Sunday, September 29, 2013

What Could Those Empathy Researchers Be Thinking? Complications, Controversies, Research, and Practice

The above title is a weak attempt at humor. Many of the best and brightest in our field have touted the importance of empathy in the treatment of sexual offenders. It’s as though we’ve always known it in our hearts: If you truly understand someone’s internal experience, you’re less likely to hurt them.  Yet the available research begs to differ, and this is frustrating to many of us. What could the researchers have been thinking? And, what are we all feeling?

The June 2013 issue of Sexual Abuse: A Journal of Research and Treatment contains an article by Ruth Mann and Georgia Barnett titled, “Victim empathy intervention with sexual offenders: Rehabilitation, punishment, or correctional quackery?” It has already garnered considerable discussion in professional circles; although opinions remain divided. Perhaps, that is a good thing. It is time to consider the role of empathy in the lives of each individual who has sexually abused, rather than among large groups of sexual offenders.

Some history might be in order:
  • From antiquity, most religious orders and spiritual groups valued empathy and compassion (e.g., “walking a mile in someone’s moccasins” is a common descriptor in parts of the USA, just as “seek first to understand” is among Steven Covey’s seven habits of highly effective people, and “Namaste” translates as “the light in me honors the light in you”).
  • While much of our field emerged from behavioral-therapy attempts to reduce deviant sexual arousal, many of our field’s pioneers spoke of the importance of understanding victim experience (e.g., Jan Hindman).
  • Concerns about treatment have sometimes focused on developing empathy among treatment participants who have high levels of psychopathic traits. Central to these concerns was that a focus on empathy might actually teach clients how to become more effective at exploitation.
  • In 1996, a meta-analysis by Karl Hanson and Monique Bussière found that victim empathy was not predictive of sexual re-offense.
  • In 2002, an influential book by Yolanda Fernandez and her colleagues emphasized, among other things, that empathy is difficult to measure and, therefore, difficult to research.
  • Other research findings have suggested that while victim empathy (e.g., learning and understanding the harm one has done to specific individuals) is not predictive of sexual re-offense, empathy for others in general can be.
  • In 2009 and 2013, Jill Levenson and I, along with our colleagues Shan Jumper and David D’Amora, published three studies of consumer satisfaction surveys. In each of these surveys, clients in two civil commitment programs and one outpatient practice stated that victim empathy and accountability are among the most important elements of treatment. Questions remain, however. Were these clients simply repeating back what they’d heard in treatment?

Into this breach step Mann and Barnett, who observe that as many as 95% of North American treatment programs for people who have sexually abused target victim empathy, which is rated among the top two treatment targets by those programs.  Mann and Barnett further remind us of the work of Paul Gendreau and his colleagues, who coined the term “correctional quackery” in response to programs that give priority to anecdotal evidence and the pet theories of administrators.

Mann and Barnett further describe the fuzzy definitions of empathy that have been included in studies, ranging from remorse to a variation of awareness, each of which can be very different experiences. They further observe an important but rarely discussed point: that a lack of empathy for past victims does not explain the willingness to abuse again in the future. They also note that after-the-fact minimization of harm is a common human experience.

In the end, the authors conclude, “None of the various meta-analyses of sex offender treatment program effectiveness have examined the impact of different treatment components at the level required to draw conclusions about victim empathy intervention” (p. 289). The authors also state, “We conclude from our review that the theoretical basis for victim empathy work with sexual offenders is inconsistently articulated, poorly understood, and largely untested empirically” (p. 295).

Under these conditions, it is difficult to know whether professionals should go off in search of more research or go home and take a long, hard look in the mirror. Maybe we are not as empathic and understanding as we would like to believe. Perhaps, if our methods and measures are as disparate as the research studies seem to indicate, we do not understand empathy as well as we think.

David S. Prescott, LICSW

Friday, September 20, 2013

Does Canada Need Harsher Penalties for Sexual Offenders?

            In the September 16, 2013 edition of the Globe and Mail, Canadian Prime Minister Stephen Harper is quoted as having said:

“We do not understand why child predators do the heinous things they do and, in all frankness, we don’t particularly care to.”

            These comments were made during a press conference in Richmond, BC in support of the Conservative government’s plan to introduce legislation this fall to “crack down” on people who sexually abuse children. The proposed legislation will reportedly include consecutive sentencing, mandatory minimum sentences, and publicly accessible registries; practices currently popular in the United States.     
            The sexual abuse of children evokes strong emotional responses in every Canadian, especially when children are abducted, sexually abused, and murdered by predatory offenders. However, it is important to remember that, although tragic and troubling, these latter cases are truly rare. As difficult as it may be to comprehend, these extreme crimes are also virtually impossible to predict or prevent. The offenders who commit them, however, do not represent the norm when it comes to sexual abusers.
            Mr. Harper’s comments imply that there is little known about sexual offenders and the reasons why they commit their crimes. This is simply not true. We understand quite a lot about sexual offenders, including pedophiles. The vast majority of sexual offenders target family members or friends, not strangers, as is commonly believed. More than two-thirds of sex crimes occur in the victim’s own home, often committed by a parent. Some higher risk sexual offenders have strong sexual interests in children (pedophilia) that lead them to offend, but not all child molesters are pedophiles or necessarily at high risk to reoffend.
            Mr. Harper also stated that we don’t care to know why sexual offenders do what they do. The Prime Minister’s comments are disheartening. The first step towards prevention is understanding the nature of the problem. Mr. Harper carelessly trivializes the accomplishments of dozens of Canadians who have dedicated their lives and careers to better understanding sexual abuse, including why it happens, how to help offenders stop, and how to prevent the abuse from happening in the first place.
            For almost half a century, Canada’s approach to offender management has been the envy of the world. Rates of sexual offending and reoffending in Canada have been in steady decline for the past two to three decades. In explaining these trends, we can point to directly to advances in risk assessment, treatment methods, and community supervision and citizen engagement—most of the seminal research on these topics having its origins in Canada. Indeed, many Canadian practitioners have been recognized internationally for their contributions to public safety. At home, several have been appointed Fellows of the Royal Society of Canada or Officers of the Order of Canada—our highest civilian honour.
            So, does Canada need harsher penalties for sexual offenders? Canadian research has shown for years that we do not. In fact, Canadian research has conclusively shown that more punishment does not lead to less crime. Do we need more prisons? Not likely. Do we need more resources for treatment and abuse prevention programs? Absolutely. The real challenge is primary prevention: How do we stop it from happening in the first place?
             Canadians are understandably concerned about sexual abuse, but our system is not broken. Mr. Harper’s government seeks to implement US-style criminal justice and correctional measures. However, the American example holds a dark promise. The US incarcerates more of its citizens than any other country. Our American compatriots have become increasingly aware that they can no longer bear the financial and human costs of a “get tough on crime” agenda. Prior to pushing ahead with new legislation, Mr. Harper would be well-advised to both check with his American colleagues and to review Canada’s illustrious history in criminal justice research.
            Better still, if Mr. Harper should ever care to better understand these issues, he might take a look in his own back yard and quit scaring ordinary Canadians whose tax dollars have long contributed to the many effective solutions we already share with the world.

Robin J. Wilson, Ph.D., ABPP is a Canadian psychologist in private practice in Sarasota, FL, and an Assistant Clinical Professor (Adjunct) of Psychiatry and Behavioural Neuroscience at McMaster University in Hamilton, ON. He has worked with sexual and other offenders in hospital, correctional, and community settings for nearly 30 years.