Friday, March 29, 2013

Can Rape Be Stopped? Part Two

In our blog post of earlier this week, we raised concerns about the messages being offered by Salon writer Irin Carmon regarding rape and the value, implications, and importance of prevention efforts. Interestingly, Ms. Carmon has written another article for Salon on a quite similar subject, “Steubenville Rapists Can Be Saved,” which we believe is well worth reading.

The secondary headline for this article represents a very different slant: “For all the justified outrage at the Steubenville offenders, rehab can and does work.” In this tagline, she captures the anger and fear that so many people may feel when they read these stories. She also points to the conundrum that the public faces when we realize that we want the people (children, teens and adults) who sexually abuse to be successful and learn to live healthy, safe, and productive lives. Why? Because their success means that we all are safer.

But, how does this reconcile with the words of the previous article that claims it is difficult to reach the rapist with prevention messages?

It is important to acknowledge that there is a small percentage of people at risk to engage in sexually abusive behavior who will never be reached through prevention messages. As such, there is a need for resources to report, prosecute, and convict those individuals who are truly and, perhaps, incorrigibly, dangerous. However, the vast majority of children and teens who abuse will never sexually abuse again. With effective interventions we increase our ability to work with these youth and ensure that we can put into place the protective factors and provide the treatment needed to keep them and their communities safe.

As much as it often comes as a surprise to most members of the community-at-large, a lot of what we just wrote regarding adolescents applies to adults who have abused as well. Overall, the true key to effective risk management is the appropriate identification of those fewer individuals who pose the greatest degree of risk, and the subsequent use of our now considerable repertoire of risk management tools (e.g., containment, supervision, and evidence-based treatment) to intervene commensurate with the level of risk posed.

However, turning our attention back to young persons, like those involved in the Steubenville case, through research we continue to learn more and more about the risk factors for first time perpetration, as well as the protective factors that will make a difference in a child or teen’s life. If you have never seen the 40 developmental assets, take the time to look at this important work by the Search Institute.

Ms. Carmon ends the article with a hopeful quote about prevention from nationally and internationally acclaimed researcher Mark Chaffin:

We do a fair amount of victimization prevention, as a nation but we don’t do much perpetration prevention. If it’s relatively straightforward to change the behavior after it’s happened, it ought to be relatively straightforward to prevent it from happening in the first place. So that’s a reason to be optimistic.
Dr. Chaffin challenges us to share a new perspective and, hopefully, move the conversation to focus on what we can do to strengthen prevention efforts, enhance community safety, and strengthen the safety net around children and other vulnerable persons in our communities. The change may be small – simply changing the prevention messages for children to say that “No one has the right to touch you and you also don’t have the right to touch someone else.” The change may involve a larger investment, such as the growing number of bystander prevention programs that talk about intervening with persons at risk to be victimized, as well as the person who is at risk to abuse.

We agree with Mark Chaffin: Now, more than ever, there is reason to be optimistic.

Joan Tabachnick
Robin J. Wilson

Wednesday, March 27, 2013

Can Rape Be Stopped?

That is the title of a recent article in Salon by Irin Carmon and, unfortunately, the answer was a flat “No.” However, a close read of the article reveals a number of assumptions that easily brought the writer to the wrong conclusion.

The author wrote: “But the problem with saying ‘tell men not to rape’ is that the majority of rapists probably won’t listen. That’s because the majority of them are repeat offenders who don’t care about consent.” Carmon based this statement upon unique research conducted by David Lisak focusing on men in college. Lisak explored the sexual behaviors (and in some cases sexual abuse) reported by young men who were not convicted of any sexual offense. His study found that a large number of self-reported campus rapes were perpetrated by a small number of repeat offenders.

In science, it is generally unwise to make generalizations on the basis of “unique research.” More often, we require independent confirmation of findings before we begin to accept that something may be true in the larger scheme of things. As such, it would be a stretch – and we would say inaccurate – to claim that telling men about rape will not work. We are aware of a considerable body of research that suggests strongly that the dynamics of sexual harm are actually quite complex; that is, a single factor theory like ‘they don’t care about consent’ is unlikely to be a sole or even principal reason why some men engage in this behavior. Yet, on the basis of the findings of one study, Carmon has constructed a “one size fits all” argument, and by doing so we all lose an important opportunity to prevent sexual harm.

Using a public health approach, the best prevention programming will be comprehensive and guide interventions at all levels of the ecological model. What that means is that interventions should be directed at:
  • the individual who might be at risk to abuse, to tell them to stop before anyone is harmed and to reinforce what it means to have a healthy consenting relationship,
  • the relationships for that individual, such as his (or her) friends and family to encourage them to talk with friends when they see unhealthy behaviors
  • the college community and its administration, so they can be encouraged to set a zero tolerance culture for the campus
  • society, through promulgation of laws that address this issue and provide funding for victim services, as well as help for potential abusers willing to come forward for counseling.
We believe that it is time for people concerned about sexual harm to reframe the discussion from one of risk management to one of prevention, and there is good cause for optimism. Indeed, for anyone who does not believe that some people who have sexually abused (or who were afraid they might) would ask for help, we would suggest a review of an incredible program in Germany called Prevention Project Dunkelfeld (translated as “dark field”). A hospital in Berlin sent out public service announcements telling men to call for help. In 2008, it was reported that over 800 men called Dunkelfeld’s hotline for help. This clearly contradicts any conjecture that prevention programs targeting men just won’t or can’t work.

David Finkelhor’s four-factor precondition model is a good way to understand how the volume of rapes on campus could occur. In this model, Finkelhor suggests that four conditions must be met for someone to rape. These include:
  • Motivation to sexually abuse
  • Removal of external inhibitors
  • Removal of internal inhibitors
  • Breaking the resistance of the victim
For colleges and universities, it is almost a perfect storm – where young men who used to have families or faith communities to watch over them are suddenly thrown into a fairly loose environment where they are encouraged to have sex. With alcohol or drugs, the internal inhibitors for young men at risk to abuse are removed as well as the resistance of the victim. We saw something akin to this dynamic in the recent Steubenville case.

There is hope. A number of programs targeting college men have begun to emerge. Mentors in Violence Prevention is a longstanding program targeting seniors in sports to take a leadership role in violence prevention. Men Can Stop Rape and the My Strength Campaign all have proven track records targeting men. There are also a number of bystander programs demonstrated to be effective with women and men. In addition to the Bringing in the Bystander program at the University of New Hampshire, there is the Green Dot program, the One in Four program, and a free book that Joan wrote, which you can order through the National Sexual Violence Resource Center.

After a combined nearly 50 years of work in prevention and seeking to better understand sexual harm, we can say that we have seen enough research, as well as men who have abused in treatment, genuinely grappling with how they came to this point in their lives, to know that we can make a difference in the lives of these young men if we intervene, especially before someone is harmed.

Joan Tabachnick
Robin J. Wilson

Tuesday, March 19, 2013

Which is “Better”? Risk-Need-Responsivity and the Good Lives Model

There has been much saber-rattling in some quarters about GLM “versus” RNR. While on a bad day it can seem like it evolved from the Ultimate Fighting Club, for many of us it has been like watching close friends having an extended disagreement. In my mind, it should be about processes and not polarities. - David Prescott
When I was an undergrad I had my first opportunity to observe an academic turf war between behavioral and cognitive psychologists. Students trying to absorb the big picture were largely baffled and perhaps amused that polarized professors seemed to believe these branches of psychology were mutually exclusive. Perhaps such turf wars are an interesting study in another area of psychology – social psychology.

There have been spirited discussions over the last decade about what the basic tenets and essential differences are between two evolving models for sexual offender treatment: Risk-Need-Responsivity (RNR) and the Good Lives Model (GLM). Given that both models appear to be credible and valid, are supporters perhaps competing unnecessarily for prominence?

The truth is there is room for many theories and models for the assessment, treatment, and management of sexual offenders. It’s a big tent. Given that myth and misinformation about sexual offending run rampant in the management of sexual offenders, it seems an unfortunate distraction that there is a sense we have to choose between these two beneficial models.

For those interested in reading more about how the principal authors of RNR and Good Lives distinguish their models, these recent journal articles are enlightening:
Although Tony Ward has offered critiques on the strengths and limitations of the RNR principles, articles such as Ward, Melser, & Yates (2007) and Wilson & Yates (2009) are anything but “anti-RNR.”

Some of the debate centers on whether RNR focuses too much on avoidance goals at the expense of approach goals; or whether GLM principles are useful in the assessment of risk. Recent writings on GLM specifically address the need to match programs on the RNR principles, and offer ways to conceptualize this. Certainly, there is more to RNR than risk management; just as there is more to GLM than simply promoting “good lives.” There are, perhaps, many ways to utilize the principles of RNR and GLM, and still adhere to the models. How clinicians and programs go about this can vary significantly.

Those of us that have been around for enough years have seen basic principles of psychology worked and re-worked in various combinations, resulting in many different therapeutic models. David Burns sold a gazillion books on Feeling Good by explaining principles of psychology and human nature in the most basic and hopeful terms. Albert Ellis suggested a simple paradigm of actions, beliefs and consequences that helped explain how our cognitions and behaviors interact with our feelings and experiences. Concepts of Narrative Therapy add a rich and colorful context for reframing life’s scripts. Marsha Linehan combined personal and professional experiences with well-established therapeutic concepts and tools to give us a treatment model with a snappy new name – Dialectical Behavior Therapy. Multi-Systemic Therapy has demonstrated that an ecological approach to recovery can be very effective with adolescents. Motivational Interviewing is indispensible with involuntary clients. The goals of lifestyle balance and self-determinism outlined in the Saskatchewan NewStart model of life skills were early precursors (among others) to those found in current strength-based and GLM-type approaches.

Past and current therapeutic models, including those used in the treatment of sexual offenders, are all permutations of well-established principles of psychology and sociology, uniquely assembled like building blocks. Putting theory and concepts into a model, and developing a model into a professional paradigm are exquisitely complex. Clinicians who provide treatment to those who have sexually abused would be wise to be well-armed with many theories, concepts, and models, as well as possessing an ability to individually customize treatment to the needs of clients.

There are differences and similarities between RNR and GLM. Perhaps most importantly, they both promote a strength-based, pro-social approach to treatment. And, in doing so, they both provide an important counterbalance to the tendency in our field toward an overly-simplistic understanding of psychopathology as both the etiology of sexual offending and the narrow focus of treatment. Do these models really compete? Not in ways that really matter. They both support a humanizing, ecological approach to the unique assessment and treatment of individuals who have sexually abused.

Some might characterize the debate as ‘apples and oranges’ – maybe we can simply agree on ‘fruit.’ Beyond some academic questions about their origins, evolutions, and differences, GLM and RNR really are complementary. There is some likelihood and, perhaps, a little irony that both GLM and RNR are probably better off for the critiques from the other. In the end, there is little doubt that both RNR and GLM are valuable aids for both professionals and clients. Indeed, in amalgamation with other treatment theories, concepts, and models, they both contribute to a more effective therapeutic milieu. The beneficiaries are better lives AND safer communities which, also contrary to popular belief, are not mutually exclusive.

Jon Brandt, MSW, LICSW
 (Note: Don Andrews passed away after writing, but before publishing, his 2011 article; it might be considered his last word on RNR. The (2011) link above is to the Criminal Justice and Behavior abstract. CJB has made the full articles to Ward, Yates, and Willis (2012) and Wormith, Gendreau, and Bonta (2012) free on their website. The full articles are also available to ATSA members through the ATSA website.)
David Prescott and Robin Wilson contributed to this blog.

Monday, March 11, 2013

A Guest Post by Dr. Michael Seto

Crossing the Line:
Distinguishing Fantasy and Intent In Sexual Crimes

Michael C. Seto, Ph.D.
Director of Forensic Rehabilitation Research, Royal Ottawa Health Care Group
Author of the forthcoming book, Internet Sex Offenders (June 2013, American Psychological Association)

Gilberto Valle, a New York City police officer, is currently on trial for plotting to kidnap, torture, rape, kill and cannibalize women, including his wife and some of her friends. This case has drawn a great deal of media and public attention for its disturbing details, and for shining some light into the shadows of the Internet, where extreme websites are available for almost every conceivable sexual variation, including cannibalism, necrophilia, and sadism.

A key aspect of this case are computer records of Mr. Valle’s chats with others about how he would carry out his alleged plans, and a charge that he illegally accessed a law enforcement database to gain information about one of the women. Does this digital evidence indicate Mr. Valle was plotting to commit these crimes, as the prosecution has claimed, or is it evidence that Mr. Valle was expressing his sexual fantasies online, with no intention of carrying them out, as his defense has argued?

There has long been interest in the connection between fantasy and behavior in forensic and legal arenas. This has been a central question in my research and clinical work over the past 20 years. The question usually is prompted by behavior rather than fantasy: Someone commits a sexual crime – molests a child, rapes a woman – and he (the perpetrator is usually male) is arrested, prosecuted, and convicted. Psychologists or other mental health professionals are then asked to try to understand what his motivations were: Is he a pedophile, sexually attracted to young children, and acting upon that attraction? Is he sexually aroused by sexual violence? What are his sexual fantasies, and how might that translate to crimes he might commit in the future?

Pre-Internet, mental health evaluators had to infer the contents of someone’s sexual fantasies because our understanding was constrained by a simple fact: Only the perpetrator really knew what was in his mind, and he might not tell us the truth, for very understandable reasons given the legal consequences. (Who would choose to admit to atypical sexual fantasies when facing years in prison?) The Internet has changed this, so that we can now gain valuable insight into someone’s sexual fantasies and desires by examining the pornography he views online, the websites he visits, and the content of his emails, instant messages, and message board posts. Even if he denies it, evidence of persistent and repeated access to particular kinds of pornography and sexual content is indicative of his sexual interests. For example, one study my colleagues and I completed suggested a majority of men convicted of child pornography offenses would meet diagnostic criteria for pedophilia; yet we found in another study that many of these men have never sexually molested children in the past (based on criminal history and their self-report).

What then distinguishes those who express their fantasies online only, and those who also act on those fantasies in the physical world? What is the likelihood that someone will act on these sexual fantasies? Our ongoing research suggests child pornography offenders who act on their sexual interests and fantasies differ from those who do not by younger age, impulsive personality, callousness, and substance abuse. Another recent study suggested that offenders who sexually approach minors online can be distinguished into “fantasy-driven” and “contact-driven” offenders. Fantasy-driven solicitation offenders spent more time online and engaged in more protracted interactions with minors. Their main interest was sexual gratification while online, including sexually explicit chats, masturbation in front of a webcam, and exchange of pornography. The contact-driven solicitation offenders, in contrast, spent less time interacting online; their main interest was in finding minors who would be interested in meeting them in real life.

We know that some sex offenders engage in “practice” behavior, such as following children or women before they commit a sexual assault, or exposing themselves to child or female victims over a period of months or even years before committing hands-on offenses. As I discussed with Rachel Aviv, the author of a recent New Yorker piece on sexual offending, the clinical and legal challenge is determining when someone is expressing their fantasies online, and when someone is preparing to act. I was involved in a similar case where the offender had accessed child pornography and written violent, sexually explicit stories about how he planned to abduct, rape and kill his friend’s young daughter. There was physical evidence to suggest he was making the transition from fantasy to action, though he vehemently denied any intentions to act.

The same dilemmas in differentiating individuals and forecasting the future are faced in other situations involving online evidence: When is someone simply expressing his frustrations with other students and/or teachers at his school on social media, and how can we tell if he is actually working himself up to committing a mass shooting? When is someone expressing his outrage at perceived American slights in online chat rooms, and how can we tell if he is instead preparing to commit a terrorist act?

There is science to guide these determinations, but our ability to predict future behavior is imperfect. There are risk factors we can look for in clinical interviews and careful review of files – including personality traits, criminal history, and sexual history – but they are noisy correlates, and no factor is definitive: Many young, impulsive, callous, and substance-abusing men break the law, but they are very unlikely to commit sexually motivated homicides, which are fortunately quite rare. This is the central problem of criminal profiling: What is the truly distinctive feature or set of features that can help investigators find the right suspect? The same noise-to-signal problem is faced in counter-terrorism efforts, in trying to identify the truly risky individuals from the chatterers.

Decisions can be informed by scientific knowledge, but we cannot clearly and confidently mark the line between expressing fantasies online and action in the physical world: Our scientifically based opinions about risk are expressed in probabilities, not certainties. Moreover, the Internet has created a new psychological space where sexual fantasy (usually private) can be expressed in a public domain, and where the distinction between expressing fantasy and expressing intention is even further blurred. Hanging over this confusing psychological space are the serious costs for making a mistake in either direction: Incarcerating someone for “thought crimes”, no matter how heinous or abhorrent; or not intervening before something truly terrible happens.