Friday, March 17, 2023

The challenges of community risk management

By Kieran McCartan, PhD, and David Prescott, LICSW

Community risk management is always a difficult balancing act, and we are grateful to the supervising agents and clinicians who make it happen! On one level it involves preventing someone from reoffending, while simultaneously helping them develop a post-conviction, and often post-prison lifestyle that is incompatible with offending, while at the same time protecting the public. Often these goals can seem paradoxical, as we need to give someone the opportunity to desist while in a less-than-completely-controlled environment. What makes this challenge more difficult is the reality that risk management discussions between professionals and the public don’t always match up. The public often sees prison sentencers as too short, and not understanding the release conditions governing how people are managed in the community. At the same time, professionals often argue for nuanced and flexible risk management plans that offer individuals the opportunity to road test their risk management plans, desistance skills, and opportunities for non-offending in safe, controlled circumstances. In the UK, as well as in other countries, risk management plans are governed by risk, assessment and tied to sentence length, via index offense severity. This means that there is a recognition that risk is individualized and dynamic. It also means that risk management, like incarceration, is expensive. The public often want professionals to manage and contain the risk, whereas the reality is that professionals provide the context for the individual to manage their own risk. This leads us to the high-profile risk management story of the week, the recall of Gary Glitter.

This week, former pop star Paul Gadd (known professionally as Gary Glitter), who once sold over 20 million records and is among the top 100 most successful chart acts ever in the UK, was recalled to prison after only a few weeks of freedom in the community. He had served roughly half of a 16-year sentence for sexually abusing three young girls decades ago. Glitter was released at the halfway point in his sentence, as is often the case in the UK, and moved to a hostel in January where he was recorded tying to access the dark web and download child sexual abuse imagery on his smartphone. This breach of his license conditions was filmed by another person living in the hostel and reported to the authorities. According to the New York Times, “In 2012, Mr. Gadd had been arrested as part of an inquiry set up to investigate accusations of sexual abuse against Jimmy Savile, a longtime BBC host. That arrest led to Mr. Gadd’s conviction in 2015 on one count of attempted rape, four counts of indecent assault and one count of sexual intercourse with a girl under the age of 13.” Previously, he was convicted in 1999 for downloading and possessing thousands of child sexual abuse images; he was acquitted on a charge involving the sexual abuse of an underage girl in the 1970s. From there, he lived in Thailand and then Vietnam and was convicted of sex crimes in each country. Mr. Gadd is now 78 years old.

We are not going to critique that Gary Glitter case, but instead use it as an example of the challenges of managing risk in individuals released on license. Glitter is a good example of a chronic repeat offender who uses every opportunity to reoffend, as is demonstrated by his litany of offenses, trials, breaches, and recalls. The challenge that the HM Prison and Probation Service (HMPPS) faces is how to control and monitor his rehabilitation, treatment, risk management, and limit his opportunities for re-offending within the context of his current sentence. Do they keep him in prison indefinitely? Do they place him in an open prison or another form of secure setting? Do they limit his access to mobile phones, technology, and other similar resources? In addition to the other balancing acts, HMPPS is tasked with protecting both the public and the human rights of prisoners and people under the care of probation, and it is all rooted in difficult decisions about the risks that people on license pose to the community and to themselves. These are all challenging questions that apply not only for Gadd, but other high-risk individuals. In addition, with the glitter case his celebrity is an additional factor that needs to be considered above and beyond other potential risky offenders. A glimpse into his history reveals the kinds of flight from justice (via his yacht!) that others could only dream of.

Gadd’s case is a reminder both prices paid by society to manage people at elevated risk of re-offending and the human toll that abuse takes. At 78, one might easily assume that Gadd would be easy to supervise in the community. On the other hand, technology (including access to social media) has completely changed the profile of possible risks that require monitoring. And throughout everything, little is known about the wishes of those who Gadd abused. The average community supervision agent working with these individuals must possess knowledge of criminal re-offense trajectories across the lifespan, technology, the habits, and schedules of each client, etc. and keep in mind that each client can be very different. In Gadd’s case, he remains quite wealthy and resourceful.

The Glitter case highlights the important nuances of risk management. In his case, recall to prison is a risk-management success rather than a failure. It highlights that the system can work; but the real question is, what next?

Friday, March 10, 2023

Restorative Justice and sexual abuse: Emerging research from Scotland

By Kieran McCartan, Ph.D., & David S. Prescott, LICSW

The field of sexual abuse can be emotionally charged, challenging, and often causes us to reflect on our lives and actions. There are times when professionals draw lines (quite often artificial) between people who work with those who have harmed and those that have been harmed. It is common to hear that professionals in each field have different agendas and want different things, to the point of being at loggerheads. We disagree, even as we acknowledge that it can sometimes appear that way when we make snap judgments of others without really understanding where they are coming from.


Instead, we would say that the “victim side” and the “offender side,” as they are often called, want the same thing (i.e., the abuse to stop, victims to be support and people who have offended to be held accountable and manage their risk moving forward). The real difference is in the perspectives they bring to their daily work. One area of rehabilitation and therapeutic work in the wake of sexual abuse that brings these sides together is Restorative Justice. We have discussed Restorative Justice on the blog before and recognize the sensitives it involves and the process for both sets of participants, so this is not a rehashing of old ground but rather an opportunity to discuss new research and practice. As much as any approach, Restorative Justice shows that there aren’t different “sides” to the issues, but diverse roles that we can all play in our attempts to end sexual violence.


Scotland has always had a reputation for being forward thinking in its approaches to health, justice, risk, and risk management, particularly in the areas of sexual abuse, drugs/alcohol, and youth crime. Recently, there has been momentum in Scotland to understand the role that Restorative Justice can play in helping to repair the damage created by sexual abuse. In 2021, a nationwide consultation was led by Thriving Survivors (with a number of other organizations across the sector) on  with survivors of Domestic Abuse and Sexual Violence to Establish Awareness, Opinion, and Demand Related to the Ongoing Development of a National Restorative Justice Policy and Practice Framework for Scotland. The consultation highlighted “the importance for survivors of domestic abuse and sexual violence that their voices are heard and that they have a choice related to how they deal with the aftermath of their victimization, including access to Restorative Justice.” This resulted in a series of recommendations including more research, development, and consultation on the issue, which led to the publication of a second report with some of the key players from the original, published last week, called “Restorative Justice & Sexual Harm: the voices of those who have harmed”.


The new report is based on a mixed-methods research design with people convicted of sexual offenses and their views on the relevance, use, and impact of Restorative Justice. The research found that the 44 participants who understood what Restorative Justice is described it as a process led by those who have been victimized, and that if it was not handled properly, it could be retraumatizing and activating for victims; caution is required. The participants felt that the benefits of doing Restorative Justice, if done properly and thoughtfully, outweighed any potential negative outcomes. This resulted in the authors suggesting that although cases should be looked at and considered in an individual light, they should be considered as people who can understand, be receptive to, and benefit from the use of Restorative Justice. The report gave some key recommendations, including that facilitators running Restorative Justice programmes in sexual abuse cases need to be specially trained; the consent of the participants need to be properly obtained; that the process needs to be trauma-informed; all participants should be fully briefed on what to expect from the process; if a traditional face-to-face approach is not appropriate then an alternative approach should be investigated; and the cognitive ability, neurological level, and psychological wellbeing of all participants should be checked as well catered to throughout the process.


In many respects, this publication reinforces previous research and policies in Restorative Justice (i.e., look at individual cases and then tread gently), but what makes it stand out is that it has been done with people convicted of sexual offenses. This is an important report in that it reinforces what a lot of research in the field of sexual abuse has indicated over the years: that people convicted of sexual offenses in the main want to understand the harm that they have done, become accountable, and move on an offense-free life. Additionally, this report also recognises the importance of trauma-informed approaches to this work, indicating that men convicted of sexual offenses offend have trauma histories that they are recovering from and that have contributed to their offending, and therefore the restorative justice process can help their healing.

Friday, March 3, 2023

Educator Misconduct and the Need for Meaningful Prevention

By David S. Prescott, LICSW, and Kieran McCartan, Ph.D.

The current issue of the Sexual Abuse journal opens with a study by Elizabeth Jeglic, Cynthia Calkins, and their colleagues. It explores sexual misconduct by teachers serving US students from Kindergarten through 12th grade. According to their findings:


Overall, 11.7% of the 6632 participants reported having at least one form of educator sexual misconduct during grades K-12, with 11% reporting sexual comments and less than 1% reporting other forms of sexual misconduct (e.g., receiving sexual photos/messages, being kissed, touched sexually, or engaging in sexual intercourse/oral sex). Those who reported misconduct showed significantly more difficulties in current psychosocial functioning than those who did not report educator misconduct. Academic teachers most often perpetrated the abuse (63%), followed by coaches and gym teachers (20%). Educators who engaged in sexual misconduct were primarily male (85%), whereas students who reported experiencing educator misconduct were primarily female (72%). Rates of disclosure were very low (4%) and some sexual grooming behaviors like gift giving (12%) and showing special attention (29%) were reported.


It can be difficult to comprehend what this all means. Doubtless, there are observers who believe that the 1% figure of being kissed, touched, sexual intercourse/oral sex is encouraging and could be worse. Others (including us) believe that any sexual abuse is unacceptable. A quick Google search suggests that there are over three million educators in the US, suggesting a tremendous amount of abuse that goes undetected. That 11.7% of students should report sexualized comments made by teachers, and that such commentary and possible victim-access behaviors correlate with psychosocial difficulties, shows a high degree of need for prevention efforts. Whatever the intentions of an individual teacher in a particular set of circumstances, this study is clear in its findings. 

After polling a small number of teachers, it seems that all too often teacher-education programs stress what to do if one is concerned that someone else is abusing a child. It is rare that these same programs emphasize that this behavior is unacceptable to engage in, and rarer still that teacher-education programs provide information on why even sexualized comments are unacceptable. Our K-12 teacher colleagues report that the lion’s share of discussion around the potential harm of abuse happens during job interviews. Our programs can easily do far better than this.

At a time when conspiracy theories abound about organized groups of influential people grooming children, this paper shows something far more basic: that too many students experience their teachers as violating boundaries and trust. Making matters worse is not just the inherent power imbalance, but the not-unfamiliar feelings of affection that kids can feel towards teachers and caregivers. As we (and others) have said before, abuse is abuse and kids need safe spaces for education. The problem of abuse in schools is not simply the “hot for teacher” trope that one might hear in popular media. Abuse prevention needs to move beyond what we can do to prevent and intervene in others’ abuse and also focus on what we all need to do to maintain our best boundaries. While discussions of prevention often discuss “abuse” as a broad, unspecified category that happens elsewhere in our communities, education about checking out one’s own motives (not to mention ongoing education about the potential unacceptable risk of sexualized comments) would be timely.

Likewise, our public discourse in these areas often focuses on rage against abuse in general and the use of terminologies and person-first language that are, in fact, in widespread use elsewhere. The reality of abuse prevention is entirely different: abuses take place in our schools, churches, police departments, and other venues where trust is paramount. Posting hateful messages that unnecessarily alter lives and careers on Twitter is easy; offering ideas for prevention to those in charge of schools and teacher education is another matter. Our message to society is that if we want to prevent child sexual abuse, it is time we look in the mirror.


Friday, February 24, 2023

The European Commission’s mapping criteria for Help Seeker and Perpetrator Prevention Initiatives in Child Sexual Abuse and Exploitation.

By Kieran McCartan, Ph.D., and David S. Prescott, LICSW

Earlier this week, the European Commission published a new document titled “Help seeker and Perpetrator Prevention Initiatives - Child Sexual Abuse and Exploitation.” Its aim is to support initiatives for Child Sexual Abuse (CSA) help-seeker and perpetration prevention. The idea is that by creating a common taxonomy of prevention programs for several different stakeholders, we can collectively understand and share best practices around CSA prevention initiatives. The report is a step towards the creation of a European Union (EU) knowledge platform on CSA prevention initiatives, which will support EU Member States to develop and roll out tailor-made prevention policies according to their respective cultural and societal environments and needs.

On May 11, 2022, the European Commission published a proposal to prevent and combat CSA, with a strong emphasis on prevention; but even though preventing and combatting child sexual abuse is a priority of the European Union, there has been no common EU-wide approach or concrete framework to highlight what member states had already accomplished. A plethora of different terminologies and taxonomies exist to describe prevention programmes (a common issue across the EU in general), making the information about such initiatives limited, unclear, and unstructured.

Collectively the JRC, DG HOME, the newly emerging prevention network developed by the team, and a number of interviewed practitioners and experts reached a common consensus on the idea that to raise awareness of existing prevention programmes for people at risk of committing sexual offenses it was necessary to categorize and evaluate them. For this purpose, a dedicated working group was established, and the output of this common effort are 14 classification criteria that will support EU Member States to develop, implement and research prevention work in different countries. The 14 agreed classification criteria are:

1.       TARGET identifies to whom the initiative is addressed, such as people who fear they may offend.

2.       CONTEXT refers to the environment in which the intervention is given.

3.       METHODS refers to the tools, treatments, support opportunities and programmes proposed to the targets.

4.       INITIATIVE PROVIDER refers to the nature and main activities of the entity or initiative provider that is offering the program and/or treatment as well as  the one that implemented it.

5.       FUNDING refers to the money allocated to the program and/or treatment.

6.       COSTS refers to the costs that would be sustained by the entity proposing/setting up the program

7.       THE FOUR PREVENTION STAGES (Primary, Secondary, Tertiary, Quaternary, described in previous blog posts and the extant literature).

8.       EVALUATION aims to capture the outcomes of the initiatives.

9.       ACCOUNTABILITY of the programmes refers to the processes and mechanisms put in place by the initiative provider to appraise the programme at different stages to ensure that the programme remains accountable, and that it is working towards the goals.

10.   LEGISLATION refers to the legal national framework under which the specific programme/intervention is being deployed.

11.   COLLABORATION refers to the synergies and complementarities that can be established with different entities involved in the prevention of CSA.

12.   DISSEMINATION refers to the actions taken to raise awareness about the prevention initiative among (potential) stakeholders.

13.   TARGETS’ RIGHTS are explored in terms of privacy, anonymity, and safety to preserve and assure confidentiality, assurance of empathy, etc.

14.   ACCESSIBILITY refers to several elements of the preventive programme that can be related to: the language of the resources, the availability of complementary tools to the traditional text-based ones, the standardisation of tools provided, and he cultural responsivity factors.


(The criteria are adapted/replicated from document)


The 14 classification criteria were then applied to five case studies (PedoHelp – France; Parafilik – Czech Republic; Out of the Net - Spain; Sexual Aggression Control – Spain;  Circles of Support and Accountability (CoSA) - European union-united kingdom) to see how they aligned. The results indicated that the five case studies did align and that the criteria were useful in the development and implementation of prevention programs. Additionally, the report goes on to discuss a series of international prevention mapping tools (i.e., INHOPE prevention initiative report, Eradicating Child Sexual Abuse (ECSA), PedoHelp, Helplinks (a Europol website as part of the Police2Peer project) and the UNICEF promising programmes to prevent Child Sexual Abuse and Exploitation report. The report finishes off with a series of smaller sections describing relevant information on several programmes for people who fear they may offend, for people going through criminal proceedings and post criminal proceedings, as well as those for minors.

This is an invaluable resource for policy makers, practitioners, and researchers alike. The report demonstrates the development of good practice available in developing interventions for people at risk of committing a sexual offence or those who have. I would strongly recommend looking at it and learning from its findings.

Friday, February 17, 2023

Spirituality in Treatment?

 By David S. Prescott, LICSW

When I was a very, very new clinician, I worked in a residential treatment program for adolescents. One day, I was tasked with handling the admission of a new student. Typical of many of our admissions, he was escorted to our program with all of his belongings in a couple of clear plastic bags. He had a few changes of clothes, numerous pairs of old sneakers, and a poster with a drawing of a wolf and the words “spirit animal.” 

At the time, as now, there were periodic discussions in the media about how adults, and in particular schools, handled the topics of religion/spirituality and sex education. The bottom line was that each was a third-rail issue and among the fastest routes to being the subject of an official grievance or complaint. I asked the adolescent about the poster and with standard teen reticence he stated only that he had a connection to wolves. Leaning more in the direction of avoiding trouble than deep understanding, I let the matter drop and helped him to settle in. It’s a decision I’ve regretted for years; there are any number of ways I might have been more helpful in that moment. Instead, I took an easy way out. While we were able to talk about his spiritual path later on in treatment, I’d already established a relational template in which these discussions were less likely to occur. I’d also provided a lesson in adult discomfort with some topics. 

Fast forward a few decades to when I worked in a civil commitment program. A notorious client refused any treatment and all but a few interactions with the administration. He angrily complained to the facility director that because he worshipped the Norse God Thor he should be allowed to keep a sword in his room, along with a blacksmith’s hammer and anvil. This situation seemed to require little clinical nuance: The Security Director took over the discussion and said that he could have a piece of cardboard painted silver to resemble a sword and left it at that. Were we closer? I think not. 

In this second case, contextual factors ruled out serious discussion. This person was refusing treatment while exercising his rights. The clinical staff all had far more urgent matters at hand, or so it seemed. Had someone been able to listen to this person not just to resolve the issues, but with a goal of deeply understanding the client, it might have led to an honest discussion of how they might work together to find religious items that represented this man’s beliefs. 

Even more recently, after pondering the above, I came to find that one of the few books, probably the only book written on the topic of managing objections by self-identified Christians to participating in abuse-specific treatment is long out of print and unavailable; it had been self-published. Likewise, my (and others’) search for an expert who can talk about how to help Muslims place treatment goals and activities into the context of Islam has also turned up no leads despite some promising starts. 

Meanwhile, within the field of treating individuals who’ve sexually abused others, it is unusual to see discussions of enlisting spirituality in treatment. In some cases, modifications made by administrators and clinicians to the Good Lives Model involve tucking spirituality away under the broader rubric of inner peace. I’m confident that many clinicians do excellent work in this area, and yet we seem to remain so quiet about it. After a certain point, I have to wonder what this says about us.  Are we afraid to discuss these matters that we could help make stronger as protective factors, as in the first example? Do we not consider spirituality because it only seems to connect to a small portion of the principles of risk, need, and responsivity? Or are we too busy to consider spirituality, as in the second example? Or do we consider it unlikely that our clients have bona fide spiritual paths? Or do we, in some cases, actually believe them incapable of redemption or of building a more solid spiritual base? 

I don’t have answers to these rhetorical questions and don’t consider myself to have any particular expertise in spiritual matters. I once visited a country that had experienced significant strife over religious freedoms. When conversing with someone new, one never inquired about where the other had gone to school, since that would be an indication of religious beliefs. For them, it seemed that spirituality had become a kind of demilitarized zone. 

A colleague recently commented that in her region in the American south, Christianity is indeed a focal point of treatment. A colleague in South America recently stated the same. As an outsider, I’ve often wondered about programs that describe themselves as having a spiritual foundation in only one direction. Are we really doing enough? 

The possibility for practical challenges and ethical tensions is ever-present. On the other hand, those assisting individuals who have abused have long faced ethical challenges in the routine performance of their everyday duties. Still, it’s more common to see requests for immediate concerns such scoring risk scales and what kinds of travel restrictions might limit where clients may travel in particular US states. 

In the end, every human being has a desire to know how they fit into the universe around them, as described in Robert Emmons’ book, The Psychology of Ultimate Concerns. Perhaps it’s time for a broader conversation in our field?  

Friday, February 10, 2023

Desistance, Recovery and Justice Capital: Putting it all Together.

By Hazel Kemshall, Kieran McCartan, & Joy Doal 

On the afternoon of the 16th November we presented a session for the Academy of Social Justice on our new HMI Probation research insight paper called “Desistance, recovery, and justice capital: Putting it all together”. After the presentation there where several conversations and discussions, most of which were responded to at the time, but not all were. This blog is a response to some of those additional or detailed comments and questions that we did not have time to discuss fully on the day in question. The blog is broken down into four main themes, each of which will be answered in turn;

  1. Role of the probation officer including PQUIP training.
  2. Community engagement in understanding and responding to crime.
  3. Improving the focus on prevention.
  4. Responding to diversity and exclusion.


Role of the probation officer

The role of Probation officers and their responsibilities align with a focus on desistance, recovery, and justice capital.  His Majesties Prison and Probation Service
(HMPPS) emphasise “Preventing victims by changing lives”, and works to enhance access to pro-social capital, increasing skills, and enabling more positive decision making are all shown as contributors to desistance over the long term (Kemshall 2021, and Kemshall et al, 2021).  What kind of activities work well? The following practices are supported by research:         


  • Modelling and encouraging reciprocity, that is, mutual exchange rather than merely appropriating things. Social norms and the smooth running of society is rooted in reciprocity so it is important service users can implement it (Best, Musgrove and Hall, 2018; Kemshall, 2021; Weaver, 2015).


  • Identifying and accessing routes to building trust between the service user and others, and between the service user and the key groups that can afford opportunities to change (Christakis and Fowler, 2009).
  • Providing dignity and value to the service user combined with appropriate boundaries on conduct and behaviour (Bush et al., 2016; Rex and Hosking, 2016).


  • Fairness and justice in applying legitimate sanctions and the appropriate use of ‘supportive authority’ (Bush et al., 2016; Maruna, 2012).


  • Hearing the service user ‘voice’ and offering individualised service delivery based on a comprehensive and holistic assessment (McNeill, 2006).


  • Partnership with the service user where possible, realistically recognising the barriers to joint working, and accepting that, at times, particularly in the early stages of supervision, the practitioner may have to be the ‘senior partner’. The practitioner should be an ‘enabler’ not a ‘rescuer’ (Kemshall, 2022b; Rex and Hosking, 2016).


  • Creation of positive networks of opportunity and routes to change (Christakis and Fowler, 2009; Kemshall, 2021; McKnight and Block, 2010).


  • The importance of recognising trauma and adverse experiences in the lives of service users; taking a trauma-informed approach recognises the importance of the life course in people’s pathways into and out of criminogenic behaviour practice (McCartan, 2020).


  • Recognition of the impact of stigma, marginalisation, structural disadvantage, and intersectionality on service users (Alliance for Women and Girls at Risk, 2017; Barlow and Weare, 2019; Byrne and Trew, 2008; Farrall, 2019). It is important to see the individual in the socio-ecological environment that they exist in, and to understand that the different levels of this environment all contribute to preventing reoffending, successful risk management, and desistance. 

( See Kemshall & McCartan, 2022 for information and full references)


Community Engagement

Statutory agencies like Probation and more broadly HMPPS may struggle with community engagement, not least because of their statutory role and dependence on government funding.  However, there are good examples of community engagement and community wide initiatives, often by the third sector, that have demonstrated effectiveness in this area.  Some not only raise public awareness but also innovate new approaches to crime reduction.  Most use Public Health methodologies to crime reduction, and most notable in the UK are:



The Cure Violence (2022) public health initiative on a criminal justice issue has now spread to over 20 countries worldwide. The initiative takes a health-based approach to prevent and respond to violence, as well as violent crime, working at individual, interpersonal, community, and societal levels. The approach importantly contextualises the causes and responses to violence and then works to change individual and social norms around it. In recent years, Cure violence has developed to the point where it sees violence as a global epidemic that requires a structured population-level response. In addition, interventions at the societal level, particularly through social and criminal justice policies, have more recently focused on developmental factors and the reduction of adverse life events (Public Health England, 2019; Public Health Wales, 2015; Scottish Government, 2018); and interventions targeted at life-course events and mitigating crime trajectories (McCartan, 2020). 


Although we all, professionals and members of the public, recognise the need for greater messaging and a stronger community engagement strategy regarding the prevention of and response to criminogenic behaviour, especially sexual and violent offending, what strategies work best in communicating with the society at a broader level;

  • Clear messages with a focus on success.
  • Examples of what has worked and why.
  • Do not fuel prejudice and “crime anxiety”, rather
  • Tell the public what positive steps they can take.
  • Emphasise partnership working to reduce crime.
  • Build trust by being as transparent as you can be, and focusing on crime solutions.
  • Work with local leaders, “opinion formers” and those trusted locally- general campaigns especially via the media are less successful and are prone to being “hijacked”.

(See Kemshall, and Moulden, 2016 for information and full references)


Improving the focus on prevention

One of the main challenges in reducing crime, especially first-time offending, is the lack of a systematic approach to crime prevention strategies. Quite often crime prevention strategies are piecemeal and bespoke with different regions and cities in the UK taking different approaches, often spearheaded at a local level by innovative and well-intentioned individuals. Which poses a challenge to a national, or country level, as there is often not a clear evidence base or consistent approach, which means that when HMPSS OR Ministry of Justice look to engage with the preventative intentions they cannot do so from a well-informed position. The reality of preventive approaches is that they are “practice informed” rather than “evidence based” which means that you are taking a calculated gamble on an innovation which you think will work. This is a challenge at the best of times, but especially in the current economic climate. Therefore, what do we do? The solution seems to be emerging through work that is linking public health and criminal justice together in new, innovative approaches to preventing criminogenic behaviour (i.e., the Together for Childhood project spearhead headed by the NSPCC which looks to create a city wide placed based approach to the prevention of child abuse). The development of closer ties between public health and the prevention of criminogenic behaviour means that we can reconceptualise offending behaviour, re-establish it in a developmental frame and think about it across the socio-ecological approach (i.e., individual, interpersonal, community and societal) which means that prevention of first time offending (primary and secondary prevention) is as relevant as prevention of repeat offending (tertiary and quaternary prevention), thereby opening the door to a reasoned debate about the potential for a systematic and sustainable approach to prevention. We have seen this in the development of new policies like the Council of Europe’s Recent Recommendations on “the assessment, treatment and management of people accessed or convicted of a sexual offence”.

(see McCartan, 2021, 2022; McCartan & Kemshall, 2021 for information and full references)


Responding to diversity and exclusion

Practice focused on the delivery of positive, ethical, and person-centred assessment and interventions that are trauma-informed, compassionate, and cognisant of the contextual issues surrounding the person, including issues of multiple disadvantage, are the most likely to respond effectively to diversity and exclusion.  Anawim provided an excellent example of this, with attention to culturally relevant interventions and activities (often including food), person centred assessments, skill building, and practices aimed at enabling service users to become fully functioning and well-embedded citizens. Anawim and women’s centres more broadly, by working alongside Police or Probation can address women’s intersectional needs holistically and as staff tend to represent the communities the women are from, can relate better. As they are not in the enforcement role they can build more genuine relationships which can also (funding allowing) continue those relationships after court Orders are completed. The social relationships and peer support gained by interacting in the centres and attending groupwork and courses also extend outside of the confines of the Orders.


This blog has been a response to questions and issues raised in regard to our HMI Probation insights paper and resulting talk, it looks to expand upon what we have said and clarify some main theses. The important thing to remember is that desistence is being promoted as part of the recovery capital being delivered by HMPPS through their good, effective, and engaged practice (justice capital) but that we are often not good at recognising it and highlighting it. Justice capital is essential to good, effective engagement which results in desistance but in order to achieve it as a system wide level we need to highlight it in training, recognise it in practice and discuss it in public.


Thursday, February 2, 2023

The importance of trauma-informed care

By Minne De Boeck (president NL-ATSA, criminologist University Forensic Centre, coordinator Stop it Now! Flanders), Floor Somers (intern University Forensic Centre) & Kasia Uzieblo


Approaching individuals who commit sexual crimes (ICSC) from a holistic perspective, can give insight in their trauma histories. While it is not possible to say that trauma caused a person to commit a sexual offense, there is growing evidence that certain types and the number of adverse childhood events (ACEs) are associated with different types of sexual crimes. Hence, it is important to gain insights into the impact of these traumatic experiences and - by doing so - to gain insight in the connection between past and present behavior.


On December 5, 2022, a symposium about the impact of trauma on ICSCs was organized by the University Forensic Centre (UFC) in Antwerp, Belgium. At the start of the symposium the chair, the criminologist of UFC, (Msc.) Minne De Boeck, explained the importance of trauma-informed care in ICSC, and described how the topic obtained more scientific attention thanks to strengths-based approach to offending behaviors. Nonetheless, she noted that there is still a lot of hesitation and reluctance in practice to pay attention to trauma in ICSCs. Possible reasons for this reluctance are a lack of knowledge about and training in trauma treatment, a fear of being manipulated by the client when focusing on the trauma, and a fear that these traumas would be used as ‘excuses’ or ‘justifications’ for their behavior.


The first presenter was, Dr. Melissa D. Grady, who received her M.S.W. and Ph.D. from Smith College School of Social Work. Her clinical experience includes clients who have experienced trauma, depression, anxiety, anger management problems as well as other mental health issues. In addition, she practices, writes about, and conducts research and trainings on ICSCs and evidence-based treatment. At the symposium, she discussed trauma, the connection with sexual offending, and possible treatment programs.


Trauma-informed care (TIC) shifts the focus from ‘what is wrong with you’ to ‘what happened to you’. Grady emphasizes that to understand trauma one needs to be person-centered, because every adverse event can be experienced differently in intensity. Small or large traumas cannot be universalized. Being left alone at the playground for 10 minutes can have an enormous impact on someone, while a car accident for another person can be less of a shock.  ACEs can have lasting effects on health, behaviors, and life potential. Research finds that 45,7% of male ICSCs have 4 or more ACEs comparing, whereas in the general population 9% experiences 4 or more ACEs. Thus, ICSCs are a very traumatized population. A higher ACE score not only elevates the chance of committing a sexual crime, it also increases the chance to commit more different types of crimes. A study of Melissa Grady and colleagues (2022) on the therapeutic needs of clients, suggests that the vast majority requests to discuss their traumatic past. Clients assert that there is a strong connection between their traumatic histories and their subsequent offending behavior. Some describe their offending as a repetition of their own past victimization. However, many clients also note that potential connections between trauma and offending are rarely discussed or acknowledged in treatment. This shows a big discrepancy between the clients’ needs and the focus of clinicians. The question arises how we - as clinicians - respond to such findings? Are we really exploring enough in therapy? Ms. Grady suggests questioning our own practices. A comment was made from the audience about trust issues these people face and therefore the unwillingness to speak openly about their traumas. Someone else mentioned not feeling comfortable or specialized enough to dig deeper into the traumas. It is therefore important that clinicians, working with ICSCs, have expertise in how to discuss trauma, how to treat in a trauma-informed way or that they know where to refer the client to.


The pressing question that remains: how do we make the connection? What are the theoretical links between ACEs and sexual offending? Trauma can cause deficits, followed by risk factors, criminogenic needs and eventually aggression in order to regulate and self-soothe. Sexual abuse predicts, for example, the development of criminogenic needs associated to sexual offence. To understand this process better, Ms. Grady refers to the importance of the attachment theory of John Bowlby. This theory focuses on the early relationship between caregiver and child. Based on this relationship, the child develops an internal working model - a blueprint on which the child bases his/her expectations about future relationships. The attachment behaviors in the internal working model continue to follow the same pattern in the future: ‘not nice to us, so not nice to them’. People with insecure attachments experience many struggles such as mental illness and deviant regulation of affect, cognition, and behavior. Ms. Grady stresses the need for programs that preventively analyze vulnerable children to interfere with this ‘prison pipeline’. In addition, she underlines the importance and impact of building (therapeutic) trust relationships in the guidance and treatment of ICSCs. Despite someone’s insecure basis, clinicians should have the capacity to make changes in these patterns and rebuild trust.


Is our program trauma informed and how do we implement this in our daily practice? Trauma-informed practitioners view trauma not as a discrete event, but as a set of experiences that deeply influence the person’s world view, narrative and identity. To consider whether your program is trauma-informed, you can consult the trauma-informed principles (TIP) Scale by Cris M. Sullivan and Lisa Goodman. To implement it in practice, there are different therapy modalities and models. A useful model discussed in the symposium, is SAMHSA’s 6 key principles of TIC, commonly used in the US. These principles are: safety, trustworthiness & transparency, peer support, collaboration & mutuality, empowerment & choice and cultural, historical and gender issues. Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity, and possibly a cultural change at an organizational level. In addition to trauma-informed care, Ms. Grady mentioned trauma focused treatments, like Trauma-Focused Cognitive Behavioral Therapy, EMDR, Cognitive Processing Therapy and Exposure Therapy, all designed specifically to address the individual’s trauma and to target specific trauma symptoms and reactions associated with PTSD. These treatments extend beyond TIC and require specific training and expertise.


The second presenter was David Prescott (LICSW), the Director of the Safer Society Continuing Education Center. As a mental health practitioner for 38 years, he is best known for his work in the areas of understanding, assessing, and treating sexual violence and trauma. He discussed the implications of trauma research for professionals treating sexual offending behaviors and offered ideas for practitioners to employ from several different approaches. Mr. Prescott started with the three important elements of sexual offending treatment: risk, need and responsivity. It is important to match the level of services to the level of risk, target dynamic risk factors/criminogenic needs and use empirically supported approaches. Responsivity refers to the offender’s ability to learn from a rehabilitative intervention by providing cognitive behavioral treatment and modifying this intervention to the individual. There is general responsivity which refers to implementing theoretically relevant and evidence-based models for individual change, such as cognitive-behavioral and cognitive-social learning models. Specific responsivity can be regarded as a ‘fine tuning’ of the cognitive behavioral intervention. Mr. Prescott addressed that there is no method or model that fits everybody. Always take into account someone’s strengths, abilities, learning style, personality, motivation, and bio-social characteristics. This may raise questions like, ‘am I the therapist that this person can respond to?’ or ‘is this the program that this person can respond to?’.


Furthermore, Mr. Prescott indicated that clinicians could help these individuals find constructive ways of managing their emotions. It is the goal of (trauma-informed) treatment to teach people how to investigate every feeling they have, to help people live in the present. He recommends not only using CBT but also focusing on their physical reactions and impulses, by including for example yoga and several forms of meditation, like he does in his practice. Mr. Prescott also suggests the use of basic principles in TIC like motivational interviewing and feedback-informed treatment to get more effective.


We can conclude that there is no concrete nor universal answer (or method) to the pressing question: How can we put TIC into practice? It is the responsibility of all clinicians to help grow the empirical evidence and best practices. We need to explore more in depth what works and why it is working. Because we cannot get around the fact that working towards a concrete evidenced-based treatment for ICSCs implies including their trauma history.