ATSA Annual Conference 2018

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

The annual ATSA conference took place from the 17^th – 20^th October in Vancouver. The conference was a real mix of research, practice and engagement with international colleagues from 16 different countries including the USA, Canada, UK,  Australia, New Zealand, Sweden, Germany, Hong Kong, Netherlands, Belgium and Israel to name a few. In this blog we are going to take you on a whistle stop tour of the event.

 

For Kieran, the highlight of the conference was Ruth Mann’s opening plenary in which she discussed the challenges of developing an evidence base. Ruth’s presentation focused on what the risk, consequences and impact of being evidence based are in the real world, and more specifically in a public arena; especially if the evidence base negates your current working practices. Ruth discussed the recent changes to sex offender treatment in the UK and the government evaluation which initiated these changes (i.e., it indicated that previous programs had no impact or made people slightly worse, rather than better); reflecting upon the personal, political and policy fallouts. Ruth discussed the content of the report, her reflections of the impact of the report on systems as well as institutions, and report’s consequences for the management/treatment of people who have committed sexual abuse.  In closing, she reminded us that if we are to be truly evidenced based we have to be open to all forms and outcomes of evidence, even the evidence that indicates that what we are doing may not be best practice or achieving what we want it to achieve. To Kieran, this set the tone of the conference as ATSA has always been about sharing good practice and reflecting upon problematic practice.  

 

The engagement event at the 2018 ATSA conference was based around bystander intervention and had colleagues from Simon Frasier University (Ashley Bentley) and community action groups (Katheren Szabo) talking about the work that they were doing to prevent sexual abuse. The fact that the speakers were coming from different parts of the community, used different approaches and engaged in different activities (from campus sit in’s, to poetry readings and gardening clubs) really indicated the range of activities and novel ways that we can engage different “communities” around sexual abuse prevention in ways that are meaningful to them. The engagement event this year was targeted at people involved in professions at the frontline of safeguarding and community participant (i.e., teachers, volunteers, community workers, etc) and this resulted in some interesting and practical debates.  

 

The international roundtable this year had a series of 8 minute talks from 9 different speakers, each from a different country, on public/media attitudes to sexual abuse in their country and how professionals are engaging in the debate. This was interesting as there were a lot of common themes across countries (i.e., “not in my backyard”, negative media stories and good/bad examples of professional and policy maker engagement) as well as some distinctive good practices in certain countries that we could all learn from internationally. The roundtable really cements ATSA as an international conference!

 

The entire conference was a high point of the year for David. Although pinpointing specific moments is next to impossible, three come immediately to mind:

 

First, I had the privilege of moderating a symposium with Tony Ward, Gwen Willis, and Roxie Heffernan. Tony and Roxie discussed many of their recent projects which involve looking at the processes underlying risk and protective factors. A down side to having so much research available to us regarding these factors is the temptation to reify them as discrete factors rather than viewing them as proxies for underlying processes which will be different for each person. Although on its own this is not a new idea, Ward and Heffernan have explored this in very great detail in their risk-causality method. For Tony and Roxie, this method provides a new level of explanatory depth to our knowledge of risk and protective factors. For Gwen and David, it provides rich areas of clinical understanding.

 

Second, Laurie Rose Kepros delivered a fascinating workshop describing the effects of experiences within the legal system on people convicted of sex crimes. Titled the process is the punishment, she explored how elements of these experiences can actually have a detrimental effect on engagement in rehabilitation efforts (e.g., engagement in treatment and with supervising agents). This is clearly a situation involving multiple perspectives. On one hand, the US Supreme Court has been clear that law enforcement officials can use deception as a part of the investigative process. On the other hand, this same deception can be devastating to others’ attempts to engage meaningfully with these people after their conviction, particularly when they view professionals as agents of the police power of the state. As one might imagine, the subsequent discussion was lively, with advocates of each perspective describing points for consideration.

 

Finally, Michael Seto delivered a moving speech as he accepted this year’s Lifetime Significant Achievement award. With his father and brother on stage, he described the important contributions of immigrants to the cultures who receive them. Originally from Hong Kong, Seto is a clear example of why this is so.

 

For Alissa, the Vancouver ATSA conference was among the best she has ever attended.

 

Along with Joan Tabachnick and Cordelia Anderson, Alissa co-led a pre-conference seminar titled Accountability and Responsibility in the Era of #MeToo. We quickly learned that this is an important issue that many clinicians are currently grappling with. The presenters lead participants in pseudo-restorative justice circles, which provided opportunities to experience the power of authentic human connection. By embracing and honoring a common humanity, clinicians and restorative justice practitioners can create safe spaces for those who have sexually violated others and those who have experienced sexual abuse to find common ground and healing.

 

Perhaps the best example of this was articulated by our Friday morning plenary speaker, Gerry Oleman, a First Nations man who has been involved in creating change for First Nations communities since the 1970s. Gerry spoke about the importance of connecting to language, to nature, and to each other. He spoke about the atrocities committed by colonizers, including the rape of First Nations people, the forced enrollment of indigenous children in residential schools, and the violent removal of indigenous people from their land onto reservations. Gerry spoke about the importance of healing, not allowing the pain, anger, and violence, stay on his heart. It was a lesson that everyone in attendance was privileged to hear.

 

One of the primary benefits of being an ATSA member and attending the annual conference is the opportunity to connect with friends, colleagues, and collaborators from around the world. This was true for Kieran, David, and Alissa who had the chance to present on a panel with Danielle Harris, Jill Levenson, and Gwenda Willis. On Friday afternoon, we presented a panel titled Are We Listening: Valuing All Individuals Impacted by Sexual Victimization.

 

We were each given ten minutes to present on one of the specific voices impacted by sexual victimization. None of us knew what to expect with this unique format, but the feedback we received from audience members reminded each of us about the passion inherent in our individual work that we then bring to the table when we work as a team. After all, we are all better together.

 

The primary take-away from these conference experiences for all three of us was the importance of working together towards common goals… “Better Together”, the conference theme, appropriately described it. In the end, we are all at our best when we can discuss the issues of the day, acknowledge differences, come together to establish new ideas and goals, and make them happen; next year it’s Atlanta, Georgia!!

Beyond Headline News: The Promise and Healing of Restorative Justice.

By Alissa Ackerman, PhD

On September 28, 2018, HBO’s Vice News Tonight aired a special on consent and accountability. The episode ended with a restorative justice (RJ) session that I facilitated. For the first time, a mainstream media outlet highlighted the power and depth of RJ in cases of sexual misconduct.

I have written elsewhere about the importance of RJ. During the heightened conversations around accountability in response to the Brock Turner case, Dr Jill Levenson and I co-authored several blogs on what a different conversation might look like, even appearing as guest bloggers for the Sexual Abuse blog. We have written about the importance of a change in discourse, where we no longer see those who have perpetrated sexual abuse and those who have experienced it as diametrically opposed and we have discussed the importance of actual accountability, a process that the criminal justice process seriously thwarts. Yet, in the years of engaging this work, I have not experienced the promise of a moment of reckoning such as this one.

The conversation around RJ and sexual misconduct is not new, but it has not been mainstream either. The Vice News episode on consent and accountability created an opportunity to shift popular discourse. Prior to this episode, few had even heard of the term restorative justice. One television anchor repeatedly referred to the process as reformative justice. Despite the lack of collective knowledge or understanding of what RJ promises, the responses I have received since the HBO episode aired almost two weeks ago have been both heart wrenching and full of hope.

I have heard from those who have experienced sexual abuse who want nothing more than to find closure and hope for the opportunity to sit face to face with the person who harmed them. I have heard from people – both those in my life and complete strangers – that the Vice News episode expanded their thinking about the ways they have behaved in the past. I have also heard from those who are now remembering experiences that were harmful.

For too long we have allowed our conversations around sexual abuse and misconduct to remain siloed. This includes many of us in the fields of sexual abuse treatment and prevention. There are professionals who advocate for those who have been sexually victimized and those who work with individuals who have sexually violated others. Even when we recognize that many of our clients fit both boxes, we tend to talk about “survivors” and “perpetrators” as mutually exclusive groups.

The fact of the matter is that all of us focus on the same end goals – healing and prevention.

The Vice News special featured two RJ participants, Alexis and James. I have been working closely with Alexis and James since January. Their progress, both as individuals and collectively, has been nothing short of amazing.  Both articulate how the process has helped them rediscover each other’s humanity. Alexis has seen a marked decrease in the PTSD symptoms she had lived with for the previous ten years. More healing has occurred in the last nine months than in the previous ten years, simply because the two were willing to connect in a vulnerable and authentic way.

Criminal justice processes can include RJ. In fact, most of the RJ work in which I have engaged has been with men and woman mandated to treatment after a sex offence conviction. The most life-changing and life-affirming moments have arisen from these RJ processes, but they leave me wondering what impact RJ could have at the beginning of the criminal justice process. How much harm, pain, and shame could be avoided if we engaged? How many people would take accountability for their actions, or at the very least consider the harm their behaviour may have caused if there were spaces for them to do so?

When I first began speaking about RJ and sex crimes, the very idea offended many people. Today, those same people have inquired about how they can be involved. The HBO Vice News episode finally shined a light on a process that can help heal individuals, communities, and perhaps our entire society. One cannot disentangle the timing of this episode and our current political climate. Indeed, Lara Bazelon published a piece in Slate about how we are in dire need of RJ in the wake of this most recent Supreme Court confirmation. We remain fully entrenched in an adversarial model that has proven repeatedly that it does not work.  Perhaps when we move away from such a model, healing can finally begin.

We are professionals in the field of prevention and treatment and we must be the first to step out of our silos.

Even Folks in Our Field Get the Blues: When Implementation of Best Practices Goes Wrong, Part 1

By David S. Prescott, LICSW

A participant in a training recently described frustration in adopting Motivational Interviewing in their practice.  This confirmed a concern I’d seen expressed in social media. As the discussion progressed, another participant expressed similar experiences. Although small in number, their concerns were important: There can be side effects when adjusting to the use of positive, collaborative, strengths-based approaches such as Motivational Interviewing (MI) and the Good Lives Model (GLM). How can this be? What can we do?

First, it’s important to examine the context. In many instances, the complaint centres on probation officers and other supervising agents who come away from trainings believing that they now need to behave like therapists. Others have complained that they have to pay attention to how they respond and use reflective listening rather than focus on efforts at rehabilitation. Still, others feel cornered into working in a fashion that is at odds with their personal style. One person lamented that clients are challenging their treatment before they even get started. The result, in the estimation of these professionals, is that clients can appear more hostile, often with a sense of entitlement. Where public safety and client care are on the line, these are important concerns.

What do we know? First, the jury has returned on many of the characteristics of effective treatment for people who have abused. Marshall (2005) summarized findings showing that the most effective therapists are those who are warm, empathic, rewarding, and directive. In practice, any one or two of those qualities can be easy, but balancing all four can be a challenge. Three years later, Parhar and her colleagues demonstrated in a meta-analysis that the more coercive the treatment experience for mandated clients, the less effective they are. There’s really no question that the often harsh and confrontational practices of yesteryear don’t work and can make matters worse. It is no wonder that Moyers and Miller (2013) argued that low levels of demonstrated empathy are toxic. Since that time, the use of MI (and its derivatives) with criminal justice populations has only become more widespread. Earlier this year, Blasko and Taxman (2018) found that clients who perceived their probation officer as fair and respectful had lower rates of violating their conditions and returned to prison less frequently.

Does that really mean that effective practices create more problematic clients? I don’t believe so, although it’s an important question. Here’s what I mean:

First, clients feeling free to challenge their treatment and treatment providers at the outset may actually be preferable in the long run to clients who give the surface impression that they are actively engaged but in fact participating minimally. As the old adage goes, “A man convinced against his will is of the same opinion still.” Although every case is different, there may even be real merit in challenging one’s circumstances prior to making peace with them and getting involved in meaningful change processes. This idea is central to self-determination theory, which holds that extrinsic motivation often precedes intrinsic motivation. In the long run, pushing back against extrinsic motivators as a pathway to awakening internal motivation can have real value in treatment.

Further, there are contextual challenges with our training approaches. All too often, trainees are “voluntold” to attend trainings and adopt the new practices (that strange experience of being volunteered by a supervisor to participate against one’s will). Not surprisingly, there is a strong parallel process between the practitioner who is ambivalent about adopting new treatment methods and the client who is ambivalent about change. As much as agencies focus on what they believe are best practices, it is easy to forget the importance of the change process for the professional. Further, the fact that some agencies prefer some evidence-based approaches over others speaks to the fact that we are often not as evidence-informed as we would like to think.

Then, there are other problems with implementing new approaches. Often overlooked, an entire body of research has examined how treatment implementation efforts succeed and fail. Bringing in the expert from out of the area to do training is easy; implementing with fidelity and minimal attrition and client drop-out is another matter entirely. Often, this can occur when professionals only learn the basics and are expected to jump into practice. For example, many MI trainees wonder how they will carry out parts of their job (sometimes known as “telling the hard truth”) without having learned the explicit methods for doing so (for example, the elicit-provide-elicit method of providing information and feedback).

Finally, all of these efforts rest on the foundation of a strong working alliance. The alliance is often mistaken for having a good relationship with a client, but in fact has been defined for decades as having an agreement on the goals and tasks of treatment, as well as agreement on the nature of the working relationship. More recent conceptualizations consider the strong personal values and beliefs of the client. In my experience, many programs who seek enthusiastically to develop expertise in a specific model or set of techniques can also be those that rate themselves as doing well enough with their alliances that this needn’t be an ongoing area of focus for them. This is despite the fact that simply ensuring a solid alliance is itself a highly evidence-informed practice.  

In the end, when clients become challenging despite the available collaborative approaches, it may be as simple as returning to basic discussions about what the client wants out of the experience in order to establish goals. After that, the practitioner can work on gaining clarity on the exact nature of who the practitioner and client are so that they can agree on the nature of the relationship. Next, the practitioner may want to ensure that his or her approach is a good fit for the client, and consider a person’s unique characteristics, culture, values, and beliefs.

All too often, the problems lie not in the methods or models, but in the ways, we attempt to implement them. This can be especially problematic when we attempt to use newer methods without first ensuring a solid working alliance.