Wednesday, July 31, 2019

ANZATSA Biennial Conference 2019

By Kieran McCartan, Ph.D.

The biennial ANZATSA conference took place from the 24th – 26th July in Brisbane. The conference was a real mix of research, practice, and engagement with colleagues from across Australia, New Zealand and internationally (with attendees and speakers from a range of countries including the USA, Canada, UK). In this blog, I am going to take you through the conference highlights.

On the first day (Wednesday) there were 11 ½ day workshops that focused on a range of topics, including Risk Assessment (David Thornton; Simon Hackett & Marcella Leonard; Maaike Helmus; Ray Knight & Judith Sims-Knight); the registration and disclosure of information relating to people who had committed sexual offences  (Katie Gotch, Margret-Anne Laws, Karla Lopez & Kieran McCartan); the voices of victims on the integration of people who have been convicted of sexual offences back into the community (Kelly Richards, Jodi Death, Carol Ronken & Kieran McCartan); the prevention of sexual abuse (Stephen Smallbone); and treatment/interventions (Richard Parker; Sharon Kelley) The workshops enabled professional, policy and practice conversations to take place in a controlled, informed environment.

The 2019 plenaries combined research, practice and innovate approaches from an international group of speakers, most of whom were from outside Australia and New Zealand. The Thursday keynotes addressed children who had committed Harmful Sexual Behaviour, their client voice and the impact of treatment/interventions, on their life course desistence as well as how we could adapt our practice to better serve them (Simon Hackett). This was followed by a discussion of what matters and what works in risk assessment and how it ties to reducing risk of recidivism (David Thornton), The third keynote on Thursday was a panel discussion on the process and impact of the Australian Royal Commission, which highlighted the challenges of implementing its recommendations in practice (Gary Foster, Kathryn Mandla & Professor Stephen Smallbone).

One of the main themes of the conference was hearing different voices and it's fitting that the Indigenous voices (Maori, Aboriginal and Tori Strait Islanders) and the victim's voices (through conversations on the Royal Commission) were front and center in the plenaries as well as in the parallel sessions. These sessions were important and thoughtfully developed, highlighting the ways that Australia and New Zealand where moving forward in the arena of hearing and respecting the Indigenous voices and how we can develop appropriate risk assessment, treatments/interventions, and integration strategies developed with traditional peoples in mind. Which should give all participants, especially from anglophone northern hemisphere countries, pause for thought in the way that we address these issues in our own countries. In addition, it was good to see and hear a focus on the victim's voice at a treatment and management conference for people convicted of sexual offenses as it reinforced that these two sides of the field are not as detracted from each other as they are often portrayed; the only way to truly understand, respond to and prevent sexual abuse is to hear all voices.

The National Office for Child Safety led two co-design workshops for the development of a National Strategy to Prevent Child Sexual Abuse on the last day of the conference. Which was interesting to attend and quite innovative in the context of a conference as policymakers got to discuss issues with researchers and practitioners, hearing each other’s voices and building approaches that were fit for purpose. These sessions where quite innovative and I would recommend that sister conferences in the field (NOTA, ATSA, ATSA-NL, CoNTRAS-TI & IATSO) would consider doing the same thing.

Other parallel workshops spanned a full range of topics and speakers of which this is just a flavour) including, integration of people who have sexually offended back into the community; public health approaches to sexual abuse and prevention; youth who sexually harm; institutional sexual abuse; & pornography. The parallel sessions were a good mix of research, evaluation, practical working, professional learning and knowledge exchange.

The second day of the conference (Friday) closed with an interesting mix of keynotes, a panel session that focused on the voices of Indigenous peoples (Lynore Geia, Neil Campbell, Carol Vale, & Claire Walker), another that addressed research on typologies of people who commit rape (Ray Knight) and how much we know about undetected sexual abuse (Sharon Kelley).  All the keynotes tied together ideas of the importance of assessment, management, and integration in a thoughtful, fit for purpose fashion tying together research, practice and policy effectively.

In addition to the traditional conference activities, ANZATSA 2019 also had an engagement event. This year we changed our focus from members of the public to professionals. We advertised the engagement event to professionals who have safeguarding as part of their jobs, but that safeguarding is not their main role (and therefore would not be attending the ANZATSA conference) including, teachers, foster carers, members of charities and NGO’s, etc. They had approximately 70 participants sign up to attend the event. The session heard from national (Detective Inspector Rouse, Professor Martine Powell & Carol Ronken) speakers, chaired by Nance Haxton (the wandering journo), about how to raise informed and confident children that can discuss sexual abuse, and exploitation, and able to ask for help. The engagement event reinforced the main theme of the conference and highlighted that we as a community need to come together to stop child sexual abuse.

ANZATSA 2019 fitted a massive amount of material in across three days, which left me informed, refreshed and looking forward to 2021’s meeting.

Friday, July 26, 2019

Prevention of sexual abuse and the treatment of people who have committed sexually violent behavior: A current state of affairs

By Kasia Uzieblo, Jeffrey Lauer, & Minne De Boeck (Dutch Chapter of ATSA, NL-ATSA)

Five years ago, two colleagues, Wineke Smid, Jan-Willem van den Berg (Van der Hoeven kliniek, Utrecht, the Netherlands) and Jules Mulder (De Waag & Stop it Now! Netherlands) dreamed of founding a Dutch Chapter of ATSA (NL-ATSA). With this chapter, they wanted to enhance Dutch and Flemish practitioners’ knowledge on evidence-based and best practices in prevention, assessment, and treatment of sexually deviant behavior. They also wanted to encourage and facilitate a fruitful two-way interaction between North-American and Dutch speaking researchers and practitioners. A mere five years later, NL-ATSA has become a fully-fledged chapter of ATSA. Moreover, the chapter can be regarded as a prominent player in both the Netherlands and Flanders (Belgium), when it comes to informing practitioners about the scientific understanding of sexual violence and the treatment of people who have committed sexual offences. Proud of its achievements, NL-ATSA doesn’t want its fifth birthday to pass quietly and organizes two events to place this festive year into the spotlight.

A first event took place on the 25th of June. This event was entirely devoted to a special edition on sexually deviant behavior published by the Dutch Journal of Sexology which was edited by former and current NL-ATSA board members, Jan Willem van den Berg and Kasia Uzieblo. During each conference, session experts elaborated on a topic depicted in the special edition by zooming in on best (research) practices within this particular field.

The first presenter, Eveline Schippers (De Waag, Utrecht, the Netherlands), described the results of her innovative study on creating sexual deviance through incentive transfer in a male community sample. Antisocial behavior and sexual deviant interests are regarded as two important risk factors for sexually deviant behavior. However, current knowledge on how these sexual deviant interests originate is very limited. The Incentive Motivational Model (Smid & Wever, 2018) describes sexual arousal as an emotion, that is triggered by a competent stimulus signaling potential reward, and comparable to other emotions coupled with strong bodily reactions. According to this model, sex can be used to regulate emotional states, and emotions can be used to consciously or automatically regulate sexual arousal. Excitation transfer implies that one emotion triggers or reinforces another. But there might also be a sexual component to it. An example of sexual excitation transfer is when athletes become sexually aroused when they won a competition (i.e., when euphoria leads to sexual arousal). With the current study, Schippers aimed to examine whether people become more sexually aroused when experiencing a strong positive and/or negative emotion than when they are in an emotionally neutral state. Her first results suggest that mainly movie clips depicting aggressive content seem to elicit sexual excitation transfer and that genital excitation transfer might not fully align with the subjective (thus self-reported) experience of sexual arousal. This coupling between emotion and sexual arousal could provide interesting new avenues for treatment programs.

The importance of prevention strategies was highlighted in the second plenary session by Minne de Boeck (University Forensic Centre and Stop it Now! Flanders, Belgium) and Jules Mulder (Stop it Now! Netherlands). Taking into regard the high prevalence rates of child sexual abuse and the gravity of the impact of sexual abuse on someone’s life, it is astonishing that only a few programs focus on the prevention of sexual abuse on a primary -and even- secondary level. Notably, most of these projects focus on (potential) victims and on the environment (e.g., parents and school) of potential victims - and exceptionally- perpetrators, but not so much on the (potential) perpetrator him-/herself. Also, most of current prevention programs focusing on the (potential) perpetrator are situated on the tertiary level and hence focus on the prevention of recidivism, and not on preventing sexual abuse of ever happening in the general population (i.e., on the primary level) or in specific risk groups (i.e., on the secondary level). The presenters emphasize that if we want to be serious about preventing sexual abuse, all stakeholders (e.g., schools, sports clubs, practitioners, and policymakers) should start thinking in terms of prevention on the three levels and should start developing initiatives accordingly. De Boeck and Mulder presented three real-life cases (a case of child sexual abuse in a daycare center, sexual abuse by Jehovah’s witnesses, and sexting). These illustrations elicited inspiring discussions with the audience on the benefits and limitations of preventive strategies.

In the third and final plenary session Zohra Lkasbi and Daniël Neves Ramos (ZNA University Psychiatric Center for Children and Youth, Antwerp, Belgium) discussed the assessment in and treatment of minor perpetrators of sexually violent behavior. It is astonishing to note that this topic receives so little attention in literature and practice. Current theoretical knowledge on this issue remains very limited. And in practice they are often confronted with denial from different agencies: even for professionals, it seems to be difficult to acknowledge the existence of such behavior in minors, with all that this implies for the treatment of these minors. The presenters described the limited empirical knowledge on prevalence rates, the risk and protective factors for sexual violent behavior in minors, and interventions. The presenters illustrated the problems they are encountering in practice by describing a clinical case. With this case, they demonstrated that their patients are often minors who exhibit a wide range of psychosocial problems and risk factors. It also became clear that many of these patients have experienced traumatic events and that treatment programs should sufficiently take these traumas into regard. Finally, these clinicians often struggle with pharmaceutical interventions given that little is known about the efficacy and side effects of these interventions.

In the afternoon, four workshops took place. In a first workshop Jan Willem van den Berg and Marc Lexmond (Van der Hoeven kliniek, Utrecht, the Netherlands) presented “A Positive Life Plan”, which is a treatment plan developed by van den Berg and colleagues. With this treatment, plan practitioners are offered a tool to develop a treatment module that adheres to the principles of the Good Lives Model (Ward & Stewart, 2003). In the second workshop, Els Van Daele and Kris Vanhoeck (I.T.E.R., Brussels, Belgium) focused on the factors that might facilitate the development of a therapeutic alliance with clients who have committed sex offences. Through role-plays with the participants, they developed suggestions on how to avoid pitfalls and create opportunities to develop such an alliance with their client. The third workshop of Kasia Uzieblo and Eelco van Doorn (Van der Hoeven kliniek, Utrecht, the Netherlands) aimed to counter the most prominent myths about psychopathy and to illustrate that positive treatment outcomes can be obtained in patients with psychopathic traits. In the final workshop, Kim Ellen Biesmans, and Lieke Nouwen (STEVIG, Forensic Care and Centre of Expertise, the Netherlands) introduced a treatment program that they developed for individuals with intellectual disabilities who committed a sexual offence. This treatment program uses the Integrated Theory of Sexual Offending (ITSO; Ward & Beech, 2005) as a reference point.

This successful, sold-out event was again a reminder of what Wineke Smid, Jan Willem van den Berg and Jules Mulder have accomplished: Five years after the launch of NL-ATSA, the chapter plays a crucial role in building bridges between the production of knowledge and its diffusion to Dutch and Flemish practice and broader, to society. Hence, we are in great debt to the founders of NL-ATSA.

And for the curious readers amongst you: Our second birthday event will be a four-day conference on the assessment and treatment of sex offenders, which will take place from February 4 until February 7, 2020, in Antwerp, Belgium. More information is coming soon!

Smid, W. J., & Wever, E. C. (2018). Mixed emotions: an incentive motivational model of sexual deviance. Sexual Abuse, doi: 1079063218775972.

Ward, T., & Beech, A. R. (2006). An integrated theory of sexual offending. Aggression and Violent Behavior, 11(1), 44–63.

Ward, T., & Stewart, C. A. (2003). The treatment of sex offenders: Risk management and good lives. Professional Psychology: Research and Practice, 34(4), 353–360. http://dx.

Thursday, July 11, 2019

ATSA’s Role in Addressing Campus Sexual Misconduct as an Opportunity for Prevention

By Joan Tabachnick Katie Gotch

Please note that this is a joint blog by the ATSA prevention and policy committees - Kieran 

Over the past ten years, the media and a growing advocacy movement have focused the public’s attention on campus sexual misconduct. Campuses throughout the world are facing this issue, and a growing number of countries are issuing guidelines that call on colleges and universities to improve the way they respond to and prevent sexual misconduct on campus. 

Advocates worldwide acknowledge that preventing sexual misconduct on college and university campuses requires comprehensive prevention strategies and policies for students, faculty, staff, and institutions.  A comprehensive prevention strategy includes providing services to all persons impacted by sexual harm – those who have been harmed, those who have caused harm, those at risk to cause harm, and the people connected to these individuals.

Given the importance of this issue, you may ask yourself: what could ATSA and its members provide in addressing campus sexual misconduct?  

We believe that ATSA has a unique lens and expertise in this growing conversation based upon our collective expertise and understanding of the perpetration and prevention of sexual misconduct.  The Centers for Disease Control and Prevention (CDC) in the United States has argued for the importance of this lens, stating that “a decrease in the number of actual and potential perpetrators in the population is necessary to achieve measurable reductions in the prevalence of sexual violence” (DeGue, Simon, Basile, Yee, Lan, & Spivak, 2012; DeGue, Valle, Holt, Massetti, Matjasko & Tharp, 2014).  Therefore, by incorporating the available knowledge and ATSA’s expertise on the assessment, treatment and prevention of abusive, illegal, or harmful sexual behaviors, a college or university’s ability to prevent and respond effectively to campus sexual misconduct will be strengthened. This includes what we know about effective interventions and protective factors for individuals who have committed some form of sexual harassment, misconduct, assault, or violence. 

To help articulate this point of view, ATSA’s Public Policy Committee and ATSA’s Prevention Committee joined together to develop a document outlining our contributions to this important conversation.  The document discusses the need to identify evidence-informed policies and practices that: 

hold individuals who perpetrate sexual assault accountable for their behavior; 

provide safety and support to individuals who have been harmed to facilitate healing; 

provide services for those who have caused harm with the resources necessary to stop their harmful behavior; and 

prevent sexual assault from happening in the first place.

The document additionally offers some key recommendations which are provided as suggestions to build a more effective response and prevention approach targeting the perpetration of sexual misconduct.  The recommendations include: 

connect with local expertise on the perpetration of sexual misconduct;

appropriately sanction and provide treatment to those who have caused sexual harm that is grounded in an individualized evidence-based approach; and

include perpetration prevention lens to existing prevention programs.

It is our hope that, by including the current knowledge regarding individuals who have sexually harmed with the emerging research and programs that show early and effective interventions can stop sexual misconduct, colleges and universities will be one step closer to achieving the important goal of preventing sexual misconduct. 

For more information, including additional resources on this important topic, check out the ATSA document: Addressing Campus Sexual Misconduct. It is a resource for all and we encourage you to share it widely!

Tuesday, July 2, 2019

Norway is increasing their focus on systematic treatment to high-risk persons who have sexually offended

By Ingeborg Jenssen Sandbukt

In 2015, the Norwegian Directorate of Health allocated money for a three year pilot project offering treatment to high-risk, sex-convicted persons. The project, BASIS (an acronym derived from the Norwegian name, Behandling Av Seksuallovbruddsdømte I Sør-øst) was carried out in the period 2016-2019 in the South-Eastern region of Norway. The project collaborated closely with international experts to implement a Good Lives Model-derived individualized sex offence treatment approach in Norway. Up until then, individual treatment aiming to reduce recidivism was rarely offered to this group while in prison, and the Correctional Service called for better and more systematic treatment options.
Norway’s structural policies are closely aligned with what Braithwaite called reintegrative shaming. (Reintegrative shaming, which focuses on the individual’s behavior and is related to the trend towards positive criminology, is not to be confused with traditional shame, in which the person feels bad about who they are.)  Sentences are relatively short in length, and persons convicted of sexual offences live side by side with other prisoners. Rehabilitation is considered a corner-stone in the Norwegian Correctional Service, and there are no registries after release.
However, there has been a substantial increase in the proportion of prisoners serving sentences for sex offences for the past 20 years, and the increase is seen as a challenge for the Norwegian Correctional Services. Persons convicted of sexual offences now make up about 19 % of the total prison population, compared to about only 6 % in 2000. The main reason for this increase is not a higher number of persons convicted of sexual offences (although we have seen a small increase in convictions as well), but a new Penal Code leading to more severe punishment for serious crimes, including longer prison sentences for sexual offences. Current court practice witness of an extensive increase in lengths of sentencing for some types of sexual offences for the past ten years, and it has been argued that Norway’s penal state has moved in a more punitive direction (Shammas, 2016). Several Continental European countries have in fact for the past years enacted more restrictive laws on sexual offending (McAlinden, 2012). In addition to longer sentences for sexual offences, other less severe crimes are more often than before subject of other forms of punishment than imprisonment, leading to a larger proportion of persons convicted of sexual offences in Norwegian prisons (Shammas, 2016).
Through the BASIS project, the health sector has collaborated with the Correctional Service to identify and locate high-risk individuals. All sex-convicted persons in the chosen region have been subject to a systematic risk screen using the STATIC-99R. Persons with a risk score of 4 and higher have been offered further assessment and individual treatment with trained psychologists. The STATIC-99R has not yet been validated in Norway, but the project group is working on results from a retrospective follow-up study to confirm validity.
Individual treatment using the Good Lives Model has been successful among patients (n=21) in the BASIS project. The future- and strengths-based approach seems to fit with the Norwegian values and the focus on rehabilitation and re-inclusion after release. Patients have stayed motivated and most have wanted to continue treatment after conditional release from prison. The collaboration between treatment providers and Corrections staff has been a key factor to succeed in implementing this new method for patient inclusion and treatment in Norway. Furthermore, the BASIS psychologists have had the opportunity to participate at international conferences like ATSA, and quality of treatment has been secured through regular supervision sessions with outside consultants.
A final conference marking the end of the BASIS project was held in Oslo June 4, 2019, with attendees participating from around Norway. The BASIS project’s final report, launched at the conference, recommended that systematic risk screening and individual treatment of the high-risk group is implemented nationally to reduce sexual recidivism among sex-convicted persons. As a result of the systematic work through these three years, authorities have allocated money to offer similar treatment in all health regions in Norway, based on the BASIS model. This is great news, and an important step in the direction of ending sexual abuse. Systematic risk-screening will be continued as a first step in including patients, and The Good Lives Model is the chosen treatment approach.
McAlinden, A.-M. (2012). The governance of sexual offending across Europe: Penal policies, political economies and the institutionalization of risk. Punishment & Society, 14(2), 166-192. doi:10.1177/146247451143557
Shammas, V. L. (2016). The Rise of a More Punitive State: On the Attenuation of Norwegian Penal Exceptionalism in an Era of Welfare State Transformation. Critical Criminology, 24(1), 57-74. doi:10.1007/s10612-015-9296-1