Wednesday, December 18, 2019

Race, Bias, and Risk Assessment

By David S. Prescott, LICSW, & Kieran McCartan, Ph.D.

Note: We are grateful to Tyffani Dent for her contributions to the discussions that led to this post.

On August 1, 2014, in a speech about risk assessment processes, then–United States Attorney General Eric Holder said of the available measures:

Although these measures were crafted with the best of intentions, I am concerned that they may inadvertently undermine our efforts to ensure individualized and equal justice.  By basing sentencing decisions on static factors and immutable characteristics – like the defendant’s education level, socioeconomic background, or neighborhood – they may exacerbate unwarranted and unjust disparities that are already far too common in our criminal justice system and in our society.

His points were well-taken and yet not without considerable push back. The most common response at the time was that the existing tools certainly outperformed the unstructured judgment that in turn was wildly susceptible to bias. This point, too, was a good one. Earlier this Autumn, Jennifer Skeem, associate dean of research and associate professor of social welfare and public policy at the University of California, Berkeley, stated in a major address to the National Forum on Criminal Justice that extensive review of post-conviction risk assessments of federal convicts found “no evidence of predictive bias by race.”

Perhaps that’s one of the issues we need to address first; many aspects of racism take place beyond the awareness of those who work within the structures where racism is found.

As outside observers who have tried to watch developments in risk assessment closely, there is no question that the right risk assessment methods can be useful, but we question whether there isn’t evidence of inherent bias available right in plain view. For example:

-  It’s well-established that people of color are more likely to be arrested, often as a result of over-policing. They are incarcerated at a rate of more than five times that of white people. 

-  It’s also established that people of color are less likely to be referred to diversion programs, and can be subject to bias even within that referral process. All of these points can result in higher scores on risk assessment instruments compared with whites, especially against a backdrop of true crime rates remaining unknown. 

-  Likewise, racial disparities can be found in the bail system. This fact often goes missing in broader discussions of racial disparities in the legal system.

-  Obviously, not all risk assessment methods are created equally; many rely on items that lend themselves, more and less, to racial bias. Items related to family (for example, past family incarceration) and community stability scored outside of an understanding of their context may not accurately reflect a person’s propensity to commit crime.

In some circumstances, further questions arise as to whether many instruments aren’t more effective at predicting who will be arrested than predicting who will commit crimes.

People of color tend to experience intersectionality more than white counterparts, which means that their different socio-political and individuals labels put them at risk of being a victim of crime and of, potentially, being someone who could commit a crime. In addition, people of colour, sometimes because of factors crystalized through intersectionality, are more likely to experience trauma as well as adverse experiences; which matters in how we work with and respond to them. This means that there is an opportunity for better primary, secondary, tertiary & quaternary prevention (see previous blog). However, because of the socio-political aspects of race, vulnerability, trauma, economics, and access to social care in America (and worryingly so in the UK as well) issues related to intersectionality, race and crime never gets truly understood or dealt with.  A clear example of this is a recent report that indicates that UN peacekeepers from multiple countries, of multiple races committed systematic sexual abuse while in Haiti. Experiences of sexual abuse, whether through victimisation or perpetration, does not have a race determinate; but race does play a significant role, though intersectionality and socio-economic-political factors, in the way that we define, prevent and respond to sexual abuse.

Of course, we are not the first, by far, to address this and related topics. We do, however, believe that professionals can become more effective by studying the myriad issues involved that this blog post is only barely able to touch upon. Despite the excellent advances made by our risk assessment instruments, very serious challenges remain.  

Monday, December 16, 2019

A Statement from the Association for the Treatment of Sexual Abusers

As an organization, our mission is to prevent sexual abuse. We believe every individual has the right to live free from sexual victimization. We believe that people who commit sexual abuse should be held accountable for their actions and supported in their rehabilitation, while supporting the victims of sexual abuse.

ATSA promotes evidence-based treatment and guidance for individuals at risk of committing abuse and for those who have abused others. Our ethical standards demand high ethical behavior and professional integrity among our members, without exception.

We know that individuals who sexually abuse others cross educational, socioeconomic, gender, and ethnic lines, and are frequently respected members of families and communities. 

On December 9th, ATSA learned that Dr. Kurt Bumby had been charged with sexual abuse. He has been a respected member of ATSA, and a past leader in the organization and in the broader sexual abuse research and treatment community. Once we learned of the charges, the Executive Board immediately suspended Dr. Bumby’s membership pending the outcome of the case.

These allegations have shocked and saddened all of us at ATSA. Like any community, we are dealing with the emotional and practical impacts of this situation. We are experiencing the ripple effects of allegations of abuse and how it impacts everyone involved in these situations. 

Our mission to end sexual abuse will continue. And, as always, we encourage you to be part of this effort.

Friday, December 13, 2019

Shining a light on sexual violence helps prevent it

 A statement from the Association for the Treatment of Sexual Abusers

One of the most effective ways to prevent sexual harassment and violence is to shine a light on it.

When organizations are transparent about incidents of sexual abuse, they help everyone understand the factors that can lead to sexual abuse and how to develop systems and processes to prevent that abuse.

Uber’s recent release of sexual abuse data is an example of that. The level of transparency Uber has displayed is a credit to their commitment to end sexual harassment and assault. By providing this information, they are taking a step toward preventing future victimization.

We already know some of the factors that can encourage perpetration – isolated working conditions, significant power and pay disparities, hierarchical organizations that discourage reporting or lack independent investigatory channels, and male-dominated fields. The data from Uber may enable us to shine more light on these and other factors that contribute to sexual assault in the workplace.

Preventing sexual assault and future victimization will make a significant difference in many people’s lives. The human harm caused by sexual abuse that goes unaddressed by employers is significant. It can derail careers, create a ripple effect of financial difficulties, cause mental and physical health problems, and result in long-term traumatic impacts on the person who was abused.

Businesses that work to prevent and address sexual abuse not only save these human costs, they also save money.

Data from FY2017 found that workplace sexual harassment and assault settlements negotiated by the EEOC cost U.S. companies $46.3 million that year. Because the EEOC is involved in only a small percentage of such cases, actual total litigation costs in the United States are much higher. Studies also show that businesses pay anywhere per case from $75,000 for out-of-court settlements to $200,000 and up for jury settlements. Companies also lose money through reduced staff productivity; higher employee turnover; increased insurance costs; and, occasionally, boycotts. And these economic costs are not limited to the United States. They are a worldwide issue.

By being open about the sexual abuse their drivers and passengers have experienced, Uber is giving us the information we need to help prevent these types of assaults. This is an excellent example of social and corporate responsibility that others would be wise to follow.

For more information about the factors that can lead to sexual abuse and how to prevent abuse, visit

For additional details about the costs of abuse, see the following sources:

Friday, December 6, 2019

Stop it Now! Scotland: going upstream to prevent Child Sexual Abuse

By Stop it Now Scotland!

Stop It Now! Scotland is a small team based in Edinburgh who works with adults and adolescents who have sexually abused children, viewed child sexual exploitation material or who are worried about their sexual thoughts and feelings towards children. This week we have launched an online resource that distils what we have learned from those who offend or at risk of offending, providing information for communities in Scotland and the professionals who serve them about the practical things we can all do to prevent child sexual abuse in the first place.

The aim of the resource is to help adults who are protective to become more effective in their efforts to prevent sexual abuse, and to help those who present a risk of harm to children to make safer choices.

Upstream was funded by the Scottish government and based on a CD-ROM (remember them!) we developed in 2011 to help build the capacity of individuals and communities to prevent child sexual abuse in Scotland.  As time moved on it became apparent that a CD-ROM was no longer fit for purpose. But also we reached a stage where we needed to comprehensively refine and strengthen the Toolkit, properly test and evaluate its fitness as a practical resource to prevent abuse before it might occur, and align us to effectively deliver (in a systematic and evidenced way) primary prevention of child sexual abuse and sexual exploitation in Scotland.

It was at this point that we started to develop the online resource. Whilst the content of the existing toolkit was an important ‘starting point’ in our work we also wanted to include more information and resources to help in the changing task of keeping children safe. A big part of this is strengthening the capacity of adults to safeguard children and also building the resilience of communities to keep children safe.  We also want to help anyone who is around children to identify the risky behaviour of themselves or others to allow them to intervene and prevent child sexual abuse before it occurs. We wanted to include materials on the prevention of harmful sexual behaviour in childhood and adolescence. And we wanted to ground all of this in bystander theory – the idea that there are practical things we can do to make a difference when we encounter behaviours that are inappropriate or potentially harmful.

The new resource is broken down into five sections. These are Learn, Identify, Prevent, Act and Engaging Communities. There is also a Get Help section for anyone in a situation that needs immediate action.

The resource gives practical advice based on a wide range of scenarios and frequently asked questions that often come up during our work. “What if I don’t like the way my uncle is playing with my daughter?” or “What are the warning signs that a child is being abused” or “How do I make my church group safer for children?”. We have tried to make the language as accessible as possible without losing some of the detail and nuances of the complex world that we live in. The Engaging Communities section contains a range of resources that professionals can use when engaging the public about prevention.

It was developed specifically for a Scottish audience but we hope this resource can be used more widely. Have a look, and if it is useful, share the resource with colleagues, friends and family or tell people about it on social media. The message of Upstream is simple; together we can protect the next child from harm.

Wednesday, November 27, 2019

When Others Decide the Effects of Abuse

By David S. Prescott, LICSW, & Kieran McCartan, Ph.D.

A vital study that appeared a few weeks ago has attracted surprisingly little attention. Esme Fuller-Thompson (from the University of Toronto) and her colleagues examined 17,014 survey respondents, including 651 known to have a history of sexual abuse as children. From their findings:

Remarkably, two-thirds [65%] of the childhood sexual-abuse survivors in our sample met the   criteria for complete mental health -- defined as being happy or satisfied with life most days in the past month, having high levels of social and psychological well-being in the past month, and being free of mental illness, suicidal thoughts and substance dependence in the past year. While the prevalence of complete mental health among childhood sexual-abuse survivors is higher than we had expected, it is still substantially less than that found in the general population [77%]. (p. 6)

Not surprisingly, the study found that factors such as social isolation, chronic pain, and substance dependence were impediments to “complete mental health” (a term that describes the study’s goals accurately, but may be conspicuously, even amusingly, absent in the daily life of many readers).

These findings are far from surprising. Many of those working with people who have been traumatized are familiar with post-traumatic growth, with some professionals having experienced it personally. As our colleague Alissa Ackerman has observed, “You are never more than a stone’s throw away from a survivor of abuse.”

On the other hand, these are findings that challenge traditional beliefs about abuse. The familiar refrain of abuse leaving people “scarred for life” can be harmful in its own way, including when those who have been abused hear this from friends, family, therapists, or prosecutors seeking a conviction. The simple fact is that we need a more nuanced approach in understanding abuse. The problem isn’t that all forms of abuse cause inevitable harm. The problem is that abuse poses an unacceptable risk of harm. No one has the right to state categorically how abuse affects others.

What might be most fascinating about this study is its historical context. It has only been 20 years since the 1998 meta-analysis by Rind, Tromovich, and Bauserman was condemned by a US Congress formal resolution and sparked significant controversy. They had produced similar findings, although they framed their study quite differently. From the abstract: “negative effects were neither pervasive nor typically intense, and that men reacted much less negatively than women”. Obviously, how one frames the issues contributes to how they are understood by others.

These lessons in controversy appeared again in 2009, with the publication of Susan Clancy’s book, The Trauma Myth. Clancy, too, experienced substantial push back in the media, and spent considerable time explaining her work. By this time, and in the wake of rejection by the academic community in the US, she had emigrated to Central America.

All these facts and findings suggest that understanding the nuances of harm and trauma can take years of dedicated study and practice to comprehend. Even the most seasoned professionals often find themselves surprised by what they learn in their ongoing practice. The lessons of how research findings are presented are no less significant. How we frame the issues matters, especially regarding sexual abuse where victims offer feel unheard and/or unrecognized by the system. Forcing victims into frames that help us respond to their abuse without necessarily helping them is problematic. We need to hear and respect what victims say about the abuse they have experienced and the way that it has impacted them. Musician Frank Zappa may have expressed it most succinctly when he said that, “The most important thing in art is the frame.” In this case, that means hearing and respecting the voices of those victimized.

Friday, November 22, 2019

The importance of international collaboration

By Kieran McCartan, PhD, & David Prescott, LICSW

Last week our blog focused on the ATSA conference and some of the interesting plenary addresses, preconference presentations, and concurrent workshops that occurred throughout it. Of course, this is not the only conference that we have blogged about this year. We have highlighted the NOTA, ANZATSA, CoNTRAS-TI, and NL-ATSA conferences as well. The primary take-home message from these blogs (as well as the conferences themselves and the people who make them happen) is the volume of work that its going on internationally in the field of sexual abuse and the potential for collaboration.

Collaboration and sharing good practices is essential to moving any field of work forward, but it is particularly important with respect to the global issue of sexual abuse. Sexual abuse does not respect borders, and everyone has the potential to be impacted by it. Therefore, it’s important that we learn from each other. The purpose of collaboration is not to use research, risk assessment, risk management, treatment and/or prevention in a way which imposes westernized, or anglophone, ideas around sexual abuse; but rather to exchange new ideas, alternative solutions and helpful suggestions.

True collaboration can be very hard to accomplish. Every program and conference takes place in a different cultural context. Understanding and appreciating this context and the people involved is crucial to the success of any collaboration. Once established, however, collaboration encourages adoption and contextually appropriate responses that help reduce the likelihood of recidivism and promote safeguarding. We have seen this at a higher level in ATSA with collaborations with similar organizations, like NOTA (UK & Ireland), ANZATSA (Australia & New Zealand), IATSO (Europe), NL-ATSA (the Dutch Chapter of ATSA), CoNTRAS-TI (Italy) and Les Centres Ressources pour les Intervenants auprès des Auteurs de Violences Sexuelles (CRIAVS) (France), as well as at a practical ground level in research and practice collaborations.

In practice this means that one country, professional, or program might see a challenge that they face from an alternative perspective forcing them to reconsider their approach. One example of this is in New Zealand, as discussed by Margret Ann Laws at ATSA 2019 and published in the recent edition of the ATSA Forum, where the register for people convicted of a sexual offence is constructed and run in a proactive fashion. In New Zealand, all police officers are trained in risk assessment, and register is conceptualized as a tool to support people in their desistance from sexual offending. Therefore, the register in New Zealand is characterised as being supportive rather than punitive, the way that it is conceptualized in other parts of the world. By flipping our perceptions of existing frameworks and ideologies we can move towards a preventive, prosocial approach to sexual abuse. 

In addition, collaboration is also about working together, as well as sharing innovative practices, and thinking about how we can push the field forward and/or redefine challenges. At conferences and related events, one often hears conversations about the start of new collaborations, research projects, replications and innovations to training/development. This is great and long may it last! We are seeing this in the newly implemented international project on treatment efficacy with leading researchers and treatment professionals coming together to develop and streamline the best approaches.

Friday, November 15, 2019

ATSA Annual Conference 2019

By Kieran McCartan, PhD, & David Prescott, LICSW.
The annual ATSA conference took place from the 6th-9thNovember in Atlanta, Georgia. The conference was a real mix of research, practice and engagement with over 1,200 participants from the USA, Canada, UK, Australia, New Zealand, Sweden, Netherlands, Norway, France, Belgium and Israel to name a few. In this blog we are going to take you on a whistle stop tour of the event.
The 2019 ATSA conference had 31 preconference presentations covering a range of topics including Risk Assessment, online offending, youth who sexually offend, treatment and interventions as well as a session for students on training and career development. The keynotes this year where by Professor Teresa Gannon (Are treatment Programs for sexual offending effective), Professor Paul Bloom (Against Empathy), Linda Dahlberg (Going Upstream: The fundamentals, evolution, context, and practice of primary prevention) and a conversation between Kurt Bumby and Kristen Houser on communication/messaging about working in the field of sexual abuse. The main conference had 100 workshop presentations and 36 poster presentations, with approximately 200 speakers presenting, covering prevention, victims, youth, adults, learning disabilities, minor attracted youths, policy, assessment, risk, management, and community engagement. In addition, this year saw the lifetime significant achievement award go to Jill Levenson, the Gail-Smith Burns award go to David Fowers, and the Early Career Award go to Kelly Babchishin, Congratulations to all!!!
For Kieran, the highlight of the conference was the first two keynotes, Teresa Gannon’s & Paul Bloom’s; although very different they talked to core ideas surrounding treatment and intervention. Teresa Gannon gave us an overview of her recent meta-analysis on the success of treatment programs, which showed that treatment can work but to do so the skills and the training for providers matters. Treatment success is about more than just program structure and integrity, the human delivering the treatment matters! This complemented Paul’s keynote on against empathy, which really made us focus on what empathy is and how effective it is in treatment and risk management. Empathy is a controversial topic in treatment programs and interventions for people convicted of a sexual offence, so it was pleasant to hear about it from a philosophy-political-social-psychological point of view, rather than just a treatment one. Do we need our clients/service users to have empathy for their victims to stop them re-offending or even to stop offending in the first instance? Is it compassion, insight and self-regulation that we are really looking for in them? Also, how much empathy do we need to have to be competent and skilled therapists, treatment providers and researchers? It was an interesting talk that went beyond pure semantics and allowed us to think about the role of empathy in the field and everyday practice. To Kieran, these keynotes set the tone of the conference as ATSA has always been about reflection and being a critical friend to each other.
The international roundtable this year was focused around risk assessment, risk management and treatment/interventions with 7 speakers from 7 different countries (USA, Canada, UK, New Zealand, Israel, Netherlands, Belgium). The session ran differently this year with the roundtable focusing on 4 topics and the speakers addressing how each topic was handled in their country, therefore we could see the comparison first hand. Which worked well and stimulated a lot of debate. Again, as in previous years, 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, this year was noteworthy for the quality of the participation. At a workshop titled “The Pornography Debate”, those in attendance proved the axiom that intelligence often comes in asking the right questions rather than having the right answers. In this case, these questions came in the form of “Is any porn user ever entirely satiated” and “Is it possible to have a sexual encounter that does not involve at least a little objectification?” Likewise, participants in a workshop on the often traumatic effects of the legal system on clients were open to discussion in ways that are far rarer in other conference situations. This year was a lesson that not only does ATSA boast some of the best workshop experiences in the field, it also has amongst the most knowledgeable and thoughtful attendees.
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. The primary take-away from these conference experiences for the two of us was the importance of working together towards common goals so we could participate in “shaping the future”, as the conference theme appropriately described it. We are looking forward to ATSA 2020 in San Antonio, Texas!!

Wednesday, October 30, 2019

The SAVVY CONSUMER – A Guide for professionals working with children and young people in relation to pornography use and harmful sexual behaviour

By Cyra Fernandes, Australian Childhood Foundation & Russ Pratt, Prime Forensic Psychology

Please note: This is a slightly longer blog than usual but it was felt that the whole blog needed to be presented in its current form. Kieran

In our previous blog (August 2019), my co-author, Dr Russ Pratt, and I discussed a number of issues to do with youth viewing pornography, and specifically how pornography might influence youths’ sexual practices, behaviors, attitudes, and perceptions.
We discussed that we ha[d]
“…created a developmentally focused, “savvy consumer” model for youth which advocates ‘zero-tolerance’ for pornography viewing for very young children, combined with a ‘harm-minimization’ model for older adolescents. The model has, at its heart, the belief that the ability to both critique the falseness of pornography, and highlight positive, real-world sexual health practices will ensure that the qualities of healthy, safe, and desired sexual practices remain in-focus during treatment.
In particular:
·         Respect,
·         Mutual consent,
·         Equality and partnership,
·         The freedom to say no, and;
·         The freedom to negotiate equally regarding healthy, respectful sexual pleasure and activity. (ATSA Blog, 2019)”
In today’s blog, we do just that.
Any professional who has worked with families where harmful sexual behaviors, problem sexual behaviors and/or sexually abusive behaviors are present has most likely heard the question;

“How can I help my child understand that what they see in pornography does not represent real-life sex?” 
We have already “set the agenda” that – in our views - pornography strongly influences and thus shapes the sexual beliefs, desires, expectations and practices of young people.  Further, we have stated that it plays an influential role in the development of harmful sexual behaviour with many of the young people we work with. Particularly at-risk are those youth who utilise pornography to make-up for sexual inexperience, however poor parental role modelling and supervision, or even absent parents also raises risk. Those youth suffering developmental issues (intellectual disability, autism spectrum disorders and ADD/ADHD) which impact impulse control are also ‘at-risk’. Unfortunately, this cohort seem to experience difficulty in seeking support from adults who might have helped them make sense of what they had seen in regards to ‘pornographic scenarios’ viewed (Prescott & Schuler, 2011; Pratt and Fernandes 2015).
Gaining understanding of effective work with sexually abusive youth impacted by pornography

During 2016, we conducted a survey of practitioners who worked with sexually abusive youth aged up to 18 years. The world-wide survey attracted 183 valid responses, with the majority of participants coming from Australia, the United States, The United Kingdom and Canada.
Regarding the main findings from the survey, several key points emerged, as noted below;
·         Overwhelmingly, respondents believed that their sexually abusive clients were influenced by the pornography they were viewing,

·         They were seeing younger children presenting for treatment and they believed this was due to younger onset viewing of pornography,

·         They believed that pornography provided a “see-all” template or technical manual for youth who were sexually inexperienced,
·         Whilst they indicated they were comfortable working with sexually abusive youth, they indicated they wanted more ‘tools’ that were specifically designed to engage their young clients in regards to both viewing pornography and being influenced by it.
In response to the issues raised by the survey (and in particular the last point), my colleague and I created a series of points, which, when expanded, we believe provides a developmentally-driven (and thus developmentally appropriate) model  – a 9-step guide (initially a 12-step guide) with a focus on working with young people to understand and – where developmentally appropriate – engage in healthy, respectful and safe sexual practices. At the same time, the model aims to highlight the ‘unreal-ness’ and ‘falsity’ of what Crabbe () refers to as “porn world”. We called this model of work the “Savvy Consumer” model, as we felt that the best way to ‘bullet proof’ our young people to porn’s impact was to assist them to “…critique the product” as any savvy consumer would (and porn is a product).
The Savvy Consumer model is developmentally focused - advocating for zero tolerance of pornography viewing for very young (pre-pubescent) children however then combining this with a harm minimisation approach for post-pubescent youth. Additionally, the model advocates on commencing this training from a very young age, however commencing with “E-safety” rather than porn per se, based upon our belief that the internet is a rather dangerous place to hang out whatever your age may be. The model can be utilized in working both with general population of children and young people as well as those who have engaged in harmful sexual behaviour. We set out the model, below, in detail.
1.     Education regarding risks on the internet (not just pornography) must start in early childhood (by six-years of age). Education commences with safety-skills enhancement around safe use and does not mention sex or pornography. If you are old enough to scroll, you are old enough to get into trouble online. We need to begin the conversation early with children about the importance of being safe and very cautious when sharing private information about yourself.  It is also important that adults closely monitor both the content that children are viewing and what they might want to send out into the cyber-world. This is the age to begin education about what is suitable for their child to watch and how this will change as they progress to adolescence.

2.     Net-nanny filtering, password protection, age verification and parental monitoring are all pro-active and vital strategies used to protect “the accidental user” and the “interested [in all the wrong things] user”. Many children and young people report accidentally stumbling onto pornography because of innocently clicking on pop-ups.  Other youth report keeping their usage of sites that their parents would likely not approve of secret. Adopting a strong internet filtering and monitoring processes will reduce the likelihood of these situations occurring. Of course, good relationships with your kids and talking about risk is also vital.

3.     From a developmental perspective, it is important to practice Zero Tolerance for viewing Pornography where kids are under 12 years of age (really, prior to puberty). When comparing early onset viewing versus later onset viewing of pornography, limited research suggests problematic outcomes for the early onset viewers including higher rates of casual sex, greater levels of and tolerance for aggression, violence and sex being linked (for adults see Wright, Tokunaga & Kraus, 2015). Also, increased consumption of pornography later in life, and higher rates of bestiality (Owens, et. al., 2012; Skau, 2007, Skau & Barbour, 2011).  

4.      “Pornography Sex” has a tenuous relationship to “Real Sex”.   Although at times uncomfortable, it is vital that we start conversations with young people in which we are clear (in matter-of-fact ways) that pornography has very little in common with real-life, healthy sexual behaviours and both romantic or sexual relationships.  We want them to understand very clearly in pornography we see actors following a script – and that the script is often demeaning and disrespectful to women.
5.    Approaching puberty (around 11-12 years of age) sex education should incorporate both the physical and the relational aspects of sexual activity. As well, at this age, simple information and education about internet-based pornography commences.  There should be opportunities for children and young people to gain education and information about sex from a variety of sources such as schools, parents, and specialist-educators, rather than the internet itself.  At this stage, sex-education focuses upon mutual consent, respect, boundaries, laws, and pleasure and therefore presents sex as enjoyable by both parties.  Given what we have seen over the past several years in regards to how pornography seen on the internet has shaped and influenced youth’s sexual belief systems, these ‘educational steps’ regarding children’s beliefs about the difference between real sex and porn sex will be vitally important in developing respectful relationship within our community over the next few important formative years.

6.     The Savvy Consumer model assumes that by 13 or 14 years of age (as supported by research), most youth will have viewed pornography (Lim et. al., 2017; Mitchell, et. al., 2014).  Realistic discussion of what they are seeing has to commence. As parents and practitioners; it is crucial that we maintain a curious and non-judgemental stance when talking to youth about their porn usage This is likely to assist in more open and ongoing conversation with young people and allows us to help shape their understanding that the internet-images seen are not realistic reflections of healthy sexual relationships and behaviours.

7.     By the age of 16 (and likely younger), sex education has to include “What women want and what men want” and what porn suggests women want. Sex education should address issues such as the prevalence and practice of heterosexual anal sex, multiple sex partners (mainly seen on the internet is multiple men and one women) in the real world as opposed to on pornography.

8.     Education programs should not be heteronormative or assume that females do not watch pornography.  Whilst most pornography is viewed by males (Ogas & Gaddam, 2011); research is suggesting that significant number of women are viewing pornography regularly (Fischer, et. al., 2019). Additionally, a significant number of gay, lesbian, bisexual, transsexual, intersex and queer young people are accessing the internet for information in relations to “their” sexual behaviour (Lim et. al., 2017). Sex Education programs that are not inclusive of these populations risk derision and critical rejection by all youth.

9.     Sex-education skills should include skills-building regarding the ability to critique pornography. We cannot stop young people using the internet and accessing pornography – even if we wanted to. As authors we have debated how likely it is that we can even successfully achieve ‘zero-tolerance’ for the pre-pubescent (see point 3), however we concluded it was too important a point not to try and achieve.   Rather than an abstinence model into later adolescence, which would likely be unsuccessful, our resources should be directed towards educating and supporting youth to develop skills to consider and critique both the pornography they might see, as well as the roles that pornography assigns to the participants within the movies. Who has power, how do the participants treat each other and what might that be like to be treated in that way? What role does pain, humiliation and degradation play in pornography and why would people enjoy this? In other words, how does pornography “fit in” with their beliefs, desires and (if applicable) sexual practices.  It might be the case that youth who are are particularly susceptible to the influence of pornography might require broader, ongoing support by key adults to assist them to display the confidence to “speak up” about what they have seen.

To conclude
We have set out a case – based on research (ours and others) that pornography significantly influences young people’s sexual beliefs, expectations and practices. Also, children and young people who are broadly “at risk” are more likely to be vulnerable to porn’s influence due to trauma’s impact on their ability to understand the nuances associated with determining ‘real-life’ and ‘porn-world’ sex.
We believe that the Savvy Consumer model provides a simple, effective framework for professionals and parents to assist children and young people – from an early age – to critique both pornography and its influence. Additionally, the Savvy Consumer model will assist in developing their understanding of healthy sexual practices. 
We use the analogy of the Die-Hard action films to make our final point. Most youth have seen the Bruce Willis/Die Hard series. They understand that the violence and damage inflicted is pure fantasy, most likely due to having experienced being hit/hurt/injured at some point in childhood. Sex is a different matter – they have nothing to critique pornography against. As we cannot stop adolescents viewing pornography, we can teach our children and young people to critique it – and be savvy consumers. We want them to treat pornography with contempt, or perhaps like the Die-Hard action films –outrageous fantasy, pure and simple!

Fisher, C. M., Waling, A., Kerr, L., Bellamy, R., Ezer, P., Mikolajczak, G., Brown, G., Carman, M. & Lucke, J. (2019). 6th National Survey of Australian Secondary Students and Sexual Health 2018, (ARCSHS Monograph Series No. 113), Bundoora: Australian Research Centre in Sex, Health & Society, La Trobe University.

Lim, M.S.C., Agius, P.A., Carrotte, E.R., Vella, A.M., & Hellard, M.E. (2017). Young Australian’s use of pornography and associations with sexual risk behaviours, Australian and New Zealand Journal of Public Health, 2017 online, doi: 10.1111/1753-6405.12678.

Mitchell, A., Patrick. K., Heywood, W., Blackman, P., & Pitts, M. (2014). 5th National survey of Australian secondary students and sexual health 2013. ARCSHS Monograph Series No. 97, Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.

Ogas, O, & Gaddam, S, (2011): A Billion Wicked Thoughts: What the World's Largest Experiment Reveals about Human Desire, Dutton, UK,

Owens, E.W., Behun, E.W., Manning, R.J., & Reid, R.C. (2012). The impact of internet pornography on adolescents: A review of the research. Sexual Addiction & Compulsivity, 19, 99-122.

Pratt, R., & Fernandes, C. (2015). How Pornography May Distort Risk Assessment of Children and Adolescents Who Sexually Harm. Children Australia, 40, pp 232-241 doi:10.1017/cha.2015.2.

Pratt, R., & Fernandes, C. (2015). Understanding and Responding to Pornography Use with Adolescents Who Have Engaged in Harmful Sexual Behavior: Developmental Considerations. ATSA BLOG

Prescott, D.S., & Schuler, S.A. (2011). Pornography and its Place in the Assessment and Treatment of Adolescents who have sexually abused. Neari Press. Holyoke, MA.

Skau, B. (2007). Who has seen what when? Pornography’s contribution to the social construction of sexuality during childhood and adolescence. Unpublished Doctoral Thesis, Wilfrid Laurier University, 2007.

Skau, B. & Barbour, H. (2011). The pursuit of “Good Sex” in a pornified world: Assisting adolescents in constructing positive sexual scripts. Paper presented at the 30th Annual ATSA Conference, Toronto, Ontario, Canada.

Wright, P.J, Tokunaga, R.S., & Kraus, A., (2015), ‘A meta-analysis of pornography consumption and actual acts of sexual aggression in general population studies’, Journal of Communication, 66(1), 183-205.





Wednesday, October 16, 2019

Repressed and Recovered Memories: Implications for our field

By David S. Prescott, LICSW

Many professionals (and the lay public) came of age at a time when it was believed that traumatized people commonly repressed all memories of having been abused. It made sense at the time: If the abuse was bad enough, the mind could just completely block it from memory. The mind is an amazing thing, right? The motivations were certainly positive, with the idea that bringing abuse to light could help people to live better lives. Those who lived through those times will recall that these recovered memories often occurred against a backdrop of maxims such as “always believe the victim” without questioning the methods by which people came to believe themselves to have been victimized.

Not long after these efforts, researchers came along and produced findings that were nowhere near that simple. Elizabeth Loftus has become a champion of explaining the myriad vagaries of memory, while Scott Lilienfeld has documented a number of ways that false memories have caused life-altering harm. In a conference presentation on hypnosis in therapy attended by the first author, Michael Yapko once described the recovered memory movement as a near-death experience for hypnotherapy. Havoc ensured, often referred to as the “memory wars”. Since those days, it has been increasingly clear that people might not remember every detail of their traumatic past, but research simply hasn’t confirmed the complete repression/blockage of memory that has driven so many therapeutic interventions.

Within the past month, Henry Otgaar, Mark Howe, Lawrence Patihis and their colleagues (including Scott O. Lilienfeld and Elizabeth Loftus) have just published a paper on the current status of “recovering” memories of trauma that clients had long repressed. A pre-publication version can be downloaded here. The findings are sobering. From the abstract:

We show that the belief in repressed memories occurs on a non-trivial-scale (58%) and appears to have increased among clinical psychologists since the 1990s. We also demonstrate that the scientifically controversial concept of dissociative amnesia, which we argue is a substitute term for memory repression, has gained in popularity. Finally, we review work on the adverse side effects of certain psychotherapeutic techniques, some of which may be linked to the recovery of repressed memories. The memory wars have not vanished: They have continued to endure and contribute to potentially damaging consequences in clinical, legal, and academic contexts.

To be clear, the authors are referring to repressed memories as the “complete blockage” of memories related to trauma. There’s no question that our minds can distance us from painful memories, but the standard response to trauma is more likely to be the inability to forget about it. There is any number of implications that follow.

First, there is a question about the sequelae of adversity and trauma as experienced at different ages. Under what conditions does it become unhelpful to explore past experiences? Examples from recent publications provide points to consider. A recent BBC article explored the concerns of clients in treatment having to describe their abuse of others in excruciating detail. A recent book describes, also in detail, the role of recovered memories in the infamous Jerry Sandusky case, and the harmful effects of treatment administered with the assumption that it was helping. Whether one is exploring what one has done or had done to them, it is vital to recall that treatment poorly delivered is not a benevolent event; any problem professional can make better they can almost certainly also make worse.

Second, whether treating abuse or preventing further harm, it can be easy to minimize the vulnerability and suggestibility of clients in treatment. Research into coerced false confessions is just one example of how powerful professionals can be, and how easily they can manipulate the people in their care. Can therapists seeking to uncover past events be certain that they are not involved in similar processes?

It maybe worthwhile for professionals to return periodically to the codes of ethics of their professions in order to consider the risks and benefits of the programming they deliver and to reconsider to what extent they have the truly informed consent of their clients. Likewise, there remains a question of what the least restrictive alternative is: Do programs that compel complete accountability inadvertently create new risks or cause new forms of harm that our field hasn’t yet explored?

Ultimately, with all of the sequelae from trauma and adversity in evidence in the lives of so many clients, it seems there is a question of why we don’t spend more time looking forward at constructing a better life and less time over-emphasizing the deconstruction of the past. Important to emphasizes is that many programs are working today to get this balance right, and many resources exist for providing treatment for abuse and aggression that minimize the potential risks. The findings of Otgaar et al described above are not entirely new. However, they do point to the ongoing necessity to consider our actions. It seems that while therapeutic fads come and go, we still face obstacles to understanding and helping our clients.