Thursday, September 17, 2020

Not so cute after all? The controversy over “Cuties”

 By Kasia Uzieblo, Ph.D., David S. Prescott, LICSW, and Kieran McCartan, Ph.D.

In recent days, a controversy arose over a Netflix-produced movie titled, “Cuties”. Its marketing campaign featured young girls dressed provocatively. It drew instant criticism in social media with some claiming it is a movie for pedophiles; others even stated it will elicit pedophilia. The topic has also become politicized, with politicians apparently fueling the idea that the movie is evidence of an underage child sex trafficking cabal in Hollywood. The furor over risqué art is nothing new, but the speed with which Netflix was chastened and responded was impressive: Netflix apologized, canceled the marketing campaign and in some countries has seemingly removed the award-winning movie from its platform. Ironically, most agree that the marketing campaign did not reflect the actual content of the movie effectively. The film was about a girl caught between the cultures of her French schoolmates and her Senegalese Muslim family and reflected the director’s story. Still, opinions of the content have been sharply divided within our field.

 

So, did we judge too soon? Most probably. Many judged the metaphorical book by its cover, without having seen the actual movie. The experience shows us the many perils of social media. Although social media has its merits, it tends to ignite polarized discussions with little room for nuance and reflection. Social media encourages the rapid browsing of headlines and elevates provocative items. Users are rewarded for (re)posting provocative, splashy items by giving them more followers and retweets, even if the story is untrue. Hence, social media focuses our attention on the number of likes and distracts people from accuracy. This is a dangerous evolution that is increasingly misused and abused by certain people and groups in society to mislead people on political, economic, health, and climate issues, to name a few. All of this is important for those us who spend much of our careers attempting to dispel inaccurate, seemingly mythical information about sexual abuse.

 

Will people change their judgment on the movie? Some might, and many will not, even when they hear what the story is really about. Information that is initially accepted but later corrected, is found to have a persistent influence on people’s memory and reasoning. New information will always be weighted and interpreted in light of information already received (Ecker, Lewandowsky, Pin Chang, & Pillai, 2014). In addition, people are more likely to accept (mis)information when it is consistent with their believes and attitudes (see for a review, Lewandowsky, Ecker, Seifert, Schwarz, & Cook, 2012). Thus, the danger in this story also lies in the fact that this controversy will fuel wrong conceptions on pedophilia and facilitate child trafficking conspiracy theories.

 

Will the movie ‘elicit’ pedophilia, as some have argued? There are two possible questions within this idea. With media willing to sexualize children in high supply everywhere in western society, perhaps we should be engaged in a broader discussion about this topic. On the other hand, questions regarding whether this film will create pedophilia where none existed before might best be answered with the question of whether watching films about gay people have ever changed anyone’s sexuality at a fundamental level. While there is always the possibility that any media will move people into some kind of action, people’s fundamental sexuality is simply not that subject to change.

 

Further, while there are provocative images and content within Cuties that some will view as confirming their existing offense-related attitudes and beliefs, the film is best understood in context. The ongoing debate reinforces the point that problematic content is always available and easy to access for our clients. This means we need to respond to this with our clients. It is not that different from the times before the Internet, when our clients would commonly use non-pornographic child sexual abuse imagery. Those who are interested in children will always find this content, with the difference here being that it was given directly to them. 

 

The main issue remains that these headlines and social media attacks divert from the important discussion that the director intended to have with the audience. She wanted to ignite a discussion on the sexualization of children. As the directors stated, “I wanted to open people’s eyes to what’s truly happening in schools and on social media, forcing them to confront images of young girls made up, dressed up and dancing suggestively to imitate their favorite pop icon.” This is the discussion that should get our attention. When I (Kasia) bring this topic up in my classes – which I have been doing over almost the last 10 years - many students argue that I’m not a feminist. Girls and women have the right to dress how they want; an argument that many pop icons promote as well. But isn’t the pressure that these girls feel to dress provocatively so that they can be part of the current pop culture not also a sign of oppression? And isn’t this form of oppression also worthy of close examination? Perhaps our rush to judgment precludes other, more important discussions, including those regarding where oppression begins and ends?


Thursday, September 10, 2020

“But they must have known”: Am I getting this wrong?

 This blog was written by an individual from the UK who wanted their story heard but wishes to remain anonymous.

This is a blog in a continuing series about the impact of the arrest & prosecution of individuals convicted of having Indecent Images of Children on their families (please see a previous blog by a professional and a family member). The author of this blog has wished to remain nameless, but please be aware that the individuals who contribute to these blogs, while anonymous, are different individuals. Kieran

The “But, they must have known!” blog presented the story of an ex-partner of an IIOC and her experience and emotions in the five years since ‘the knock’. My situation is almost identical, just five years on, and I wanted to highlight how the focus on the event and the immediate aftermath is not enough, and how the situation continues to evolve, and even heighten, as the year's progress. I am an ex-partner of a man arrested for IIOC offences 10 years ago. He received a community sentence and 5 years on the SOR. My children do not know. 

On the night that my ex-husband was arrested, my 2 sons (3 and 6) were playing in the living room. We had a great family, the kids loved their dad, and contrary to what people may imagine, there were no signs, we were very happy, and for the children, that meant an unexpected decimation of the family. Ten years on they still don’t know about their Dad, but this is what I imagine THEY FEEL.

Confused

Every day after the knock my eldest asked me: “What did Dad do wrong?” Every day I distracted him with: “Look what your brother just did”. One day, about a year after the arrest, he asked me: “Did Dad kill someone?” and I vowed that the next time he asked I would tell him the truth. He never asked again! I struggle to imagine another situation where what appears to be a happy and stable family unit would be terminated without the permission to grieve or to talk about the trauma. I told my children (and friends and family) that we decided to separate because we weren’t making each other happy. When people say: “The children will be better not hearing the arguments, or living with the tension”, I envy those families because my children were not better without the arguments or tension because there were no arguments and there was no tension. Is it akin to the death of a parent? I imagine in that situation there is permission to talk about Dad and how great he was. The children don’t have to see their Dad unemployed and broken, but silent as to why this has happened. It’s a world based on lies, deception and, ultimately, a disengagement, because the topic cannot be discussed. I hope that they are too young to dwell on the inaccuracies and the contradictions, but I fear that may be false hope.

Scared

I think my children feel scared. When your world falls apart in an instant, one of the outcomes is hyper-vigilance. Within a day their mum turned from a laid back, happy person to someone who panics at the sound of the phone or knock at the door, who over-reacts when school phone to tell her you have done something wrong, and who often breaks down at things she never did before – without explaining why. While mum used to have lots of friends, enjoy a glass of wine and relish the chance to mix with other adults, she makes excuses to avoid seeing people, she rarely goes out and she doesn’t talk much anymore. For the (ex)partners of IIOC offenders, the crime has a life sentence – the lies, the deceit, the fear,  it consumes you to a point where the safest option is to retreat, and for my children, that overnight transformation must be terrifying.

Do they know?

I think that one of the hardest parts of being the remaining safeguarding parent is projecting every emotion you feel onto how your children might feel. Are they scared or is that my emotion? Are they confused, or does this all wash over them? And feeling the intense and unrelenting desire to tell them why their life changed so dramatically, but all the time knowing that, once said, that cannot be unsaid. These are thoughts, emotions, and behaviours that are not recognised or supported by agencies set up to deal with offenders, victims, or children of prisoners (the overwhelming majority of IIOC offenders receive a community sentence). For my children, and for me trying to parent them, there is no guidance or support, and the overwhelming feeling I have is: “Am I getting this wrong”.

Thursday, September 3, 2020

Community Violence and Individual Anguish

 By David S. Prescott, LICSW

The news across cities in the US has once again been horrifying. We, professionals, have found ourselves at our wits’ end trying to figure out what we might do. Watching the news is a harrowing experience. Ignoring it is irresponsible. While some details of each incident may be debatable, the overall trends couldn’t possibly be clearer. People of color have died under circumstances that are questionable at best (and this is an attempt to express it diplomatically). All of this comes against a backdrop since the start of the summer of documented, nationwide increases in anxiety, depression, substance use, and suicidal ideation. Why mention this topic in a blog that typically focuses on issues relevant to sexual violence prevention?

First, most of this blog’s readers have in one way or another made life as well as a living in trying to help build healthy lives and safer communities. For the most part, we all have skin in this game. Yet for all of our specialized efforts anxiety, depression, illness of all sorts, and overt violence – including overt racialized violence – are on the rise. We still don’t have a clear picture of what has been happening with family violence behind closed doors. Where will we want to focus our next efforts? With what resources?

I was recently on a call with colleagues discussing work with at-risk children and adolescents. The question arose about whether any kids in the current era are not at risk, given their exposure to so many horrific events. While, on average, kids from minority backgrounds and marginalized communities are at much higher risk for every kind of bad outcome, it is an interesting question. The challenge of how best to form connections with kids who have been abused was once front and center in our minds, but it may be more realistic now to ask whether we can possibly understand their current realities and emerging world view. How should we change our assessments and treatment in response to the gruesome realities of daily life in 2020?

It’s sad, but not unsurprising, that here at the end of the summer social media for professionals has been quiet on these issues. An earlier draft of this blog post shared with listservs for clinicians of various backgrounds prompted almost no response in some quarters, despite it specifically asking what readers were doing in response to these events. Certainly, there are questions about the boundaries of listserv discussions when the pandemic and our current community violence is so intertwined with politics, economics, and other topics that have been historically off-limits, often for good reason. On one listserv for solution-focused practitioners around the world, there was no response at all. On a US-based listserv for over 2,000 psychotherapists, there was only one response -- a reminder to vote in November.

Nonetheless, there is no way that this same silence goes unnoticed when those of us providing treatment don’t acknowledge the deep, life-altering anguish surrounding us in discussions with clients and co-workers. In just one example, a colleague related how an academic dean sent around an email in sympathy for those affected by Hurricane Laura and the wildfires but never mentioned the numerous instances of civil unrest or their tragic causes. Some professionals feel that it’s important to get the conditions just right before having discussions about race. Meanwhile, professionals of color observe that they have been waiting for centuries for those conditions to become “right.” Some professionals have correctly noted that participating in social media can present a high risk of being misunderstood. On the other hand, practitioners frequently participate in uncomfortable discussions about everything from the sensitive details of victimization to the nuances of sexuality; perhaps it’s time to work on our communication skills?

Further, it seems that all too often our discussions of trauma-informed care are easier when the trauma is clearly of someone else’s doing rather than our own. It’s easier to look at overt violence at an individual level than to look at cultural trauma boiling over -- a trauma that we may well have contributed to, whether actively or passively. Every now and then we discuss clinical approaches to clarification, reconciliation, and reunification for individuals on this list, and yet we’ve been absent from any discussions about how we might apply these ideas to ourselves in a larger social context.

What can we do?

Perhaps the most effective response we’ve heard in recent weeks was from programs in the Southeastern US, where the director asked for data to be reviewed. This involved data about the length of treatment, number of sessions, treatment outcomes, etc. To quote the director, “Across the board, we found that we were not practicing in an equitable way. Our clients of color were less successful, (had) longer lengths of treatment, (had) more disruptions in treatment . . . It initiated a process that we are in the middle of to make changes, with consultation from some folks that are much more astute about equitable systems, in creating a more equitable and culturally responsive practice.” In a subsequent private email exchange, this person emphasized that it was the staff members who had done the heavy lifting to make these changes possible.

In another case, the editorial board of a journal outside of our field engaged in a lengthy self-assessment process in order to completely revamp their procedures. Yet another set of circumstances prompted a lawyer involved in the field of therapeutic jurisprudence to describe how so much of her work had focused on justice with individual cases that she had to re-think how she views community responses to violence. Still, another described, with some grief, how she had changed her legal practice because she could no longer justify her practice in family law to herself.

At the front lines of our work, however, direct questions remain. For example, a young black man is arrested after a brief chase. In his assessment interview, he states that he does not trust people in authority. When asked for clarification, he says, “Just look at the news!” Where are the bounds of our judgment in describing his attitudes and/or behavior as “antisocial?” Where do objectivity and subjectivity begin and end under these circumstances? To what extent do we say that circumstances are “different in the current era” when the primary difference is the ease of access to a video recording? After all, the statistics and concerns have not actually changed much over the years, although the possibility of documenting violence has.

Clearly, addressing issues around race; the backdrop of violence, anxiety, fear; and in some cases suicidal ideation will require efforts at the individual and community levels (and by the community, we mean the full range that the word implies, from professional organizations such as ATSA to our society beyond). This will have to include deep soul-searching and difficult conversations as well as educational approaches, policy reviews, and the like.

As Martin Luther King, Jr., famously asked: “Where do we go from here? Chaos or community”?

Note: The individual communications noted in this blog are shared with the permission of those who communicated them.

 

Thursday, August 27, 2020

“The Train Keeps a’Rollin” … 10 Years Later

 By Kieran McCartan, Ph.D., David Prescott, LISCW, & Kasia Uzieblo, Ph.D.

In the UK we do not have high school reunions, they seem to be something quite American or reserved for 80’s movies; but if this blog had a reunion, this post might be it.

 

Ten years ago, in July 2010, Robin Wilson started the blog with the blessing of Maia Christopher and James Cantor as a way of continuing the public and professional outreach of ATSA and its Journal, Sexual Abuse. The blog was to be a platform for discussing, via concise messaging, the main issues, challenges, and progress of the sexual abuse research and treatment field. The aim of the blog was to be informative but critical in an accessible way. Whether the blog has accomplished that is for its readership to decide and comment on. What the blog has done is provide a commentary on the reality of sexual abuse for professionals and the public for 10 years. Just to give a behind-the-curtain snapshot: over this period we have produced 372 posts, averaging between 30 – 45 annually, with approximately half a million individual hits across the life of the blog, means that we average 200-250 hits per day, from across the world (although westernized, anglophone countries are where most off our readers come from).

 

Over the last 10 years, the blog has had a number of in-house writers (Robin Wilson, David Prescott, Jon Brandt, Kieran McCartan, Alissa Ackerman, and Kasia Uzieblo). We have also had a number of external writers, some invited and others who volunteered themselves or ideas (including Norbert Ralph, Michael Seto, Danielle Harris, Jill Levenson, Don Grubin, Tyffani Dent, Franca Cortoni, Joan Tabachnick, and Cordelia Anderson, to name a few as we have had over 30 contributors please do have a look at the back catalog to see who else has contributed ). In sum, the blog has had strong influences of practice, academic, and international approaches to it. Over the course of this period, we have covered topics, including risk assessment, treatment, polygraphy, residence restrictions, the (non-)impact of Halloween, myth-busting, desistence, re-offending, community reintegration, professional practice, prevention, individual and systematic issues (i.e., gender, race, vulnerability, etc), and policy. The blog has often reacted to current affairs, as well as discussed ongoing debates in the field and society; we have never shied away from touchstone issues and won’t going forward either.

 

So, as this is our anniversary, what has changed and what has not? We believe the public policy landscape in the USA and internationally has shifted somewhat We also believe our field now discusses sexual abuse prevention even more than in the past. We have seen beginning increases in the use of person-first language in our communications, just as the field has started to take more of a client-centered approach. Finally, we are starting to see more nuanced public discussion in the media.

 

However, not everything has changed: we still see punitive policies, a fractured use of the evidence base, and emotion/ideology clouding the development of realistic policy and practice. Budgets are cut routinely, and professionals are expected to do more with less. Ten years on it feels like the deckchairs have been re-arranged when a wholesale redecoration is what has been needed.

 

This is not to say that there are no signs of hope for the future. The advent of the #metoo movement, increases in bystander intervention, corporate “wokeness”, the rise in awareness brought about by movements such as Black Lives Matter, increased victim advocacy, the debate surrounding the best ways to help people who are attracted to children and to prevent offending, and an increasing realization that sexual abuse is a (public) health issue, as well as a criminal justice one, mean that a new vision for the future is underway.

 

Change takes time and ours and related fields have a long way to go. On balance, it seems we are on the right path. Professionals need to keep emphasizing the importance of using the available evidence and making our knowledge and experience available to others as a concrete means of preventing as well as responding to sexual abuse. We also need to keep an open mind to new perspectives and learn from our colleagues in both westernized and non-westernized countries.

 

In ten years, the biggest strength to the blog has been the voice of contributors, both in-house and external, and to that end, we encourage anyone, and everyone from all around the world, to contribute. We are always open to new voices and perspectives. Here is to another 10 years, it’s not an ending rather a marker on a never-ending journey!

Wednesday, August 12, 2020

Developmental perspectives on "lying and manipulation" in juveniles who sexually offended.

By Norbert Ralph, PhD, MPH, private practice, San Leandro, CA.

As a clinician working with juveniles who sexually offended (JwSO) I find that these youth are frequently described as "lying and manipulative" which is presumed to be part of the pattern of behaviors that led to sustained criminal charges. Such behaviors might include things like denying or minimizing harmful behaviors and the effects on victims, for example. A developmental perspective can be useful to understand these behaviors from the youth's point of view, and importantly also adult reactions to them, and the interaction between the two. It can help in developing strategies and interventions to avoid future harmful behaviors and develop prosocial behavioral patterns in the youth.

The ethical and moral framework of professionals involved with juvenile justice youth is an important factor in the probation process. Sexual violence, whether by adults or juveniles, is among the most serious crimes, a cultural taboo, and significant harm is often done to victims. Societal and personal ethical reactions to sexual crimes by juveniles often becomes part of the legal and probation process and evoke strong negative emotional reactions. This moral view of juvenile transgressions may also resonate with the psychiatric categorization of juvenile delinquency. For example, DSM 5 criteria for Conduct disorder includes, "Often lies to obtain goods or favors or to avoid obligations (i.e., “cons” others)" (American Psychiatric Association, 2013).

Evidence-based models contrast with these personal moral attitudes regarding sexual crimes. For example, the How I Think Questionnaire (Barriga, Gibbs, Potter, & Liau, 2001) assesses offense-related thinking patterns based in part on Kohlberg's theory of moral development. For example, the instrument has scales which assess developmental immaturity and egocentricity, sometimes described as thinking errors, such as Lying, Self-Centered, Blaming Others, and Minimizing/Mislabeling. These thought patterns are viewed as part of developmental immaturity using Kohlberg's framework for moral development and not fixed and presumably untreatable traits.

A complementary model is Hy and Loevinger's (1996) work on ego development which provides an evidence-based theory of psychosocial development throughout the lifespan. Adolescence is a period of rapid psychosocial development. Most older teens and young adults score at the I-4 or Conformist level which reflects an internalized sense of socially appropriate behavior, rules, and laws. The next lower level, the I-3 Self-Protective level is most prevalent in pre- and early adolescence, from age 10 to age 13. In one study of JwSO, 92.5% were either classified at the I-2 Impulsive or I-3 Self-Protective (relatively lower levels of ego functioning), compared to 43% of a non-clinical 14-year-old sample (Ralph, 2017a). Similar to Europeans in the Middle Ages who viewed the Earth as the center of the universe, youth at the I-2 or I-3 level view their own needs and goals as paramount, and don't have a differentiated model of external rules, laws, and rights of others that facilitate prosocial and "win-win" interactions as might be present in higher developmental levels found more frequently in adults. For these youth, rules, or facts (e.g., you missed your appointment) that get in the way of things the youth wants to do, are seen as something to deny or avoid, unfair so they can be ignored, not true, wrong, mistaken, etc., rather than youth at a higher level than see "facts are facts" and "rules are rules", and like it or not, they are just there.

Ralph (2017b) describes factors and treatment methods that promote psychosocial maturity for the general juvenile probation population, and specifically for JwSO. These interventions view deficits in prosocial reasoning as a modifiable risk factor for delinquent and harmful behaviors that are treatable. These methods help the youth "up their game" to use more effective and mature methods of social-emotional reasoning about the choices they make. Complementary literature described in Ralph (2019) reports that incarcerated youth who psychosocially mature in detention have improved the frequency and severity of recidivism. More psychosocially mature youth have more sophisticated internal models or paradigms of "how the world works" and can do the "cost-benefit" analysis to avoid future problems. For example, Ezinga, Weerman, Westenberg, and Bijleveld (2008) in a community sample found more delinquent behaviors in youth at the I-2 or I-3 level in contrast to higher levels.

A developmental perspective on harmful behaviors by youth may help explain adults’ reactions to JwSO. Adults who are at the I-4 Conformist level, higher than the I-2 and I-3 levels have an internalized sense of rules, laws, and expectations, different from one's own wishes. People are either "good" and moral, or "bad" and immoral. The assumption of adults in this stage is that teenagers involved in harmful behavior know right from wrong and are deciding to be "bad" because they think they might get away with it. In my experience, this perspective often dictates that the most effective approach with youth with moral immaturities include verbal criticisms and severe sanctions. Such measures, while in some circumstances appropriate, if over-utilized may further traumatize youth where trauma itself had been a factor in offending, and also there is evidence that "get tough" approaches are not effective (Lipsey, 2009). This "get tough" view of JwSO and appropriate interventions may "bump up" against a developmental perspective. This disparity in perspectives may account for conflicts regarding disposition planning advocated by treatment providers on the one hand, and judges, probation officers, and district attorneys on the other.

In summary, risk factors, and treatment interventions for JwSO optimally should include developmental considerations, among other approaches. It is useful not only in designing more effective treatments and disposition planning for JwSO, but also in every day clinical work with these youth and consultation with the probation and legal system. In real-life clinical work these behaviors when can provide a useful framework for considering therapeutic "next steps" for youth in therapy and treatment planning.


References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.

Barriga, A.Q., Gibbs, J.C., Potter, G.B., & Liau, A.K. (2001). How I Think (HIT) Questionnaire manual. Champaign, IL: Re-search Press.

Ezinga, M. A. J., Weerman, F. M., Westenberg, P. M. and Bijleveld, C. C. J. H.(2008). Early adolescence and delinquency: Levels of psychosocial development and self-control as an explanation of misbehavior and delinquency. Psychology, Crime & Law,14(4), 339-356.

Lipsey, M. W. (2009). The primary factors that characterize effective interventions with juvenile offenders: A meta-analytic overview. Victims and Offenders, 4, 124-147.

Ralph N. (2017a). Moral Reasoning in Juveniles Who Sexually Offend. ATSA Forum, XXIX(2).

Ralph N. (2017b). Prosocial Treatment Methods for Juveniles Who Sexually Offended. ATSA Forum, 2017, XXIX(3).

Ralph N. (2019). Neuropsychological and Developmental Factors in Juvenile Transfer Hearings: Prosocial Perspectives. Journal of Juvenile Law & Policy, 23(1), 1-24.

Friday, August 7, 2020

The Color of Money: How we fund sexual offense work

 

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

 

One of the main challenges that professionals working in the broad field of sexual offending is funding; namely, how much there is and where you can get it! We have previously written about the challenges of identifying and truly knowing the extent of sexual offending that there is in society, and therefore the number of resources needed to respond to it both from a victim and perpetrator perspective. This complex mathematical, and very human, the problem has been made challenging of late as we have started to think about the prevention of first-time offending in the same breath as preventing re-offending. This means that we need to make a small pot of money go a lot further and do a lot more. But how can we achieve balance with this? 

 

Quite often one hears from colleagues in the sexual abuse prevention, treatment, and activism fields that times are tough and that there is not enough money to go around to fund the services that they need to (not even close to what they want to) deliver. For all the political hyperbole around sexual offending and its impact on individuals as well as communities it is underfunded, and when push comes to shove it is always first in the queue when additional cuts need to be made. This is particularly relevant when you consider the scale of sexual abuse, between one in four and one in eight people being impacted by it at some point in their lives. Sexual abuse, therefore, is not a one-off offense that randomly strikes at small groups of society. With figures like this, sexual abuse is a pandemic with a potentially greater hit rate than COVID-19. This leaves us with a paradox: we know it's common and it traumatizes people with a long-lasting effect and yet we still do not fully fund efforts at preventing and treating it! It is important to state that we are not just talking about services for people convicted of sexual offending, although the punishment side of the equation is better funded than the rehabilitation side, but also victims of sexual offenses who have also had funding cuts, and services reduced. It is across the board! 

 

So, what do we do about it? This is a challenge because we often hear that budgets are stagnant and that there can be no more investment. Often this is tied up with politics, governance, media discourses, and public mood, which means that asking for money at the right or wrong time can result in a feast or a famine. This is unsustainable and is often reversed later in the funding cycle or in the next funding cycle. We need a more sustained funding strategy rather than just a reactionary one. A more sustained funding strategy allows more innovation and positive adaption, rather than cutting or squeezing existing budgets to do small, underfunded projects. So where does the “new” money comes from to support ongoing work in, and develop innovative work in, sexual abuse? 

 

One solution, as discussed by Wilson Wong in a piece about defunding the police, is that we move and reallocate the existing pot of money to use it better. The argument here is that the best and most suitable organizations should be the ones that deliver the services and, in this instance, maybe the police are not the best ones to respond to, support, and manage those impacted by sexual offending. That work could instead be done by third party organizations and charities. In addition, it reinforces the broader move in the sexual abuse field at the minute to be more trauma-informed and service user lead. Following on from this, if we broaden our remit around sexual offending and continue to incorporate elements of health, public health, education, and local communities we can open more funding pots. With various organizations and statutory bodies funneling monies into a combined project then not only will we have more funding, but we will also have more buy-in and impact. Additionally, the way that broader society, both corporate and private, funds sexual abuse support/treatment organizations is important. If sexual offending is an epidemic, then where is the national fundraising drive or the equivalent corporate response? Sexual offending research and practice are not funded the same as cancer research, or HIV/AIDs research, but the impact that sexual offending has is the same. 

 

 We need to change the funding formula with respect to sexual offending, both in terms of victims and people who commit it, so that its fit for purpose. So while the defund the police movement has thrown up a suggestion on how to tackle the funding challenge in sexual offense work maybe it’s more “refund”, “change funding”  than “defund”? Funding sexual offense work should not be a deficit, it should not be taking the funding away from other sources to support it, but rather should be a reallocation to make existing practices work better.  

 

Thursday, July 30, 2020

Deceit, Sex, and Sexual Assault: Where are the Lines?

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

Please note that this blog is also published on the NOTA prevention website too – Kieran.

While working in a large residential treatment center for youth about twenty years ago, the first author (David) ended up with a note passed between two students. In it, a 16-year-old male client claimed to a female client from a different campus that he had a condo near the casinos in Atlantic City, New Jersey. It was bittersweet at the time, reflecting the age-old attempts by young men to impress young women while displaying epic ineptitude. It would have been obvious to nearly anyone that he possessed few social skills, much less a condo that they could escape to. The author found the reason for hope that the young man would someday be able to have the relationships he desired, while at the same time being concerned about the young man’s methods in the short term.

From here, however, things too often take a darker turn. Seemingly consensual activities in the context of getting a job or advancing within one. If the job or advancement doesn’t come through, how best to understand the results? Fraud, sexual assault? There is an entire style of pornography devoted to tricking women into being filmed having sex through the false promise that they are auditioning to become porn stars. What is the source of gratification beyond the sex in these situations? The gullibility of the woman being filmed? And of course, much of the #metoo movement resulted from the experience of being pressured into sex if one wanted to continue working in one’s chosen field.

A recent case in the UK adds to these important but thorny questions. Jason Lawrance was found guilty last summer of sexually assaulting a woman twice. Although the sex had at first been consensual, he had lied about having had a vasectomy. He subsequently texted her to say that he was “still fertile. Sorry.” She took emergency contraception and eventually had an abortion. Fraud? Sexual assault? Intrinsic gratification from the deception itself (sometimes known as “duping delight”)? The issues abound in a situation with a truly tragic ending.

The more immediate concern, however, is that Lawrance’s convictions were overturned. The Court of Appeals reportedly said that the “convictions were unsafe.” Meanwhile, Lawrance is currently serving time for other sexual assault convictions and remains in prison. Ultimately, the court said that “Lawrance's "lie about his fertility was not capable in law of negating consent".

This view of deceit is interesting and worrying because it drills to the very heart of the problem: the absence of “informed consent” is at the very core of sexual assault. However, of concern to the court was the nature of the actions that remove consent. The challenge here is a truly grey area. At what point does deliberate trickery become the coercion that is central to sexual assault? After all, gaining children’s compliance through trickery has long been recognized as a hallmark of child molestation.

The issue is almost not whether it is true that Lawrence had a vasectomy (as with David’s student and his fictitious condo), but rather that they said that they did and were believed. The woman in question made an informed decision based on false data that was created for the purpose to deceive. Further, by all appearances, Lawrance made an informed decision to create an illusion of informed consent.

It’s possible to discuss this situation from a number of perspectives, from the possible sexual and nonsexual motivations of an egregious behavior to questions about what specific crime categories this might fall under. What is clear, however, is that the idea of what constitutes consent is again back under discussion. In our opinion, this decision undermines decades of advancement in determining the importance of actual, meaningful consent. In some ways, it is similar to revenge porn posted in a technically legal fashion because the filmed partner simply consented and did not draw up a proper legal contract to define the parameters of the consent and the conditions under which the video could be distributed and viewed.

What is clear is that should the current decision be accepted as a legal precedent; it will take considerable public dialog to create new laws that are both sensible and meaningful. The overarching problem, in this case, is that it will likely dissuade victims of sexual offences from going forward because they feel that they won’t be believed, especially in situations where “consent” is difficult to establish or refute.


Thursday, July 23, 2020

Constructing victims as offenders: Challenges in responding to the dysfunctionality in sexual abuse.


By Kieran McCartan, Ph.D, David S. Prescott, LISCW,  & Kasia Uzieblo, Ph.D.

All too often, professionals and the public alike can view abuse as involving those who cause harm, and those who have harmed. This dichotomous view, in which people become labeled and understood as either “offenders” or “victims” overlooks the often-horrific circumstances that the people involved have endured. For example, it can be a common experience that children who grow up in adverse environments become an easier target for those seeking to exploit their vulnerabilities. Often, those same children may be implicitly or explicitly coerced into illegal behaviors. This is one example of the pernicious nature of sexual abuse; one never knows how young people will respond to circumstances that are by definition difficult to survive.

This is clearly evidenced in a recent story about young people who had been victimized in the Rochdale sexual abuse grooming scandal in the UK. In recent years in England and Wales, there have been a series of gang-related grooming scandals coming to light. Quite often, these scandals involved victims who had not been listened to, respected, treated properly of believed. Sometimes they were prosecuted for crimes directly linked to their own abuse (for example, a girl becoming agitated and arrested for disorderly conduct when the police wouldn’t believe that she was being abused), or at least seen as being as complicit in their own abuse. The girls in question were often arrested for other illegal behaviors as well. These unacceptable responses often derailed cases, made the crown prosecution service wary, and caused serious harm to these children in later life (i.e., mental health, social and employment issues). This kind of double victimization by the system who neglected their abuse and punished its symptoms is manifestly inhumane. The public is witness to the impact of trauma and adverse experiences on the development and life course of these girls.

Research shows us that those who have been victimized by sexual abuse and other crimes often have multiple interrelated vulnerabilities. Therefore, it should not be a surprise that victims of crime are dysfunctional in other ways that could lead them into contact with the system. Our hope is that this case leads more adults to see these multiple vulnerabilities and to understand problematic behaviours holistically so that we can provide the correct tailored support to the individual. Seeing multiple vulnerabilities as causal factors, in a rational choice sense, that lead people to be “willing” victims only does more harm.

Ultimately, we hope that more professionals can understand developmental and life-course challenges appear to normalize abuse in the lives of young people. It is simply not the case that adversity causes young people to seek out abusive situations. When society can change our perspective on the people that come into our services to be more prevention-focused and trauma-informed, we can understand that we need to change our language and ways of working to better support them.

One clear example of this need to shift our understanding is the language used around sexual abuse as opposed to sexual exploitation. In sexual exploitation, we talk about gifts, compliance, and aspects of choice, whereas in sexual abuse we often do not. This is problematic because sexual exploitation is itself a form of sexual abuse involving very similar victim-access behaviors. The use of terms such as “gifts” gives the impression that the victim is a willing accomplice and, therefore also guilty. This draws attention away from the fact that they have been victimized and labels them as “problematic”, which can impact them personally, legally, and socially. Another example is the still widely held belief in a “just world”. People, including professionals like police officers (Sleath &Bull, 2012) still far too often tend to perceive the victim’s misfortune as deserved, also in sexual abuse cases. As we know, this belief in a just world is related to victim-blaming and might explain why we tend to have that blind spot for these adverse life events.

Fortunately, we are starting to see some changes around this. One of the authors’ (Kieran) neighboring police force in Gloucestershire have made a commitment not to arrest young people for low-level anti-sociality linked to their victimization (and stands in contrast to the case in Michigan in which a girl was jailed for not doing her homework). This means that they can focus on supporting the young people by addressing the causes of their victimization and making sure that the individuals responsible are held to account.

Thursday, July 16, 2020

Is This Logical? Applying Therapeutic Logic in Mental Health Law Proceedings


By David S. Prescott, LICSW, Kieran McCartan, Ph.D., and Kasia Uzieblo, Ph.D.

A new study in the International Journal of Forensic Mental Health deserves our field’s attention. Sven Pedersen, Thomas Nilsson, and Lena Eriksson examined the experiences of people who are patients in forensic psychiatric services and recurring mental health law proceedings. Readers are likely already aware that all work at the intersection of mental health and the law can become challenging on even the best days. As challenging as it might be for professionals, however, it is apparently even more frustrating for the patients themselves.

The themes that emerged from the interviews were:

1.  A manifest hierarchy with the patient at the bottom
2. Patient contributions as irrational and unwelcome
3. The patient as evidence, not a person
4. The devaluating effect of not being heard or being treated as something bad
5. Lack of useful allies willing to challenge the status quo
6. The need for compliance and loyalty

In analyzing the themes within the patients’ narratives, the authors stated that “Taken together, these themes illustrate a process whereby the patient is kept from influence through a manifest hierarchy based on authority more than on evidence or argumentation; through the objectification and devaluation of the patient; through the lack of potent professional support; and through the need to abstain from challenging the authorities in order not to disrupt their benevolence. The six themes are structured linearly, in accordance with the process described above.” (P. 4)

It may be that the best news in these findings is the fact that anyone tried to seek out the experiences of these people and that there was a structure in place to do so. It is doubtful whether either would have occurred a century ago except in an informal or haphazard fashion. The bad news is that these circumstances send contradictory messages to the very people who need open and straightforward dialog the most: people with diagnoses of major mental disorder.

These contradictions include: On the one hand, you should have input into your treatment and legal proceedings. On the other hand, we will not value what you say about your experience. On the one hand, we want you to talk with us about that which is meaningful to you, and on the other hand, we may dismiss what you say outright. On the one hand, we want you to have a better life and on the other hand, we continue to view you as dangerous, irrational, and a probable liar, and not more than the sum of your diagnoses and your offenses. While it is no surprise that these clients wouldn’t find the experience to be helpful, the paradoxical nature of these contradictory messages brings forth the possibility of making matters worse in treatment and the legal proceedings.

Sadly, our field does not lack information on how to work with these individuals. Jaakko Seikkula and his group in Finland have demonstrated that early intervention using an open dialog approach can address each of the concerns expressed above. Motivational Interviewing can also be helpful. Ultimately, what these findings show is the importance not only of the structures of interventions but the spirit in which these interventions is offered. This (again) reinforces the need to hear, and recognize, the voices of our service users in the treatments and interventions that we deliver with them.

The fields of health, medicine, psychology, and psychiatry have attended to the service user’s voice for a long time at an abstract level. Yet in our work with people who have caused harm to others, these ideas and findings rarely appear to be applied at the individual level. We question whether this doesn’t leave treatment clients with a two-tiered client-engagement program based on their offense and not criminogenic needs. Our clients’ aspirations are not so different from ours. For example, they also strive for a feeling of connectedness and a sense of self (Clarke, Lumbard, Sambrook, & Kerr, 2015).

Perhaps the biggest take-home message from Pedersen et al.’s work is that even with the most challenging population, in the more challenging arena, there is a need for proactive engagement between professionals and their clients to better understand the impact of the criminal justice process on those who experience it. This is starting to happen with the consideration and implementation of trauma-based approaches at a policy and practice level. Therefore, we in the sexual abuse field need to ask ourselves how can we further develop this work in our own practice?

Finally, researchers also have a responsibility within this regard; we have already gathered uncountable data on the characteristics of forensic patients and on their offenses, but we tend to overlook that these participants are individuals who may actually themselves suffer from the offenses they have committed, who may have been traumatized by the judicial process they went through, or who feel more like a guinea pig that has to be studied because of his/her criminal behavior rather than for who he/she really is.    

Monday, July 13, 2020

Welcoming out new blogger: Kasia Uzieblo

Dear all,

It gives me and David great pleasure to introduce a new member of the blogging team, Kasia Uzieblo.

Kasia Uzieblo is a senior researcher at the Forensic Care Specialists (Van der Hoeven Clinic, the Netherlands) and visiting professor at Ghent University and Vrije Universiteit Brussel (Belgium). In the past, she has developed a research program on forensic psychology (University College Thomas More, Belgium), a nationally renowned educational program for forensic practitioners, and a professional network for Flemish forensic psychologists. Her research focuses on the underlying mechanisms (e.g., psychopathy, relational dynamics) of violent behavior, including sexual violence, forensic psychological assessment (e.g., risk assessment), the impact of (sexual) violence and help-seeking behavior in both victims and perpetrators. She has published more than 60 manuscripts/book chapters/essays and has organized numerous conferences/training/symposia on the aforementioned topics. Kasia Uzieblo also serves as a board member of multiple scientific and professional committees and societies, including ATSA. She is the past-past president of the Dutch chapter of ATSA (NL-ATSA) and is a member of the international ATSA committee. She is currently following training to become an official Static-Stable-Acute trainer. In addition, she conducts forensic psychological assessments for the court and in the forensic psychiatric clinic, the Van der Hoeven clinic.

I hope you will join us in welcoming Kasia. We will have a blog, as normal, later in the week.

Best

Kieran & David.

Friday, July 10, 2020

“But, they must have known!”: The perspective of a non-offending partner of a man convicted of downloading indecent images of children.


This blog was written by an individual from the UK who wanted their story heard but wishes to remain anonymous.

Please note: a few weeks ago, we had a blog from Anna Glinski, which prompted a conversation with the author of this blog about their experiences being the partner of a person convicted of possessing Indecent Images of Children. Kieran

What is it like being the non-offending partner of an IIOC perpetrator? Hard. Everything about it is hard.

In 2015 my ex-husband was given a 3-year Community Order and 5-year SHPO for downloading >1000 indecent images of children from 2011-15 across all three categories (majority B). No videos.

The knock-on the door by the Police came as a complete shock as I had no inkling that he had a sexual predilection to underage girls. For the first couple of weeks after the arrest my sons, aged 3 and 6, had no contact with their Dad as per his bail conditions. I then signed a Supervised Access Only Contact Agreement with Children’s Services that I was advised would remain in place indefinitely. This, combined with the overwhelming fear of the predicted media exposure, prompted my decision to relocate.

Everything about my past, present, and future suddenly had a whole new perspective. I went from being a full-time mum who lived in a nice part of my hometown with children attending the local faith school and a husband with a very good job, to a divorcee with a vague backstory of why I needed a fresh start somewhere new.

As he remained part of society at every stage of the Judicial Process, we have had to find a new way of being with him as part of our world. The ramifications of this crime do not get less significant in time and the effect on children evolves as they grow up. I FEEL

Angry/restricted. None of this is fair. I have done nothing wrong, yet I need to make unending compromises to protect my family against negative community response because of our association with an abhorrent crime that we were innocent bystanders to every aspect of life is affected, from social interactions to employment options. I do not foresee this changing when his sentence is completed in winter 2020.

Judged/marginalized. From day 1 I felt as though I was being assessed whether I was a good enough Mum by anyone I had contact within a professional capacity, however as I ticked the right boxes, none proactively maintained any contact with us after 3 weeks post-arrest. To begin with the lack of attention from authorities was akin to relief, but as time has progressed, I perceive this demonstrates that my boys are the unseen victims of this crime and the impact on their childhood seemingly acceptable collateral damage to achieving a conviction. I thought people would think I was stupid for not knowing about his online behavior, or in denial, and would wonder whether I had the same interests too, plus would question any historical interaction their children had with mine. Now I know, through lived experience, I am invariably judged for allowing my children to still have supervised access with their Dad.

Unsupported Even though I hate the thought of my kids being considered vulnerable, this scenario triggers several Adverse Childhood Experiences, which means that they are. At the start, when I became aware of something I was blind to before, I desperately needed help to protect them from this significant threat to their well-being. Unfortunately, as we were(are) not classified as Victims, I could not find any support for us from any source. I struggle to find professionals who fully empathize with our situation, therefore am simply left alone to make up appropriate safeguarding measures for my boys as I go along. The impact on my mental health has been significant: after being repeatedly declined anti-depressants, with a long waiting list for NHS therapy, I have had no other option than to self-fund counseling.

Resentful. From the start, he had a network around him to help him live life forward. Police made it clear that any break in confidentiality about the nature of the investigation could increase his suicide risk. I took on the responsibility of keeping secret the reason behind my sudden change in circumstances which consequentially created distance within pre-existing friendships. Until the charges were made public in Magistrates Court I lived in limbo for 5 months not knowing the full scope of the investigation to protect his Right to Privacy. Probation monitored him regularly and supported getting him back into employment. He managed to meet and move in with a local woman who accepted his conviction. I have had nothing as I moved to a place that gave us anonymity.

Sad. I feel heartbroken that my boys have been robbed of a traditional father figure. I can only protect them from this for so long before they will learn preciously early in life that people are not always what they seem. They are going to have to face a huge emotional and psychological challenge as teenagers when they grow to understand what their Dad did.

Strong/proud. I had to forgive myself that I could not have seen what he took such great care to hide. As someone who has had a relationship with a man convicted of this crime I have felt: confused; naïve; misunderstood; full of self-doubt; disappointed in myself for missing it; burdened with a family secret; scared; isolated; lonely; ashamed; torn; irrelevant; guilty; fearful for the future; bereaved; like a victim. Yet I have got back up each time this situation has brought me to my knees and that makes me resilient.

Friday, July 3, 2020

Returning to the Basics: A UK Case Goes Terribly Wrong


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

A BBC News report from earlier this week tells a disturbing story: a man released from prison despite a number of warning signs abducts and sexually assaults women whose ages range from 11 to 71. He has now been given 33 life sentences. In a style telling of how people often respond in these situations, the third sentence of the article notes that “so far only one person has since been demoted.” It seems clear from the article that much more is at play than the question of how many heads should roll.

What happened? A broader inquiry has just been published by HMI Probation has highlighted challenges within the local probation services, issues within the system, the impact of transforming rehabilitation, and funding. From the BBC report, it seems that Joseph McCann, 34 years old, had been convicted of burglaries. While in prison, there was considerable staff turnover, which people managing his case changing every year or so. Risk assessments examined his likelihood for further burglaries, while at the same time he sent letters containing threats of sexual violence to family members and his case manager. Reportedly, many of the professionals involved, already beset with high caseloads and other difficult workplace expectations, did not communicate all of the potential risks that McCann posed. Perhaps most telling is that although he had been seen by probation ten times in the two months after his release, he had been assigned three different probation officers during that time.

Obviously, we (the authors) are in no position to point fingers or place blame. In fact, we wish to underscore that what happened in this series of events is a tragedy that will likely forever alter the lives of all involved. It is not difficult to imagine some of the recommendations that will appear in the final report on this incident. Doubtless, caseloads, staff turnover, and other resourcing issues will receive a mention and may result in action. The authors believe that this case crystallizes the problems of and the fallout from the failed Transforming Rehabilitation agenda in the UK, the fracturing of probation service had a massive, problematic impact on the management of people with a criminal conviction. As we move towards the building of a new probation service this case highlights several concerns that we hope will be addressed:

The first is that when it comes to community supervision, supervision, and (risk) management, communication is vital. No amount of training, policy, or protocol is entirely helpful when the expectations of one’s job preclude one’s ability or proclivity to communicate. Our hope is that whatever measures are taken, they enable supervising agents and agencies to communicate meaningfully with one another.

It also seems that this tragedy poses an excellent opportunity to create training models that emphasize sharing information in general and communication skills specifically. Although we have no way of knowing, in our experience, training budgets are often among the first resources to be cut when political situations demand belt-tightening. The opportunity to re-create, or re-establish, a service enables us to put training, staff support, and political engagement at the top of the agenda.

The other challenge raised by the report was that McCann’s perspective was taken at face value, that staff overemphasized his perspectives on this own rehabilitation and underplayed their critical edge. This presents a challenge and an opportunity. In the UK we are moving towards a trauma-informed way of working, hearing the service user voice, and engaging the person with a conviction in their reintegration. But, how do we do this in a way that facilitates proactive risk management, staff security, service user engagement, and community safety?  

Perhaps most importantly, though, is that when considering risk, it is essential that professionals ask, “risk for what?” Often, we label people who break the law in accordance with the laws broken, as if they were all specialists in one area of crime or another. In this instance, it seems that any discussions of risk were focused on crimes of record instead of the warning signs that were apparent to many involved in the case. Compounded with what appears to have been intensive staff turnover, much of this tragedy appears to have occurred not because people didn’t have the right answers but because they weren’t in a position to ask the right questions.

Friday, June 26, 2020

Sexualization of youth, complexity, complicity, and uncomfortable truths.


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

In the last few days, a story has emerged about actress Megan Fox and her sexualization in the movie Bad Boys 2. In her words, 

"I had just turned 15 and I was an extra in Bad Boys II. They were shooting this club scene and they brought me in, and I was wearing a stars and stripes bikini and a red cowboy hat and six-inch heels. [Director Michael Bay] approved it and they said 'Michael, she's 15 so you can't sit her at the bar and she can't have a drink in her hand', so, his solution to that problem was to then have me dancing underneath a waterfall getting soaking wet."

While describing this to talk-show host Jimmy Kimmel, his audience apparently laughs and he makes jokes, including stating that these actions were “perfectly wholesome.” While Megan Fox has since said that she did not feel that she was  assaulted or preyed upon in what I felt was a sexual manner”, what the story does is reveal some uncomfortable truths about the way that we sexualize you girls and women.

Bay and Kimmel’s actions have been discussed and debated across social media, with blame being laid at everyone’s door for her sexualization. No one has accepted responsibility for what happened, and no account is forthcoming on why it happened. People have blamed her for “consenting”, her parents for not being responsible, Michael Bay for sexualizing her, and the movie industry for just “being that way”. Even Fox herself has stated that the media and society have “mishandled” this situation, describing these experiences as “inconsequential … I have endured some genuinely harrowing experiences in a ruthlessly misogynistic industry.” Of course, just because Fox did not consider the Michael Bay situation to be sexualization does not mean that it was acceptable.

The real issue, in our opinion, is that so many adults sexualize youth and are comfortable adults in doing so, particularly in the name of entertainment. Former porn actress Mia Khalifa recently addressed some of the issues involved in an interview for the BBC’s Hardtalk, when she described many of the people and processes she had experienced at the age of 21. This is something that we have talked about on previous blogs about pornography; however, it is also important to focus on the social nuances of sexualization.

The major question that arises in this situation raises involves informed consent. One of the main responses to the Megan Fox is that “she consented” or” she took the money, therefore she can’t complain”. Each of these is loaded and challenging statements.  The first issue is that given her age Megan could not consent; her parents would have to have consented to her appearing in films. We wonder if there is not more to consent in these circumstances. Even if she could have consented, could she have fully understood the implications? If she could not provide meaningful consent, who was responsible for providing consent on her behalf? Who is the responsible authority the parents, the studio, the director? In addition, it is important to keep in mind that under these circumstances, consent is loaded at best. What is this person consenting to? Why are they consenting to it? What pressures exist to consent, and who is looking out for this person’s long-term self-interest?

This story also reinforces the complexity and paradoxical nature of our relationship with sex, sexualization, and youth. Megan’s story reinforces that while we as a society has no problem consuming sexualized images of youth (as demonstrated by our recent blog about Pornhub), people don’t want others to know about it because it would reflect poorly on them. Jimmy Kimmel's reaction to Megan’s story clearly demonstrates this as he joked, brushed it off, said that everyone does it and that some are better at not mentioning it in public. Therefore, for many, it is acceptable to view, think, and do it, but not to mention it. Kimmel’s response, while reflecting the beliefs of many, is not helpful. It was, and is an opportunity, for us to collectively think about how we experience and portray sex, sexuality, and how we can best work with people around this.

The reality of Megan’s story is that it highlights the social construction of sexuality and sex. Our society has created a narrative that the sexualization of youth is acceptable, allowed the processes that enable this narrative, and has become quietly comfortable with the results. The authors feel it is time to discuss these challenges so that our communities can better understand why we accept this and how we can change the narrative. Some points for consideration include:
  • challenging the societal norms around the sexualization of youth.
  • accept our responsibility and role in the creation, maintenance, and consumption of this material.
  • recognizing that sexualized behavior, especially problematic sexual behavior, exists on a continuum.
  • understanding the impact of sexualization on the person experiencing it, particularly where the sexualization is not a direct contact offense.
  • the need to confront sexualization at the boundaries or at blurred boundaries as well as how much we are willing to push back.