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.