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.

A moment of clarity for the online world

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

 

It almost goes without saying that the online world has changed dramatically in recent years. Where we once distinguished between the “real” and “online” worlds, their interaction now compels us to view the influence of the one on the other. How do we think about the way that we behave, our actions and interactions ion the online environment? Over the years we have heard everything from online behaviour is different from offline, online behaviour is a precursor to offline behaviour, they are all the same behaviours but in different environments.

 

This all means that it can be difficult to process and comprehend online behaviour, especially around sexual harassment, and abuse. This blog is a product of three stories in the press this week, the first being the ongoing case of Andrew Tate for sexual exploitation, trafficking, and misogyny; the second being a feature piece by Emily Atack trying to process if she is somehow responsible for the online abuse she has received on a daily basis; and third being the recent report that viewing Child Sexual Exploitation material increased 10 fold over lockdown. Although these three stories may seem different, they are connected through our attitude and response to the online environment and the range of sexually abusive interactions that occur there; interactions that we somehow will not tolerant offline.

 

The debate over freedom of speech and approaches to policing it on the internet are frustrating and often circular, ending in a dead end. It is not our desire to re-ignite them here, but to draw attention to the fact that abuse is abuse and harm is harm regardless of whether it happens online or offline. In the past few months, we have seen at least two colleagues excoriated by people in social media who were either unable, unready, or unwilling to view their comments in the proper context. In other venues, some have ended their lives as a result of online abuses. The medium through which harm occurs should not lessen the perceived reality of it or the accepted outcomes. Harm in online and virtual communities is still harm and can result in very real and tangible impacts on people’s mental health and wellbeing. But time and again we dismiss this harm as somehow less because it did not happen in person. What can we do about it?

 

We need to face up to some stark realities. We can remember that because something is online does not mean that it’s not real. The virtual world plays a massive role in the way that we see the actual world and our attitudes and behaviours. We need to take online harms seriously and hold platforms and corporations to account even as we support free speech more generally. A good example of this is in England and Wales where they are trying to get it put into the new online harms bill that CEOs and directors of online companies will be held criminally responsible for harmful material on their sites that endanger children. This is a significant step forward, as it promotes accountability and responsibility. Up until now, that accountability and responsibility has mainly been in the hands of the user rather than the provider. Additionally, we need to get better in teaching everyone about the reality of the internet and online environments. For years, we have operated on the assumption that people should use “common sense,” but this needs to change. A good example of this is some of the work happening is schools, as a result of the Andrew Tate case.

 

We are not saying that we need to ban the internet or close it down but rather we need to take these harms seriously if we are to prevent abuse. We need this “moment of clarity” to recognise that its not an aside to everyday life that its at the heart of everyday life and therefore needs to be taken seriously, we cannot strive to change the reality of offline, in person sexual abuse while ignoring the conversations, networks, images and material available online.

The David Carrick case: An opportunity to change that the police need to engage with.

By Kieran McCartan, Ph.D., Kasia Uzieblo, Ph.D., and David Prescott, LICSW

Over the last couple of days there has been an accumulation of evidence in a sexual abuse case that has rocked the British police: the case of David Carrick. Mr Carrick was a serving police officer who had admitted and been convicted of a series of rapes and sexual assaults over a significant period (20 years at least) using the skills he obtained as a serving police officer to manipulate, intimate, and rape women. All of this is worrying and a cause for concern, but made even more so by the fact that Suella Braverman, the Home Secretary, raises the issue that this may be the tip of the iceberg with more cases to come from other serving officers. She argues that the police need to “double down” on identifying and rooting out problematic officers. This is an important, but challenging issue; how best to tackle this?

Before we get into what the police can do to address problematic officers, it’s important to remember two things. The first is that this is not just a police issue. There are problematic and challenging individuals in all professions who use their positions to enable sexual abuse, even within our own field. For example, we have talked previously about the challenges of counsellors/therapists overstepping their boundaries and foreign aid workers in disaster zones using their position, influence, and access to commit child sexual abuse and/or exploitation. All this means that we need to recognize that people may enter these frontline positions because of the access and influence that it provides them, or that because of the job that they do and the culture or the work or organisation they start to change their attitudes and beliefs so that they are more likely to engage in problematic and abusive behaviour. Therefore, some people do a job because it enables them to abuse, whereas others started abusing because the culture of the job impacts their mindsets. It is important to state that not all frontline professionals, police or otherwise, abuse or accept a culture of abuse, but any reports or cases undermine the integrity and trust in the organisation from the public.

Secondly, the police – especially the Met police in London – are going through a process of culture change as there are deep-rooted issues in force culture and practice that needs to be rooted out. In many ways the David Carrick case is a “perfect storm” impacting the police. Therefore, a culture change project is already happening in respect to how serving police officers think about vulnerability, abuse, and engagement with communities.

What can the police do to prevent serving officers from using their position and training inappropriately to abuse people? We offer the following:

Screening: It is important the screen police officers at the start of their training and to check in with them throughout their service period. Having a clear screening and risk assessment process would help identify problematic attitudes and behaviours which would enable timely interventions to prevent abuse before it happens. It would also enable the police to see the impact of frontline service and organizational culture has on serving police officers, meaning that they can changing internal processes if needed. Of course, this should not be done thoughtlessly. It is important to first analyse which personality and/or behavioural characteristics could be problematic in this context and how best to screen them in the most reliable way and by whom.

Training: When thinking about the training that police receive, it is important to include aspects of intersectionality, vulnerability in the communities, as well as in the populations they serve, and a recognition of the degree of power and influence that their role brings. Here it is also important to dwell sufficiently on what behaviour is or can be transgressive, what consent may or may not entail within their job, what impact their policing behaviour may have on others, and how to conduct their policing with the necessary professionalism. This all seems obvious, but it is not. These issues are particularly important regarding specialist training (i.e., safeguarding, combat, surveillance, etc).

Reflection & trauma informed practice: It is important to consider and be sensitive to the role of trauma in lives of people before they join the police as well as the trauma that they experience while in the police. It is important to recognize the role of trauma in the development of problematic beliefs and attitudes amongst frontline police officers that can result in abuse, harassment, and/or victimization of vulnerable populations. By engaging in trauma informed practice it enables the police to highlight and engage with challenging attitudes and behaviours in a considered way, that reinforces the role of the police and recognises the challenge of positional power and control amongst frontline officers over the communities they work with.

 Culture shift: As mentioned previously mentioned the police in England and Wales, but especially the Met police, are going through a process of re-examine their cultural attitudes towards Violence against Women and Girls; recognising that there is a problem of sexual abuse and sexual harassment amongst serving police officers.

Community engagement: The police need to re-engage with communities to improve their public image and increase their perceived trustworthiness on matters relating to sexual abuse, sexual harassment, and violence. This means that the police, individually and collectively, need to change their messaging to communities and engage with them in a way that they will respond to positively, whether this is through messaging or actions.

The challenge of “bad seeds” or problematic frontline professionals should be tackled at an organisation, community of practice level rather than simply writing them off as unique, stand out individuals. Organisation, police or otherwise, need to recognise the potential for abuse from people who start working with them or the capacity of abusive behaviours to emerge because of working with them. This is a challenge and requires systems change and a culture shift, but its essential that this happens to restore trust in the organisation as well as encourage service users to continue using them. As Phil Zimbardo has observed, there may be bad apples, but there are also bad apple barrels and bad producers of these apple barrels.

 

A cautious welcome to 2023

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

We deliberately opted not to do a year in review post this month. Our colleague, Katie Gotch, summed up the attitude of many towards the New Year with a quote she’d heard: "I need 2023 to come in, sit down, shut up, and don't touch anything."  The quote summarizes the main reasons why we took a different approach this year: we want to move on and engage with 2023 rather than dwell on what did not achieve or simply pat ourselves on the back about what we did well.

For David, one of the signal events of 2022 happened at the margins of our field. Joanna Moncrieff and her colleagues published a paper that many felt put the last nail in the coffin of “Serotonin theory”: the belief that Serotonin plays a causal role in depression. Whatever the nuances of SSRI medication and depression, it was surprising to see how many professionals responded by blaming the media and saying words to the effect of, “We’ve known this for years.” It brought to mind the massive marketing ploys of the pharmaceutical industry, that hyped the idea of depression being caused by “chemical imbalances.” Whatever the actual statements by individuals, there was no attempt by “Big Pharma” or their related professional organizations to disabuse professionals of this notion. Of course, we are now seeing similar hype related to the use of psychedelic drugs, which appear to be very helpful to some and a nightmare to others. A leading proponent of these methods, Rick Doblin, has stated publicly that he hopes to help create a “spiritualized humanity” by 2070. Elsewhere, pharmaceutical companies were compelled to settle any number of lawsuits related to the opioid epidemic.

While there is no question that medications can help people, one hopes we can see a return in 2023 to a quieter and broader focus on those therapeutic principles that research has shown really do help people change. In an era where treatment providers remain exhausted from the conditions of the pandemic, David’s biggest hope is that our field can focus more on the characteristics of effective therapists,  and the factors common to all effective forms of psychotherapy. Study after study has pointed to the importance of these areas in treatment, even as they do not receive as much attention as other, more aggressively marketed approaches. The mechanisms of change are complicated; perhaps we can go back to the basics of good therapy. In line with the request for 2023 not to touch anything, let’s give the last word in this area to Public Enemy, who famously sang, “Don’t believe the hype.”

Also in 2022, we unfortunately failed (again) to completely wipe sexual violence (and other types of violence) off the map. On the contrary, through the war in Ukraine, we Europeans closely observed how common sexual violence is within a war; how it is used as a torture technique and how soldiers make use of their power and the chaos to commit such acts with impunity. With all this chaos and the countless problems that these Ukrainian families are facing, Kasia holds in her heart the prevalence rates of domestic violence since the start of the war. In addition, many scandals have erupted in Belgium and several neighboring countries, and the general community has been (again) harshly confronted with the facts: sexual transgression can happen anywhere and can be committed by anyone.

If we can speak of a silver lining at all, it is the fact that sexual violence still receives attention from society and policy. But it is high time that we don’t just exclaim this realization through hashtags or similar on social media or during political shows, but actually take action in 2023, action that focuses on prevention and draws on both empirical insights and practice. Kasia briefly touches on two issues that could facilitate such actions or at least offer interesting opportunities. The first issue has to do with a personal experience. Although she has been lecturing to various audiences for many years, in 2022 she gave a lecture on the prevention of sexual violence at a conference organized by victims of sexual violence. This has been one of the biggest challenges of her professional career: what language can I use and what can I not? Does this audience want to hear about prevention? Does this make me seem to minimize what has happened to them? These are some of the questions that kept her awake. Fortunately, an attack with rotten tomatoes or a reverberation of boos never came. On the contrary, the audience reached out afterwards: They wanted to hear more about research and clinical experiences, and they wanted to help think about how they could help support effective prevention programs. Kasia therefore hopes that 2023 will be the year when the ‘world’ dealing with those who have committed sexual offences and the ‘world’ dealing with those confronted with such offenses will move another step closer together and join forces to push for more effective prevention.

And that brings her to her second issue, which is the policy and legal changes that are looming in Belgium. 2024 is an election year in Belgium. That makes 2023 a year when politicians want to score or at least attract attention to themselves. Kasia hopes that after implementing mainly harsher punishments for perpetrators of sexual violence in 2022, they will now take the little time that is left, to develop and/or implement evidence- and practice-based strategies to prevent sexual violence, that they will be guided by the insights of experts from science and the field, and that they will think long(er)-term. In 2022 steps have been taken to -among others- develop a substantiated risk assessment and management policy for probation officers and to require thorough risk assessments in court investigations. But Belgium still faces major challenges in the actual implementation of these new policies, and in areas such as treatment (e.g., various groups of offenders are excluded from therapies and hence do not get an opportunity to work on themselves). 2023 can be seen as the year of last chances for the current government, including within our field of work. On that front, Kasia hopes for two things: that policymakers will prove this year that they have the right goals in mind (adequate prevention) and that colleagues in the field will not hesitate to speak up when things threaten to go in the wrong direction.

For Kieran, building on what Kasia has said, 2023 offers us the opportunity for connected global efforts aimed at effective prevention and coordinated responses to sexual offending. In Europe, there have been increased conversations and co-ordination between policymakers, professionals, and organization around reduction of violence against women and girls. These have occurred alongside an increased interest in epidemiological criminology approaches that examine sexual and domestic violence from a health perspective. This feels like a watershed moment in the prevention of sexual abuse, as there are opportunities to develop effective and evidence-based policies within and across countries: the opportunities for transnational offending have opened up in the wake of the pandemic, both in terms of travelling to commit contact offenses as well as in the opportunities for online offending. Sexual and physical abuse are global issues requiring a coordinated approach. Therefore, it is important that we use all the opportunities that we have to “lean in” and further the conversation.

Fighting Against the Single Story: The Bechdel-Wallace Test for Child Sexual Abuse Prevention

By Joan Tabachnick*

I first heard of the Bechdel-Wallace Test in 1985 in a comic strip called “Dykes to Watch Out For” by the artist who eventually wrote the book for a successful Broadway play called “Fun Home”.  In the strip called “The Rule”, one of the female characters explains to another woman character that she only goes to a movie if it satisfies these three very simple requirements: 

●        The movie has to have at least two women in it,

●        who talk to each other,

●        about something other than a man.

I recently watched a film titled Rafiki (which means friend in Swahili) about two women growing up in Kenya.  In a TED talk, the film’s director, Wanuri Kahiu spoke about the Afro-bubblegum movement which has its own test to change the narrative about the way Africa is portrayed in the movies.  The movement was started to push against the danger of a single narrative about Africa - one that tends to focus on the extreme poverty, the spread of diseases such as HIV and the political strife throughout the continent.  According to Kahiu, the intention of the movement is to promote a “fun, fierce, and fantastical representation” of Africa and change the way that Africa is perceived around the world.  To qualify as “Afrobubblegumist Art” art about Africa must:

 

●        show at least two healthy Africans

●        who are financially stable (and not in need of saving) and

●        who are “having fun and enjoying life.”

Because of Kahiu’s inspiring talk, the danger of a single story was very much on my mind when I was asked to give a 25-minute recorded talk about how to talk about child sexual abuse.  The narrative about child sexual abuse is that all victims are forever damaged, and that the sex offender is a predatory monster who we are almost helpless to stop. This single narrative does not recognize the wide diversity of circumstances that lead to abuse, it does not offer insights into how to see these behaviors in people we love, nor does it offer any insights how to prevent sexual abuse before a child is harmed.

Beyond naming the problems with the existing narrative, I also knew it was essential that we modeled talking about a topic no one wants to talk about.  In my 30 years of doing this work, I am constantly reminded that adults need to know how to talk about sexual abuse – if we expect a child to be able to tell what happened to them, adults need to feel comfortable using these words, can say the proper names for body parts, and know what questions to ask.  They also need a sense of hope that they can make a difference in the lives of people they care about.  Modeling the conversation is the best way to demonstrate how to talk and how to be “askable” to our friends, families, and other professionals. 

Luckily Pamela Mejia, Head of Research and principal investigator at the Berkeley Media Studies Group, had the same idea, and joined me for the discussion.  We then asked Karen Baker, the executive director of PCAR (and former ATSA board member, prevention committee co-chair, and founder of the Gail Burnes Smith Award) to join us to bring in the perspective of survivors as well.  We were then lucky to have Rebecca Fix from Johns Hopkins as our moderator who kept the conversation going

Our goal was to model how to have conversations about CSA and focus on the real stories rather than the typical trope of the “monster lurking at the edge of our playgrounds” or the updated version of the “monster stalking your child online…”  Pamela offered some research about how the media portrays the people who cause the sexual harm and reinforces the dominant narrative by focusing on strangers outside of the family, typically someone with dozens if not hundreds of harmed children in their wake.  Karen shared some real-life examples of how families can talk about these behaviors and the boundary crossing, especially before anyone is harmed.  And together we spoke about how the current portrayal of people who engage in sexually problematic behaviors means that we don’t see boundary crossing and other early signs of abuse in the people we love. 

So what does this have to do with the Bechdel Test?!? 

My favorite part of the panel discussion was the challenge to each other and the audience: What would the Bechdel Test for child sexual abuse look like?  If we could control the narrative of Hollywood, what would we want to see, even in our minimum standards?  While we did not narrow this down to just three criteria, we think as a starting point that fictional stories about child sexual abuse should feature:

·         Talking:  Two characters are able to talk about CSA, have a conversation (not yell or scream about it).  And then when faced with the knowledge that a child has been harmed, the character is able to ask for help and is portrayed with an ally – they don’t have to do it alone.

·         Positive movement:  the person harmed might be portrayed as feeling the harm but also feeling that life is not over and they are able to move forward) or the person who caused the harm is seeking help and changing their behaviors.

·         Health:  There is some mention of body autonomy and respect for children (including teenagers).  Or even better, there is a conversation about healthy sexual behavior or sex education. 

·         Ending:  The movie could portray a different ending, other than the criminal justice system.  In fact, that the final scene of the movie is not punishment and hurt and abuse in the system but there is a possibility of hope or healing (end like a children’s book).

·         Bonus:  Person who caused the harm is someone the film led the audience to care about, and when their abusive behavior is found out they are held accountable AND people in the narrative continue to care about them.

To us these are just a few of the ways that we would want to start to change the narrative.  So we want to ask, what would be your Bechdel Test for this issue?  Let us know!

 

* Special thanks to Karen Baker, Pamela Mejia and Rebecca Fix for their important contributions to this evolving conversation.  

A long way to go

By David S. Prescott, LICSW, and Kasia Uzieblo, Ph.D

Two recent articles in the New York Times illustrate how the context of our work can shape our clients and our practices. The first article describes how the New York State inspector general’s office “has documented significant racial and ethnic disparities in discipline across New York State prisons, finding that over a six-year period, Black inmates were 22 percent more likely to be disciplined than white ones... The report comes six years after The New York Times published a 2015 investigation into racial bias in state prisons. The Times found that Black prisoners faced more punishment than white ones, leading to loss of privileges, longer stays in solitary confinement and, ultimately, more time behind bars…

“State inspectors reviewed 385,057 misbehavior reports filed from 2015 through 2020 to expand upon The Times’s analysis. They found that the discrepancies had actually worsened over time, most significantly in 2020, when Black prisoners were 38 percent more likely, and Hispanic prisoners 29 percent more likely, to be cited in misbehavior reports.”

Importantly, “The inspector general concurred with The Times that these discrepancies were most pronounced for violations that were, according to the report, arguably more subjective. The largest disparities were for offenses like gang activity, assault on another inmate and “involvement in a demonstration detrimental to facility order,” which saw Black prisoners five times more likely, and Hispanic prisoners three times, to be found in violation than white inmates.”

In the second article, About 200 to 250 people incarcerated in Louisiana jails and prisons have reportedly been held beyond their legal release dates in any given month, with the average additional time lasting around 44 days in 2019. As one lawyer observed, “To our clients, it is an extremely scary experience because they do not know why they are being held, when they will be free or how they can get free,” he added. “All they know is they should not be behind bars.”

It can be easy to miss these stories in the seemingly never-ending parade of crime stories in the media. However, it seems that unless we pay attention, we ignore these practices at our peril. Many ATSA members have felt the anguish of not being able to change the often ineffective and sometimes unjust systems in which some of us have worked.

It behooves us to stay attuned to the fundamental unfairness and injustices that often surface in various corners of the criminal justice system. We do not say this to throw shade on any one individual or institution in any particular area. At the same time that these events are taking place, many other institutions and agencies are working to improve their approaches. Likewise, in our experience, those in the helping professions often want nothing more than to make positive changes that will reduce risk while simultaneously enabling individuals to build lifestyles that are incompatible with offending.

Nonetheless, it’s vital for us to understand and discuss how the broader systems in which we work end up causing harm to people, including those referred to us in treatment. The implications are far-reaching, including for risk assessments and classifications within the various systems that have authority over these individuals.

Our clients absolutely take note of these experiences. It makes sense that if the media and our clients notice these various injustices, and yet we don’t acknowledge, know about, or account for them, we shouldn’t be surprised when our clients conclude that we can’t understand their perspectives and that they can only work with us in a limited capacity. Psychotherapy clients who feel heard, understood, and respected benefit more from our interventions than those who don’t. Working with our clients means understanding their perspectives without writing them off as treatment-interfering factors. Unfortunately, in this case, understanding and working with their perspectives involves involves taking a long, hard look at the systems within which we operate and being prepared to respond to clients accurately, empathically, and without colluding either with them or the systems involved.

Whatever the potential biases of the journalists and the media outlets, the data are shocking and impinge on human rights. Further, they illustrate that at the very time we have information to guide our attempts to level meaningful sanctions, some of our systems are actually becoming worse and in need of more effective leadership. 

 

 

Redrawing sexual offenses: the role of technological evolutions in online sexual behavior - A report on a webinar organized by the Dutch Affiliation of ATSA

By Minne De Boeck, Lotte Valepijn, Ellen Janssen & Kasia Uzieblo

Sexuality is constantly evolving in terms of how we date, in terms of how we shape our sexual identity and in terms of how we consume pornography. Social media and technological evolutions encourage and influence these changes. Technological trends, including robots, drones, and VR, keep evolving and exerting influence on our sexual behavior. This can be about positive developments, but it can equally create new opportunities for misuse. Hence, these technological changes create many challenges on a societal level, but also for law enforcement and for forensic care, challenges that are difficult to keep up with. 

On November 22, 2022, a webinar on technological evolutions and their role in online sexual behavior was organized by the Dutch Affiliation of ATSA. The webinar was launched by the President of the Dutch Affiliation of ATSA, Minne De Boeck. She also took the opportunity to introduce her successor, Maaike Blok, who will succeed her in 2023.

The first presenter was Catherine Van de Heyning, Professor at the Faculty of Law, Antwerp University, public prosecutor and independent expert on the advisory committee of the Human Rights Council of the UN, Belgium. She discussed the legal framework in Belgium regarding online sexual penal law, which was thoroughly analyzed with a particular focus on Image-Based Sexual Abuse. She stated that the present age represents a true image culture caused and strengthened by social media, the omnipresence of smartphones and the COVID-19 pandemic. The perception that adolescents can be their own gatekeepers in an online setting because they grew up in a digital era needs to be debunked. Belgium is proud to be a pioneer when it comes to legislative developments to battle online sexual violence. Several phenomena such as sextortion, forced sexting and deep nude were discussed in light of the new Belgian legislation. Sexting (sending nude pictures) is not a criminal offence. It only becomes punishable once the vulnerability of the other person is taken advantage of, for instance in the case of coercion or violence, or when the sexting images are forwarded without consent. Likewise, sexting between minors is not always viewed as a problem. The presenter also shed light on certain unfortunate sexting trends that have arisen. For instance, doxing that occurs when the identity of the victim is broadcasted to inflict more damage is becoming a true problem. Another phenomenon that becomes increasingly prevalent is the misuse of deep nudes. This entails searching for nude pictures of (potential) victims and editing them in such a way that pornographic content is produced. All phenomena target victims in different ways. Predominantly victims between 15 and 30 years old are targeted and girls/women are targeted more often than boys/men. Moreover, female victims are more often confronted with widespread circulation of the pictures, which inflicts even more damage.

Jeroen ten Voorde (Professor of Criminal and Criminal Procedural Law, the Netherlands) shed some light on the Dutch legal framework to cope with sexual transgressive behavior, including online behaviors. His presentation included both recent developments and plans to deal with new trends such as robots and the use of sex dolls. More concretely, there are apparent problems regarding criminalization and penalization. For example, rape is only illegal when there has been a relevant interaction. With online sexual communication, there has to be an attempt to seduce or groom. Dutch policymakers want to tackle these discrepancies in the future by introducing an interaction criterium by law. In addition, there are certain scenarios which are not yet criminalized. For example, according to the Dutch penal law, watching child sexual abuse material as such is not punishable. This issue is expected to be solved with a new child pornography provision. However, the Dutch penal law does not have a solution for the spreading of deep nude/fake pornography. These presentations show how the legal framework keeps evolving and tries to keep up with new forms of transgressive behaviors.

Zohra Lkasbi (Clinical psychologist and behavioral therapist for children and adolescents, Belgium) focused primarily on adolescents and online sexual transgressive behavior, which is also the topic of her new book. The influence of the digital evolution on the concept of sexuality manifests itself in different ways, ranging from POPU (problematic online porn use) and the non-consensual spreading of sexual content to peer-to-peer online grooming. The latter is heavily facilitated by the fact that everyone has continuously access to smartphones and social networking sites. Special attention was given to dual offenders, who have committed both online and offline offenses. These offenders are often excluded from research, which causes a gap in our knowledge. Various therapeutic interventions such as the use of an internet-and media safety plan, the Flag System, an evidence-based tool for assessing acceptable and unacceptable sexual behavior or using internet zones to tackle online sexual inappropriate behavior are being applied but its efficacy has not been established in research yet.

Manon Kleijn (PhD-Student at Fivoor Science and Treatment Innovation at Tilburg University, the Netherlands), has studied online and offline child sexual offending. She examined how individuals approach minors online to abuse sexually and identified various pathways. First, she described the person who actively ‘approaches’ his victim by (1) bringing up his sexual intentions in the first few sentences and who mainly engages in short conversations, by (2) manipulating his victim (e.g., by giving compliments and showing affection with the aim of acting on sexual intentions), and by (3) discussing sexual topics. Second, she identified an ‘avoidant pathway’. These individuals do not take a lot of initiative and do not have clear intentions. Finally, a mixed group was also identified.

In the final part of the webinar, Dr. Dean Fido and Dr. Craig A. Harper (senior lecturers in Forensic Psychology, University of Derby and Nottingham Trent University respectively, UK), focused on image-based sexual abuse from a psychological perspective. This abuse encompasses phenomena such as revenge pornography, upskirting, cyber-flashing and deepfake pornography. The presentation shed light on each phenomenon. Firstly, revenge pornography was discussed, a phenomenon that always implies a core motivator as a response. Often, people think of “the cheating wife”, yet research suggests that most perpetrators are not the victim’s former partner. A potential hypothesis that was brought up was that revenge pornography supposedly is produced predominantly by men so they can brag about their sex lives. A second phenomenon, called upskirting, refers to individuals creating footage by taking pictures up the victim’s skirt. In light of this phenomenon, the presenters discussed the case of Gina Martin. She was one of the first females that wanted to report the situation after being a victim of upskirting, yet there was nowhere she could go since upskirting did not exist in any legal framework. Another upcoming phenomenon, cyber-flashing, is not illegal and can only be legally prosecuted under the guise of public harassment. With regard to creating and using deepfake pornography, two possible underlying mechanisms were discussed: hypersexuality of perpetrators and achieving sexual gratification. The presenters introduced the Beliefs about Revenge Pornography Questionnaire – a scale developed to assess social beliefs concerning revenge pornography.  Their recent studies suggest more lenient judgements of deepfake generation and dissemination for celebrities, males and when images were created for self-sexual gratification. Similarly, there is a stronger tendency to victim blaming when the victim is a male. Victims who are male and attractive are perceived to experience less harm in cases of upskirting behaviors. Interestingly, proclivity to make and distribute deepfake and proclivity in upskirting behavior seem to be linked to psychopathic personality traits.

We can conclude that there is still a lot of room for improvement in terms of judicial responses to these new phenomena, and preventive initiatives. More research on these new phenomena and the sharing of best practices are highly needed. However, we also need to acknowledge that social media and other technological evolutions are evolving so fast that it is impossible to keep up in clinical practice and in terms of judicial responses. Notwithstanding, practitioners, researchers and legislators need to remain aware and pay attention to current trends in order to prevent victimization and perpetration as adequate as possible.