, it might be because you haven’t done enough yoga and meditation. Self-care, like our states of mind is no longer simply about the toll that our work with clients can take or the stress that occurs when we’re behind in paperwork.

Having experienced suffering and social injustices in his home country of Vietnam, Thich Nhat Hahn talked about the importance of “engaged Buddhism,” in which meditation and the study of Buddhist ethics are not just a way of coping, but of staying engaged in times of injustice and suffering. Likewise, even the Black Panthers strongly advocated self-care as vital to the survival of the Black community, especially at a time when they couldn’t trust a government that was almost entirely white. They focused on areas such as health care, housing, and childcare – all things based more on community needs than the individual. Less known is that Rosa Parks was a yoga practitioner against a backdrop in which self-care was not seen as a luxury but a way to become more empowered. Understanding that our experiences cannot be compared to theirs, to what extent, and in what ways, might we learn from these examples to benefit ourselves, others, and the communities we serve?

Ultimately, self-care can mean many things. It can take the form of individual time spent recharging, and it can involve communities taking care of themselves when no one else will. It might be that special spa day that provides brief respite, or it could be that opportunity to rest with a specific goal of getting back to the work of helping others and overcoming the toxicity that can overtake us if we’re not careful.

 

Reflections on the Prevent to protect through support (2PS) “Risk and Desistance Hexagon” training.

By Kieran McCartan, PH.D., Kasia Uzieblo, Ph/D.,, Sophie King-Hill,  Ph.D., & Josie Solle, B.A

On the 30^th  of January 2024 the Prevent to protect through support (2PS) project held its second professional networking and training event in Brussels. The networking event focused on the importance of understanding risk and risk assessment in the prevention of child sexual abuse.

The context of the event

Risk assessment is often a challenging area of professional practice because of its links to sentencing, treatment planning, release, community integration and public protection. Assessing risk is a significant foundation in modern societies (especially northern hemisphere and westernized societies) approach to preventing future sexual offending, reducing victimization and managing challenging, as well as dangerous individuals. However, it is also a contested area with several different risk assessment approaches (i.e., the use of actuarial risk assessment scales, structured professional judgment, clinical insights, etc), several different risk assessment scales and tools, as well as different professional, cultural and country-based attitudes to and understanding of good practice. This means that assessing risk and developing good evidence-based practice looks differently organisationally, nationally and transnationally. This poses and issue for the development of coherent national and international standards on the issue. Therefore, we have a challenging and hotly debate landscape that can be confusing for professionals and policy makers, never mind the public.

The development of the “Risk & Desistence Hexagon”

For many years the focus of understanding risk was based on reducing re-offending, managing challenging people in the community and public protection; however, with increasing conversations and frontline practices focusing on preventing first time offending the assessing risk conversation has moved upstream. Preventing first time offending, especially sexual offending, is challenging at best for many reasons aside for professional attitudes to risk assessment, including, a lack of information, a lack of guidance, a lack of an evidence bases to compare the individual back to ands a lack for professional experience in doing this work. As part of the 2PS project Professor Nicholas Blagden was tasked to develop a secondary prevention a tool to help professionals assess the risk of first time offending as well as to understand the early career offending behaviours of people at risk of committing a sexual offence. The idea of assessing risk in in the secondary prevention sphere is challenging. Over the last year Professor Blagden, with colleagues from the 2PS network, has developed the “Risk and Desistence Hexagon” which is a professional decision making tool based on a traffic light system to help professionals understand the risk at their clients pose and plan their service deliver, interventions or referrals appropriately. It is a living document that can be revisited and built on across the professional’s engagement with their client. The aim of the Hexagon is not to define risk, but rather too assesses the risk that a person poses and plan accordingly with the aim of preventing offending behaviour and/or an escalation on offending behaviour.

The event was the first opportunity to road-test the tool to professionals, academics, and practitioners from across Europe; therefore, a good opportunity to gain some insights into the Hexagon and its use.

Academic reflection

Dr Sophie King-Hill: There is something to be said about getting a range of experts in a room, in person, to spend a day picking apart a problem and looking at ways to approach it. The transparency around the tool was useful in relation to its development and intentions. One key point that is pertinent to any assessment/mapping/planning tool for harmful sexual behaviours interventions is the balance between the complexity that is needed to approach a multi-faceted issue coupled with the simplicity that professionals need. This simplicity is required due to lack of training, resources and time. There is no easy solution to this thorny problem. The use of a ‘traffic light system’ is a good example of this – on one hand it is visual, gives key and immediate indicators as to how urgent an issue is and is easy to understand given its application to everyday life. However, the risk with the simplicity of it is that it may wash away the context and the professional judgement needed for such complex issues. There is no easy fix for this. Meeting in Brussels at the 2PS event to discuss the prototype of an important tool gave time for these key issues to be unpicked.

Practitioner reflection

Dr Kasia Uzieblo: Assessing the risk of first-time offending in practice is no simple task; it not only presents practical challenges but also raises important ethical and deontological questions. A fundamental challenge lies in determining when we can realistically speak of a risk group for sexual offending. What signals should practitioners rely on to make such an assessment? Unlike organizations such as Stop it Now!, which often have a clearer (though not always definitive) framework for identifying individuals at risk, many other services may struggle with these questions. How should frontline professionals, social workers, or helpline responders interpret early warning signs, especially in the absence of a concrete offense? This is precisely where the Risk and Desistance Hexagon sharpens these questions from practice. Rather than providing rigid categorizations, it offers an evidence-based tool to facilitate structured decision-making, particularly in areas such as child protection. The Hexagon does not claim to define risk in absolute terms but rather equips professionals with a structured approach to assess potential concerns and determine appropriate actions. 

As the coordinator of a frontline helpline for people affected by violence, sexual abuse, and child maltreatment, I see the potential of the Hexagon in certain cases. Its structured framework makes it accessible for professionals in different settings, including frontline services. At the same time, we experience a need for a tool that supports decision-making regarding (acute) risks and advisory processes, particularly based on information obtained solely from victims or their surroundings. These cases present unique challenges, as risk assessment often relies on fragmented information, making structured guidance even more crucial. 

In addition, for this tool to have its full impact, it will be essential to ensure that decision-makers at various levels, across different settings, are also aware of its existence and application or at least be aware of the evidence base concerning risk and desistence factors. Developing a shared language and vision across different settings and professions remains crucial, as continuity in assessing risks and intervention is key to effectively preventing harm. These discussions will be instrumental in refining the tool further and exploring its validity and integration into existing risk management frameworks.

Conclusion

Over the next couple of months, the hexagon will be piloted across a broad European professional network as part of its development process. If you would like to learn more or attend a piloting event, please get in touch with the 2PS team. The next 2PS professional engagement and networking event will be on the 26^th of August in Poznań, Poland as part of the International Association for the Treatment of Sexual Offenders (IATSO) conference. 

Andrew Tate and the dark echo chamber of online hate and (sexual) violence

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

Scrolling through my X-feed recently, I was struck by an alarming trend: videos of Andrew Tate bragging about (sexually) abusing women have suddenly become an almost daily intrusion. His unashamed glorification of (sexual) violence and misogyny is a stark reminder of how far platforms like X and Facebook have strayed from their responsibility to maintain safe, accountable digital spaces.

But Tate’s presence is just the tip of the iceberg. These platforms have become fertile ground for hate speech, disinformation, and outright incitements to (sexual) violence. And now, with Facebook’s decision to forgo fact-checking posts, the spiral toward unchecked harmful content feels even steeper.

The amplification of hate

Hate speech and violent rhetoric thrive on engagement-driven algorithms. The more outrageous and provocative the content, the more likely it is to be amplified. Andrew Tate’s incendiary videos are a perfect example: their shock value ensures likes, shares, and comments, propelling them further into people’s feeds—even those who want no part of it.

There is a fear that digital platforms serve as breeding grounds for harmful ideologies that spill over into offline behavior. Studies have indeed shown links between violent (sexualized) media, tolerance of violence and real-world violence (e.g., Burnay et al., 2021; Müller & Schwarz, 2019; Sengupta et al., 2024). Dehumanizing language—especially against women, minorities, and other marginalized groups—normalizes abuse and lowers the psychological barriers to committing (sexual) violence. The result? A culture in which acts of aggression, including sexual violence, are trivialized or even celebrated.

Platforms’ negligence is complicity

When Facebook abandons its fact-checking program, it opens the floodgates to disinformation. This isn’t just about misleading political ads; it’s about the broader erosion of truth. Lies about sexual assault victims, false narratives blaming survivors, and denial of systemic issues - all these contribute to a hostile environment that discourages survivors from speaking out and emboldens perpetrators.

X, under its current leadership, has only exacerbated the problem. By rolling back content moderation and reinstating previously banned accounts known for spreading hate and violence, the platform sends a clear message: hate/violent speech is not only tolerated but prioritized.

The mental health fallout

For those subjected to this onslaught of hate, violence, and misogony the psychological toll is substantial. Survivors of sexual violence, already navigating the trauma of their experiences, are re-traumatized by the proliferation of content that mocks, discredits, or outright denies their pain (e.g., Andreasen, 2020). Witnessing the normalization of such violence can trigger anxiety, depression, and feelings of hopelessness, not just for survivors but for anyone committed to creating a safer world.

Young people, who are among the heaviest users of these platforms, are particularly vulnerable. Repeated exposure to misogynistic and (sexually) violent content can distort their understanding of relationships, sexual behavior, and consent, while also normalizing harmful behavior. The long-term consequences on their mental health and societal values are staggering. As a parent, it’s nearly impossible to keep up with the ever-changing landscape of social media and its addictive nature. Even with vigilance, shielding children from harmful content feels like a losing battle when algorithms prioritize engagement over safety. The sheer volume of toxic material can slip through the cracks, making it harder to guide young people and protect their mental well-being and development. This challenge underscores the need for systemic changes in how these platforms operate, but also in how we cope with these platforms.

A shared responsibility

We cannot longer treat platforms like X and Facebook as neutral tools. Their algorithms, policies, and decisions actively shape our culture and, by extension, our realities. As an acquaintance of mine recently remarked dryly when I pointed out the falsehoods about violence on social media: we live in different realities.

Of course, platforms bear an immense responsibility and must primarily implement the necessary protective measures. We have highlighted this in previous blogs as well. But forgive my cynicism: the likelihood of this happening seems particularly slim these days.

It is therefore especially important that we take on our role and responsibility. Educating ourselves and our children about the dangers of online violent speech is crucial. Schools should integrate digital literacy and respect (sexual) education into their curricula, empowering young people to critically evaluate content and reject harmful narratives. Parents, friends, and community members must remain alert and proactive, recognizing signs and stepping in when necessary. We have highlighted these needs in previous blogs, but unfortunately, I must note that the message does not yet seem to be percolating sufficiently to the general public and relevant settings. For instance, sound sex education in schools still too often leads to protests in Belgium but also elsewhere. Education in digital literacy has had a very slow and fragmented start in Belgium, but I suspect this is also the case elsewhere. In short, we must continue to highlight these needs and encourage parents, schools and other relevant services to invest sufficiently in this area.

Daring to speak out is equally important. By challenging hateful rhetoric—whether online or in personal conversations—we can create -albeit small- ripples of change. Silence in the face of hate and violence only enables it. Together, we must foster a culture of accountability, empathy, and courage that counters the toxic dynamics of today’s digital platforms.

Also, scientists should not be silent on the sidelines. In an era where research findings are increasingly dismissed as mere opinion or a “different reality”, discussing evidence-based links between hate and violent speech, and (sexually) violent behavior has become fraught with difficulty. This skepticism undermines efforts to address systemic problems, as factual evidence is often overshadowed by emotional or ideological debates. To combat this, it is essential to keep on promoting a broader understanding of how research is conducted and why its findings matter. But it is also required that academics continue to raise these practices and issues with the general public and with policy. Solely focusing on scientific publications that do not reach these target groups, I fear, will not make a significant difference.

Addressing the issue of online hate and (sexual) violence requires not just individual action but also robust policy interventions. Europe, for instance, must strengthen its stance on regulating digital platforms. The European Digital Services Act is a step in the right direction, but enforcement is key. Policymakers must ensure that tech companies are held accountable for the content they host, with significant penalties for failures to act against hate speech and disinformation. It is also of utmost importance that such initiatives continue to resist the growing (financial) power of these platforms. By standing firm and pushing for comprehensive, enforceable policies, Europe and hopefully other regions can set a global example in creating a safer digital space.

Where do we go from here?

The current trajectory of these platforms is unsustainable and deeply harmful. If we fail to hold them accountable, we risk normalizing a culture where hate and violence, including sexual violence, are not just accepted but celebrated. This is not merely a digital issue; it is a societal one, with real-world implications for safety, justice, and mental health.

Andrew Tate’s presence in my feed is a symptom of a much larger problem, but it’s also a wake-up call. We must demand better - from tech companies, from policymakers, and from ourselves. Because every time we scroll past hate and (sexual) violence, every time we let disinformation slide, we become complicit in its proliferation.

References

Andreasen, M. B. (2020). ‘Rapeable’ and ‘unrapeable’ women: the portrayal of sexual violence in Internet memes about #MeToo. Journal of Gender Studies, 30(1), 102–113. https://doi.org/10.1080/09589236.2020.1833185

Burnay, J., Kepes, S., & Bushman, B.J. (2021). Effects of violent and nonviolent sexualized media on aggression-related thoughts, feelings, attitudes, and behaviors: A meta-analytic review. Aggressive Behavior, 48(1), 1-26. https://doi.org/10.1002/ab.21998

Müller, K., & Schwarz, C. (2019). Fanning the Flames of Hate: Social Media and Hate Crime. Journal of European Economic Association, 19(4), 2131-2167.  https://doi.org/10.1093/jeea/jvaa045

Sengupta, N. K., Hammond, M. D., Deak, C. K., & Malhotra, R. S. (2024). Ambivalent Sexism and Tolerance of Violence Against Women in India. Psychological Science, 35(7), 712-721. https://doi.org/10.1177/09567976241254312

Development of Sexual Interest in Adolescents: Transformative & Practical Implications

By Norbert Ralph,  PhD, MPH

Adolescence is the period between puberty and full sexual maturity, characterized by rapid, transformative development of sexual interests (Blakemore, 2018). This phase is pivotal in understanding youth with problematic sexual behaviors (PSB). Harry Stack Sullivan referred to this as the "lust dynamism," a powerful motivational force emerging in early adolescence (Sullivan, 1953), marking a shift from Platonic to erotic possibilities in relationships. Although sexual reactions begin in infancy, they undergo qualitative changes during adolescence (American Academy of Pediatrics, 2016). This shift fundamentally alters how adolescents perceive the world, as illustrated by Mark Twain’s Huck in The Adventures of Huckleberry Finn illustrates this transformation.

"That evening when I thought it all over I said to myself, I reckon a body can think a good deal about a girl and not really know it. But there I was, thinking about her all the time, and wishing she was right there next to me, and I felt good just thinking about it" (Twain, 1884).

Changes in behavior and thinking occur with this paradigm shift. Fortenberry (2013) reported that in one sample, 6% of 9–10-year-old boys reported sexual fantasies, increasing to 66% among 13–14-year-olds. Less than 2% of 9–10-year-olds expressed interest in sexual intercourse, compared to 12% of 13–14-year-olds. Among 511 American 6th, 7th, and 8th graders, 56% reported at least one current crush, with more girls having crushes (61%) than boys. Robbins et al. (2011) found that across adolescent age groups, more males (73.8%) reported masturbation than females (48.1%). Among males, masturbation increased with age: 62.6% of 14-year-olds reported prior occurrences compared to 80% of 17-year-olds. Recent masturbation in the past month also increased with age in males: 42.9% of 14-year-olds compared to 67.6% of 17-year-olds.

During adolescence, a paradigm shift in relationships and sexuality occurs, involving: 1. Hormonal, 2. Brain, and 3. Anatomical Changes, which interact in a systematic and coordinated fashion. Biologists refer to this as multicausality: different factors contribute to a single functional outcome—an adult human with sexual interests and behaviors.

•    Hormonal: Kelsey et al. (2014) reported that average male levels of testosterone increase approximately a hundredfold from ages 7–10 to 13–17. Increases are linked to sexual exploration and experimentation (Fortenberry, 2013), and also impulsivity and preference for immediate rewards (Laube et al., 2017).

•     Brain: Although a 10-year-old’s brain size and shape are similar to an 18-year-old’s, differentiation and pruning of connections change markedly (Peterson & Schiff, 2021). Blakemore and Choudhury (2006) note the limbic system in young adolescents is hypersensitive to rewards compared to adults. Frere, Vetter, Artiges, et al. (2020) associate changes in the amygdala and hippocampus with developing sexual interest. Brain areas for judgment, impulse control, and planning—linked to prefrontal cortex development—mature until age 25 and beyond (Steinberg, 2014). This mismatch between reward and control systems resembles a car with a sensitive accelerator and weak brakes. This mismatch aligns with Canadian data showing the peak age for harmful behaviors by juveniles against children is 13, followed by 14, about twice the rate of neighboring age groups (Statistics Canada, 2012).

•    Anatomical: Physical and sexual maturation are major areas of change during adolescence. Between ages 10 and 18, males on average double in weight, grow a foot, and triple in grip strength (Tanner, 1962; Malina et al., 2004). Changes in sexual anatomy are conceptualized through Tanner Stages (Marshall & Tanner, 1970). For males, these changes include pubic, armpit, and facial hair growth, as well as testicular and penile development. Penis size nearly triples from ages 10 to 18 (Ponchiett et al., 2001). Males ages 9–14 have immature reproductive systems and are generally infertile; by ages 15–18, most develop the potential to father children (Nieschlag & Behre, 2001). There are different but equally significant changes for females.

Adolescence marks a high-risk period for PSB due to the paradigm shift to adult sexual interests. Describing these multisystem changes helps youth with a history of PSB and their families understand these behaviors and how to manage them better. They benefit by knowing that decision-making can be impaired by strong emotions like sexual interests, which can significantly weaken judgment and impulse control (Insel & Tabashneck, 2022). In my clinical experience, factors like prior sexual trauma and exposure to problematic pornography may accentuate PSB. This helps not only understanding PSB but also strategies to prevent them in the future.

In summary, understanding the dramatic development of sexual interest and motivations in early adolescence is useful for clinicians, youth, and families. It helps give an understanding regarding PSB causes, the development of safety and management plans, and prevent future issues. Managing sexual interests involves understanding their strength, development, and effects on judgment, and also how they can be part of a fulfilling life.

Dismantle the frame: Reflections on a scoping review of the SSA literature

By Peter Yates, Ph.D., Eve Mullins, Ph.D., Stephanie Kewley, Ph.D., & Amy Adams, M.A.

Background and introduction

A recent national survey in Australia found that 1.6% of the population had been sexually abused by a sibling, which if replicated would equate to over one million people in the UK and over five million people in the USA (Mathews et al., 2024). As with other forms of child sexual abuse, sibling sexual abuse is likely to have a long-term impact on children harmed and adult survivors (Cole, 1990; Cyr et al., 2002; Rudd and Herzberger, 1999; Tyler 2011), and it is also likely to have significant and long-term consequences for the child responsible for the harm, for their parents, other siblings, and the wider family (Archer et al., 2020; Tener et al., 2018; Yates, 2017). Despite being so harmful and widespread, it remains under-recognised (Noble, 2022) and many children are left unprotected and unsupported (Yates & Allardyce, 2021). There has been only one review of a small number of papers (Bertele and Talmon, 2021) since the narrative review carried out by Tidefors et al. (2010), so we set out to conduct a thorough review of the literature on sibling sexual abuse in order to inform policy and practice, and to set an agenda for further research in this area.

What we did

We searched for empirical literature on sibling sexual abuse through academic and grey literature databases, excluding things like case summaries and practice guidance to focus solely on research studies. We found 91 papers since 1980 that reported on sibling sexual abuse as the primary focus of the study, so this review represents the most comprehensive overview of the current body of knowledge in this field to date. Having read the papers carefully and extracted the data, we conducted our analysis using the PAGER framework (Patterns, Advances in knowledge, Gaps in knowledge, Evidence for practice and Research recommendations) (Bradbury-Jones et al., 2022). The full review can be found at Yates et al., (2024).

What we found

Despite previously having what we thought was a thorough knowledge of the subject, we found a number of surprises. Sibling sexual abuse is commonly thought of as older brothers abusing younger siblings in the context of a ‘dysfunctional’ family (Why else would children be behaving in such a harmful sexual way?). Professional guidance bears out this trope, giving professionals criteria to be able to recognise when sexual behaviours between siblings are harmful and the risk factors around this. However, in our review we found challenges to this stereotype, calling into question how we understand sibling sexual abuse and the research-knowledge cycle that perpetuates this understanding.

Age differences are often cited as a way to differentiate abusive from other forms of children’s sibling sexual behaviour (e.g. Yates and Allardyce, 2021), with a gap of 2-5 years being regularly cited as an indicator of abuse and of the older child being responsible for that abuse. However, nine papers in our sample reported examples of the child responsible being younger than the child harmed, and many others recorded a gap of less than 2 years Importantly, in some research, an age gap has been used as a criterion or as part of the definition of SSA, therefore perpetuating an idea that age difference is necessary for the sexual behaviours to be abusive. Relying on age differentials to make sense of children’s sibling sexual behaviour therefore risks not only mis-identifying behaviours as non-abusive, but also making incorrect assumptions about which child is responsible.

Similarly, most of what we know about sibling sexual abuse concerns the abuse by boys of their sisters and, to a lesser extent, their brothers. Indeed, much of the early research only focussed on Brother-Sister dyads.  As such, we know very little about girls abusing their brothers or sisters. Official records such as social services case files and law enforcement reports suggest that the vast majority of sibling sexual abuse involves boys as the children responsible. Krienert and Walsh (2011), for example, found that 92.2% of 13,013 incidents reported to law enforcement in the United Sates concerned boys as the children responsible, and only 7.8% concerned girls. However, a very different picture emerges from survivor reports – albeit that sample sizes are much smaller. An online survey of 33 survivors by McDonald and Martinez (2017) found 19% of the abuse involved girls as the children responsible, and a study of 43 survivors by McGrath et al. (2008) found 16.2% involved girls. This suggests that up to a fifth of sibling sexual abuse may involve girls as the children responsible - a significant proportion - yet this abuse is officially reported less often and we know little about the characteristics of these girls who display such harmful sexual behaviours. There is evidence, however, that sisters’ sexual behaviours towards their siblings can have long lasting negative impacts even if not characterised as abusive (O’Keefe et al., 2014; Stroebel et al., 2013). Does the prevailing understanding that this is predominantly a behaviour instigated by boys leave us blind to seeing girls’ sexual behaviours towards their siblings as abusive?  To what extent would our understanding of the phenomenon of sibling sexual abuse – its characteristics, its aetiology – and our responses to it be altered, if we had a much deeper understanding of girls as the children responsible?

Finally, families in which sibling sexual abuse has taken place often share similar characteristics, such as high levels of parental conflict and domestic abuse, parental affairs and parental physical and/or emotional absence. These are the families that come to the attention of the authorities. However, we know very little about sibling sexual abuse that takes place in families which do not share these characteristics, where there are no obvious family problems and when the children responsible do not have a history of experiencing abuse. The research indicates sibling sexual abuse can and does happen in families where there are no evident issues. Grant et al.’s (2009) study of 38 boys, for example, found that 29% were not known to have experienced any form of abuse. Again, if we knew more about the dynamics in these situations, how would that alter our understanding of sibling sexual abuse and improve our responses?

Our overall sense of the research literature is that it has been shaped by particular lenses, or frames. Frames are like mental filters through which we perceive and interpret the world, and one of the features of frames is that when we encounter evidence that does not fit the frame, we tend not to perceive the evidence at all or otherwise do not give it due attention (Yates, 2020). Sibling sexual abuse appears to have been framed in the literature and guidance as an issue of older brothers abusing their younger siblings within the context of other family abuse and stress. As a body of research, insufficient attention has then been given to abusive sibling sexual behaviour by girls, younger siblings and in families where there is no apparent stress. Our understanding of this phenomenon would be improved if we were to pay more attention to the issues that do not fit our convenient ways of framing it.

Final reflections

Having worked in this field for some time, we thought that we had a good grasp of what is known about this subject. Interrogating the literature in this thorough way, however, has challenged some of our assumptions, some of our taken-for-granted knowledge, and raised questions about how we know what we think we know. It isn’t simply a matter of research being of variable quality; rather the body of research frames this subject in particular ways that leaves some important questions unasked, let alone unaddressed. We hope that future research, building on this body of existing knowledge, will open up new horizons in this field, break new ground, and dismantle our existing ways of framing this subject.

References

Archer, E., Nel, P. W., Turpin, M., & Barry, S. (2020). Parents' perspectives on the parent-child relationship following their child's engagement in harmful sexual behaviour. The Journal of Sexual Aggression, 26(3), 359-371.

 

Bertele, N., & Talmon, A. (2021). Sibling sexual abuse: A review of empirical studies in the field. Trauma, violence & abuse, 15248380211030244.

Bradbury-Jones, C., Aveyard, H., Herber, O. R., Isham, L., Taylor, J., & O'Malley, L. (2022). Scoping reviews: the PAGER framework for improving the quality of reporting. International Journal of Social Research Methodology, 25(4), 457-470.

 

Cole, A. V. (1990). Brother-sister sexual abuse: Experiences, feeling reactions, and a comparison to father-daughter sexual abuse. ProQuest Information & Learning.

 

Cyr, M., Wright, J., McDuff, P., & Perron, A. (2002). Intrafamilial sexual abuse: Brother-sister incest does not differ from father-daughter and stepfather-stepdaughter incest. Child Abuse & Neglect, 26(9), 957-973.

 

Grant, J., Indermaur, D., Thornton, J., Stevens, G., Chamarette, C., & Halse, A. (2009). Intrafamilial adolescent sex offenders: psychological profile and treatment. Trends and issues in crime and criminal justice (375), 1.

 

Krienert, J. L., & Walsh, J. A. (2011). Sibling sexual abuse: An empirical analysis of offender, victim, and event characteristics in National Incident-Based Reporting System (NIBRS) data, 2000–2007. Journal of Child Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders, 20(4), 353-372.

 

Mathews, B., Finkelhor, D., Pacella, R., Scott, J., Higgins, D.J., Meinck, F., Erskine, H., Thomas, H.J., Lawrence, D., Malacova, E., Haslam, D.M. and Collin-Vezina, D. (2024). Child sexual abuse by different classes and types of perpetrator: Prevalence and trends from an Australian national survey. Child Abuse and Neglect (147)

 

McDonald, C., & Martinez, K. (2017). Victims’ retrospective explanations of sibling sexual violence. Journal of Child Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders, 26(7), 874-888.

 

McGrath, T. M. (2008). The Long Term Psychological Effects For Survivors Of Sibling Incest And Their Capacities To Have Adult Relationships That Are Intimate And Autonomous Seton Hall University Dissertations and Theses (ETDs). 1640.

 

Noble, A. (2022). Awareness and understanding of SIBLING SEXUAL ABUSE amongst professionals in frontline sectors in England and Wales. internal-pdf://2931589147/SARSAS SIBLING SEXUAL ABUSE Professional Survey Report_ - Marc.pdf

 

O'Keefe, S.L., Beard, K.W., Swindell, S., Stroebel, S.S., Griffee, K. and Young, D.H. (2014) 'Sister-brother incest: Data from anonymous computer assisted self interviews', Sexual Addiction & Compulsivity, 21(1), pp. 1–38.

 

Rudd, J. M., & Herzberger, S. D. (1999). Brother-sister incest—father-daughter incest: a comparison of characteristics and consequences. Child Abuse & Neglect, 23(9), 915-928.

 

Stroebel, S.S., O'Keefe, S.L., Griffee, K., Kuo, S.Y., Beard, K.W. and Kommor, M.J. (2013) 'Sister-Sister Incest: Data from an Anonymous Computerized Survey', Journal of Child Sexual Abuse, 22(6), pp. 695–719.

 

Tener, D., Lusky, E., Tarshish, N., & Turjeman, S. (2018). Parental attitudes following disclosure of sibling sexual abuse: A child advocacy center intervention study. American Journal of Orthopsychiatry, 88(6), 661-669.

 

Tidefors, I., Arvidsson, H., Ingevaldson, S., & Larsson, M. (2010). Sibling incest: A literature review and a clinical study. Journal of Sexual Aggression, 16(3), 347-360.

 

 

Tyler, A. (2011). A Comparison of Father-, Stepfather-, and Brother-Perpetrated Incest Abuse of Incarcerated Women and Girls. University of Colorado at Boulder.

 

Yates, P. (2017). Sibling sexual abuse: Why don't we talk about it? Journal of Clinical Nursing, 26(15-16), 2482-2494.

 

Yates, P. (2020). “It’s just the abuse that needs to stop”: Professional framing of sibling relationships in a grounded theory study of social worker decision-making following sibling abuse. Journal of Child Sexual Abuse 29(2), pp. 222-245.

 

Yates, P., & Allardyce, S. (2021). Sibling sexual abuse: A Knowledge and Practice Overview. Centre of Expertise on Child Sexual Abuse.

 

Yates, P., Mullins, E., Adams, A. and Kewley, S. (2024) Sibling sexual abuse: What do we know? What do we need to know? Stage 1 analysis of a 2-stage scoping review. Child Abuse and Neglect. https://doi.org/10.1016/j.chiabu.2024.107076

 

 

Tackling and preventing inter-partner abuse in young people through evidence based relationships and sex education

By Sophie King-Hill, Ph.D., & Kieran McCartan, PhD.

Editor’s note: This is an extended version of a blog post by the authors for the conversation - Kieran 

A new report by the Youth Endowment Fund (YEF) has demonstrated that 49% of children and young people aged between 13-17 have experienced violent or controlling behaviours when in a relationship. This is based on a survey of 10,000 young people in England and Wales, of which 27% have been in a relationship in the past year. The survey outlines that children and young people who are excluded from school, those who are involved in gangs and/or exploitation, those with special educational needs (SEN) and those supported by a social worker are at higher risk of experiencing inter-relationship violence and control. The violent and controlling behaviours include forced sexual activity, physical violence, causing fear of breaking up and/or disagreeing with a partner, and explicit content of themselves being shared online. Additionally, 27% of the sample stated that they had experienced threats or images of sexual assault and 33% had been exposed to content involving violence against women and girls.

The importance of Prevention

The findings of the study paint a concerning picture as to the position of young people in England and Wales and highlights the reality that enough is not being done in relation to prevention and early intervention. Evidence highlights that effective prevention of harm and abuse is important in all domains of life and that with the correct knowledge, skills and intervention proactive work can be carried out to reduce the risk and impact of social harms. Current policy and practice guidance argues that there needs to be better integration between health and justice so that a developmental, life-course approach can be taken to understanding social issues and deliver the correct intervention to the right population in the most appropriate ways. Therefore, consideration needs to be given different populations are engaged with, underpinned by evidence. In the context of young people and peer harm and abuse it means hearing and valuing the voice of young people so that relationship and sex education suits their needs, is grounded in their lived experiences, and helps them safeguard themselves and others. However, many current policies and resources on the prevention of sexual abuse are focused on adults (see 2PS, ECPAT and EU for more information) but this focus is starting to shift to include and talk to CYP about their problematic and concerning behaviour (see Moore centre and Lucy Faithful Foundation, Together for Childhood for more information).

The findings also highlight that violent and controlling behaviours are embedded in a complex intersection of issues requiring multi-level solutions. Although this is not a new idea, it is important to reiterate. Further, it encourages us to think about our responses to violent and controlling behaviours across all levels of society (i.e., individual interpersonal, community, societal) and across all the populations within society, and how best to deliver these messages and interventions. A key aspect of addressing these issues is through robust, evidence-based, relationships, sex and health education. The Youth Endowment study also demonstrated that these were lacking, with only 55% having lessons on consent and only 40% having education on healthy relationships and recognising unhealthy relationships. It is important to recognise that while the content of the relationship and sex education is important, equally important are the skills and knowledge of those delivering the education.

The importance of relationships and sex education

It is evident that we are failing many children and young people through the lack of robust, incremental, research-based education on sex and relationships. Research in this area demonstrates that many children and young people are receiving education on sex and relationships that is too little too late, and schools are teaching students what they already know. Only 39% of children and young people in the Youth Endowment study who reported experiencing violence and controlling behaviour stated that they had received sessions on consent, with only 31% of this subgroup receiving sessions on sexual harassment. This is in the context of the 2021 Ofsted rapid review (involving interviews with  900 pupils in England, who reported that sexual harassment is a common aspect of school life for a majority of pupils) and the Everyone’s Invited website, which has received over 50,000 testimonials of sexual harassment and violence in schools since it began in 2021. Additionally, over half of the 106,984 child sexual abuse cases recorded across the 42 police forces in England and Wales in 2022 where offences committed by young people aged between ten and 17; which was a rise from the previous year previous figures.

Recommendations

First, it is important for educators to involve parents and carers in these conversations to ensure that consistent messages are being received across the school and home contexts.

Schools and educational establishments need to create safe spaces for learning and open, frank conversations with children and young people about both healthy and toxic relationships. These can be both formal sessions and informal learning contexts but must be centred around non- judgemental approaches. This can be fostered through group agreements that encompass both the young people and the educators.

Bystander intervention is another approach that has gained traction in public discourse in recent decades. However, this must be considered carefully, as young people can risk putting themselves in psychologically and physically damaging situations. Additionally, most bystander intervention programs are designed for the physical environment and with children and young people living their lives across online and offline environments what does an online/digital version of bystander intervention look like.

 

More work need to be completed with young men and boys as some of the highest reports of sexual abuse and violence comes from girls aged 15-17 and carried out by men and boys. This needs to be carried out with the best interest of all genders in mind and to be free from blame and judgement, rather including young men and boys in being part of the solution and teaching them aspects that they need to know. It is also useful to be aware that the term 'violence against women and girls' immediately takes boys out of the discussions around being victims of all forms of violence themselves.

The changing landscape of children and young peoples relationships

Understanding the seamless interplay in the online and offline worlds for young people should also be at the forefront of sessions on healthy relationships. This learning, by professionals can only come from the perspectives of children and young people themselves. One of the most important aspects of approaching sessions such as these are the voices of young people, who are experts in both the digital and non-digital world around them and how these two aspects interconnect and what they need from professionals to understand and negotiate these worlds. With the introduction of the Online Safety Act over the next year there is an opportunity to do some more development in this area and really understand what online support looks like and how problematic behaviours transition across the real world/digital world interface. With the development of services, like Shore by the Lucy Faithful Foundation, we can see that professionals and policymakers are starting to develop resources for the prevention of sexual abuse ion CYP.

Conclusions

What is clear is that what we are currently doing is not working and many children and young people are suffering as a consequence. Early, robust, young person-led relationships, as well as health and sex education can be a vital step to reducing the adverse outcomes seen in the YEF report. The challenge that the YEF report indicates that engagement and work in this area needs to move forward. Byn taking a public health approach conversations can be opened up in new and different ways that allow us to think outside of the box and do something innovative. For too long the conversation about relationships and sex education has been separate to other aspects of the lives of children and young people. Young people need to be spearheading work in this area, supported by professionals, to ensure positive outcomes in all areas of relationships and sex.