Making the Case for Prevention

By Joan Tabachnick and Pamela Mejia

Prevention is like “Mom and Apple Pie.”  Everyone agrees that prevention is crucially important, everyone agrees we should support prevention, and there are a growing number of studies which show that prevention is the best investment our society can make – to stop sexual violence before anyone is harmed.  Yet even for professionals and advocates in our field, prevention is often an afterthought.  In the public domain, especially in the middle of the emotional reactions to yet one more horrifying case, one fact often gets lost: Sexual abuse is preventable.

How do we change that balance and integrate prevention into all of our work?  How do we convince the public and key stakeholders that prevention is important?

This fall Berkeley Media Studies Group (BMSG), in partnership with the National Sexual Violence Resource Center (NSVRC), and RALIANCE released two new research-informed guides, titled Where we’re going and where we’ve been: Making the case for preventing sexual violence and Moving toward prevention: A guide for reframing sexual violence that describes:  

1)      how we communicate about sexual harassment, sexual abuse and sexual assault,

2)      how audiences understand the problem and equally important,

3)      how to use that understanding to focus on prevention. 

This research began five years ago with a deep dive into analyzing current narratives about sexual violence and prevention through the lens of news coverage.  They then learned how experts and field leaders communicate and think about prevention through structured interviews and listening sessions around the country, including at ATSA board meetings and annual conferences.  Finally, with the help of Goodwin Simon Strategic Research, they conducted extensive public opinion research to identify which stories, values, data points, and storytellers could help illustrate for different audiences that preventing sexual abuse and assault is not only possible, but a concrete and important part of our public, community and family response.    

Sexual violence prevention is more than just education.  A comprehensive approach includes tertiary prevention, the core of what ATSA members do every day.  However, ATSA also has information that is key to primary prevention – but how do members communicate that crucial information?

These resources describe keyframes that ATSA members can use to create an effective prevention message – a message that helps the listener understand their complex emotional reactions and engage in the idea of primary prevention as a necessary solution.  In brief, an effective message about prevention should:

·         Evoke shared values with the audience

·         Acknowledge any of the audience’s negative feelings and lingering doubts

·         Describe the speaker’s journey (our own understanding) of how we began to understand prevention

·         Articulate the problem clearly

·         Name at least one concrete solution and illustrate success. 

These messages, and the guide’s “rule of the road” fit well to the recent ATSA Journal statement asking ATSA members to use person-first language and to take the time to describe the behaviors of our clients, rather than labeling them as “sex offenders”, the exact problematic behaviors we work to change. 

To learn more about each of these components – and the research that shaped the recommendations – please see Where We’re Going and Where We’ve Been and Moving Toward Prevention.

The list looks may look daunting  – but the ATSA Prevention Committee has already developed some of these key elements in our framing document on how ATSA members can talk about prevention (See ATSA’s Framing Document).  That frame evokes the shared values that guide our work – preventing sexual abuse to keep our communities safer.  The Prevention Committee’s infographics (See ATSA’s Infographic Documents) also articulate the problem and what ATSA can offer in terms of a solution.  ATSA has a unique perspective to offer about preventing the perpetuation of sexual violence – a critical element in preventing first-time harm.

BMSG also challenges each of us to articulate our own journey towards understanding the need for prevention.  If you are reading this blog posting, you care about prevention – can you also talk about why you care and can you tell someone how you got there?  What was the “turning point” where you started to believe prevention was possible, or when you decided to pursue this work? 

If you are moved by this work, as I am, take the time to explore these resources:  Visit BMSG’s website for more information on framing prevention, examples of how to apply these guidelines to specific types of systems-level change, and ideas about how to engage the media to talk about prevention.

With all of the passion that ATSA members bring to our work, our everyday conversations about what we do and WHY we do this work to make our communities safer it is essential that we do not do this alone but that we also involve our contacts, colleagues and peers.  Let them know that prevention is possible.

Joan Tabachnick is the co-chair of ATSA’s prevention committee

Pamela Mejia, Head of Research for the BMSG

It’s time to get over it: Risk goes down with time free in the community

 By David S. Prescott, LICSW, & Kieran McCartan, PhD

An extraordinary trend in recent criminological and psychological research, which has gone largely unnoticed in public discussions of policy and practice, is that a person’s risk of re-offence goes down the longer they are in the community. Given the very high stakes of public protection, risk management and human rights, it’s time these findings receive wider public discussion.

In 2010, Michael Caldwell published a meta-analysis of studies of juveniles in which he noted that “Studies that examine sexual recidivism during adolescence find monthly sexual recidivism rates that are more than 4 times higher than those found in studies that rely only on adult recidivism records. Neither the level of secured placement (community, residential, or secured custody) nor the use of arrest versus conviction as an outcome significantly influences sexual recidivism rates”. In other words, adolescents re-offend less as they enter adulthood, which reinforces the criminological research on general recidivism (by leading authors such as David Farrington and Terrie Moffitt) and desistence (for example, Fergus MacNeill, Shadd Maruna, and Beth Weaver).

In 2014, Karl Hanson, Andrew Harris, L. Maaike Helmus, and David Thornton published a study examining the re-offence rates of adults and found that “Overall, the risk of sexual recidivism was highest during the first few years after release, and decreased substantially the longer individuals remained sex offence-free in the community. This pattern was particularly strong for the high-risk sexual offender….Whereas the 5-year sexual recidivism rate for high-risk sex offenders was 22% from the time of release, this rate decreased to 4.2% for the offenders in the same static risk category who remained offence-free in the community for 10 years.”

Most recently, Rachel Kahn, Gina Ambroziak, Karl Hanson, and David Thornton examined 5-year re-offence rates, and – focusing on the lowest risk adults who had sexually abused -- they found that, “Within this lowest risk category, recidivism rates are equivalent to rates of spontaneous offending among non-offender populations… Adjusted to a common 5-year period, estimated recidivism rates ranged from 0.22 to 5.67% with a median rate of 0.90%. The lowest recidivism rates were observed for the studies that used incarceration as the outcome criteria.” Kahn and her colleagues also asked, “If we are to take the Risk Principle seriously, what level of sexual offender-specific treatment should be provided to individuals whose risk is so low that 98 out of 100 would not re-offend if we did nothing?”

Why is this so important? To start, many professionals working with people who have abused have worked under the assumption that people who abuse are unable or unwilling to change. Ideas such as “there is no cure for sex offending” were so pervasive as to be written into statute. Indeed, many laws and the findings of the US Supreme Court have been based on the faulty belief that re-offence rates are “frightening and high”. Despite international news coverage dispelling this misconception, little has changed. It is vital that evaluators and therapists alike are aware of the importance of time free in the community.

Taking together the findings from elsewhere in the literature, it seems that the most effective means for preventing sexual re-offence lie in active approaches, such as treatment and supervision based in principles of risk, need, and responsivity. Currently, our communities all too often rely on more passive approaches that restrict liberties, such as public registration, notification, and residency restrictions, but these approaches do not reduce risk.

Until our communities and policymakers recognize that the same “rules” and evidence are found across people who offend (and that people who offend sexually are not unique) based on studies now involving hundreds of thousands of criminal offenders, we will continue to funnel resources into policies found to be largely ineffective. Given that knowledge about what works to prevent crime is readily available to these policymakers, it is unconscionable that there has been little, if any, move towards empirically informed policy within our legislatures.

Just last week, we blogged about international perspectives on the management of people convicted of sex crimes and noted the number of countries that appear to follow the United States’ lead. It’s time to stop this trend and up our game with respect to informing the public about the many ways we can prevent abuse meaningfully. 

A special issue of the IATSO Journal: A brief overview

By David S. Prescott, LICSW

The journal Sexual Offender Treatment, now in its 13th year, recently released a special double issue on special issues in sex offender risk assessment and management. In doing so, it provides an overview of what is happening in areas around the world. The project is definitely worth a deep dive, with this post offered as a summary and invitation to further review of this issue. The journal is published by ATSA’s sister organization, the International Association for the Treatment of Sexual Offenders.

As co-blogger Kieran McCartan observed in the preface, “This special edition started as an international roundtable at the Annual ATSA (Association for the Treatment of Sexual Abusers) conference in Kansas City in 2017, which was organised by the ATSA international committee, which had representatives from 9 countries (UK, Belgium, USA, Canada, Netherlands, New Zealand, Sweden, Italy, & Germany).”  Contributors to this roundtable were asked to submit 4,000 words, with additional commentary provided by ATSA President Franca Cortoni and IATSO Secretary General Martin Rettenberger.

This double issue is too extensive to cover in detail but contains fascinating updates from around the world. Danielle Harris and Samara McPhedran open with an overview of trends in Australia, which include similar trends towards more punitive responses to those in the USA. For example, although there is a registry of persons convicted of sexual crimes, it is not publicly accessible. There are some (concerned parents, lawmakers, and a very vocal news commentator) who are pushing to change this and expand the reach and accessibility of the registry.

Meanwhile, in Belgium, Kasia Uzieblo and her colleagues contribute with a discussion on the need for consistent approaches to risk assessment, particularly in the wake of a high-profile, tragic case. As elsewhere, the public’s moral outrage is a challenging backdrop against which to build science-based policies and approaches. In Canada, Mark Olver and L. Maaike Helmus describe the implementation of risk assessment measures, including recent controversies regarding the use of this instrumentation with people of aboriginal descent. In contrast to these countries, Anita Schlank describes the differences between many of the individual states within the US, including differences in sentencing and residence restrictions. Other contributions include those by Carla Xella in Italy, Anette Birgersson in Sweden, Ting Ming Hwa and colleagues in Singapore, Wineke Smid in the Netherlands, and many others.

Understanding what is happening in other corners of the world can produce considerable dividends in understanding how our individual jurisdictions can be better. Further, learning about innovations elsewhere can be enormously helpful in our attempts to end sexual violence.

Application of the Good Lives Model in China

By David Prescott, LICSW, & Gwenda Willis, PhD

During the past week, we were invited to provide a four-day training on the Good Lives Model (GLM) to the Society of Rehabilitation and Crime Prevention (SRACP) in Hong Kong. As many readers will be aware, the GLM has come into widespread use around the world. Originally designed with a focus on people who have sexually abused, the GLM can be (and has been) modified for use with people who have committed a number of harmful behaviors.  Indeed, the SRACP works alongside people returning from prison for any type of offending.

In essence, the GLM holds that all human beings seek out certain experiences, goals, and states of being (Prescott, Willis, & Yates, 2015; Willis, Prescott, & Yates, 2013; Ward & Maruna, 2007). For example, virtually everyone wants to be good at something in his or her life. The GLM further holds that in many instances, these good life goals play a central role in problem behavior. For example, one’s drive towards independence and autonomy can contribute to harmful behaviors that are as diverse as partner violence and substance abuse. The same goes for good life goals such as being connected to others, finding peace of mind, and experiencing happiness and pleasure. Ultimately, the GLM separates itself from other forms of treatment for problem behaviors through its twin focus on building competencies as well as managing risks. It does this with an explicit focus on “approach goals”: those goals we set for ourselves that we can approach instead of simply avoiding.

Applying any model across cultures brings inherent challenges. Fortunately, SRACP had experience in this area. They have been active for many years in selecting empirically grounded methods and approaches that could be useful within their specific context. In recent years, they had worked to import methods for adhering to the principles of risk, need, and responsivity. As a group, the professionals involved (primarily from social work backgrounds) had studied in additional areas of psychotherapy, such as Eugene Gendlin’s Focusing.

The broadest discussion of cultural differences in the application of the GLM was in the area of two of the GLM’s overarching common life goals: Personal choice/independence (i.e. having a measure of independence and autonomy in one’s life) and relatedness (i.e. being connected to others). In the context of Asian societies with collectivistic orientations, differentiating these goals can be a challenge. For example, the simple question, “How are you doing” brings a different meaning in the Far East than it would in the western world. “How are you doing” implicitly means, “How are you doing, including in the context of your family and other loved ones?” When clarifying the elements of an individual’s desired future lifestyle, separating these components out for discussion can be a novel experience. Similarly, the GLM’s focus on an individual’s conception of a good life and their good life plan was integrally linked to that of their families.  Nevertheless, personal choice/independence was implicated in many of the case examples of crime that came up during the four days. The individuals that SRACP treats have often behaved in ways that bring them into conflict with their overarching goal of being connected to others (for example, by committing crimes that bring dishonor to them). Although finding the right balance of independence and connection to others can be difficult for anyone in the world, it provides particularly rich opportunities for clinical discussion in China.

SRACP has also grounded its implementation efforts in research. Implementation science has shown that these efforts can take very considerable time and effort. It is never as simple as bringing in outside experts and providing training. A major focus for us has been in building on the experience of others to find implementation strategies that involve and are meaningful to those working at the front lines. To this end, consultation and the development of materials for assessing progress in the SRACP’s specific context are ongoing.

References

Prescott, D.S., Willis, G.W., & Yates, P.M. (2015). Application of an integrated good lives approach to sexual offender treatment. In D.S. Prescott & R.J. Wilson (Eds.), Very different voices: Perspectives and case studies in treating sexual aggression (pp. 176-195). Holyoke, MA: NEARI Press.

Ward, T., & Maruna, S. (2007). Rehabilitation: Beyond the risk assessment paradigm. London: Routledge.

Willis, G.M., Prescott, D.S., &Yates, PM. (2013). The Good Lives Model (GLM) in theory and practice. Sexual Abuse ln Australia and New Zealand: An Interdisciplinary Journal, 5, 3-9.