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 stopitnow.org 

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.