Friday, September 30, 2022

To cancel or not to cancel: Should this be the question?

 By Kasia Uzieblo, Ph.D

September 12. After almost three years without concerts, we were finally back in front of the Antwerp Concert Hall. Unfortunately, with very mixed feelings. Arcade Fire was performing, one of the most successful indie rock groups of all time. However, the group found itself in the eye of an unexpected storm, at least for outsiders like us. On August 27, Pitchfork published an article on alleged sexual misconduct by Win Butler, the front man of the band. Three women and one gender-fluid person made allegations of inappropriate sexual interactions and sexual assault. A couple of days later, the Canadian singer-songwriter Feist, announced that she would leave the tour with the band following these allegations. What followed was a veritable Twitter storm: people shared their disappointment en masse, numerous fans wanted to sell their tickets at rock-bottom prices, and many fulminated over the fact that ticket sellers did not want to provide refunds. The images of the first concerts in the UK were telling: many shared pictures of half-filled halls. Various radio stations around the world decided to stop playing the group’s music. It looked very much like the group would be completely cancelled. But it gradually became clear that the group had decided to face the storm with their heads held high and allow the tour, which involved dozens of people, to go ahead.

In Belgium, however, the mainstream media remained conspicuously silent on the issue. The contradiction between the (online) noise and the silence on the Belgian platforms where you would expect discussions were striking. I noticed that I did miss those discussions, I missed a debate. I missed some footing and a sharing of reflections. This also surprised me; I’ve been working on the topic of sexual violence for almost a decade, I have worked with people who are confronted with such violent behavior and people who resort to such behavior, as well as with people who both were victimized and who committed sexual offences. And yet.

Rationally, we know – as someone working in the field- that a person is more than his/her misconduct. We know that a person can have both good sides and talents but at the same time may be able and willing to go beyond other people's boundaries. We also know that, whatever Butler will say about this, his version of the facts will hardly get a chance.

But of course, no matter how much experience one has, no matter how many discussions one has had on the topic, reason and emotion sometimes go their separate ways. Before the concert, we struggled with a lot of questions: With attending the concert, do you condone the acts of which Win Butler is accused of? By applauding, do you endorse possible abusive behavior? By singing (in my case: blaring) the band’s songs along, don’t you a wrong signal to victims of sexual misconduct? And many more.

After the concert, a couple of not-very-profound pieces on these dilemmas appeared in (very) few newspapers. These were unfortunately limited to describing some reactions from people who attended the concert. Some of the reactions: “To go or not to go: I have had the discussion at home with my friend, but as far as I know, it remains only accusations and there is no official complaint. If he were under suspicion, only then would I reconsider my decision." and "We have to admit that we didn't actually think about it". A few fans also didn’t want to react because they didn’t want to contribute to “misplaced mass hysteria”. But also: “I don't condone that - neither Butler's behaviour - but eliminate everyone who has never committed a mistake and 1,000 people are left on earth." and “as long as it sticks to accusations, it is unfair to punish the whole group.”. At first, I was somewhat relieved reading the responses: people appeared to be able to give people a second chance and not go along with black-and-white thinking and with thinking in terms of monsters versus angels. But soon cynicism crept in and many questions arose: aren’t these people just finding reasons to justify any lack of reflections on the matter and/or their enthusiasm for the concert? Would they be so nuanced about my clients as well? Other comments in an English newspaper that tended to apologize the alleged misconduct did not reassure me either: “He’s a rock start, it comes with the territory, it's the lifestyle.”, “Women are chasing him every day of the week. They are one of the biggest bands in the world.” or “No offence to the male species but a man’s a man.”

What I notice is that people are beginning to tire of the subject of sexual misconduct. The debate on how we as a society should or could best respond to (alleged) misconduct is hardly held anymore, especially when it comes to more ‘ambiguous’ cases that do not correspond to people’s general perception of sexual violence and to cases that concern a person who does not adhere to the general view of the monstrous sexual predator. As we see in the examples above, victim blaming tendencies and a wide range of cognitive distortions then lurk around the corner. In my view, even more dangerous is that we increasingly seem to be looking away, ostensibly hoping that when we look away, the problem does not exist or will pass by itself. With the many problems the world is currently facing (climate, war, inflation, just to name a few) and the fear and anxiety that come with it, issues on (sexual) misconduct seem to fade again into the background. And when it is discussed, only two possible ‘solutions’ are often put forward: should we cancel the perpetrators or not?

The apparent arbitrariness with which these choices are made within society (to look or not to look, to discuss in depth or to ignore, cancel or not to cancel) also affect our clients and patients. They see this happening. For some, such observations may provide confirmation that their behavior may not have been so bad after all. Many will however be left with rather a sour feeling: Why do others get a second chance, and not me? Why am I ‘canceled’, and not them?



Friday, September 23, 2022

Slow Listening and the Context of Anguish

 By David S. Prescott, LICSW

ATSA member Kris Vanhoeck published a fabulous article in the most recent edition of ATSA’s newsletter, The Forum. Titled Slow Listening to Persons Who Committed a Sexual Offence, he explores the importance of what he terms “slow listening.” He states: “While studying about listening and listener skills I came across the concept of ‘slow listening’. Stemming from movements like Slow Food or Slow Living, Slow Listening is about finding new forms of awareness regarding sound consumption.”

The idea of slow listening is not itself new (Vanhoeck points to the work of Carl Rogers). There have been, for example, areas of the 20th century musical world that referenced “deep listening” (see the work of Pauline Oliveros). Vanhoeck, however, places it into an entirely new context:

Making time for careful ‘forensic listening’ is a compassionate act of Unexpected Kindness. Kindness in respect to the person in front of us, not of the behaviour that brought him/her here. I’m here for you - you can choose to talk, you are in charge, you own your story - we have time - I will listen. Kindness is an essential part of Non-Violent Resistance. Nelson Mandela refers to the South-African Ubuntu tradition (Nussbaum, 2003). In essence, Ubuntu is a Nguni word for interconnectedness, for our common humanity, and the responsibility to each other that comes from our connection. In his opening speech on 26 May 2007 to launch The Elders, Nelson Mandela expresses his belief that “whatever techniques they use, in the end it is kindness and generous accommodation that are the catalysts for real change” (The Elders speech). In this way, unexpected kindness can be a powerful tool (Vanhoeck, 2019).

This observation is timely. Just this week, the New York Times published a suite of articles highlighting how “mental health” issues can be about far more than personal pathology. Earlier this month, The Guardian ran an article titled, “I’m a psychologist – and I believe we’ve been told devastating lies about mental health.” Its primary message is that, “Society’s understanding of mental health issues locates the problem inside the person – and ignores the politics of their distress.” The article provides interesting observations, such as:

If a plant were wilting we wouldn’t diagnose it with “wilting-plant-syndrome” – we would change its conditions. Yet when humans are suffering under unlivable conditions, we’re told something is wrong with us, and expected to keep pushing through. To keep working and producing, without acknowledging our hurt.

 My quibble with the language above is that while we can always talk about the politics of distress, it can easily distract us from understanding and empathizing with the context in which this distress exists. Whatever the political dimensions, these times (economic uncertainties, climate emergency, war, the pandemic and other infectious illnesses) are stressing just about everyone out. Importantly, this includes our clients. As we go down our list of proximal indicators of impending risk – escalation of negative mood, disappearance of social supports, emotional collapse, etc. – it seems that we really do live in times when even more external factors are influencing risk.

Privately, I have wondered if the media attention to our collective “mental health” in the current times hasn’t come into existence because the problems long faced by marginalized people (those of color and with minimal power and privilege) have now entered the mainstream of society. Whatever the case, we may have an opportunity to better empathize with our clients, especially those in the community. It is certainly true that many are in difficult circumstances secondary to their own actions. On the other hand, it can be easy to overlook the nearly insurmountable challenges they can face.

Whatever the case, Mr. Vanhoeck’s article, along with the recent attention to mental health by the media, remind us that sometimes the best risk management, as well as the best therapy, can be as simple as a relationship marked by long, slow, deep listening and understanding.





Thursday, September 15, 2022

The evolution of Rape laws in Spain.

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

We know that victims of sexual abuse – adults and children – do not always come forward to disclose their abuse and seek justice for what has occurred to them. This can have long lasting psychological, emotional, social, and health implications for them and often the people around them. Research and practice have provided ample evidence of why people do not disclosure, but a main reason is often that they don’t feel they will be believed or treated respectfully. One of the challenges that the criminal justice system often faces is proving a lack of consent. Cases often do not get beyond a police investigation, or they might get derailed in court. The net result is that we have a very poor understanding of the prevalence of sexual abuse both globally and country-by-country, with prevalence studies based on official and/or self-report data only being able to tell us so much. Therefore, there need to be new methods for improving the reporting and prosecution rates for sexual abuse and rape. In Spain, they are changing their approach by changing their national consent laws and the legislation that accompanies them.

In line with other countries, Spain is changing its consent laws from one based upon proving that consent was not given to ones proving that consent was given, known by the slogan, “Only yes means yes”. This means that all sexual encounters need explicit consent from all parties before they occur. The reason for this change in approach was an infamous case from 2016. In Spain, it is referred to as the “wolfpack” case, named after the WhatsApp group that the men involved called themselves. In 2016, five men gang raped a 14-year-old girl and , and recorded the rapes on their mobile phones. The video evidence indicated that the men were on the streets looking for someone to victimize. Upon selecting the girl in question, they led her off the streets to a secluded basement and raped her multiple times.

In court, it was revealed that there were seven videos, totalling 96 seconds. One of the men posted on their WhatsApp group what they had done, boasting about it and another of the men posted messages in a WhatsApp group celebrating what they had done and promising to share the recordings. There is no argument about what the men did or the age of the victim; the issue became what the girl didn’t do. The police report stated that the victim maintained a "passive or neutral" attitude throughout the scene, keeping her eyes always closed. When the case got to court the men were acquitted on rape charges, as they did not appear to use overt violence and because the girl was drunk and did not resist. Spanish law states that it is not rape if it does not involve overt violence or intimidation.

The men were jailed for nine years for sexual assault, which has a different legal standing and threshold. Not surprisingly, this was seen as too lenient and led to calls for a retrial and mass protests on the streets of Madrid with women’s rights activities arguing that it has made Spain less safe for women.

The trial led to a reconsideration of Spanish rape laws which are understandably seen as outdated and unrealistic, not evidenced-based, reinforces rape myths and misperceptions, and is nether trauma-informed nor compassionate in nature. The new “only yes means yes” legislation passed in the Spanish parliament means that “Consent can no longer be assumed to have been granted by default or silence.” This means that Spain’s rape and sexual harassment and sexual assault laws come into line with each other. it also means that people who have been victimized will no longer have to prove that they experienced violence, intimidation, or distress in the rape which is more appropriate.

Research has indicated over the years that people respond to rape and sexual assault in different ways and at different paces, which means that the reaction at the time is not necessarily as prescribed as the courts may want it to be. Therefore, it is important that we understand the individual’s perspective and take into account their narrative about what happened at the time. The other benefit of a consent-driven rape law is the removal of ambiguity because it focuses on the action not on the outcome; there is clarity around behaviour and expectation. In developing this law Spain is joining a number or countries and regions looking to change their sexual abuse and rape laws to be more victim oriented and consent driven. For instance, in 2018 Sweden changed its law which now states that the lack of consent is enough to constitute a crime (the ‘consent law’). Hence, all participants need to have actively signalled consent. Similar changes have been observed in Iceland, Greece, Belgium, and the Netherlands. In Sweden, this has led to a 75% rise in rape convictions according to some sources.

The question now is what next? what will Spain’s public education and community engagement strategy be around consent? How can consent take place? This legal change is considered by many commentaries as the next step in Spain’s response to the #MeToo movement, but that begs the question of what other preventive and responsive approaches to sexual abuse and sexual harassment will they develop?

Friday, September 9, 2022

Setting the Standard for Disclosure in Treatment

By David S. Prescott, LICSW

Recent weeks have seen at least three discussions in various forums of how – and whether – to treat individuals who are denying, minimizing, or simply don’t want to discuss their past behaviors. Where exactly do we set the bar for entering treatment? When one provider has stated strong recommendations for treatment that involves possible risks to others, is it ethical for another provider to treat something else at the client’s request, thereby very possibly not addressing what appear to be the more serious issues? Many practitioners have asked how they can hold a client accountable when they severely minimize their behaviors.

It's important to say from the outset that there are no clear answers, only more questions. Some programs require that clients be ready, willing, and able to discuss their past behaviors from the outset. All other things being equal, this can be unassailably standard practice, particularly in settings that can’t provide treatment to everyone who is referred. Of course, one might well ask: Are we missing opportunities to reduce risk among others who may look at first like they are denying or minimizing their actions when just below the surface they want to change but don’t yet know whether they can trust the treatment process.

The landmark 1998 meta-analysis by Karl Hanson and Monique Bussière found not only that denial was not a risk factor, but that failure to complete treatment is correlated to increased risk for sexual re-offense. The revelation that denial did not emerge as a risk factor continues to surprise professionals entering the field to this day, and many interesting papers have resulted from this finding. With some smaller exceptions, this overall finding has not changed. However, taken together, accepting someone into treatment who denies their offense and then terminating them adversely when they don’t confess may actually increase whatever risk is present. A more balanced approach is needed.

To that end, a number of approaches have emerged. In 2012, Ware & Mann recommended viewing disclosure as a process and not necessarily an event. They observed that there are many reasons why a person might not readily take responsibility for their actions and argued that over-emphasizing disclosure might actually be harmful. Still, clients who deny or minimize their actions can often be turned away by treatment providers who find their denial morally objectionable. Much has been written on these issues, including a recent paper by Ware & Blagden (2020).

One psychologist, in a recent training, summarized his thoughts about working with high-risk clients: “If they can disclose anything about what was happening at the time of their crime, I can work with them.” Others have described how working on the various criminogenic needs of each client even in the absence of disclosure might be sufficient to reduce risk (although one could not call it “abuse-specific treatment”).

What options are there? While a blog post cannot adequately cover what is available throughout the literature, some ideas for moving forward include:

Starting by conducting an assessment. In the arena of treating drug and alcohol use disorders, it is well known that simply engaging in an assessment can reduce substance use. Explorations around what it would mean for the client and their loved ones if s/he did disclose might yield useful avenues for further discussion. Some motivations for not disclosing are easier to overcome than others.

Likewise, it may simply be the case that the client becomes willing to disclose more information as the therapeutic process unfolds.

The therapist can use their knowledge of risk domains (for example, impulsivity, negative emotionality, suboptimal coping skills, etc.) to help the client build strengths that may protect against any further offending.

Important to remember is that simply being in treatment means that there is someone in the client’s life who can help them be aware of warning signs that something bad might be imminent (emotional collapse, financial issues, collapse of social supports, escalations of negative mood, etc.).

Even absent any discussion of past crimes, therapy could be a venue for discussing sexual health and responsibility, masculinity/femininity, etc. Building strengths in these areas could be a further protective factor.

What is that compelling treatment in the absence of any agreement on treatment goals or methods is likely doomed from the start. Further, a 2008 meta-analysis found that more coercive treatment methods were less likely to work.

In the end, each program and professional needs to confront many questions, including the potential harms of denying treatment to people who might benefit from it, and to what extent our own attitudes and beliefs may prevent effective treatment provision that can benefit clients, the community, and those who have been victimized alike.





Thursday, September 1, 2022

Current Prevention Trainings Aren't Reaching College Men: Four Things Colleges and Universities Can Do to Change the Culture.

 By Silvia Zenteno (Director of Educational Programs and Training at It’s On Us)

Colleges are not doing enough to prevent and address gender-based violence on their campuses. Last school year, we saw hundreds of campus-wide protests with students speaking up to tell their institutions what they need and what is or is not working. Students deserve more than to just be told, "Thank you for sharing your story," which our research has found happens all too often. We have also found that in response to gender-based violence on campus, colleges and universities often prioritize their own reputations and checking the box on Title IX requirements, rather than protecting survivors or investing in prevention training to address campus sexual assault in the first place.


Sexual violence happens every day in the United States and around the world, and our existing approaches are not working. It is time to do something about it. Its On Us, a leading nonprofit in college campus sexual assault prevention started by then-Vice President Biden in 2014, recently released research that colleges can use to improve their prevention programming on campus, and if campuses start implementing these findings and recommendations now, it is possible to prevent an incident from happening tomorrow.


Since our initial launch as an initiative of the Obama-Biden administration following recommendations from the White House Task Force to Prevent Sexual Assault that noted the importance of calling everyone into the conversation on sexual assault prevention, It’s On Us has grown into the nation’s largest nonprofit program dedicated to college sexual assault prevention and survivor support while activating students on hundreds of campuses in our awareness and education programs.


In this work, we recognized that, to date, no major study had been completed to evaluate the attitudes and perceptions of students who participate in their schools’ prevention programming, and whether this programming impacted their behaviors.


That’s why we recently released our Engaging Men: National Campus Sexual Assault Attitudes and Behaviors Report, a first-of-its-kind study exploring the attitudes and perceptions of male-identifying students and their likelihood to get involved in the prevention of gender-based violence on campus. This research collected information on the types of prevention programming schools are conducting, as well as their effectiveness, reach, and possible gaps by using an exploratory qualitative method to better understand the experiences, attitudes, and behaviors of young college men.


We partnered with HauckEye, a consulting and insights firm, to conduct in-depth, one-on-one interviews with college men representing diverse campus communities. A benefit of qualitative research like this is its ability to explain behavior that cannot be easily quantified by allowing participants to detail their experiences and feelings.


This study found several important insights:

    Men generally aren’t aware of the extent of the problem on their campuses: Most participants were unaware of the extent of sexual violence on campus. While some schools have had high profile incidents, several respondents thought these were all isolated incidents. Framing the issue as solely a Greek life problem means that many participants did not think the issue affected them or their school.

    Current trainings are inadequate: The vast majority of participants reported that the prevention trainings they received, often online-only, were boring and ineffective. Positive prevention education experiences were in-person and included an interactive component like a certification. One student spoke highly of a comedian who came to campus and did a stand-up set about her own assault.

    Men benefit from close relationships with non-male friends and role models: The respondents most attuned to the issue of sexual violence had strong friendships with women on campus. Co-ed sports teams, for example, foster an equitable and inclusive environment on campus between participants across the gender spectrum, leading to less objectification. By contrast, respondents reported that male-only groups like fraternities incubate toxic masculinity, such as misogynistic views toward non-male peers.

    Men are too often at a loss as to how they can best help: The men in the study expressed a desire to help but didn’t feel they had the right tools to intervene. They expressed interest in training that would teach them how to intervene and deescalate situations involving sexual violence. The majority see themselves as moral people and want to do the right thing, but they just don’t know how.


It’s On Us intends for this study to be used to create actionable change in campus sexual assault prevention education. Below are four recommendations for colleges and universities to build more effective sexual assault prevention training programs:


1)    Use creative training methods: Implement more creative training methods, such as bringing a comedian to campus. Several respondents also reported that certifications for completing training helped them feel more involved. Most respondents reported that their prevention training was boring and did not feel relevant to their campus lives.


2)    Train in-person: Whenever possible hold trainings in-person to increase comprehension. Participants reported that online trainings were unengaging and ineffective. Several said they barely paid attention and passed the requirements easily.


3)    Combat assumptions: Students at smaller universities, commuter campuses, and religious schools did not think sexual violence was a major issue on their campus. Some also saw violence as solely a fraternity problem. Combating assumptions like these is key to helping men realize the extent of the problem and the need for intervention.


4)     Build connections: Men with strong ties to women and other non-male identifying people in their life felt more responsibility towards others and anger at other men who perpetrate violence. Ensuring that men, women, and gender nonconforming students are fully integrated on campus helps establish that non-male identifying students are seen as more than objects.


While this research focused on American colleges and universities, this is a global problem that will also require worldwide initiatives and action.


Schools can use these recommendations to make a change today. It’s On Us will continue to build on this research and conduct a large-scale quantitative survey to conduct further research of American colleges and universities and develop prevention education programming that educates and empowers everyone, including young men, to be a part of the solution.

Wednesday, August 24, 2022

A Closer Look at the “Minor-Attracted” Controversy

By David S. Prescott, LICSW

As I contemplated writing this blog post, I received the following email:

Subject: I am sick and need help

I am a pedophile using an alias. I cant stop with my thoughts against kids and its ruining my life. Please help me

I have no idea who this person is and a Google search on the email address provided no clue at all. Although I am a licensed clinician, I received the email via my website. Obviously, the most immediate need is to prevent children from being harmed. What is a good citizen to do in this situation?

Let’s start with the facts. In the absence of any knowledge about the individual, I take them at their word that they are tortured by thoughts of children. Research has shown that there are many people who have sexual urges regarding children who don’t act on that interest. Some may scoff at that notion and assume that everyone with these interests has already acted on them. In reality, most people have had some kind of sexual thoughts, urges, or fantasies that we have either managed or otherwise didn’t act on. Even the sender of the email didn’t want to act “against children.”


Something else is happening. Consider the findings of Sandy Wurtele, Dominique Simons, and Tasha Moreno who recruited 435 people to complete an online survey. From the introduction to that article:


Among men, 6% indicated some likelihood of having sex with a child if they were guaranteed they would not be caught or punished, as did 2% of women. Nine percent of males and 3% of females indicated some likelihood of viewing child pornography on the Internet. Overall, nearly 10% of males and 4% of females reported some likelihood of having sex with children or viewing child pornography.


Applied to the broader population, that number should concern anyone. As we have long known, the sexual abuse of children is not restricted to a few highly prolific, dangerous people who persist in hurting others. Rather, there are enough people with sexual thoughts about children to consider it a public health issue.

Returning to the email, my next question is who am I? Although I have expertise in this area, I have done no assessment or treatment of this individual. This cry for help does not contain enough information to make a report to any legal authority or child welfare agency. I am not an investigator. I could forward the email on to my local police, but there is no evidence that a crime has been committed, and all the evidence points to someone who is seeking to prevent a crime. The unfortunate reality is that our law enforcement organizations can’t keep up with the numbers of detectable crimes against children. And for all I knew, he might also suffer from pedophilic obsessive-compulsive disorder, in which one is afraid of being or becoming pedophilic.

What else do we know?

To start, I reside in the USA, where people cannot be charged with a crime or committed to an institution solely because of their thoughts and urges. Nonetheless, any reasonable person would want to take appropriate measures to prevent harm to children. That leads to questions about how we can all best respond to those who have sexual thoughts about children.

The first question is do we want this person to act on their interest or not? The answer to that question is clearly no.

That leads to the next question: What can we meaningfully do?

Research shows that simply trying to punish people has no effect on its own, and in some cases can make matters worse. However, the right treatment can work, as evidenced in large-scale meta-analyses. While treatment doesn’t work for everyone and many scientific questions remain, there’s much more evidence for treatment than there is for punishment. If society wants to prevent sex crimes against children, we need to get our priorities right.

From there, the next question becomes how should professionals behave with these clients?

Decades of psychotherapy research has pointed to the importance of maintaining a strong therapeutic relationship with clients. Therapists the world over know how important it is to engage clients and accept the person even if they don’t find aspects of them to be acceptable. As the saying goes, we need to love the sinner even as we hate the sin. Not every individual is a good fit for every therapist, and so some therapists understandably refer some potential clients to others.

How do professionals build the right relationship so that someone can trust them and get involved in treatment?

Entire books have been written on this topic, but for our purposes, attention to language is important. Please note that the email sender above calls himself a pedophile. On the one hand, this kind of honesty can be welcome, even refreshing. On the other hand, “pedophile” is a term almost always used in a hateful fashion. While diagnostically accurate (although current recommendations of the American Psychological and Psychiatric Association indicate that language such as “person diagnosed with a pedophilic disorder” would be optimal), it is difficult for the trained professional not to notice the tone of self-hatred in the email above. The individual describes himself as “sick” as well as a pedophile.

While it is unsurprising that people will use pejorative language to describe themselves, a central aspect of any therapy is to be careful with the use of these terms. The reason is simple: people who feel bad about who they are, who experience deep shame, who loathe themselves are less likely to benefit from treatment than those who can respect themselves even as they work to face the challenges in their life. Beyond this, there is an entire literature on labeling.

Recently, a colleague posted a YouTube video. In it, she accurately stated that people with pedophilic disorders are among the most reviled people in the world. For this reason, she uses the term “minor-attracted person.” By her own admission, she had not expressed this as effectively as she might in the video. The video was picked up on Twitter and immediately went viral with over 50,000 negative comments, primarily by people who had not watched the complete video or fully understood what she was saying.

Many, including myself, are ambivalent about the term “minor-attracted people.” My own thinking has to do with the vagueness of the language. The “Twitterverse” felt that it “normalizes” sexual interest in children when in fact its intention is the opposite. To listen to these individuals, the common message is, “It’s bad enough that we have these thoughts and urges that we don’t want. Please, we need help and understanding to prevent abuse.” Entire self-help networks have come into being because so few people are willing to provide treatment.

Many people with a sexual attraction to children have said that they prefer the term minor-attracted person as they work to prevent abuse. Everyone’s opinion will vary. Mine is that I don’t really care what’s in a name if we have a shared goal of preventing child abuse. I don’t need labels to describe people, tell the truth, or help people to take responsibility for their lives. Steering away from shaming language is not the same thing as enabling or normalizing. Hopefully, we can call each other by name and focus on the task of preventing sexual offenses. Public shaming and hatred of these people will only send them further underground and make matters worse.

In the classic parable of the Good Samaritan, a traveler (presumed to be Jewish) is beaten and left for dead. The Samaritan (whose people were sworn enemies of the Jews) stopped to help him. This was all in accordance with the Great Commandment. Within my own experience, I once watched firefighters risk their lives to put out a burning building. Their primary intention was public safety. They put the fire out first and only asked questions later.

In my view, both anecdotes illustrate the efforts of our colleagues who are involved in helping people not to act on their interests and urges towards children. They all deserve our thanks. In the moment someone is intervening to stop harm to children, does it really matter all that much what language they use as long as they are within the bounds of the law and their codes of ethics?

We live in a time when it is fashionable to call others we don’t like “groomers” and “pedophiles.” Too often, these insults obfuscate the realities of actual child abuse and serve to make people less informed instead of more. While society debates topics such as elementary school education and the rights and welfare of those in the LGBTQ communities, we should also support those professionals who are actually doing the work of abuse prevention.

Wednesday, August 17, 2022

The role of restorative justice in the field of sexual offending.

 By Kieran McCartan, PhD, Paul Gavin, PhD, Cody Porter, PhD, Charlotte Kite, MSc

Two weeks ago we held a conference at UWE Bristol on the use of restorative justice in sexual offence cases, the aim of the conference was not to fundamentally answer the question of whether you should or could use restorative justice, but rather to consider the role of restorative justice. Restorative justice is not a new concept and is just a lot across the criminal justice system, but it is seen as controversial in the field of sexual abuse, with it been seen as revictimizing the victims, potentially traumatizing to victims at the individuals who have committed the sexual abuse, as well as potentially allowing the individuals who have committed sexual abuse to relive and gain power over their victims. These debates where raised and discussed, however, the aim of this blog is not to re-walk old ground but rather to consider a way forward.

The challenge of restorative justice is often the packaging that it comes in and the months that surround it, these are important to challenge and debunk before we even discuss sexual offending.

Language: The language used in the field of restorative justice is subjective and often problematic as it explains one aspect of the work, but it does not fully encapsulate it all. The challenge is the words “restorative” and “justice” as the process can be restorative in several ways (maybe forgiveness, maybe closure, maybe therapeutic), may not result in justice (in a criminal justice or healing way) and may not end in forgiveness, empathy and/or understanding. The reality of restorative processes is that they are as much about communication and understandings, as they are about forgiveness and redemption. The reality is the language gives on perception on of the outcome that may not be reflected in the participants engagement.

Perception: There is a perception from the criminal justice system that restorative justice can be challenging and risky for all involved, which it has the potential to be on occasion, but this ignores the skills, training, and ability of restorative justice practitioners. Restorative justice is a long process with many people involved that puts the victim at the centre of the process and is not a piece of work that is undertaken lightly. Yes, there may have been problematic examples of restorative justice in the past but that is by no means the norm these days.

Process: The restorative justice process has a number poof paths that it can take, the idea that the victim and individuals who committed the crime against them sit alone together in a room is not necessarily the norm, or even the best way in practice. Restorative justice can take the form of written testimony, victims’ panels, circles, and other approaches. In deciding to do restorative justice decision s will be made with the practitioners on what the best approach for all parties involved will be. Restorative justice is a suite of techniques, a toolbox, rather a than a single prescribed approach.

Safety and Risk: In developing and using restorative justice the safety of the victims central, in terms of their psychological, emotional, and physical safety. Which is evidenced through the prep done with them in advance about what to expect, what to do if things to not go to plan, the position in the room and the role that everyone will play in the process. The restorative justice process can be stopped at any period, with no consequences.

Clarity: The most important aspect of restorative justice is an understanding of the process and the potential outcomes, it’s essential for all parties to recognise that although they might go into the process with one set of expectations this may not be what they get out of it. The process my provide closure, understanding, insight or restoration; but it may not. This is important in different ways for all the parties involved, especially for the person who has committed the offence being in a restorative justice process may not aid their rehabilitation and/or community integration in the way that they think (i.e., that the parole board, prison, or probation will look kindly on them).

 The conference was about the use of restorative justice in sexual abuse cases, throughout the day practitioners, policy makers, and academics debated the pros and cons of its use. Findings from a literature review on the topic were presented, which led to both discussions and reflections throughout the day. There was a recognition that while sexual abuse was a challenging issue restorative justice was used in other challenging forums and with challenging topics, and it was the skill of the practitioner that was central to success as was the motivation and engagement of the participants.

 For Kieran, the interesting debate came at the end of the conference when talking with one of the speakers, Dr Ian Mader, about the reality of restorative justice and a debate about whether restorative practice was a more effective term and a better way to understand the process from a sexual abuse perspective. The benefit of restorative practice is that the language is not rooted in the criminal justice system, and it does not come laden with the old pejorative discourses. Restorative practice is as much about reflection and insight, as it is about understanding and restoration. The other benefit of restorative practice id that it can be an intervention per offence, a disruption technique, as much as a response to an offence. Additionally, restorative practice fits within the trauma informed, strengths-based approach to desistence from sexual offending that we use in the UK now. Sexual abuse impacts all aspects of the victim and the person who has committed the sexual abuses lives, it plays a role in their future development and social functioning and therefore it is important to reflect and process the impact of this abuse; this is what restorative practice dies. Restorative practice does not do this via a one size fits all model and enables the victim to regain control, and power, in an often-powerless situation (both in terms of the abuse and the criminal justice response to it). While the conference did not provide responses to the question of the reality, use or efficacy of restorative justice in sexual abused cases, it allows us to recognise that these processes are important tools that can be use in some cases.


For links to the Council of Europe recommendation on restorative justice and the accompanying HMI Probation report as well as European Forum for Restorative Justice piece please see below:

Friday, August 5, 2022

Some reflections on prosocial goals and plans for juveniles who sexually offended

By Norbert Ralph, PhD, MPH  

Treatment approaches for juveniles who sexually offended (JwSO) has changed dramatically since I started doing this work in 2000. Back then the "core pathology" of these youth was considered a psychosexual disorder, and that the focus should be on sexual compulsion, pedophilic interests, relapse prevention plans, use of polygraph, confronting "denial" or minimization regarding the offenses and the youth's responsibilities, among other features. Today complementary approaches have been developed which focuses not only on "thinking errors" regarding sexual issues, but promotes prosocial reasoning in general, promotes strength-based foci, targets general recidivism, and promotes age-appropriate personal and social maturity for the youth. There is also been a substantive effort moving towards evidence-based interventions targeting sexual and total recidivism.

I thought I might pass along some thoughts about an issue that I do not recall ever seeing in trainings or the literature. While I am all for evidence-based practices, I have to confess that the following are mostly based on my own clinical experiences and judgment. I think in our field there is still room for some of this. Since I am talking about personal opinions and experience, I am not including a number of references and citations, as I might otherwise, and hope this is okay.

In starting treatment with JwSO youth, I am aware of the trauma to the youth and their family of going through the court and probation process. This can include the arrest, subsequent investigations, possible detentions or placements, court dates, probation interactions, changes to school and home life, among other aspects. In my experience, this happens even with the most respectful and careful management by all the parties. Even though the youth may have "earned" these consequences by their harmful actions, I have to deal with trauma-type reaction on the youth's and family's part in dealing with the consequences of the harmful behaviors. This may be an adjustment for some of us, since we usually identify trauma as related to someone being victimized by another, rather than experiencing appropriate but stressful consequences related to their harmful behaviors. Also, I find myself dealing with the youth with a damaged self-image, which may include of you of the self as someone who harmed others, particularly children. Additionally, "orders of the court" and a "Safety Plan" may limit prosocial opportunities and interactions in the community and participation in age-appropriate activities and relationships for these youth. 

In treatment now I am viewing part of my work as targeting these issues. For example, initially I am dealing with the trauma reaction to the court/probation process, the harmful aspects of an associated self-image as "an offender", and trying to make sure the youth has as many prosocial activities, involvements, and experiences as are consistent with court orders and a Safety Plan. The logic of this is that in the future the adolescent can function better, have less problematic behaviors, and probation involvement of any type if these issues are addressed. For example, helping the youth develop a realistic but positive self-image means they are more likely to put themselves in situations, enjoy, and gain benefit from educational recreational, and social interactions. A realistic, positive, and modest self-image, in my experience opens doors and possibilities that would not be present otherwise. Likewise, if were able to deal with the trauma reaction of such youth, they and their family are less likely to be operating from a position of fear and scared feelings. Starting from a place of fear and anxiety, makes it harder to make effective decisions and have better relationships. Additionally, if we are able to help the youth develop age-appropriate social, educational, and recreational experiences, the amount of positive and prosocial activities in their life expands. As it expands, it "crowds out" at least in theory, the possibility for negative habits or patterns of behavior. Prosocial activities also provide the key ingredient for developing prosocial relational and reasoning skills, a key goal for JwSO youth. 

As I am doing treatment now for these youth, I target these goals, and highlighting and emphasizing parts of my usual treatment approaches that relate to these areas. For example, treatment for most of us starts out with developing a Safety Plan, making sure that risks and vulnerabilities of the youth are accounted for, mainly by a variety of restrictions and supervisions. Here is an idea. How about developing something to complement the "Safety Plan", a "Prosocial Plan" at the start of treatment. This plan would develop ideas for prosocial activities, relationships, and positive thinking and problem solving experiences. The development of a "Prosocial Plan" also helps promote a positive self-image. For example, if our self-image is based on our activities and accomplishments, if the youth is cut off from prosocial activities, how can they develop a prosocial self-image? Let us develop at the start of treatment a "Prosocial Plan" to complement the Safety Plan. This is usually done towards the end of treatment, but how about putting it upfront as well?

It might be useful to develop some structured curriculum regarding issues such as this. It could also be part of  interesting research measuring and tracking, for example, trauma reactions related to the probation process, the evolution of a prosocial identity, and the development of prosocial activities, and see if these are associated with positive treatment outcomes. 

Monday, July 25, 2022

Community, Culture, and Race: Preventing Sexual Abuse in a Culturally Sensitive Fashion.

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

There has been the discussion of cultural sensitivity and reporting, recording, and prosecution of sexual abuse, especially child sexual abuse, in the UK press this week.  Over the last 10 years, it has emerged that child sexual abuse, but particularly child sexual exploitation by networks of men in England and Wales had gone investigated because of the race and cultural heritage of the individuals in question. A number of investigations, including but not limited to the independent inquiry into child sexual abuse, found that networks of men of Asian heritage were sexual abusing girls under the age of 16 for several years. The authorities knew about the cases but did not fully investigate or prosecute. They claimed that their inaction was due to  being afraid – or at least concerned about – being seen as racist. The most recent case was about sexual abuse in Telford, and the investigation found that:

-      More than a thousand Telford children were exploited over decades.

-      Key agencies dismissed child exploitation as "child prostitution."

-      Exploitation was not investigated because of nervousness about race.

-      Teachers and youth workers were discouraged from reporting child sexual exploitation by members of minorities.

-     Offenders were therefore emboldened, and exploitation continued for years without concerted response.

-      Responses to abuse came from committed individuals not from top-down directives.

The Telford case again raises questions about the way that we think about child sexual exploitation, the language used, and the criminal justice system’s approach to it. We have moved a distance in no longer seeing victims of sexual exploitation as complacent in it. We no longer talk of them as “child prostitutes” or girlfriends or see them as willing participants as they receive “gifts” from the people who are grooming them. The police have gotten more victim focused and more in tune with the double status of young people who are victims of sexual exploitation, in that they are victims first and that offense-based behavior is often an extension of their vulnerability and history of victimization. A number of police forces across England and Wales do not prosecute young victims of sexual exploitation anymore. Rather they work to disrupt the abuse and safeguard the children; a clear example of this is Operation Topaz In Avon and Somerset and Action on ACE’s in Gloucester.

However, the same distance has not been travelled in terms of connecting with communities, especially of different ethnicities, about child sexual abuse or exploitation. The police and the criminal justice system not only need to work harder and better to hear the voices of different communities regarding victimisation; it also behoves us all to  understand that abuse is abuse, and wrong, regardless of who commits it, who the victim is, and in which community it occurred. Therefore, how can we engage better on this? Our thoughts for now are:

-   Sexual abuse is a community issue; therefore, it needs a community response. This is as much about culture, race, and location. We need to get communities together to discuss, prevent and respond to sexual abuse.

-    We need to see and recognise that sexual abuse exists everywhere and, therefore, people all communities and cultural groups can stop abuse.

-    Investigations of sexual abuse and exploitation, can occur in a culturally informed and humble way. At the same time, we can reinforce that abuse is wrong and that professionals will make the difficult decisions and follow challenging prosecutions.

-    We can engage all communities and have advisory groups that represent the different cultural and ethnic communities as well as coming together as a broader society.

-   While engaging communities, we need to have difficult conversations about race. These can include a focus on how to avoid (un)intentional racially tinged statements and how to strengthen our police forces and other relevant services to give them more confidence in entering these conversations without fear. However, we will need to engage communities meaningfully in this conversation, inviting feedback along the way, so that these communities also feel less need to consider comments or even criticisms as racist.

There is no question that police and others in the criminal justice system face many risks in their work. Professionals in our field can help provide information to help these processes.

Friday, July 15, 2022

30 Years of Innovative Perpetration Prevention.

By Jenny Coleman, Director, Stop It Now!  US

Stop It Now! (Now!) is a national child sexual abuse prevention organization currently celebrating its 30th anniversary. Now! is the only organization of its kind in the US; we serve every adult responsible for preventing child sexual abuse, including people who are worried about their own sexual thoughts and behaviors toward children. Our signature programs including a free helpline, extensive online resources, trainings for professionals and caregivers, technical assistance and policy efforts. Across our work, Now! offers hope to adults, families, survivors, bystanders and professionals with an emphasis on protective actions that hold adults accountable for protecting children and creating safe, healthy spaces. Learn more at 

In 2022, Stop It Now! celebrates our 30th anniversary preventing child sexual abuse. Throughout the year and our virtual event on October 19, we’ll honor Now!’s founders, staff, volunteers, supporters and other champions in child sexual abuse prevention, and we will highlight our vision for the future of safety.

We were graciously invited to submit a blog on our anniversary activities, where we’ve been, and where we are going. But right now, it feels more important to address what’s happening in the United States in the context of child sexual abuse.

Hate groups and domestic terrorists have “hatejacked” the language of child sexual abuse – especially “groomer” and “pedophile”– to viciously attack LGBTQ+ communities and anyone else they oppose. Now! has commented on this publicity, but for our fellow members of ATSA, we have a particular responsibility to speak up when this wild misuse of language becomes public on a national and global scale.

Child sexual abuse is one of the worst things imaginable. We all want it to stop, right now and forever. We all want to keep children safe. As you know well, this “we” includes many of the people who have sexually harmed children or who have thoughts that they might.

Throwing around child sexual abuse terms as rhetorical devices only makes it harder to do the very real work of prevention and safety planning. It pushes people with concerning thoughts further into darkness. It takes a toll on victims, survivors and families. And, too often, it mobilizes groups of people around reductive, harmful slogans, policies and practices.

This comes on the heels of countless other news stories, legal cases and violent acts that led us to where we are as a country. And to that end, right now is a critical moment for child sexual abuse prevention. Though, that does always seem to be the case, doesn’t it?

In preparing for our 30th anniversary event, fellow ATSA member, early Now! staff member and expert in her own right Joan Tabachnick, PhD, shared the experience of working in child sexual abuse prevention in the early 1990s. She tells the story best, but suffice to say, no one talked about child sexual abuse above a hushed whisper, if ever. And today, Now! stands 30 years strong in having proactive, protective conversations every day about child sexual abuse, prevention, concerning thoughts and behaviors, survivor supports and safety planning.

Every day, Stop It Now! hears from caregivers, professionals and even youth who have been impacted by our prevention work. Through our Helpline, our WhatsOK youth project, our professional trainings and our partnerships, we hear the individual stories of adults stepping up and taking action to protect children.

As ever, we restore hope. It’s harder than it has been in a while, but we maintain every ounce of hope we have, and we share it freely. 

Wednesday, July 6, 2022

Ways Forward in the Wake of Psychedelic Therapy Abuse

By David S. Prescott, LICSW, and Natalie Villeneuve, MSW, RSW

Several weeks ago, we wrote a blog post highlighting concerns about abuse taking place within psychedelic therapy. This centered on revelations from a podcast titled, Cover Story: Power Trip, which uncovered how practitioners have engaged in abusive practices, often seemingly ignored by researchers. We have also recently written an article that explores the issues and offers some ideas on the way forward. In many cases, the evidence has been shocking. The main forces behind this podcast (and many other efforts), Lily Kay Ross and Dave Nickles, are to be commended for their efforts. As always, we have been grateful to the survivors who were willing to help us by telling their stories and reviewing drafts of our writings.

Since our first blog, other allegations have surfaced, such as this example, in which a therapist is reported to have taken millions from an elderly client who was a holocaust survivor. Although legal action against the therapist, Vicky Dulai, reportedly began in May 2021, the case was only reported in April 2022. These allegations were especially noteworthy given that Dulai is on the board of directors for the Multidisciplinary Association for Psychedelic Studies (MAPS), which initiated an investigation only after the case was reported publicly. Not surprisingly, MAPS trials are now under review over the alleged abuse of study participants.

For their part, MAPS has not appeared to prioritize the needs or rights of those who have been harmed. The above linked reporting discusses how it took several years for them to review video recordings of abuse that took place under their auspices. More recently, the distinguished trauma researcher Bessel van der Kolk has become the principal investigator for MAPS in Boston. Of course, van der Kolk himself had been fired from a position he held for many years following allegations of employee mistreatment in 2017.

It has seemed clear to us, as professionals working in the field of trauma, that the practice and research efforts in current psychedelic therapy have not fully accounted for the unacceptable risk of harm that takes place when abuse occurs. Setting aside the more overt forms of abuse already covered, it’s worth repeating that discussions of informed consent, and the withdrawal of consent have remained in short supply. Two recent examples come to mind.

The first example appeared on Twitter recently, when Ronan Levy, the founder of Field Trip (whose mission is to “bring the world to life through psychedelics and psychedelic-enhanced psychotherapy”) posted to Twitter about a man who had accidentally taken “magic mushrooms.” The original story described a police officer who had “unwittingly” taken this drug and now takes microdoses of it every day to alleviate his depression. Levy’s summary is, “From unwitting to witting. That’s the nature of wisdom.” The tweet implies that giving someone these drugs without their knowledge is acceptable. It also implies that microdosing psychedelics with no plan for termination is also acceptable. This has led us to wonder where the boundaries are in implementing psychedelic therapies are.

The second example is in some of the historical underpinnings of psychedelic therapies. A Google search on the term “There is no such thing as a bad trip” can be enlightening. Much of the history of this statement is addressed in the Cover Story: Power Trip podcast, but it is worthy of a deeper dive, such as in this post in Psychology Today, this paper in the International Journal of Drug Policy, and this article in Medium. Each is optimistic about the nature of psychedelics, but none seems to acknowledge that some bad experiences can be very bad indeed. Some survivors have described lingering effects from these drugs, as well as increased usage of them after the purportedly therapeutic experiences. While reframing adverse events in one’s life can be profoundly healing, it seems bizarre to tell people who have had bad experiences that they are looking at them incorrectly. It is completely contrary to what we know does and doesn’t work across all forms of psychotherapy. One early proponent, Salvador Roquet, was well known for initiating difficult experiences as part of his work. From the Psychology Today post linked above:

Another fascinating example is the therapeutic model of Mexican public health doctor Salvador Roquet, who had reasoned that the perennial human fear of death was the root of all forms of anxiety. Hence, Roquet purposefully subjected his patients to abuse and showed them violent and pornographic footage under the influence. This may seem crude, but some patients were allegedly better off after their trips.

Tying these threads together, there is ample reason to be concerned that the use of psychedelic therapy is not staying true to its Indigenous roots and that sub-cultures within it are emerging that tolerate and, in some instances, even encourage abusive behaviors. This is especially concerning when one considers what is at stake: the effective treatment of anxiety, depression, and trauma. It seems that psychedelic therapies as currently implemented need to examine not only the abuses taking place within them, but also the cultures that permit them. To that end, it is our hope that:

·       Practitioners and organizations such as MAPS, Field Trip, and many others will enlist the assistance of trauma experts and use survivors’ voices as their strongest guidance in moving forward. Advancing too quickly without this guidance poses an unacceptable risk of harm not only to deeply vulnerable clients, but also to these efforts more broadly.

·       These same entities can conduct extensive work into the nature of informed consent as it applies to research and practices that use these drugs. The nature of psychedelics makes them different in kind from other interventions. This work can involve considerations of how clients can withdraw consent.

·       As we indicate elsewhere, these entities can also develop active cultures of feedback from participants to ensure that the voices of those adversely affected are heard. By “active,” we mean working diligently to develop a culture in which each client’s voice is solicited, and each voice is heard, understood, and respected. This must be a collaborative culture, one in which the client is welcome to speak out with no concern about judgment or negative repercussions.

·       Finally, these entities can also guard against a practice which is too common elsewhere. All too often, psychiatric medications are assigned very quickly after brief office visits. These entities will benefit from guarding against processes that are so brief that they neglect the potential downside impact of these drugs.

It is our hope that deep considerations in these areas will be helpful to everyone involved, starting with the survivors themselves.