Friday, June 28, 2019

Rehabilitative Climate and the Experience of Imprisonment for Men with Sexual Convictions

By Nicholas Blagden & Ralph Lubkowski

For men convicted of a sexual offence life in prison is not easy and can often be a brutal experience. They are despised by all for what they have done. They may have lost, or fear losing, the support of those who care for them. They will be at the bottom of the prison hierarchy, living in constant fear of being identified as a ‘sex offender’ and will often be the victim of physical and verbal assaults (Schwaebe, 2005). The difficulties facing these men are innumerable. Yet, despite all of these issues, we still expect these men to be rehabilitated, to volunteer willingly for, and commit to, treatment where the intimate details of their lives are laid bare (Ware & Blagden, 2016). Treatment must seem like a frightening prospect on many levels. It is important to note that while a populist response to this may be that such individuals ‘deserve’ to feel that way, it does little to help rehabilitate individuals. The goal of prison and prison rehabilitation for such individuals must be to prevent other victims and to help men lead meaningful and pro-social lives because this is what will keep people leading offence-free lives. We know that harsh environments make people worse and not better and negatively impact both staff and prisoners (Chen & Shapiro, 2007).

However, despite the environment being highly adversarial for those convicted of sexual offences, there is very little research considering the impact. The prison climate and the attitudes of staff in that prison play an important role in successful treatment and rehabilitation of offenders. In an era when the treatment of men with sexual convictions is contested and even questioned, there is a real need to take seriously the environment in which such individuals reside and understand the opportunities within that environment to help men flourish.

Rehabilitative climate of prisons for men with sexual convictions

Men convicted of sexual offences represent around 18% of those serving a prison sentence. This has brought challenges e.g. where to locate such individuals, as many are separated onto ‘vulnerable prisoner units’, but still experience threats and fear from others. One solution in England and Wales has been to increase the number of prisons specifically for men with sexual convictions.

There is some debate as to whether housing men with sexual convictions together is a good idea. Some suggest that they may share deviant fantasies, groom others including staff and create an overly sexualised environment. These are important issues, but the incidence of such events happening is not as frequent as we might think. Recent research (see e.g. Blagden & Wilson, 2019, Blagden et al, 2016) has found incidences to be unexpectedly minor given the sample. Instead in these research studies, participants expressed that they were experiencing the prison as a “different world”, one in which they were less anxious and less fearful. This was helping men have the ‘headspace’ to contemplate change.

Prisons for men with sexual convictions with a good rehabilitate prison climate promote constructive and meaningful relationships between prisoners and staff and provide opportunities for meaningful experiences to allow men the possibility to try out new identities. Relationships matter in prison, especially for this client group, as they can be testing grounds for future relationships and identities. An important aspect of meaningful relationships for this client group (and others) is creating opportunities for reciprocal relationships i.e. those that promote shared exchanges, shared learning and understanding. Two things which have been important for creating reciprocity within the prison are peer support and active citizenship. Indeed, the reciprocal aspects of these have been found to galvanise staff-prisoner and prisoner-prisoner relationships, which is important as the relational properties of both are linked to the ‘self-change’ process (Mead, Hilton, & Curtis 2001). HMP Stafford is a prison that has an active citizenship focus. Active citizenship at its heart is about creating a community and a shared sense of ownership of the space they inhabit, it helps prisoners to engage more with the people and the world around them, to reintegrate in the community (Edgar et al, 2011). Finally, we will look at what active citizenship looks like in practice.

Rehabilitative Climate in Action - Active citizenship

In 2016 HMP Stafford was rerolled to hold exclusively people convicted of sexual offences (PSOCOs). This dramatic shift in population was closely followed by a new focus on Rehabilitative Culture across the prison estate. Stafford’s approach to these two new opportunities was Active Citizenship, a simple concept of recognising, reinforcing, and recording acts seen to be doing good for the community, environment, and others. Visually striking and simple promotional materials were produced, and staff and resident champions appointed to drive the concept forward.

Initially the result was that residents strived to be in jobs linked to “citizenship” such as carers, listeners, or resident’s council reps. Citizenship was regarded as a position to be attained and closely linked to employment or activity. There were no financial rewards, nor was it directly linked to the Incentives and Earned Privileges Scheme. The only tangible benefit was a badge, however being recognised as an Active Citizen created a new identity for those willing to do good, and built momentum behind the idea of contributing to the prison community.

As Active Citizenship embedded, it evolved. Residents looked for new opportunities to contribute, and staff recognised and valued these small acts of kindness. Citizenship became less linked to specific roles or activities, and more of a way of life. Even the badges, albeit still worn proudly by those that received them, became less significant. Contributing to helping others and making Stafford a better place became a shared objective for staff and residents, the act itself being the reward. This has led to a remarkable transformation in the past 18 months. Trust has built between staff and residents, with a progressive and innovative climate resulting in what at times seems like an avalanche of new initiatives and opportunities. Many of these have been created and driven by residents and front line staff, often in their own time and with little or no resource.

Stafford is now a place where residents are given a real opportunity to change and grow, a community where people care for each other and where hope flourishes. We do not shy away from the reality of what our residents did, or what difficulties they will face after prison but Citizenship has created a climate where they can rebuild and renew themselves. They feel valued and empowered, enabling them to confront their previous life and wrongdoing and move forwards. We are still on a journey, and there is more to do, but the foundations have been built allowing us to build something truly remarkable.


Blagden, N., & Wilson, K. (2019). “We’re All the Same Here”—Investigating the Rehabilitative Climate of a Re-Rolled Sexual Offender Prison: A Qualitative Longitudinal Study. Sexual Abuse, DOI: 1079063219839496.

Blagden, N., Winder, B., & Hames, C. (2016). “They treat us like human beings”—Experiencing a therapeutic sex offenders prison: Impact on prisoners and staff and implications for treatment. International journal of offender therapy and comparative criminology60(4), 371-396.

Chen, M. K., & Shapiro, J. M. (2007). Do harsher prison conditions reduce recidivism? A discontinuity-based approach. American Law and Economics Review9(1), 1-29.

Edgar, K., Jacobson, J. and Biggar, K. (2011), “Time well spent: a practical guide to active citizenship and volunteering in prison”, Prison Reform Trust, London, available at: Documents/Time%20Well%20Spent%20report%20lo.pdf (accessed July 8th, 2017)

Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric rehabilitation journal25(2), 134.

Schwaebe, C. (2005). Learning to pass: Sex offenders' strategies for establishing a viable identity in the prison general population. International Journal of Offender Therapy and Comparative Criminology49(6), 614-625.

Ware, J. & Blagden, N. (2016), “Responding to categorical denial, refusal, and treatment drop-out”, in Boer, D.P. (Ed.), The Wiley Handbook on the Theories, Assessment and Treatment of Sexual Offending, John Wiley & Sons Ltd, West Sussex, pp. 1564-71.

Friday, June 21, 2019

Finding pathways to prevention: An international consensus position for better management and prevention of online child sexual offending behavior

By Maggie Brennan, PhD, Derek Perkins, PhD, Hannah Merdian,PhD

A new report released today (Friday 21 June), involving over 2,000 experts in online child sex offending has made strong recommendations on how to better prevent the growing problem of child sexual offending on the internet. 

Recent surveys have found that technological developments are limiting the international capacity for the prevention, detection, and prosecution of online child sexual offending behaviour (e.g. NetClean, 2018). Moreover, “investigators still have to deal with significant numbers of offenders committing preventable crimes such as viewing and sharing indecent images and videos known to law enforcement” (National Crime Agency, 2018).

The recommendations come amid the group’s concerns about ‘epidemic levels’ of child sexual exploitation material (CSEM) offending online. The number of UK-related case referrals received by the National Crime Agency from the online industry almost trebled between 2016 and 2018 - rising from 43,072 case referrals in 2016 to 113,948 in 2018. In the year 2018 alone, the US National Center for Missing and Exploited Children received 18.4 million referrals of suspected online child sex offending cases from around the world (National Crime Agency, 2019). 

The report, developed by the International Working Group for the Prevention of Online Sex Offending (IWG_OSO), features input from a range of experts in the behaviour of online child sex offenders, including the UK National Crime Agency, Interpol, Public Health Canada, the National Society for the Prevention of Cruelty to Children (NSPCC), and the Universities of Plymouth and Lincoln, UK. 

In order to scope the nature of, and professional opinions on, the management and prevention of CSEM offending, the IWG_OSO: (1) reviewed the literature on online sexual offending; (2) conducted a Delphi survey with international experts in the management and prevention of online child sexual offending behaviour; and (3) conducted a multi-annual series of consultation events with international stakeholders in the relevant areas. 

The consultations were held between 2014 and 2019 at a range of key events, including at the IATSO and NOTA conferences, and involved clinicians, law enforcement professionals, researchers, policymakers, and offender managers and other stakeholders.

The report highlights that the prevention of online child sexual offending behaviour requires more public engagement to raise awareness and understanding of this problem, closer collaboration between behavioural experts and the online industry, a better balance between punishment and early intervention with potential offenders, as well as increased primary prevention measures to address the underlying causes of online child sex offending.

The report, entitled Best Practice in the Management of Online Sex Offending, is being officially launched on Friday 21 June at the NSPCC headquarters in London. Its recommendations for better management and prevention of online child sexual offending include:

  • Closer collaboration between behavioural experts and the online industry: Experts involved in researching, treating and preventing online child sex offending behaviour should work more closely with the online industry to help design barriers to the commission of sexual offences online. This might include collaborative work to design-out an offender’s ability to produce, share and access CSEM in online platforms and services involved in these offences, as well as further expansion of deterrence messages and splash pages into pre-offending locations online.

  • Increased public engagement with the problem of online child sex offending behaviour: Through, for example, media-supported public awareness campaigns, to increase public understanding of the problem of online child sexual offending behaviour, and to reduce the fear and stigma involved for people who wish to come forward and seek help to manage their pre-offending sexual interest in children.  

  • Better balance between efforts to prosecute and punish online sex offenders with earlier intervention methods to prevent sexual offences occurring – particularly for people with a pre-offending sexual interest in children: For example, an expansion of anonymous helplines and online deterrence campaigns targeting potential online child sex offenders, as well as greater therapeutic provision in the community.

The IWG_OSO was set up in 2014 with the support of the International Association for the Treatment of Sexual Offenders. Its members and consultees include experts in online child sexual offending behaviours, from law enforcement, academia, children’s charities, offender support services, therapeutic providers and the online industry.

The full report can be found at


National Crime Agency. (2018). Supplementary written evidence submitted by the National Crime Agency (NCA) (PFF0011). Retrieved from: http://data.parliament .uk/writtenevidence/committeeevidence.svc/evidencedocument/home-affairs-committee/policing-for-the-future/written/82068.pdf

National Crime Agency. (2019). NCA shines light on online CSAE for public inquiry. Retrieved from (2018). The NetClean Report 2018. Retrieved from https://www.netclean .com/netclean-report-2018/#insiktermobil

Friday, June 14, 2019

Knowing What Works and Doing the Work: The Relationship between Research and Clinical Practice

By Jeffrey C. Sandler, Kieran F. McCartan, & David S. Prescott.

Sometimes in life, we hear something so often that it starts to lose its meaning. A word or phrase whose presence once conveyed important information becomes background noise. We may notice when that word or phrase isn’t there, but we no longer process what it means when the word is there. For example, in the social sciences, we know that if something is described as “evidence-based practice,” then that’s a good thing. It means that particular practice is desirable, that it’s based on sound reason and an existing body of research/data. But do we ever really stop to think about what “evidence-based practice” means?

These days, the term “evidence-based practice” is everywhere in the social sciences, it’s constantly discussed. You can’t escape it! It’s integral to the social sciences in general and it’s at the heart of everything ATSA does (see, for example, ATSA’s mission statement). Has familiarity of the term bred contempt, however, or possibly even lead to a lack of understanding? For instance, we often discuss that there is a lack of professional, public, and policy connection between the language that is used in our field, such as the terms “pedophilia”, “psychopath” and “child porn”, but we often use them anyway! Is evidence-based practice another example?

With that in mind, let’s look at the term “evidence-based practice.” Let’s really think about what evidence-based practice means in general, as well as what it specifically means for researchers and clinicians that evidence-based practice is at the core of ATSA’s mission. Although it has been defined in different ways by different organizations (such as the American Psychological Association), it is worth exploring further as it has become applied.

The first part of the term, “evidence-based,” obviously means based on evidence. The key to understanding what the term means to ATSA (and the social sciences more broadly), however, is what exactly is meant by the word “evidence.” In this particular context, what we mean is research. Rigorous, empirical research. Not a few case studies or anecdotal data, but multiple studies with appropriate analyses and large enough samples to be able to draw conclusions about whether an intervention worked. Or, more specifically, enough rigorous studies for us to believe not just that a particular intervention worked in the samples in which it was used, but also that the intervention will work in different samples in which it has not yet been used. Reaching such a high level of evidence takes a lot of work and a lot of time, with the research process often starting with case studies, moving to small-sample pilot studies, and eventually reaching inferential analyses several years later. Each step in the process is important, however, and the slow, deliberate nature of the process is what eventually gives us confidence in the results generated by the process.

The second part of the term, “practice,” can best be thought of as an umbrella term meaning application. It essentially specifies that the research evidence is being used, with the manner of use different for different people. For clinicians specifically, practice means the elements of clinical work, such as risk assessment, treatment, and aftercare. And not just to the act of conducting a risk assessment or guiding treatment. Practice also refers to all the steps leading up to the risk assessment and to the treatment, such as the process of selecting which risk/need assessment methods are best suited to a clinician’s particular clients (e.g., adult, juvenile, male, female, developmentally delayed) and setting (e.g., inpatient, outpatient).

These two parts together make up evidence-based clinical practice. And just to be clear, both parts are needed. By definition, there's no such thing as good, evidence-based clinical practice without good evidence, which is to say research. The history of clinical work in the field of sexual offending is littered with examples of this. For example, empirical research-led clinical practice away from unguided (and inaccurate) clinical assessments of risk and toward accurate empirically-identified risk factors and instruments. Research also helped treatment in the field move away from older, ineffective models (e.g., shaming) and toward models shown to result in better treatment outcomes (e.g., cognitive behavioral methods).

On the other side, the most well-designed, rigorous research study on treatment or risk assessment is a waste if it isn't useful to front-line clinicians. And to be useful, the research needs to address a meaningful topic, to be structured in a way that applies to treatment or assessment in practice (not some idealized version of treatment or assessment that can’t be achieved in the field), and to be conveyed in a manner that's accessible to clinicians. It needs to bear in mind the challenges clinicians face in the field, such as limited time and resources.

The fact of the matter is that good research and good clinical practice are inextricably entwined. For both to be optimally effective, each has to inform the other. Research is at its best when it’s guided by the needs and realities of clinical work. Clinical work is at its best when it’s guided by empirical research that has identified effective techniques. Trying to separate research and clinical practice, or researchers from clinicians, merely weakens both. It’s like separating a musician from her instrument. The former runs the risk of losing her playing ability, the latter runs the risk of becoming merely decorative. There is also the question of who conducts the research that defines evidence-based practice, is it research practitioners, policy researchers, or academics? Each brings a different perspective to the table, and potentially, a different threshold of evidence. This is not to be critical or dismissive, rather to say we need to guarantee consistency in criticality, reliability, and validity.

So, what does “evidence-based practice” mean? It means researchers and clinicians (and policy-makers and supervision agents and everyone else working in the field of sexual abuse prevention) working in true collaboration with each other at each stage of the process, from knowledge generation all the way through to knowledge application. Each side must be open to the input and feedback from the other, which can only result in a stronger system and better outcomes. Only when research and clinical practice are combined are we optimally working toward our common goal of reducing sexual abuse.

Thursday, June 6, 2019

Disconnected: Where Did the Client’s Voice in Treatment Go?

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

Mick Cooper, John Norcross, Brett Raymond-Barker, and Thomas Hogan just published a study in which they sought out what treatment providers believe is important in psychotherapy and how their answers compared with what clients felt was most helpful. Asking, “Whose therapy is it?”, the authors found that, “Robust differences were found between laypersons’ and professionals’ preferences on these two dimensions: Mental health professionals wanted less therapist directiveness than did laypersons … and more emotional intensity … These findings suggest that psychotherapists should be mindful of their own treatment preferences and ensure that these are not inappropriately generalized to patients.”

To some degree, these findings call to mind those of Beech & Fordham (1997), who found that professionals providing treatment to clients who had sexually abused often believe themselves to be more helpful than their clients perceive them to be. A common theme across the entire Criminal Justice sector, not just in respect to people who have been suspected or convicted of sexual offences are that we often don’t fully take into account the service users (our client’s) perspectives in developing and delivering services.  We (David & Kieran) with Danielle Harris, and have just published a study in this same area, finding that specific themes of problematic client experience emerged in three areas of their interface with the criminal just system. These include: (a) Interactions with the formal criminal justice system (police, courts, and custodial corrections), (b) Interactions with community corrections (probation and parole), and (c) Interactions with treatment providers (rehabilitation, therapists, and evaluators). They reflect broader issues in the “criminogenic” and social care systems where clients can best be characterized as “do to”, not “done with”; which reflects a position of expert knows best and that can contravene the therapeutic alliance. As just one example from his week, David and Kieran visited Bredtveit, an all-female prison in Oslo (Norway), and saw what a more empathetic, supportive and consideration system looked like; there was a balance between the clients’ voices, social care, understanding where they were coming from (in terms of past trauma and offences they committed) and how they could move forward,

From all of this, logical question follows: If one goal of treatment is to reduce risk, doesn’t it make sense to ensure that our understanding of our clients’ experiences is in line with theirs? Shouldn’t we take action to make sure that we are, in fact, understanding their experience so that we can better tailor our services to become more accessible to clients (in line with the responsivity principle of effective correctional treatment)?

If your answers to these questions is yes, then more questions follow: To what extent do we pay lip service to client experiences in treatment and supervision? Do we as individuals believe, as Beech and Fordham found, that we are more effective with our clients than we actually are, and therefore don’t need to be concerned with seeking out their feedback and input into treatment? Would we as individual professionals actually be able (first) to establish the environment where this kind of feedback is possible and (second) to handle the feedback that we might get? Are we afraid that the feedback we might get would be impossible to act on? Do we believe we already get feedback? And perhaps most importantly, do we harbor the belief that some feedback is not worth listening to? If the answer to this last question is yes, what does that say about us? Are we willing to admit that – in line with the research – that we are missing something?

These are not easy questions to answer. It often seems that our training in providing treatment can be a hindrance as well as a help. Many of us are trained to think in terms of adopting specific models or techniques and become so focused in these areas that we lose focus on whether or not these same approaches are actually working with our clients.

Bruce Wampold and Zac Imel have written extensively about the mechanisms by which treatment work. Central to all effective approaches to treatment is the therapeutic alliance itself. Brandy Blasko and Faye Taxman have found that this same alliance works with probation officers as well. This leaves us with even more questions. Perhaps it’s time to consider more deeply that our most cherished models and techniques work because they are delivered in the context of an effective alliance? Perhaps it’s also time to explore the many ways that we are not maintaining an alliance or truly listening to our clients’ experiences at the very times we are focused on implementing our models and techniques?