“Is my client in their ‘cycle’?”

By David S. Prescott, LICSW

One of the greatest benefits of ATSA membership is the professional listserv discussions. We rarely discuss these discussions in the blog due to the listserv’s rules around confidentiality. It can be among the most helpful resources in our field; ask a question and others will reply with ideas and resources.

In the past week, a member described a situation in which a colleague asked whether a particular client might be “in their cycle,” given their recent behaviors. It’s a question that has been asked many times throughout the years. The range of responses at this time in our field’s development clearly illustrated the creativity and thoughtfulness of ATSA members. At the same time, it showed how little we actually know from research.

Obviously, if one is trying to prevent a behavior from happening in the future, it can help to know a bit about how it happened in the past and to develop skills for self-management at the times that it might happen again in the future. One might wonder reading the literature whether it ends there?

It's not entirely clear when the first ideas about “cycles” of abuse occurred. It has long been common to hear expressions such as, “We need to end the cycle of abuse” at the family, community, and societal levels. Many of the first client workbooks in our field included cycles: a visual means for understanding common patterns of behavior that end in abuse. The fields of domestic and intimate partner violence have also used cycle diagrams to explain how these forms of harmful behaviors happen.

To this day, however, no empirically validated “cycle” has been established. What does this say about us? And the cycles we use? I put this question to one of the progenitors of the field, who used it in her work with adolescents. Her answer was simple: The cycle is simply a way to help people understand their behavior. In other words, there is no cycle that has been carved in stone; it’s all based on clinical observation. The best answer to “Is my client in their cycle” might be, “which cycle?”

In 1998, Barry Maletsky wrote an article highly critical of the cycle. In 1999, Mark Carich wrote a response defending it. In 2002, Ward & Siegert described their “pathways model,” which hypothesized five pathways into offending. By 2012, this had evolved into the Self-Regulation Model, which Kingston, Yates, and Firestone said, shows the need for a “comprehensive and multidimensional offence process model that emphasizes multiple routes to offending in sexual offender treatment.” To this author’s knowledge, this remains the best study on this topic in our field. The next question really is, “Which cycle?” Isn’t it possible for a person to engage in different processes with varying motivations to arrive at the same behavior?

Another question is how many times a behavioral trajectory must take place before we can call it a cycle? If a person has only offended once or very rarely, is it still a “cycle,” since that term implies a return to offending? Is discussing cycles appropriate in that case since it can also cause clients (under the wrong conditions) to believe that re-offense is inevitable? Is our goal to help them “break the cycle” or pursue what Shadd Maruna has called “cognitive transformation”? Why do we only think in terms of cycles of abuse? Why not cycles of success? Many professionals have over the years, and yet this doesn’t make it into the literature.

In the end, it may not matter much what we call it if our treatments are working? Just the same, the questions are worth asking and the discussion is worth having, and ATSA members are having it!

Safeguarding and reality TV in Spain

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

We often hear that TV mirrors reality, and fear that people mimic the behaviors they see on TV and elsewhere in the media. It is fair to say that we, as a global culture, have become intertwined with TV, its stars, and its behaviors as well as attitudes. Over the past 20 years or so we have seen the continued growth, for better or worse of reality TV and the evolution of shows like Big Brother. However, while they popularity of these shows may wane and wave, their ever presence on our screens has not. Changing popularity may mean changing production and editorial decisions, but what it should not mean is an increase in participant risk, changing levels of safeguarding or poor/inappropriate messaging. Unfortunately, all of which happened recently on the Spanish version of Big Brother.

The show Big Brother, which is syndicated around the world, with many countries having their own version of the show and sharing other countries’ versions, has always been risqué and has often involved questionable social and moral decisions. For example, the notion of confining people in a house for a period to see how they act and interact may have started as a social psychology experiment but moved away from that over time. Decisions on casting, looking for risky, challenging, or controversial stars, the increase in alcohol consumption, more sexualization and riskier, sometimes questionable challenges, was always going to create a perfect storm. This is what played out in the Spanish version.

In the 2017 edition of the long running series, after an on screen, show-sanctioned party a male contestant sexually assaulted a female contestant; despite her clearly not consenting and saying no, it continued. The footage, although not aired, showed that the assault continued after the victim had passed out and was unconscious. It was only at this point that the producers stepped in. Although the producers and the show did remove the male contestant from the show, that’s all they did. There is no indication that they supported the female contestant or that they offered her help at the moment of the assault. Quite the opposite, they showed her the video the next day to gauge her reaction, thereby making her relive her assault. She then requested to talk to the male contestant but wasn’t allowed. She was compelled to talk to a psychologist and was told that that the matter shouldn’t leave the room. The resulting court case ended with the male who committed the abuse getting a prison sentence of 15 months and the production company being fined, all of which seems to be too little too late.

Reality shows have a responsibility to safeguard, protect contestants, and prevent harm; none of which was done in this case. Given the nature of this show, all areas of the house are being recorded, and watched live, so the producers should have stepped in earlier. Because alcohol was involved, those in charge of the show helped create the conditions where the assault occurred; they could have foreseen this as a potential outcome and planned for it. Also, the editorial decision to show the victim the footage and relive it was a deliberate choice made by the company to shock and awe; this was the wrong editorial decision. Apart from planning a risk register, thinking about the outcomes of introducing a lot of alcohol to the house (and encouraging the consumption of it and related activities) the show could have proactively responded to the victim, removed her from the show and grave to help and support. None of these things happened; it resulted in sexual assault that negatively impacted the victim.

As stated previously, this incident was preventable and seemed to happen based on salacious editorial decisions. TV and media should cause no harm to its participants and should set a tone and standard for the way that we see and respond to sexual abuse. This case leaves a damaging legacy, as it tells viewers that sexual assault is ok, that victims do not have a say in their needs, and that people should accept certain things are inevitable in certain situations, all of which are wrong! It also shows that despite all the attention to sexual violence, people still don’t always know (or ignore) how to respond appropriately to prevent such behavior on the one hand, and to provide adequate support to victims on the other hand. Hence, it is clear that we must continue to sensitize people about the issue and offer them concrete tools to respond.   

Superheroes

 By David S. Prescott, LICSW

A few years ago, my son and I went to see a Star Wars movie. I’m not a very good fan and can barely keep the characters straight. In a dramatic scene, one central figure kills his own father. My son, who had studied stand-up comedy, turned to me and whispered, “Dad I promise I’ll try not to do that to you.” Deciding that I must have done something right to raise such a funny kid, I then thought about the people in the field(s) of abuse prevention. Why is it that the Jedi knights and other characters who fight the wrongdoers are thought of as “superheroes” but the real people who prevent real violence and abuse aren’t? This is offered with lighthearted humor, of course, but many a truth is told in jest.

It's true that some ATSA members spend a lot of time sitting in offices catching up on documentation instead of saving galaxies with light sabers. On the other hand, those skilled in assessment and treatment have better evidence of the effectiveness of their work than the Jedi knights do, and do it in the real world. ATSA members and others in the field do work that many, many people couldn’t do if they tried and while they are far from perfect, the world seems to be a little bit safer for their efforts. Comparing them to superheroes might sound a bit silly, but it is an opportunity to reflect for a few moments on the results of their work.

In the USA, last month was Social Work Month. This month is Sexual Assault Awareness Month as well as National Child Abuse Prevention Month. These are compelling reminders of the importance of the work done by professionals in the field. It seems worth mentioning all of this because the people who benefit most from these efforts will never know to express gratitude because they won’t have been abused to begin with.

Meanwhile, professionals often do this work against a difficult backdrop. Budgets and grant funding seem to be cut ever more frequently, while inflation continues to affect everyone. Clients are rarely happy to be in treatment. The multi-agency collaboration that prevention efforts require can be discouraging when it goes off the rails. Professionals often live in communities beside neighbors who don’t always understand or respect this work; many professionals even find themselves the objects of “courtesy stigma.” Discussion of concepts like “burnout,” “compassion fatigue,” and “moral injury,” shouldn’t have to happen as often as they do. Many see the direct results of policies that don’t make communities safer and produce worse outcomes for clients. Professionals can even develop senses of humor that can be shocking if they’re not careful and use them in the wrong context.

At the same time, there were many excellent presentations at the MASOC-MATSA conference this week that illustrate the specialized and important work that ATSA members do. Keynote speaker Sharon Cooper, focusing on the experiences of young women of color, reminded us of how badly misunderstood children and teens can be. Patrick Lussier described the shifting contexts in which sexual abuse by adolescents has occurred and the different effects that public policies have had. Jim Worling described many approaches of working with adolescents that never did bear fruit. Kevin Creeden described the frustration and despair that parents and caregivers experience when their child enters the child welfare or juvenile justice systems. Kevin has also observed that professionals in the field need to be ready for anything when they arrive at the workplace. He says that “To really do this this work, you need to bring your dancing shoes.” He’s absolutely right.

In all, it can be easy to lose sight of how important – and difficult – this work can be. It’s often surprising to see how long many professionals last doing it. Many have found that serving this side of the cause of public safety can be intensely rewarding. Many feel called to do it. Speaking for myself, I’ve often felt that doing this work has enabled me to become a better citizen, neighbor, friend, husband, father, and man.

As the USA takes note of sexual assault awareness month and child abuse prevention month, the people in this field may not be Jedi knights; but that does not mean that there is no heroism among us.