What’s New? (And What Isn’t?)

By David S. Prescott, LICSW

Recent changes involving ATSA have inspired discussions about change. Over the years, ATSA has been many things to many people, inspiring comments such as “the ATSA conference is like coming home.” Not surprisingly, some discussion has focused on changes in leadership: Our Executive Director (Amber Schroeder) and new members of the professional staff are fully settled into their roles. The office itself is primarily virtual, with ATSA staff spread through various parts of the US (and if the pandemic has taught us anything, it’s that this kind of arrangement can be as effective as it is economical). Each of the individuals involved are getting excellent reviews by ATSA’s board of directors. And to top it off, ATSA’s leadership has updated our mission statement:

Creating a world where ending sexual harm is a shared responsibility and an achievable goal.  ATSA champions research and treatment, informs public policy, and advocates for best practice. Together, we can shift narratives on preventing sexual abuse perpetration.

It doesn’t end there, though. Every individual involved, in the office and on the board, has worked to make and adapt to the many changes necessary in the times. These changes have been as singular as getting task force reports finished and as broad as addressing the economic realities of the times. It is therefore no surprise that many would have questions about the direction the organization is going in. Indeed, there has just been a survey to inform the next iteration of our strategic plan. Some members have naturally expressed confusion, while others have observed that change is hard.

A Look Back

This all seems worth mentioning against the backdrop of our history. So much has changed. Memories of my earliest experiences with ATSA include listening to speakers such as Elaine Hatfield speaking about the history of romantic love and Dennis Doren discussing the evidence behind his approaches to risk assessment. Fran Henry, the Founder of Stop It Now! Talked about sexual abuse through a public health lens, which authors such Joan Tabachnick and Geral Blanchard were also beginning to discuss. Bill Marshall gave a plenary address in which he discussed the emerging but little-known Good Lives Model. At the time, these were all true innovations. Even the idea that sexual abuse is preventable was arguably in its infancy.

The Present Landscape

Fast forward to the present: in the past several weeks, I’ve had the privilege of attending the MnATSA and MATSA/MASOC conferences. To name just a few of the topics (and with apologies to all that are not mentioned):

·       Sexual behavior in the current era (with researcher par excellence Debby Herbenick reviewing her findings on the prevalence of rough sex and choking)

·       Treatment of clients with high levels of psychopathic traits (which was not the dominant belief at the turn of the century)

·       How to communicate with the media (in which Kelly Socia provides hair-raising examples; it is no wonder he has been asked to speak at so many conferences)

·       Sex positivity and inclusivity (presented by different people, such as Bud Ballinger and Molly Shepard in different locations, with Nikole Nassen presenting elsewhere on the topic in the coming weeks)

·       Cultural reverence, humility, and competence (with Apryl Alexander, although Tyffani Dent has spoken on this elsewhere many times in the past few months)

·       Assessments of the Impact of Race and Culture (a/k/a IRCA assessments

·       Raising awareness of the challenges faced by LGBTQ+ people (multiple workshops!)

This is not to say that these newer topics have crowded out the advances in other critical areas. Andrew Brankley gave an excellent presentation at MATSA/MASOC on controversies surrounding pedophilia, and progenitors David Thornton and Robert McGrath are slated to appear at the New York State ATSA/NYS Alliance to Prevent Sexual Abuse conference next month in Saratoga. Recently, on the circuit has been Mark Olver, giving excellent talks on topics such as offense-analog behaviors and psychopathy.

Ongoing Challenges

Things have indeed changed, often very dramatically in recent years. Some of these changes have confused and even angered some professionals. What remains fundamentally important to our field, however, is that we keep talking about the issues.

With all of these changes, however, some things still really need to change. Just during this week, we have seen Harvey Weinstein’s conviction in New York overturned (readers will remember the allegations as having sparked the #metoo movement). Likewise, the US government agreed to pay a $138.7 million settlement over the FBI’s botching of Larry Nasser’s infamous sexual assaults. It is no wonder so many people who are sexually assaulted don’t wish to come forward and don’t trust the systems involved. Where the legal system once did not take sexual abuse seriously enough, it now seems we have to come to terms with the fact that our attempts to improve it are still too far from producing the results we need.

Welcome Aboard!

If you’re new to this work, welcome aboard! We need more of the innovations and conversations mentioned above. If you’ve been around a while, please stay! We need your wisdom! Our work has evolved, and yet there is still so much to be done.

 

 

 

Sibling Sexual Behaviour and Abuse: UK-Canada knowledge exchange trip

By David Russell, PG Cert, Sophie King-Hill, Ph.D., & Kieran McCartan, Ph.D.

Before we begin it is important to set out the language we are using in this piece as it has been part of an important discussion of late. In our work over the past four years focussing on this issue we have seen many instances and examples of the behaviour between siblings being clearly sexual abuse and sexually abusive. However, there are also key examples where this is not the case and that the issues present as sexually inappropriate and/or sexually problematic. This is an important distinction, and with this in mind, for this blog, we will use ‘sibling sexual behaviour and abuse’ (SSB/A). We would also like to acknowledge that terminology in this space always evolves and that SSB/A is not a static term and is likely to change as we begin to understand more about this issue.

#SiblingsToo day is held in April each year and hosted by Nancy Morris, based in Ottawa, Canada. Nancy first developed and introduced the #SiblingsToo awareness day in 2023. This day brings together a range of lived experience and professional voices within the complex theme of SSB/A. A survivor of SSB/A, Nancy hosts a range of discussions via podcasts and videos tackling themes such as the impact, prevention and societal responsibility within the context of SSB/A.  

This year David Russell (Thriving Survivors, UK), Professor Kieran McCartan (University of West of England, UK) and Dr Sophie King-Hill (University of Birmingham, UK) marked #SiblingsToo day by embarking on a trip to Canada to share international approaches in responding to SSB/A, sharing research, learning and practice considerations.  The trip started in Ottawa at Nancy’s famous office, reflecting on the #SiblingsToo data collection and testimonial portal where hundreds of survivors have currently placed their experiences of SSB/A from all over the world.  An incredibly powerful experience, the portal highlighted the international need for bespoke supports for survivors impacted by SSB/A and the need for international co-ordination and coalition.  This supported the four of us to use the time together and record a podcast discussion called ‘in five years’. This podcast explores our professional and lived experiences to consider what needs to happen in the next five years to address the SSB/A. 

We made the most of our five days in Canada and met with a range of professionals and groups.  This included a thought-provoking meeting with volunteers at Circles of Support and Accountability (CoSA) held in Ottawa. CoSA in Ottawa works to help integrate men convicted of a sexual offence (Core Members), mainly against children, back into the community post release. Throughout the course of the conversation we learned that in addition to the traditional child sexual abuse interventions that CoSA run they also had some which were based on cases of SSB/A, which was interesting to hear especially given some of the restorative, integrative and desistence challenges these posed. This discussion highlighted some interesting themes for us all which influenced our next discussion with Dr Christine Gervais, an Associate Professor from the University of Montreal who has spent many of her academic years focusing on the rights of the child.  We then had a productive meeting with academics from The Police and Public safety Institute at Algonquin College in Ottawa, where we looked at cross over in our work and practice and potential collaborative projects.

Academically and professionally we are collectively passionate about the role of health and child protection has within SSB/A. We were particularly keen to see how frontline health and child protection teams respond and intervene with families affected by SSA/B.  To explore this further we met with child protection professionals at Childrens Hospital of Eastern Ontario (CHEO). The team here work with a range of children and young people including but not exclusive to those impacted by child sexual abuse (CSA) and those that display harmful sexual behaviour (HSB), specifically during immediate crisis.  This conversation allowed us to share learning and explore gaps within health provisions both within Canada and the UK.  Keeping with the health theme, we were interested to unpack this further and specifically understand what the current mental health service provision was in Ottawa and its role within supporting children and young people affected by SSB/A, HSB and CSA.  This established a meeting with Heidi Nichilo and her team at the Youth Services Bureau, Ottawa.  A passionate and proactive group of professionals, we were truly refreshed to hear about the fantastic work they do.  We discussed the prevalence of SSB/A within health services and explored potential ways to ensure children, young people and families have safe routes to access to supports and disclosure pathways in relation to SSA/B. 

Our final day of the trip was in the beautiful Montreal, requiring a 4:30am wake up for a train ride from Ottawa to meet Anaïs Cadieux Van Vliet, a PhD student exploring the role of siblings that have not harmed, or been harmed in a family experiencing SSB/A. An area in much need of exploration.  A quick breakfast and discussion with Anaïs and we were on route to the University of Montreal to deliver our panel input on ‘International approaches in responding to SSA/B: Research & Practice’ at the Centre International de Criminologie Comparée (CICC).  This panel input included a fascinating Q&A session and discussion, providing a safe place for an in-depth discussion.  We felt incredibly privileged to share a space with academics, students and those with lived experience, our sincere thanks to the team at the University for facilitating this and for their hospitality.

The learning from this trip has been significant and the opportunity to meet with so many passionate people working in this field has gained us further connections which we hope will support our mission in tackling SSB/A on an international level. 

This trip could not have been possible without the huge support of Nancy Morris, we are incredibly grateful to Nancy and her husband Jim for their fantastic hospitality and eclipse hunting expertise.  

For more information or support around sibling sexual behaviour/abuse please see the Thriving Survivors website: https://www.thrivingsurvivors.co.uk/

To register for the Thriving Survivors 2024 conference addressing sibling sexual behaviour/abuse please see: https://www.thrivingsurvivors.co.uk/event-details/ts-annual-conference-2024

 

The Adolescent Risk Assessment Paradox

 By David S. Prescott, LICSW

A recent conversation among ATSA members on risk assessment with adolescents sparked both new ideas and old memories.

It all seemed so simple a few decades ago. Science was marching forward in developing methods to assess dangerousness among people who had been violent toward others. There were even references to “hitting the forensic sound barrier,” with the development of high-quality measures. Understandably, the most pressing issue was how we could best classify people according to risk. Entire books were written on the topic; many of the older writings are still worth a read. It was only after we had a solid understanding of risk assessment methods in forensic settings that we could focus more on other areas. Our understanding of dynamic risk naturally led to a clearer understanding of treatment needs. Fast forward to the present, and we have promising measures for assessing protective factors. It is now thirty years since Chris Webster and his colleagues (Vern Quinsey, Grant Harris, Marnie Rice, and Catherine Cormier) published the first version of the Violence Risk Assessment Guide. It may not seem so now, but it has been an exciting few decades to be alive and watching these developments.

It has been equally exciting to watch similar efforts in the adolescent world, but for very different reasons. It was natural that researchers would attempt to develop risk assessment measures for youth. The first version ot the JSOAP was described in April 2000 in what is now Sexual Abuse, affectionately known as “the ATSA Journal.” At around the same time, James Worling and Tracey Curwen made the ERASOR available. In 2003, Drs. Prentky and Righthand published the JSOAP—II, this time with a caution that has been quoted many times in conference presentations and conversations: “No aspect of their development… is fixed or stable. In a very real sense, we are trying to assess the risk of ‘moving targets.’”

These developments were welcome. Other scales came along as well, including the JSORRAT—II, the SAVRY, the MIDSA, and others. The authors of the JSORRAT—II, JSOAP–II, MIDSA, and ERASOR earned reputations for making themselves available to questions, ideas, and discussions in both public and private settings. The results seemed consistently good but not great. The tentative progress of the adult world led these same authors to urge great caution. However, the contexts in which professionals worked soon came to expect a lot from risk assessments. Behind the scenes, I’ve heard of cases where judges would order assessments using a specific measure, causing dilemmas for evaluators who felt the tools were helpful but not the final word in assessment.

Over time, professionals noticed that the ultimate referral questions seemed to be different for kids than for adults. While adult risk assessments often focused on establishing a baseline of likelihood for future sexually violent acts, the implicit question for many professionals assessing juveniles was often closer to, “What do we need to do the help this kid make it into adulthood without hurting more people?”

As all of this was happening, thought leaders in the adolescent world had been talking about areas like the neurological impact of trauma since the 1990s. Some authors, including Janice Bremer and Jane Gilgun, began publishing on protective factors as long ago as the late 1990s (although not with the same rigor that the adult world does now). Kevin Creeden was among the first to question why we were focusing on risk when there was so much work to do with trauma and neurodevelopment. Most importantly, Gail Ryan and her colleagues (including Sandy Lane and Tom Leversee) published articles and entire books on the importance of understanding the developmental processes and environmental context of youth to best serve them. These are all ideas that gained greater credibility in the adult world later.

While this may all seem like a history lesson, some of the questions involved along the way have been maddening:

 - Given the meta-analyses by Michael Caldwell, which argues that recidivism rates have decreased since 2000, and Patrick Lussier (et al.), which argues that in fact recidivism rates have been low all along, what can any professional meaningfully say about risk for sexual re-offense?

- If we recognize that adolescents are far more likely to re-offend non-sexually, shouldn’t we abandon our sole focus on risk for future sexual harm? Or at least put it in the context of other potential harms? And strengths? And possibilities?

- How do we best understand a young person’s risk when it is so dependent on the environments in which they live, go to school, etc.? How much noise is there in the system that makes any form of prediction impossible?

Even today, a conference presenter quipped that, “Kids change so fast. Even when I go back and interview them a week later, it seems like they’ve gotten a foot taller.”

These are major reasons why the change in focus of recent years has been so welcome. The newest generation of measures, based both on research and experience, are focused far more on understanding adolescents, including their development, context, protective factors, needs, progress already made, etc. Important questions remain as to their various properties, but the thought that has gone into their development is encouraging. Their structure enables clinicians to reflect on and understand clients while developing recommendations. They help us to see past the age-old questions of risk and focuses on what professionals and caregivers can meaningfully do to mitigate whatever risks exist.

Sometimes the highest risk that adolescents pose is not to live up to their full adult potential.

The most recent conversations have focused on what to call our reports. The most common answers seem to center on the idea of needs assessments, as a few predicted many years ago.

Perhaps our greatest risk is forgetting that across world history, including time, place, and cultures, adults have always had trouble predicting how kids will turn out. The current focus in many quarters on helping kids become adults may be what we were best suited for all along.