Friday, June 1, 2018

Supporting Help-Seeking Behaviors: Help Wanted

By Ryan Shields, PhD ( and Julie Patrick (

How can we make help-seeking behaviors that prevent sexual harm the norm? The Moore Center for the Prevention of Child Sexual Abuse at Johns Hopkins University’s answer to this question is the Help Wanted project, an online prevention intervention to educate and support help seeking behaviors for adolescents with a sexual attraction to children who have not yet acted on their attraction.

This American Life

The impetus for Help Wanted came from an April 2014 interview by reporter Luke Malone with a young man named “Adam” who identified as a “non-offending pedophile” on his experience seeking help on NPR’s This American Life . The segment illuminated how the stigma of pedophilia and the fear of criminal consequences keep these adolescents from seeking help. The fear of being turned away by professionals, or difficulty in finding the right professional with appropriate expertise, leaves many to struggle alone with the collateral consequences of their attraction.

Malone also spoke with Dr. Elizabeth Letourneau at the Johns Hopkins Bloomberg School of Public Health. Given that approximately half of child sexual abuse cases in the US are committed by other youth, more must be done to address prevention with youth. Letourneau, Dr. Ryan Shields and colleagues conceptualized a prevention program to advance the healthy and safe development of adolescents attracted to younger children.

Phase 1: Help Wanted

The team conducted a qualitative study with young adults (aged 18-30) who identified as being sexually attracted to younger children on how they successfully managed their attractions when they were younger. Study participants commonly noted a sense of isolation and hopelessness during adolescence and wanting access to better information, treatment services, and role models.

The project team concluded that a prevention-focused intervention for youth recognizing an attraction to younger children was critically needed and must meet youth where they are – online. A web-based model helps reduce fear of requesting help in person and reduces difficulties with transportation, geographic dispersion, availability, cost, and stigma. To be sure, some youth will undoubtedly require more intensive services than can be provided via a web-based platform.

Of note, the Help Wanted intervention focuses on primary prevention of child sexual abuse and in this respect differs from Prevention Project Dunkelfeld (PPD) and related efforts to address youth sexually abusive behavior. As described in several publications, PPD provides an intensive treatment to men and, more recently, adolescents who are formally diagnosed with pedo- or hebephilia and who have acted on their attractions without being caught or who have not acted on their attractions but need assistance. The PPD intervention typically lasts one year and consists of a formal diagnostic assessment followed by weekly in-person group treatment sessions (Beier et al., 2015). Such an expensive and intensive intervention is incompatible with the diffusion of primary prevention interventions (Rohrbach, Grana, Sussman, & Valente, 2006). Moreover, as Letourneau and others have demonstrated, there are well-validated treatment interventions for youth who have engaged in sexually abusive behavior and been identified in formal systems (e.g., juvenile justice, mental health, child welfare) (Letourneau et al., 2013; Letourneau et al., 2009), but very few resources for youth who are sexually attracted to children but have not engaged in harmful behavior.

Phase 2: Support from Raliance

To build this online tool, the Moore Center sought additional funding from Raliance, a national partnership among leaders in the prevention of sexual harassment, misconduct, and abuse. With seed-funding from the National Football League, Raliance is dedicated to ending sexual violence in one generation and supports an impact grant program with a specific funding category to prevent primary perpetration.

A collaborative process ensued uplifting the expertise of consultants in the field to create 5 key foci for the online intervention tool. Such consultants include: Ms. Karen Baker, Pennsylvania Coalition Against Rape/National Sexual Violence Resource Center; Ms. Maia Christopher, Association for the Treatment of Sexual Abuse; Ms. Geraldine Crisci, Geraldine Crisi & Associates; Mr. Gerald Hover, INTERPOL Crimes Against Children; Dr. Jill Levenson, Barry University; Dr. Michael Miner, University of Minnesota Program in Human Sexuality; Dr. Daniel Rothman, Forensic Psychological Services; and Ms. Joan Tabachnick, DSM Consulting. Project consultants also include non-offending young adults with a sexual attraction to children.

This group prioritized five foci: 1) access to information about child sexual abuse and why it is harmful; 2) disclosure and safety skills; 3) practical advice for self-management and coping techniques; 4) building self-identity and developing positive narratives; and 5) skill building for healthy sexuality. The curriculum for these online modules is being created and tested by those with proven success using online therapeutic and mental health interventions.

Raising awareness about supporting help-seeking behaviour is also vital to the project. Dr. Letourneau’s December 2016 TEDMED talk: Child sexual abuse is preventable, not inevitable brought this information to a wider, mainstream audience. And Dr. Shields presented to sexual violence professionals at the 2017 National Sexual Assault Conference.

Advancing to Phase 3

No project is complete without piloting, revising and evaluation. More will be shared as those exciting developments unfold.

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