Tuesday, December 20, 2016

Star Wars and Sexual Abuse Treatment

Weary from many long hours of assessments, treatment, travel, and training, I went with my family to see the new Star Wars movie. I’m a dreadful Star Wars fan; most of the time I smile my way through these movies because I don’t know what’s going on. They are pleasant to look at though, and remind me of when I waited in line for an hour or more to see the very first one in the theaters in the late 1970s, probably wearing the fashions of the times: an oversized down jacket and light-colored Frye boots.

Four decades on, I found myself resentful. Why are these characters considered heroic when my colleagues aren’t? After all, the people I work with may occasionally make mistakes or become misguided, but every one of them puts their all into a shared mission of healthier lives and safer communities. As many have observed, the beneficiaries of our work will never know to say thank you because they won’t have been abused. My colleagues are not, as one defense attorney in Wisconsin once said to me, the “Death Star.” The vast majority of people working from all perspectives towards the goal of eliminating abuse are all over-worked and under-paid. Maybe it’s that our costumes and transport aren’t as cool as the Star Wars characters. I’m quite certain I would not look as lithe climbing up the ladder of a spaceship as some of the figures in the movie.

Then I realized the difference: These characters don’t have to do case notes. They don’t know from DAP and SOAP formats, and couldn’t formulate a SMART goal if Princess Lea’s life depended on it. To my knowledge, there are no ethics-codes considerations around the use and misuse of protocol droids… or any robots for that matter. These characters have never done paperwork, nor worked with someone whose job involves cracking the whip on therapists to submit their documentation. It’s no wonder they’re all so attractive and confident. They’ve probably never had to write or review an incident report after a long shift!

Meanwhile, while we are working, no one who observes us is moved to eat popcorn. When we solve problems, we don’t know if they are actually solved until the researcher (probably from Canada) with the statistical-analysis package says it worked. But that is only 15 years into the future, and even then the final report will say that “more research is needed.” It’s deeply unfair; Star Wars doesn’t have a meaningful control group… and I don’t even get to have a John Williams soundtrack! All I get is the occasional Survey Monkey request for a research project studying PTSD symptoms of professionals in our field. And worse, no one is studying the dirty little secret of our work: the most piquant symptoms of trauma often come not from vicariously reliving the worst moments of others’ lives, but from our interactions with state licensing audits.

Although I have known some professionals who might be deserving of an award for their ability to bring drama into the workplace, I have to conclude that my colleagues are people whom few know to thank for their efforts. My neighbors and family long ago learned to be very careful about asking me how things are going at work, as the answer might cause them to dissociate. As I have joked many times, describing our work to an outsider often “makes their face go straight to screen-saver.” Indeed, we often forget how much work goes into protecting the sensitivities of those around us. Thanks to our professional boundaries and ethics, there is no room for anything that sounds like “Rogue One” in our field.

We may give up some dreams going into the work of eliminating sexual abuse, but I would argue that our dream is better and in some ways already coming true. The ordinary heroes that work in our field can point to a track record of reduced violence across the time since the first Star Wars movie came out. We can’t always prove that it was our efforts, but we are definitely part of the trend.

I hope everyone has a wonderful Holiday Season… and then gets back to this excellent, meaningful work.

David S. Prescott, LICSW

Thursday, December 15, 2016

Child Sexual Abuse in organisations and institutions

Over recent years we have seen a growing recognition of the problem of child sexual abuse, both historically and non-recent, ranging from  sexual abuse by celebrities, institutional child sexual abuse and sexual abuse within the criminal justice system (i.e., the police & prison service); which have resulted in a series of Inquiries in to institutional child sexual abuse in England and Wales (Independent Inquiry into Child Sexual Abuse, the Office for the Children's Commissioner's report into CSA in the Family Environment), Scotland (Scottish Child Abuse Inquiry), Northern Ireland (Historical Institutional Abuse Inquiry) and Australia (Royal Commission into Institutional responses to Child Sexual Abuse. It is not surprising given what these inquires have suggested, especially the historical ones, that there may be more revelations to come, and indeed three weeks ago with had the revelation of historical Child Sexual Abuse at the heart of Football in the UK.

Continuing revelations, disclosures and conversations of cover up raise a host of questions about the reality of Child Sexual Abuse, the locations of the abuse and the reality of safeguarding in these places. Whether it be about institutions (i.e., Care Homes, etc.) or organizations (i.e., the Football Association [FA], BBC, etc.) there are a number of commonalities that need to be considered:

-          Safeguarding: All organizations should have safeguarding in place, those working with children and other vulnerable groups; but this must be more than documentation, it needs to be the lifeblood and within the culture of the organization. The issue is often not that there are not any safeguarding policies or procedures in place, but rather that they are not upheld or badly managed. With regard to the FA they indicate that safeguarding and policy conversations are harder to monitor, as well as uphold, at the amateur levels and we hear that policies are not always put into practice at grassroots level. This results in some institutional recognition of guilt, which is often after the fact, and a recognition that practice needs to change.


-          Prevention: Tied to ideas of safeguarding is the need for work to be done in organizations and institutions to prevent, as well as respond, to child sexual abuse. Quite often the discovery of child sexual abuse results in an institutional response, a change in policy, a criminal conviction and/or an inquiry; however, if we are thinking about prevention being part of the fabric or organizations and institutions then some of this best practice should already be happening. The prevention of Child Sexual Abuse is a growing field but it has clear benefits for organizations and institutions in terms of workforce, development, policy, and practice.


-          Communication: We know from years of research and practice that child sexual abuse thrives in cultures of isolation, where there is poor communication and little transparency. Perpetrators often convince victims that no-one will listen to them, victims are sometimes vulnerable and do not believe that they have anywhere to turn and society thinks that the state (police, social work, prison system and government) do not do enough and when they do engage it does not go far enough. Therefore, theoretically, this means that the more that we talk about child sexual abuse and neglect the more we become aware of it and are better able to navigate, prevent and respond to it. However, it’s not that simple as we do not talk about child sexual abuse consistently and when we do it can be in  pejorative terms that reinforces social norms (i.e., “offenders -  bad, mad or sick”; “victims -  vulnerable, at risk or at fault”; “the state not doing enough for victims and too much for perpetrators”; and “it’s not societies fault or responsibility”) and pushes the blame away, which we have seen not infrequently in the historical child sexual abuse scandals (“there is bad practice and poor safeguarding, but it’s really down to a few bad apples”). We need to think about how we discuss child sexual abuse in our homes, schools, institutions, organizations and society so that the narrative is evident and available there and people feel more free to talk.


-          Disclosure and discussion: The recent FA historical and non recent abuse allegations and disclosures are, as with the care home and institutional ones, particularly salient as they focus on boys and men. Research and practice has indicated that boys and men find it harder to disclose sexual abuse as it impacts their sense of masculinity and may indicate weakness in arenas, like football, were weakness is not tolerated. We need to work with young players to help them realize that disclosure is not a weakness and that they need to come forward and disclose abuse; there have been  recent campaigns around this, since the FA allegations came to light a few weeks ago including a helpline and two video campaigns one lead by Wayne Rooney and another by David Beckham. The FA’s quick response to the allegations and historically cases enforces the need to make itself an organization that puts preventing and responding to child sexual abuse at its core; similar to what the NFL has done around domestic violence and sexual assault. 


-          Vulnerability: The conversations that have started to emerge from historical institutional child sexual abuse discussions have highlighted the degree of vulnerability of the victims. This vulnerability can be deeply ingrained in them because of their social class, culture, mental health of mental capacity; but it can also be situational, as has been seen in the recent FA disclosures, were victims talked about wanting to progress, to succeed and to move on and getting close to (as well as pleasing) the coaches was a way of doing this. The vulnerability that children experience can make them a target, or at least more susceptible to child sexual abuse by individuals who recognize and want to use that vulnerability. This reiterates the need for confident, trained and responsive organizations and intuitions that are able to identify, prevent and respond to signs of child sexual abuse when they present themselves at the earliest opportunity.

Although, the focus of the conversation is currently centered on football it seems like it may be only a matter of time before this crosses into other sports, nationally and internationally. We as a society need to recognize that we have to be able to work to prevent child sexual abuse, as well as respond to it, in a proactive way that sufficiently safeguards children,  and opens up communication in a proactive fashion to discussions about how can all play a role in protecting children and in preventing abuse and exploitation. We could say that “child sexual abuse in football, just another example of a few bad apples slipping through the net” or we have the opportunity to be more proactive and recognize that child sexual abuse is a more endemic problem in all our communities and in many of our institutions and we have now have the opportunity to refocus our efforts on prevention and early intervention and on ensuring that the victims, survivors and those who have caused the harm get the help they need.

Kieran McCartan, PhD, & Jon Brown, MSc.

Friday, December 9, 2016

A milestone: Our 200th blog posting

Let me first say that I am extremely honored to be making this 200th post to the sajrt.blogspot.com site.

In the fall of 2010, I was approached by then-editor James Cantor of Sexual Abuse: A Journal of Research and Treatment. In tandem with Sage, the Association for the Treatment of Sexual Abusers was establishing a blog site and I was asked to be the inaugural blogger, as it were. I was all too happy to accept.

The original intent of the blog was to highlight and discuss findings in the published research – as a way to bring the science to the masses. However, it was not long before the perspectives reflected in posts transcended this initial focus. Indeed, sajrt.blogspot.com became a place where applied issues could be raised and, to some extent, debated. Although generally in response to or highlighting of research findings, the blog became less about hardcore research and more about what we should do about research, or where more research was necessary.

I received my initial training in this field as a researcher and, somewhat romantically, I still consider myself to be a researcher – even though the nature of my work has become progressively more applied as the years have gone by. As the nature of my work changed, so did the degree of attention I could pay to the blog, as well as the topics I thought I could responsibly handle. This led to the invitation of two associate bloggers: David Prescott – with his keen understanding of the application of research to practice, and Jon Brandt – who has consistently demonstrated a unique talent for highlighting the intersections between research, practice and, most importantly, policy.

With the addition of these two key contributors, the breadth of topics the blog could tackle increased considerably. Further, the periodic invitation of guest bloggers contributed to even greater breadth of perspective. During my tenure, I was privileged to contribute to or sponsor posts addressing controversies in diagnostics, best practices in working with juveniles who sexually offend, and hard-hitting examinations of social policy in sexual violence prevention. I believed that we were making real contributions to these important discussions. However, my professional practice continued to change – the unfortunate consequence being that I could no longer retain my role as the Chief Blogger. Enter Kieran McCartan...

I first met Dr. McCartan when he was a first time ATSA presenter at the Atlanta conference. Dressed in a light blue suit, sporting a heavy metal-esque beard, and speaking in a thick Irish brogue, he immediately impressed me with his discussions of the impact of media and public perceptions in sexual violence prevention. He was clearly the best candidate to succeed me as Chief Blogger. This was recently revalidated in his appointment to Associate Editor for Social Media for our parent journal SAJRT.

Over the past couple of years that Kieran has headed the blog, in collaboration with David and Jon, posts have been regular and consistently of high quality. Indeed, many of the most thoughtful and hard-hitting perspectives in our field have been reflected in sajrt.blogspot.com posts. I am proud to have gotten the ball rolling, but these three fellows have done a much better job than I ever could have in fulfilling the promise of this blog site.

And, it is on that note that I commend Kieran, David, and Jon on their continued high quality product. I am a strong believer in knowledge transfer and I am frequently reminded by my children that there are other ways to learn things than by reading books and journals. Even an old guy like me has had to concede that social media plays an increasingly important role in our quest for true sexual violence prevention.

Going forward, the challenges we face as a field are ensuring true adherence to evidence in establishing practice guidelines, getting further upstream in our prevention efforts, and inviting greater participation by ordinary citizens in the community safety endeavor. Here’s to another 200 posts!!

Dr. Robin J. Wilson, ABPP

Friday, December 2, 2016

Developing a Prevention Perspective: Discussing the work of Joan Tabachnick

Prior to 2009, many of us working in the field of sex offender research and treatment never considered our work as “prevention” work. In 2010 ATSA and the National Sexual Violence Resource Center joined together to present an award that recognizes people who have made significant contributions to preventing sexual violence through their work to facilitate effective partnerships between advocates working on behalf of victims and survivors and those working in the area of sex offender management and treatment. This prestigious award is in honor of Gail Burns-Smith who was a radical idealist, who believed we could have a world free of sexual violence. Gail co-founded the National Alliance to End Sexual Violence which focuses on public policy advocacy. The Alliance was instrumental in securing passage of the U.S. National Violence Against Women Act and the related funding of programs for services to victims of sexual assault and other violence. She was a founding Advisory Council member for the National Sexual Violence Resource Center from 1999-2004. While Gail has a storied passion demonstrated throughout her career, she always wanted others to continue her work, knowing that it would take all of us working together to fulfill her vision.

It is with great honor as a colleague, friend and champion in the challenge to prevent sexual violence that I introduce Joan Tabachnick as the 2016 Gail Burns Smith Award recipient in recognition of her outstanding leadership and tireless efforts in raising awareness about the necessity of preventing sexual violence, in promoting the dissemination of information about prevention strategies, and in helping every person to engage in prevention at whatever level possible.

At ATSA the term “prevention” has become synonymous with Joan Tabachnick. She is the first person who comes to mind when prevention is mentioned. She has championed all things prevention, not only highlighting for us the important contributions to prevention that we as clinicians and researchers make, but also broadening our perspectives to realize we can do more, that our work of preventing the next abusive sexual act should be expanded to stopping any sexual violence from ever occurring. She has provided us with a frame for the picture of our work that couches it in the broader perspective of prevention, encouraging us always to see that developing a prevention perspective and supporting and generating prevention programs will ultimately be the path to ending sexual violence altogether.

Joan possesses many personal and professional qualities that distinguish her and elevate her to a status comparable to Gail Burns Smith. She is warm, engaging, genuine, and passionate in everything that she does. Despite the long line of people waiting for the opportunity to engage her on multiple issues, Joan nonetheless, finds time for everyone, and when she sits face-to-face with each person she manages to communicate to each that this is the most important activity she could be doing at this moment.  She is truly supportive and helps all she encounters to hone their ideas, focus their communications, and fashion their presentations so that others will listen and hear.

Joan has served two terms on the ATSA Board of Directors and has chaired the Prevention Committee during her tenure on the Board.  It is largely because of her creative energy and tenacious efforts that this committee has been so productive. She has also been instrumental in helping ATSA develop a strategic plan, and she has mastered the ability to keep many people on track through the length of the plan. This is only a small part of the work she does.  She has worked tirelessly in the state of Massachusetts on numerous public policy issues, and as part of her work at NEARI Press she has helped us all to stay current on the best evidenced-based practices.

What is, however, most impressive about Joan is that the efforts of one person can truly make a substantial difference in addressing the need for prevention perspectives and programs. Joan has made many contributions to moving prevention into the public consciousness. In addition to all the work I  have just described, Joan has also co-authored A Reasoned Approach: Reshaping Sex Offender Policy To Prevent Child Sexual Abuse, (2011) and Engaging Bystanders In Sexual Violence Prevention, (2008, 2009).

Joan brings nearly 30 years of experience to her work in nonprofit and social change organizations. For the past 20 years she has worked in the field of sexual abuse prevention with a special focus on preventing the perpetration of child sexual abuse. Her most recent work is an NSVRC publication, Engaging Bystanders in Sexual Violence Prevention, and she is in the process of creating an online course of the same name. Joan’s expertise is evident in her numerous publications in peer reviewed journals, in her award winning public service announcements and public information materials, in the invitations to participate on national expert panels, and in the frequent media requests for expert advice on sexual coercion that she receives. Joan continually reaches across the aisles of victim advocacy and sex offender treatment, and between research and application. Most recently Joan was awarded a fellowship with the SMART office to develop a dialogue between treatment, supervision, and law enforcement orientations and to help frame the work of prevention that is at the core of all three. Because of Joan’s tireless work this fellowship has been extended.

Joan holds an MPPM from the Yale School of Organization and Management. Her unique background blends expertise in management, strategic planning, public dialogue, and social marketing. Over her career she has designed programs and products for children’s and women’s issues in local, regional, national and international settings. Gail Smith Burns would be proud of the work that Joan does, and I can think of no more deserving person for the Award named in her honor.
Becky Palmer, MS