Fidelity to the Model or Fidelity to the Client? Reflections on Treatment.

By David S. Prescott, LICSW

I have had the very great privilege this year of training in many locations around the world. Again and again, it seems that the people in our field want nothing more than to end abuse by helping those who have abused. As others have often said, many of the people who benefit from this work will not know to say thank you because the potential abuse won’t happen. Many of the contexts in which we provide treatment, however, seem to work against us; living up to our full potential as therapists can be a challenge. Why?

Even the most conservative studies find that people who abuse are often at greater risk to commit non-sexual crimes. Still, programs tend to focus exclusively on preventing further sexual crimes. While this is certainly understandable, the fact that individuals who enter treatment all have different risk profiles for various crimes, sexual or otherwise, argues against one-size-fits-all treatment regimens. Yet, this is exactly what is now happening in many jurisdictions. The more refined our assessment processes have become, it seems, the less assessment-driven our treatment programs actually are. 

Scripting was a focus of at least one workshop at this year’s ATSA conference in Kansas City, including a debate on the merits of highly scripted treatments. One manual in use is scripted down to the level of client affirmations during exercises. It is not hard to imagine how treatment participants’ experience is less one of talking with a therapist, but more about the curriculum itself. Such circumstances should lead us to wonder if it would be more honest to jettison terms like “treatment”, “facilitator”, or “therapist”, etc. and replace them with “class”, “instructor”, etc. 

Throughout 2017, I met with countless people who provide treatment based on various strict curricula, some more recently developed than others. The most common questions always centered in the same area: How do I use actual therapeutic processes with a manual that tells me what I am supposed to be doing in every session? How do I ensure a strong therapeutic alliance when the curriculum dictates what I am doing and outside stakeholders are clear that they want me to use this curriculum? How do I provide assessment-driven, individualized treatment within a framework like the Good Lives Model when my professional training has always been about following the curriculum? What if I use motivational approaches that help my client meet some goals but not others? How do I interview someone to identify their Self-Regulation Model Pathway? 

These questions come naturally in an age of empirically supported treatment protocols, in which methods such as Aggression Replacement Training can be rigidly prescriptive (although the curricula typically used in our field can’t claim to be empirically supported). Indeed, these are the right questions for clinicians to ask when considering how best to deepen their practice in individual and group therapies, specialized case management, community supervision, etc. Still, I come to the end of 2017 wondering whether clinicians haven’t surrendered our responsibility to clinical decision-making based on the needs of each client in favor of getting through the curricula that directors and outside stakeholders want us to use. Again we come back to the fundamental question asked by a conference presenter many years ago: Are we personalizing our manuals or manualizing our persons? 

Whatever one’s work environment, my hopes for 2018 include that each person providing bona fide treatment:

• Can work not just within whatever framework they use, but actively attend to the therapeutic processes that decades of research have shown to work (e.g., warmth, empathy, hope, agreement on the goals and tasks of treatment) (Marshall, 2005; Prescott, Maeschalck, & Miller, 2017).

• Privileges the client’s voice and gets feedback from their clients.

• Remembers that every conversation is most effective when it involves active attempts by the         professional to connect, explore the subject at hand, and offer ideas about the way forward.

• Keeps in mind that the most effective treatments are collaborative and marked by agreement on the nature of the relationship (i.e. do the client and therapist agree on what the therapist’s role is?) as well as a shared vision of the goals of treatment and the means by which they are accomplished.

• Works to study each client and delivers truly individualized treatment no matter which curriculum they use.

• Remains committed to the task and rigorous in implementing treatment and supervision.

• Maintains an active dialog with external agencies in order to provide the treatment that each client needs rather than simply what each stakeholder wants.

• Choreographs each session to be a dance between the momentary presentation of each client and what research shows will keep treatment in line with the principles of risk, need, and responsivity.

• Keeps that focused sparkle in their eyes when working with even the most difficult client.

In short, my greatest hope is that the people doing this work will keep the humanity in human services. It’s not just a personal value; it’s what is demonstrated to work by all of our extant research!

International conference on innovations in sexual abuse research & practice

By Kieran McCartan, PhD, & Danielle A. Harris, PhD.

A few weeks ago, Griffith University (Brisbane, Australia) hosted a two day research conference on innovative international approaches to understanding and responding to sexual offending. The symposium was a collaboration between the Griffith Criminology Institute and the Griffith Youth Forensic Service with the objective of bringing contemporary international debates [from the ATSA, NOTA and ANZATSA conferences] on sexual abuse to Brisbane. In this blog we discuss the main points of discussion and outcomes of the event.

The two day conference was held straight off the back of the 2017 ANZATSA meeting to capitalize on the fact that so many international speakers were in our neck of the woods. Several presenters made the trip from Auckland (New Zealand) to Brisbane (Australia) to share the knowledge of sexual abuse research and practice internationally, and to highlight and discuss new and best practices. The first day of the conference saw presentations from a host of international speakers from the USA (Jill Levenson; Alissa Ackerman), New Zealand (Gwenda Willis) and the UK (Andrea Darling; Carlene Firmin MBE; Kieran McCartan). The speakers addressed: the impact of Adverse Childhood Experiences; the importance and promise of Trauma Informed Care; understanding the life histories of people who sexually abuse; the importance of the labels that we attach to individuals; the interaction between the survivor voice and service user voice; the experience and potential of vicarious restorative justice; female perpetration of sexual abuse in institutional settings; and how we can develop a rounded case management approach to understanding the contextualized risk of sexual offending among peers.

All presenters emphasized the individual nature of sexual abuse and, therefore, why we need to take this into account in responding to, managing, and preventing sexual abuse in the broader community. The speakers called on all attendees to break down our professional barriers and break out of our silos so that we can work together more comprehensively. The feeling in the room was very much in line with the theme of ATSA’s forthcoming conference in 2018 #bettertogether!

The second day of the symposium was more a practical research roundtable. The roundtable was attended by the presenters from day one, plus an invited group of local researchers, clinicians, and stakeholders. After a quick round of introductions, we shared the common themes that had emerged from the international meetings in our field, with a focus on key debates and emerging trends. Most had attended some combination of ATSA, NOTA, ANZATSA, ANZSOC, ASC and/or BSC. We then broke out into thematic groups based on our previously identified research interests. Folks spent the afternoon with the opportunity and space to plan and discuss ongoing and nascent research questions; brainstorm possibilities for collaboration and data sharing; and agenda setting that prioritizes the most important issues in our field today.

Bringing this second day to fruition was a long-term goal of Danielle’s. She often found herself excited and overwhelmed at the end of a conference, but then lacked the time to have any detailed, follow up conversations. She says she would often spend the flight home furiously consolidating notes scribbled on cocktail napkins or business cards. So this was a chance for a meeting of the minds between established researchers, emerging scholars and PhD candidates, as well as practitioners and policy makers all in one room. The feedback was very positive and folks were grateful for the slower pace and opportunity to have longer and deeper conversations and, as one delegate called it, “thinking time.”

The two day event reinforced the need for us all to work together and to recognise that sexual abuse is an international issue. It was also interesting to observe that there are many more things that unite us than divide us – for example, as the US grapples with the “Weinstein effect,” and as those Hollywood revelations make ripples in international news, it was clear to see that each of our countries, cities, neighbourhoods, and fields of expertise have their own such examples. Indeed, we are all in this together. Perhaps most inspiring was the feeling that while attendees had come and were eager to learn about the approaches from abroad, each of our international guests was in turn inspired by the many inventive, innovative, and creative methods that we have developed down under. As the world gets smaller and better connected, and we acknowledge that we are more similar than different, it behoves us to explore how we can all learn from each other. This two day conference reminded us that much can be gleaned from the success of unique initiatives that have been able to flourish under legislative landscapes quite dissimilar to those in the US. Similarly, there is much to be gained by understanding how different approaches have been able to develop in communities with healthcare systems or social circumstances that are distinct from those experienced by our American cousins. 

As we move into 2018, watch this space for more information on ways we can engage in an international knowledge exchange with the goal of making society safer. 

Leper or Messiah?: Words do Matter

By Christopher Lobanov-Rostovsky

Leper or Messiah? The answer is neither.

So when we talk about the adults…mainly men…who are sexually exploiting the vulnerable young people around them, what is the right question? That is too often becoming lost in all of the current media coverage in the United States related to sexual exploitation. 

It is truly unbelievable for someone who has worked in this field for 30 years to see all that has happened in the last 30+ days. I have devoted my professional life to stopping sexual violence in all of its forms by counseling those who commit sexual offenses. I never truly thought I would see the day where society would be so openly having this discussion. So I have decided that it is time to add my voice and perspective to the growing public conversation.

The horror of sexual violence is as old as society itself. We refer to it as sexual abuse, exploitation, or harassment, and use labels like pedophile, predator, and victim. For those who don’t really want to face the issue, it can be easier to see it as all being the same. And yet in my 30 years of experience, I have seen how this issue is infinitely more complex. So what was the question again? Is senatorial candidate Roy Moore more like the father of the Messiah, as a supporter has described him, or a pedophile (sexual attraction to pre-pubescent children), as others have said? Neither is accurate.

So what is the truth? For the first time in history, a large number of people in this country, including the women reporting Roy Moore for sexual exploitation, feel empowered to come forward with their stories of sexual exploitation. The media is publicizing these stories which has the ability to facilitate change of individual behavior and the underlying culture.

Given this media coverage, the challenge to ALL of us is to learn how to talk about this. I would like to offer a few suggestions about how to have these very difficult conversations in a way that is respectful and hopefully engages all of us. In doing so, we must allow for the attention to ultimately remain focused on those with the courage to come forward and those they accuse:

1)      All of us who are reading these stories would benefit from an accurate reporting, understanding and discussion of these unfolding events. Use of emotional-laden terms like pedophile, which does not appear to be applicable in the Moore case, distract from understanding what occurred. Correct information will help us have this conversation in a constructive and productive fashion.    

 

Potential Media Reporting:

“Senatorial candidate Roy Moore has been accused by multiple women of engaging in sexually exploitive behavior. One of the women reported being the victim of what would constitute sexual assault as the behavior would be a crime if committed within the statute of limitations. The other women described the exploitation as consisting of dating them while they were still minors, but above the age of legal consent in Alabama, when candidate Moore was in his thirties. All of the women described trauma related to their experiences with candidate Moore.”

 

2)      When people come forward with their personal stories of sexual exploitation, we should offer them support and validate their experience. This does not mean we automatically accept at face value what they are saying as proof of a crime and convict the accused without proper due process. Trauma does not always express itself in a straight forward and direct manner. We need to initially support individuals who come forward to share their experiences without judgment.  

 

Potential Response to Those Who Choose to Share Their Sexual Exploitation Publicly:

“I support the strength and bravery of (person reporting sexual exploitation) for coming forward and sharing his/her story. I would encourage (accused name) to step away from his/her role as (fill in position) to seek assistance in addressing this allegation.”

 

3)      Finally, how should someone accused of sexual exploitation respond? We have seen many different responses over the past month (outright denial, inability to recall, justifying the behavior, taking responsibility for how the person reporting sexual exploitation may have misinterpreted the actions which were not meant to harm or offend, etc.). A short statement of accountability without trying to explain or excuse would best serve both the person accused of sexual exploitation, as well as the person making the allegation.

 

Potential Accused Response:

“I, (fill in name), take full accountability for my actions involving (name of person reporting sexual exploitation) and the harm this behavior has caused. I will be stepping away from my role as (fill in position) in order to address my behavior and what I can do to cause no further harm to (name of the person reporting sexual exploitation) or anyone similarly in the future.”    

 

While it is important for society to have this larger conversation about sexual exploitation, it is equally important that we allow space for the accused and the person reporting the sexual exploitation to address what happened. For the person making the allegation, this may include learning how to manage trauma and live with what happened. For the person accused of sexual exploitation, this may include an opportunity to be accountable for the behavior and receive treatment to better understand the behavior and prevent its recurrence. IF we are going to support healing and accountability, then we must do it in the right way. Leper or Messiah is too easy. It lets us all off the hook in terms of truly listening and hearing how to do our part before it happens to any other young people. So let’s have the conversation and learn from it. What do YOU say?   

ANZATSA Bi-Annual Conference 2017

By Kieran McCartan, PhD, David Prescott, LICSW, & Alissa Ackerman, PhD

The bi-annual ANZATSA conference took place from the 28^th November – 1^st December in Auckland, New Zealand. The conference was a real mix of practice and research emphasising the role of prevention, risk management, protective factors and an emphasis for an understanding of the needs of aboriginal/traditional communities in working with perpetrators of sexual harm. The conference was very international in nature with speakers and attendees coming from New Zealand, Australia, pacific islands, Singapore, USA, UK as well as The Netherlands.

The plenary sessions  focused on the need to reframe sexual harm as being more than just a criminal justice issue, with speakers emphasising the need for a public health  approach (Elizabeth Letourneau, Jill Levenson, Maia Christopher); how we reframe the socio-political debate (Maia Christopher); a need to think about the role of trauma and Adverse Childhood Experiences in the lives of perpetrators (Elizabeth Letourneau, Jill Levenson, Alissa Ackerman); how we need to build protective factors into the management and rehabilitation of perpetrators (Elizabeth Letourneau, Jill Levenson, Michiel de Vries Robbe); the need to listen to and re-evaluate our understanding of sexual harm in the context of traditional/aboriginal communities (Bryon Seiuli, Marlene Lauw, Pam Greer, Linda Waimarie Nikora) and the importance of how we listen to victims/survivors and incorporate their actual lived experiences into how we respond to sexual harm (Alissa Ackerman). The plenaries emphasised that we have reached a watershed moment in international and transitional conversations around sexual harm and that we need to reframe these issues more appropriately.

 

As we have said before, there are more things that unite our experiences in the field of sexual harm than divides us. We just need to open our eyes, ears, and hearts to learn and adapt from each other’s good (and bad) practice. One tone that remained present throughout the ANSATZA conference was that anyone and everyone with knowledge about sexual harm knows that current policies such as registration, notification, and residence restrictions aren’t working in the USA, arguing strongly that these should not be imported as is to other countries internationally.

 

ANZATSA 2017 kicked off with a public engagement event prior to the start of the conference, where the film “Untouchable” was screened. The documentary screening was followed by a panel discussion with Jill Levenson, Alissa Ackerman, Mark Hutton and Marlene Lauw. It was developed and lead by Gwenda Willis as well as her colleagues in the “Advancing Sexual Abuse Prevention”. The event was a great success with members of the public mixing with attendees at ANZATSA and really emphasising the importance of informed and constructive sexual harm policies; therefore, reinforcing and emphasising the main themes of the conference.

 

Many of the conference breakout sessions and workshops this year seemed to emphasis treatment, risk assessment and risk management.  The conference had presentations on the management of individuals who have committed sexual harm, registration and monitoring (Shephard; Hutton, Laws, Derby & Ross), female sexual abusers (Darling), understanding the sexual abuser as the service user (McCartan, Prescott & Harris), desistence (Harris), protective factors (Dickson & Willis), risk assessment (Helmus), adolescents who sexually harm (Lambie &Tolcher; Kelly, Shumack & Evans; Tolliday; Firmin; de Larcerda Mottin), perpetrators from aboriginal/traditional communities (Tofaeono; Jamisetty, Tamatea & Boer), and the role, as well as  impact, of pornography (Pratt & Hollis; Fernandes; Prescott) to name a few.

 

Additionally, several sessions focused on the needs of survivors of sexual violence, including the need for trauma informed approaches to working with clients. This was an exciting aspect of the conference, as presenters represented multiple countries, including New Zealand, Australia, South Africa, and the United States.

 

Of course, the conference location (New Zealand) ensured that there would be an emphasis on the assessment and treatment of indigenous people. One can read about this in books, but there is nothing like the actual dialog of a conference setting. Conference Co-Chair Armon Tamatea, for example, made a number of excellent points as he examined the process of risk assessment both inside and outside the cultural space of Maori life. These ranged from the use of diagnoses developed well outside of Maori culture to the pathologizing aspects for indigenous peoples of considering risk in isolation from protective factors and the cultural context of community and family.

 

The primary take-away from these experiences for all of us is the importance of redefining the field of sexual harm to being an inclusive, multidisciplinary arena that talks across the reality of sexual abuse and allows us to share good practice and learn from each other. What became apparent is that we all agree that we need to change the narrative as well as perception around sexual harm and that now, with all the issues being addressed in society, is the time to start doing this collectively. Of course, a truly multidisciplinary approach starts with each of us being able to collaborate with one another.  

 

 

 

 

 

Eroticizing Consent

By Cordelia Anderson, MA & Sara Mulholland, M.Ed, LPC

The response to #MeToo, ever growing reports of sexual harassment, and other harmful sexual behaviors, often includes responses that indicate the accused chose to see their behaviors as consensual and mutually desirable. Historic, cultural, and current mass media messages that perpetuate norms of male privilege and sexual conquest make it challenging for those who value equitable relationships and who crave mutual pleasure.  In a society that values a system of deflecting responsibility for one’s behaviors or the impact those behaviors have on others, it is challenging to hang on the basic meaning of consent.  As David Brooks wrote in his November 2, 2017 NYT opinion piece, “…in the public mind the line between unwanted sexual attention and force is growing indistinguishable.”

Consent is not a new term.  We hear this term all the time in medical settings and research.  Consent in these areas ensures participants are fully informed so they know what they are agreeing to.  Additionally, they are aware of any risks or possible effects and the right to say no.  A minor (under age 18) cannot consent to participation in these treatments or activities on his/her own.  An adult who is incapacitated or in an altered mental state cannot consent to participate in these events either.  However, too often such expectations are not considered for consent to sexual activities. 

Why isn’t clearly getting and giving consent always considered to be erotic? Perhaps consent is perceived as interrupting the flow of passion in the moment. Perhaps consent sounds too tame or heteronormative.  A less visible yet probable factor is the notions of sex and erotic being commandeered by the pornography industry.

In a pornified culture, yesterday’s porn is today’s mainstream media. The pornography industry has fueled the increase in hyper-sexualized mass media.  The ease of access to today’s Internet pornography further packages women as sexual commodities and objects to be used by male consumers.  Additionally, the porn industry portrays pain and degradation as sexy. In a pornified culture, women are said to be worthwhile only if they are sexy, and sexy is determined by how much degradation and pain they can “take” sexually.  Alternatively, men’s masculinity is questioned if  they are not consumers who, “get it,” “take whatever they want” and “get off.” 

Without some very creative writing, signing consent documents is not likely to be a turn-on. So, how do we make sexual consent erotic? How do we make it a contingency for further action?  Beyond basic education about consent, there needs to be a change of individual and societal mental filters.  Sex is often portrayed as a performance or a trophy, creating a filter in which only a scoreboard matters, rather than considering a human being.  Society needs to see the exploitive use of sex and pornified distortions for what they are, so society can see the frequency of this leading to people being harmed or causing harm. True, informed consent, is not present when one person has the power and control over another.  Arguments such as:

they knew what was coming

they did it before

they’re making good money

they didn’t say no

 they look like they liked it well enough

are cognitive distortions and justifications for persons to feel better about neglecting to care about another's pleasure (or lack thereof), pain, or humiliation. See it.  Change the filter.

Getting and giving consent for a sexual relationship can and should be rewarding in and of itself. The process can be sensual and hot.  Developing meaningful relationships that flourish takes time. It takes time to learn each other’s likes, wants, and needs.  Discovering what each person desires and establishing boundaries paves the way to a depth of intimacy that brings unparalleled satisfaction. Being able to ask, “is this okay” or “would you like me to do [fill in the blank]” and respecting his/her answers heightens arousal by diminishing anxiety, allowing both partners to enjoy each moment.

Lessons tend to be very gendered as to the meaning of consent. Men learn to see consent as an event – hearing yes or no at the time of the desired activity.  Women learn to view consent as an ongoing process, often on a more emotional and intimate level. (Beres & MacDonald, 2015).  This disconnect can lead to misperceptions on what has or has not been agreed to – especially when any power differential or social norm is involved.

Listening is a big part of effective communications. In fact, Scott and Graves note selective listening often contributes to sexual coercion.  In these cases, the one who manipulates or forces only hears what s/he wants to hear – something supporting the desire for a sexual encounter – and ignores anything negating the desired activity.  Sometimes these issues lead to the one who does the harm attempting to make the one harmed believe s/he did consent, when this was not the case.  This is just another example of someone using a power or privilege to harm another human being, then blaming those victimized instead of taking responsibility.

It would be much easier if no one ever wanted sex with anyone who didn’t fully agree to sex with them. However, when power over others is considered a turn on rather than honestly and fully being desired by the other person, the potential erotica of consent gets lost. According to the Merriam-Webster online site, the term “erotic” is among the top 20% of searched words.  This site gives the definition of erotic as simply “devoting to, or tending to arouse sexual love or desire” or “strongly marked or affected by sexual desire.” (2017).  

Having a meaningful connection with another human being fills the most basic desires of the human heart: being included, affirmed, chosen, blessed, safe, heard/understood, and touched. (Laaser & Laaser, 2008).  When seeking erotic consent in your relationships, consider the following acronym: Caring and compassionate connection, Overtly attending to each other’s needs and desires, Never negating each other’s limits, Sensual/mutually satisfying and sexy, Effort – putting in the work to make sure all is well and enjoying the moment, Nibbling away at uncertainty, Timely communication.

When these are present, the relationship is richly erotic.

References

Anderson, C. (2017). The Impact of Pornography on Children, Youth, and Culture. Holyoke,       MA: NEARI Press.

Beres, Melanie & MacDonald, Jo. (2015). Talking about sexual consent: Heterosexual women     and BDSM. Australian Feminist Studies (30)86; 418-432.

Brooks, D. (2017, November 2). Lovers, Prospectors and Predators. New York Times. Retrieved November 15, 2017, from https://www.nytimes.com/2017/11/02/opinion/sexual-harassment-predators.html

Erotic. 2017. In Merriam-Webster.com. Retrieved 12 November 2017 from           https://www.merriam-webster.com/dictionary/erotic.

Laaser, Mark & Laaser, Debra. (2008). The Seven Desires of Every Heart. Grand Rapis, MI:        Zondervan.

Scott, Katie & Graves, Clint. (2017). Sexual violence, consent, and contradictions: A call for communication scholars to impact sexual violence prevention. Pursuit: The Journal of Undergraduate Research at the University of Tennessee. (8)1; 159-174.

The Importance of “User Voices”

By Alissa Ackerman, PhD, David Prescott, LICSW, & Kieran McCartan, PhD

In the tech world, product testing is a must. To make sure a product provides a great experience for potential users and clients, it is essential that the product be tested throughout various stages of development. A company that releases a product that does not reflect customer needs will lose those customers. Likewise, restaurants that don’t solicit feedback from diners won’t stay in business long.

You may be wondering what this has to do with the Sexual Abuse blog; a lot actually! As we reconceptualize sexual harm/abuse from being a criminal justice issue to a joint public health/health/criminal justice issue, the idea of the service user becomes essential. You would never be able to do health research or development with only the practitioners, stakeholders and any research with service users being process, not outcome, driven; which is what we do in the sexual abuse/harm field. We need to understand the service user (both those who have been sexually harmed and those who have caused sexual harm) and make them part of the research process in order to develop a fully rounded service. At the 2017 ATSA Conference in Kansas City, Missouri, we heard from keynote speaker Patty Wetterling about the original impetus for the Jacob Wetterling Act and other modern sex crimes policies. Most readers would agree with Patty that these laws were created with the best of intentions. However, research has shown that the outcomes of current SORN are not the panacea we imagined them to be. We know this, as do most people who perform even a cursory Google search. More than anyone, individuals on the registry know it.

Individuals on public registries, their family members, and those who have experienced sexual victimization have an important role as “users”.  There has been some research that has incorporated the live experiences of individuals and their family members who are impacted by SORN (see Lisa Sample’s work). Most of this work has illuminated the difficulties inherent in community reintegration, as well as finding and maintaining stable employment, housing, and prosocial relationships; which is why outside of the USA any countries that have registers do not publically notify communities. The reality of the register is about “bait and switch”, it is about focusing on known offenders, who are less likely to reoffend, rather than helping victims or supporting prevention.   Conversely, there has been only one published study to date addressing the impact of SORN on those who have been sexually harmed (Bandy, 2015). This study found that individuals who have experienced sexual victimization see little reflection of themselves or their experiences in policies that were created with specific types of victims – namely children who were sexually violated and murdered by strangers – in mind. This has made it difficult for individuals who have experienced sexual trauma to seek help and support because their experiences were not like the cases memorialized in law. In addition, the white elephant in the sexual harm room is the fact that perpetrators can, not all we may add, experience Adverse Childhood Experiences (including, physical abuse, neglect, sexual abuse, etc.) which may contribute to their perpetration of abuse later in life; which means that victims get penalized twice.

User voices are integral to public policy, but sex crimes policy has negated, and in many ways silenced the voices of those most in need of a voice – namely individuals who have been impacted by sexual harm. Autoethnography is a qualitative methodology whereby the researcher uses the self as the research subject.  As a research method, scholars use their individual experiences to understand a particular phenomenon.  In the academic realm, autoethnography has been utilized by historically marginalized people: people of color, gender non-conforming people, and others whose individual voices have been silenced. This method allows for the experiences of marginalized and otherwise silenced constituents to use their experiences and voices as the subject of analytic research. Perhaps one paradigm best known for autoethnographic work is convict criminology, where individuals who are incarcerated or formerly incarcerated use their experiences to further our understanding of the field.

The authors have worked in the areas related to the service-user’s voice. Kieran and David will be joining Danielle Harris to present data in this area at the ANZATSA conference in Auckland next week. David has published extensively in and outside of ATSA on the importance of routinely soliciting the feedback of those participating in treatment programs. At the 2017 ATSA conference, Alissa co-presented a collaborative autoethnography. In the paper, Alissa and her co-author Alexa Sardina discuss the analysis of their lived experiences as survivors of sexual violence and their independent paths to becoming sex crimes researchers. Although autoethnographic work may be criticized for a lack of objectivity, generalizability, and validity it reminds us that we are personally connected to our research. Alissa and Alexa conclude that despite being trained to be objective and unbiased, their personal experiences absolutely impact their understanding of sexual violence and sex crimes policy. Further, they articulate the importance of honoring both the professional expertise and the personal experience they bring to the table. The merging of both voices offers access to people who might otherwise dismiss either of us as “just a survivor” or an “out of touch academic”. 

This is particularly timely given much of the recent discourse on prominent figures being publicly accused of sexual transgressions. Last week we published a blog piece on the importance of honoring authentic apologies. The piece garnered landmark readership with some applauding our stance and others (via social media and in trainings) articulating the need to “take sides”. As someone who is a survivor of sexual violence, who has an established career as a sex crimes researcher, and a person who works directly with individuals who have sexually offended, Alissa argues that there are no “sides”. David and Kieran have said as much in writings and trainings. Indeed, those who perpetrate sexual violence themselves have higher rates of sexual victimization and other adverse experiences in their backgrounds.

The prevention of sexual abuse requires a multi-faceted approach that encompasses victim advocates, treatment providers, researchers, individuals who have sexually harmed, and individuals who have been sexually harmed. Prevention takes a village. To privilege one group of voices over others silences groups that could have important insight. People who use autoethnography must ask themselves whether their story is useful and how might others use their story in a useful way. Alissa believes that her experiences are useful for the field – David and Kieran agree that telling of these experiences is crucial to healing at all levels of society.

At the front lines of treatment and policy, it is clear that including the service-user’s voice can improve services, identify methods that aren’t working, and produce ideas for innovation. However, we need to be brave in engaging the service user voice as it may be seen as inappropriate, useful, biased and divisive by some groups (including, policy makers). Businesses in the tech world and restaurant industry know that once you respond to a customer’s feedback, you very often have a customer for life. It’s time for deeper listening to all who are involved these services. 

The promise and importance of apology: The need for apologies to be heard and not dismissed.

By Alissa Ackerman, PhD, David Prescott, LICSW, & Kieran McCartan, PhD

Will an authentic apology ever be enough? This is a question we asked ourselves this week in the wake of Louis C.K.’s apology to the women he masturbated in front of. Last Friday, the comedian responded to a report in the New York Times where five women told their stories about his behavior with a written apology which can be read in full here.

In his statement, he acknowledged that what he did was wrong. More importantly, he explained that he justified his behavior because he did not fully understand that his behavior was a real predicament for these five women. He did not fully recognize the power differential he maintained. With this statement he is accepting responsibility for his actions.

Several outlets have published pieces chastising the apology. One in particular that has made rounds on social media can be read here. The piece admonishes Louis C.K. by rewriting the apology to make it, as they say, a real apology. It is true that he does not actually use the words “I am sorry”, but we argue that his admission and acknowledgement is a step toward healing, reconciliation, and transformation. Indeed, people who have experienced sexual abuse are frequently highly sensitive to the language of apologies and can spot insincerity quickly. While the critiques of C.K.’s apology raise important points (and the apology doubtless went through several rounds of editing), apology is still an interpersonal process that cannot be meaningfully dictated by outsiders.

Most individuals who experience sexual victimization and/or harassment agree that an apology – an acknowledgement that what happened to them was wrong - is an important step in the healing process. These individuals rarely receive an apology. Perhaps one reason that apologies are hard to come by is that when they are given they are perceived as inauthentic or not good enough. At the same time, sensitivity is required; an apology should never be written in a way that compels the person harmed to accept it or forgive before they are ready.

The Louis C.K. apology offers a teachable moment for anyone who has ever committed a harmful sexual act. It shows that it can be done and it can be powerful. It takes courage to own up to harmful behavior, but doing so offers a space for authentic connection. It is unfortunate that what appears to be a meaningful apology is met with judgement and admonishment – the very things that lead to disconnection. Professionals working with people who have abused often observe that these individuals often have intense trouble expressing their thoughts as eloquently as they and others would like. Sometimes this is due to intellectual and other learning disabilities. At other times it can be due to shame and self-hatred as a result of their actions. In the end, it is the dialog that is the most important.

In previous posts (link them here) we have written about restorative justice and how it might be beneficial in cases involving sexual harm. Restorative justice (RJ) is a framework that focuses on repairing the harm that was caused. The most typical RJ practice, victim-offender mediation, puts the person who caused harm and the person who was harmed in the same room. This can be daunting for survivors of sexual violence, which has made RJ inaccessible in most cases of sexual harm.

Professionals have not made their minds up as to whether RJ is useful in cases of sexual violence, as many believe it can cause secondary trauma for the survivor or allows the individual who offended to relive and “enjoy” the abusive incident(s). Acknowledging that, it is important to remember that in most cases both the individual who caused harm and the one who was harmed will come into contact with each other at some point in the future, as over 80% of sexual abuse cases involve people known to one another. When RJ is used in cases of sexual violence, (i.e. in CoSAs) an apology – usually written and passed via a third party – can be seen as lacking legitimacy. We end up with a challenging paradox of wanting heartfelt and freely given apologies, but do not fully engage in processes that enable this to happen.

If done correctly, one positive outcome of RJ type sessions is the insight gained by the individual who causes harm. RJ can help people understand the impacts of their actions and their offending behavior. It can also help survivors gain an understanding of why they were victimized. For RJ to begin to be effective, the individual who caused harm must admit to their offense(s) and must offer an apology.

It is easy to point fingers at celebrities about which we know little. It is easy to unleash our collective rage at these public figures. However, this outrage does not and will not end sexual violence because most people who act in sexually inappropriate ways do not fully understand that their behavior is harmful.

Louis C.K. is a prime example of this. He justified his behavior and believed that it was acceptable because he asked the women before he masturbated in front of him. He did not understand the impact of his behavior until much later. This in no way excuses his actions, but it provides a framework for understanding the mindsets of many people who act in sexually inappropriate ways.

Each of us has been affected by sexual abuse in one way or another. One of the authors, Alissa, is a survivor of sexual violence and participates in restorative justice type sessions with men in community based treatment for sex crimes. To date she has shared her story with close to 200 men, answering their questions about the impacts of sexual victimization and asking them questions about their offenses. She writes: “What I have learned in this work is that approaching individuals with authentic curiosity and non-judgement allows for connection and understanding that would not occur if I showed up with anger… I’ve learned that many of these men have very little understanding of how their actions have impacted the lives of the individuals they’ve harmed. The behavior itself and the harm it causes becomes abstract until a survivor is sitting in front of them outlining in detail how sexual trauma has changed her life. Then they get it.”

Perhaps one way for powerful people to better understand the impacts of the harm they cause when the engage in sexual harassment, sexual assault, or rape is for them to stop talking and start listening. Louis C.K. ends his statement by saying, “I will now step back and take a long time to listen.”

If he, and others in shoes like his, are willing to listen, maybe it is time for us to speak in open, honest, authentic conversations. Instead of pointing fingers, reacting in anger, judging with disgust, we should embrace dialogue and honor that just because someone should have known that their behavior was wrong and harmful, doesn’t mean they actually knew it. Perhaps that starts with an apology and the willingness to listen.

Conflation & misunderstanding: The problem of using language inappropriately

By Kieran McCartan, PhD, David Prescott, LICSW, & Alissa Ackerman, PhD

All too often, media and societal discussions about sexual abuse and harassment focus exclusively on the offence in general and often graphic terms and the related definitions linked to that offence, rather than taking a broader yet nonetheless realistic view of the individual (which is what comprehensive risk formulation, treatment, and community management focus on). Labelling people by offence makes for accessible media coverage, but is problematic in terms of understanding those who cause harm. After all, developing an understanding of the mechanisms of abuse is vital to prevention, rehabilitation, and reintegration (and something that we have discussed before on the blog).

As such, there has been a growing movement around the use of person-first language in describing people who commit sexual harm. That is, rather than stopping at terms such as “sex offender”, many of us have said for years that we should be referring to those who have sexually abused as exactly that: people who have sexually abused. In other words, by labelling behaviour and not people, society can better understand and prevent abuse and harassment. The accurate use of language matters; terminology used inappropriately or out of context it can be damaging, not only in terms of how we work with individuals who have committed sexual harm but also in terms of how we as a society and as individuals come to terms with the many issues involved.   

There are a multitude of ways to describe sexual abuse and harassment; this can be highly problematic. A recent example of this is actor Kevin Spacey’s statement about his sexual advances towards a 14-year-old when Spacey was 24. These actions involved a ten-year age gap and crossing the age of sexual consent barrier, as well as a host of social norms/conventions. Spacey, in discussing the case, referred to himself as being gay in an apparent attempt to draw attention away from the illegal nature of his behaviour, but it conflated the issue. His statement reinforced the mistaken idea that paedophilia is linked to homosexuality, which is not the case on two fronts.

First, paedophilia is not meaningfully linked to homosexuality any more than it is to heterosexuality. An attraction to one gender or another doesn’t define a person as paedophilic (which involves a sexual attraction to children). Second, being sexually attracted to a 14-year-old does not make someone paedophilic, as that term describes someone who is sexually attracted to pre-pubescent children. A person with a sexual interest in pubescent or post-pubescent children generally is often referred to as hebephilic, although the exact definitions are controversial and the subject of considerable scholarly debate. While it might be argued that this is a case of semantics, it’s not! Finally, it is extremely important to note that the act of having sex with someone too young to provide legal consent is itself not the same thing as an entrenched sexual interest in children or pubescent individuals. Behavior is not necessarily the same as a true pattern of sexual interest and arousal.

As more complaints and issues arise, we will start to see that Kevin Spacey (like Jimmy Saville and others) does not exhibit the traits necessary for a diagnosis of hebephilia or paedophilia. Rather his actions may be related to other motivations. In other words, his motivation may well be the act and not the type of victim. At a societal level, we have started to discuss the issue from the wrong perspective. It has never been more important to separate fact from fiction, and science from the apparent science fiction that makes up too much of public discourse.

We need to report and discuss sexual abuse, harassment, and victimisation using the correct terminology so that individuals who commit sexual harm and those who experience it get the necessary response that helps them; mislabelling can cause negative personal and social responses. The reality is that individuals who sexually offend have differing aetiologies. They need different degrees of support in treatment, have different types of cognitive distortions/barriers, need different interventions and face different challenges reintegration (i.e. accommodation, employment, etc); therefore, it is essential that we all understand what we are talking about, use the same language and consider the individual as the defining factor, not their offence.